Relapse Prevention Considerations for the Two CBT Cases

Introduction

When discussing relapse prevention with the two CBT cases from Weeks 9–11 and Week 10, I would focus on three main areas:

1. Identify Early Warning Signs

   • I would help the clients identify specific cognitive, emotional, and behavioural patterns that typically precede a setback.

   • For example, in the Week 9/11 case (if anxiety-related), warning signs might include increased avoidance behaviours, heightened physical tension, or catastrophic thinking.

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     In the Week 10 case (if depression-related), warning signs might be social withdrawal, loss of interest in enjoyable activities, or disrupted sleep.

2. Reinforce Skills Learned in Therapy

   • I would review the CBT tools each client has practiced, such as thought records, behavioural activation schedules, and problem-solving techniques.

   • Emphasis would be on using these tools proactively when early signs appear, not only during crises.

   • Encouraging daily or weekly self-monitoring would help the client stay aware of mood and thought changes.

3. Create a Maintenance Plan

   • For both cases, we would co-create a personalized relapse prevention plan outlining what to do if symptoms start returning.

   • This could include:

     • A list of coping strategies that work best for them

     • Support contacts (friends, family, or therapist)

     • Scheduled follow-up sessions or check-ins

   • We would discuss the idea that occasional lapses are normal and not a sign of failure—what matters is recognizing them early and acting quickly. APA

4. Encourage Lifestyle & Support System Engagement

   • I would stress the importance of healthy routines (sleep hygiene, exercise, balanced diet), stress management, and staying connected with supportive people.

   • For the anxiety case, continuing exposure practice in small doses can help maintain gains.

   • For the depression case, ongoing behavioral activation and pleasurable activities would be essential.

5. Normalize the Process

   • I would explain that relapse prevention is not about avoiding all stress or negative thoughts but about responding differently when they appear.

   • This helps clients feel empowered rather than fearful of setbacks.

Example Closing Statement to Client:

“You’ve learned skills that have helped you make real changes. Relapse prevention means we plan ahead so that if old patterns try to creep back in, you’ll recognize them early and know exactly what to do to get back on track.”