In most areas of life mistakes are regarded as important learning experiences. Curiously this notion has been conspicuously absent from the deliberations between people with an addiction and their therapist. Yet most of those who learn to control their addiction do so by themselves after a number of unsuccessful attempts. The key feature of a Relapse Prevention Programme (RPP) is that clients are engaged in a process of actively learning from mistakes. The therapist simply facilitates the learning—nudging the client along naturally occurring pathways. An RPP can be likened to a journey in which the client as driver has decided on the ultimate destination. The therapist simply acts as accompanying navigator. A ‘successful’ journey involves passage through a number of overlapping phases which broadly correspond to preparing for the journey, getting started, handling slips, managing daily hassles, the pursuit of life goals and maintaining vigilance. In this chapter each of these phases is described in turn, but they should not be thought of as following in strict sequence.
Part of the art of conducting the RPP is judging when to introduce material that might ‘ordinarily’ be taught later in the scheme. Continuing the metaphor of a ‘journey’, it would be inappropriate to introduce an RP Programme if the client refuses to go to the station (that is, the client is in what Prochaska and DiClemente, 1982, term the precontemplative stage) or if the client is simply pacing up and down the station platforms (that is, is in what Prochaska and DiClemente, 1982, term the contemplative stage). Strategies for dealing with clients in these early stages are described elsewhere in this volume by van Bilsen and van Emst and also in Scott (1989). The RPP is predicated on the assumption that the client is taking active steps to modify his addictive behaviour, RPPs can encompass almost any client goal, whether it be abstinence, controlled drinking, or switching from injecting to inhaling. A client may, for example, at the beginning of therapy be on