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Relapse Prevention
 Reducing risk of relapse / Discuss what a relapse is and provide information on relapse rates.
Explain that medication and psychosocial treatments both help reduce the risk of relapse.
Also, involving families in education and the treatment process helps prevent relapse.
Explain that impending relapse can be prevented or reduced in severity by detecting it early and treating it immediately.
 Early warning signs / Reflect back on the development of the client’s first-episode of psychosis. Ask about changes in behaviour, thoughts, and feelings before the psychosis developed. What did they notice was different? What did the family notice was different?
Explain that prior to relapse there are usually similar non-specific changes before the psychosis appears which are called “early warning signs”.
Inform the client/family that sometimes the warning signs will be the same as they were before the first episode; however, sometimes these warning signs can be completely different. Therefore, it is important that they monitor for all types of warning signs (even types that they haven’t experienced).
 Stress management / Warning signs are often the result of being under stress. Relate this to the risk of relapse through the stress-vulnerability model.
Explain that often all that is needed to reduce these warning signs are some strategies to help reduce stress. Relate this to what was covered in the stress management session (or if not yet covered, give brief overview).
 Medication / Sometimes, stress management strategies are not sufficient in eliminating warning signs and an increased dose of medication (or some other change to medication regimen) might be required.
Discuss how medication strategies approved in advance by the psychiatrist may be employed when warning signs become evident.
 Occurrence of relapse / Discuss the possibility that relapse still might occur and how early intensive treatment can reduce severity of relapse.
 Relapse Prevention Plan / Develop a Relapse Prevention Plan with the client/family (use the “Relapse Prevention Plan” template in this section). Mention that this needs to be reviewed regularly (at least every three months) but more often if there is a change to: medication, stress levels, treatment team, or worsening of symptoms.
Consider including in the action plan – contact information for you and/or psychiatrist, individualized stress management strategies, use of hospital emergency if risk present, and medication strategies approved by the psychiatrist.
Stress the importance of open communication between client, family and treatment team about early warning signs and the use of strategies to prevent relapse. Discuss how it is important to err on the safe side and how it’s okay to have false alarms.
 Handout / Give the client/family the handout “Relapse Prevention”
Give the client/family a copy of the filled in template “Relapse Prevention Plan”
Keep a copy of this on the client’s chart.

This page is an overview of a topic and is not a formal part of the CarePath nor is it to be used for documenting care. It is checklist format only for your convenience.