Relapse Prevention

On my last session of CBT, my counsellor and I reviewed everything that we had covered throughout therapy and we created a relapse prevention for me to keep hold of in case I ever needed it after therapy.

About mid-way through therapy I was beginning to become fearful of who I was going to turn into once my therapy was finished. I could notice the changes in me and my friends/family had begun to notice some changes but I didn’t know who I was going to turn into. Everything that I was used to was changing, my personality, opinions, diet, likes/dislikes they were all changing and I think in a way, I wasn’t expecting it to be as big of a change. The life I was living, the life that I was so adamant I would be living for the rest of my life was changing in a way that I never thought would be possible and it was scary.

Then there was the fear of relapsing once I had finished therapy, and not being able to get myself out of that hole again, so my counsellor and I worked together to create a relapse prevention.

Since finishing therapy, I haven’t actually ever looked through this but I found it a few weeks ago on some old emails and it’s a somewhat heart-warming read for me. It’s reassurance in a way that the likelihood of me relapsing is fairly slim because the prevention just comes naturally to me now. The relapse prevention is a series of questions asked by my counsellor to which I then answered.

What was the problem that brought you to therapy?

Worsening of my symptom last year. Struggling with depression and anxiety linked to past experiences. Family were worried about me and encouraged me to get support.


What has changed since I first accessed support?

Home life – I’m able to sit downstairs with my family and watch TV, eat dinner etc. I’m spending more time with family.
I’m feeling more independent and don’t have to rely on others to go places as much.
I feel like I have accepted past events and my feelings are more manageable.
I’m able to rationalise my thoughts more and not dwell on negative thoughts.
I’m blaming myself less for things that happened.
The black cloud has lifted and I don’t feel as weighed down by things.
I’ve accepted myself and have more confidence. I’m not doubting myself – appearance and mentally. I’ve realised I can be myself and don’t have to be loud all the time.


What specific techniques have helped?

Using Silvercloud as a step towards the one to one helped me to understand things more.
Using TIES to process past events. Talking through past events and trying not to block memories and emotions.
Also using TIES to remember happy events.
It’s okay to get upset and to have times when you are worse and it’s also okay to be happy. I deserve to be! Human beings all types of emotions and that’s okay – people are not robots!
Using journal to record positive events and positive imagery technique.
Understanding how and why I thought certain things – being able to realise that things didn’t happen because of me personally and were not my fault. Examine evidence for thoughts rather than just accepting all thoughts as facts.


What further goals do you have for the future?

Continue with positive journal.
Continue to use TIES.
To be able to go more places alone – Trafford Centre, Manchester, to run in the day.
Long term goal: To be able to help others who are struggling. To be honest about my own feelings and how I got to this point.


What might be trigger situations for feeling worse?

Family do’s
Work situations


How could you manage these situations to avoid a setback?

Using grounding techniques and ties if experiencing flashbacks or intrusive memories
Looking through memory book so not always focussed on negative memories
Using TIES
Trying to look out for negative thoughts and challenge these
If wake up in a bad mood – look through journal or try to think of positives, try not to catastrophize things
Trying to have a work/life balance – do pleasurable activities and relax rather than focussing on work in spare time


What signs would you notice if things were starting to get worse again?

If having more than few down days in a row and my mood is low for a longer period without being linked to a specific event
Doubting self more and feeling paranoid
Focussing on the negatives more than the positives
Sleeping more and spending more time in bed
Short tempered and moody towards family
Avoiding larger social situations and busy places
Sweating more
Getting more illnesses


If you noticed these signs what self-help measures could you try?

Acknowledge it and accept rather than ignoring it and just trying to get on with things
Look back through self-help materials and info from sessions – try to use techniques like TIES etc (as above)
Speak to friends or aunty


If you were unable to manage things yourself where could you get further support?

Go to mum
See GP
Or self-refer to Think Wellbeing Tel: 01942 264 051
Look up local services in Australia


And that was my relapse prevention, something straight forward and straight to the point. Even reading it back now, it proves to me that I don’t need to doubt myself about my mental state, I am good now and I will still be good in the future despite what could happen. There is no need to worry about relapsing.

Doing a relapse prevention helps you acknowledge and remember why you started therapy, the changes therapy has made on you as a whole as well as your life, the warning signs to look out for as well as how to help yourself and who to turn to if you need an extra helping hand.

I will say it again, therapy was the best thing that could’ve happened to me.

Thank you for reading,

Sending much love to you all,

Emma xo