Pathways of recovery: preventing further episodes of mental illness (monograph)

What are the basic elements of relapse prevention?

Page last updated: 2006

Currently, there is no comprehensive framework agreed for relapse prevention within the context of mental illness. There are frameworks available for recovery and for psychiatric rehabilitation, but the focus of these is quite different, although highly relevant to relapse prevention. Review of the national and international literatures shows that most relapse prevention initiatives are single-issue medically-based responses that prioritise maintenance medication and recognition of early warning signs. The chronic illness management and rehabilitation literatures provide useful guidance, but have not been applied in the context of mental illness. It is possible, however, to identify the core components of relapse prevention for mental illness and show how these contribute to providing effective continuing care within a recovery orientation.

Fundamentally, relapse prevention requires awareness, planning, and the provision of timely and appropriate intervention responses. Laurie Curtis operationalises relapse prevention as the 4As of crisis prevention: awareness, anticipation, alternatives and access (Curtis 1997). To implement such an approach, actions need to be undertaken by all those involved in the continuing care and recovery of people with mental illness: by people who have experienced mental illness, their families and carers, clinical service providers and planners, non-clinical service providers and planners, policy makers, and communities.

Awareness - acceptance, attitude and recognition

Anticipation and planning

Alternatives

Access and early intervention