Discussion: Termination of Therapy and Relapse Prevention
When approaching relapse prevention with the two CBT cases from Weeks 9–11, several considerations are essential. Relapse prevention is not simply about anticipating setbacks but rather equipping clients with tools to recognize early warning signs and to apply the skills they have practiced during therapy.
1. Reinforcing Skills Learned in Therapy
In the cases we reviewed, both clients demonstrated progress through identifying automatic thoughts, restructuring cognitive distortions, and practicing behavioural activation. As therapy nears termination, it is important to highlight how these skills can be generalized beyond the therapy setting. A relapse prevention plan should encourage clients to continue practicing thought records, relaxation strategies, and activity scheduling so these coping mechanisms become part of their daily lives.
2. Anticipating High-Risk Situations
Clients should be guided to explore situations that may trigger old patterns of thinking or behaviour. For example, stress at work, interpersonal conflict, or feelings of isolation could all serve as potential relapse triggers. By collaboratively identifying these situations, the PMHNP can help the client prepare proactive strategies, such as engaging support systems, reframing negative thoughts, or using problem-solving techniques learned in therapy.
3. Normalizing Setbacks
It is important to normalize the possibility of setbacks without framing them as failure. Relapse is often part of the recovery process, and presenting it this way reduces shame and promotes resilience. Clients should be reminded that the goal is not perfection but progress—using lapses as opportunities to revisit coping skills rather than abandoning them.
4. Establishing Ongoing Support Systems
Both cases would benefit from a structured support system after therapy ends. This could include booster CBT sessions, peer support groups, or check-ins with a trusted family member or friend. The PMHNP should encourage clients to clearly identify who they can reach out to if symptoms re-emerge, ensuring they do not feel alone in their journey. APA
5. Enhancing Self-Efficacy
Finally, relapse prevention planning should strengthen the client’s belief in their ability to manage future challenges. Reviewing progress made during therapy, celebrating specific improvements, and linking them to the client’s personal effort reinforces self-efficacy and motivation.
Conclusion
Relapse prevention in CBT requires an individualized and proactive approach. For both cases, planning should include reviewing coping skills, anticipating triggers, normalizing setbacks, engaging support systems, and building self-efficacy. By framing termination as a transition rather than an ending, the PMHNP can empower clients to continue applying their CBT tools confidently, reducing the risk of relapse and promoting long-term recovery.