Relapse Prevention Therapy (RPT) at Shine
Clinically reviewed by Joe Papa, LICSW · Licensed Independent Clinical Social Worker
Most relapses begin long before the first drink or drug use. RPT teaches you to recognize the warning signs, physical, mental, and emotional, before they become a crisis. Serving Saugus, Lynn, Revere, Malden, Chelsea, and the greater North Shore.
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What Is Relapse Prevention Therapy?
Recovery is not just about stopping. It is about building the skills to stay stopped.
Relapse Prevention Therapy (RPT) is a structured, evidence-based approach originally developed by Dr. G. Alan Marlatt at the University of Washington. It is built on a core insight that most relapses do not happen suddenly, they unfold over time, through a predictable sequence of physical, mental, and emotional warning signs that, once recognized, can be interrupted.
RPT teaches people to identify their personal high-risk situations, understand the stages of relapse before physical use occurs, and develop concrete strategies for each one. It does not promise that recovery will be easy. It equips people with the tools to navigate the hard moments, which is exactly what lasting recovery requires.
At Shine Wellness & Recovery, RPT is woven into our PHP, IOP, and Outpatient programs as part of a comprehensive clinical approach. It works alongside CBT, DBT, and Motivational Interviewing to give every client the fullest possible toolkit for long-term recovery. All care at Shine is trauma-informed, meaning RPT is delivered with an awareness of how trauma and relapse are connected.
Proactive not reactive
RPT does not wait for a crisis. It builds awareness and skills before high-risk moments arrive so you are never navigating them unprepared.
Personalized to you
Every person's relapse warning signs and high-risk situations are different. RPT at Shine is built around your specific patterns, not a generic checklist.
Backed by NIDA and SAMHSA
Relapse prevention is identified by the National Institute on Drug Abuse and SAMHSA as one of the three most evidence-supported strategies in addiction treatment, alongside medication and monitoring.
Why Relapse Prevention Matters
The numbers make clear why this work cannot wait until after a relapse happens.
of individuals with addiction will experience a relapse, rates comparable to other chronic diseases like hypertension and diabetes, according to NIDA
Source: National Institute on Drug Abuse (NIDA)
of individuals revert to previous patterns of drug or alcohol use within one year post-treatment without proper relapse prevention support, per NIDA research
Source: National Institute on Drug Abuse (NIDA)
evidence-supported relapse prevention strategies identified by StatPearls and NIDA: therapy and skill development, medications, and monitoring, all integrated at Shine
Source: StatPearls, National Center for Biotechnology Information, 2023
These numbers are not meant to discourage, they are meant to be honest. Relapse is common. It is also preventable with the right preparation. Across Saugus, Lynn, Revere, Malden, Chelsea, and the greater North Shore, Shine is built to provide exactly that preparation.
The Three Stages of Relapse
Relapse is not a moment. It is a process, and it starts long before the first use.
One of the most important things RPT teaches is that relapse rarely happens without warning. Long before someone picks up a drink or a drug, they move through three distinct stages, emotional, mental, and physical. Understanding these stages is the foundation of relapse prevention.
Emotional Relapse
You are not thinking about using, but your emotions are setting the stage.
In emotional relapse, the person is not consciously thinking about using. But their emotional state and behaviors are creating the conditions that make relapse more likely. This is the earliest and most treatable stage.
- •Bottling up emotions instead of expressing them
- •Isolating from friends, family, or support groups
- •Not asking for help when struggling
- •Poor self-care, skipping sleep, meals, or exercise
- •Attending support groups but not sharing
- •Focusing on other people's problems to avoid your own
- •Increasing anxiety, irritability, or mood swings
"At this stage, the best relapse prevention is self-care and honesty, not managing cravings, because cravings haven't started yet."
Mental Relapse
Part of you wants to use. Part of you doesn't. The war has started.
In mental relapse, the person begins to think about using, first occasionally, then more persistently. There is an internal struggle between the part that wants to stay sober and the part that is beginning to romanticize use. This is where RPT skills become critical.
- •Thinking about people, places, or things associated with past use
- •Glamorizing or romanticizing past use, remembering the good, forgetting the cost
- •Lying to yourself or others about how you are doing
- •Bargaining, "just once," "just a little," "I can handle it now"
- •Planning a relapse around upcoming events or opportunities
- •Seeking out situations where substances will be present
- •Craving substances more frequently or intensely
"Mental relapse is where most people try to white-knuckle through alone. RPT gives you something better, a plan, a call you can make, and skills to interrupt the cycle before it completes."
Physical Relapse
The first use, and what comes after.
Physical relapse is the stage most people think of when they hear the word "relapse", the moment of first use. But by this stage, the emotional and mental groundwork has already been laid. Physical relapse is the end of a process, not the beginning of one.
- •The first use often happens in a moment of high emotion combined with opportunity
- •Physical relapse can be a single use or rapidly escalate to previous patterns
- •The "abstinence violation effect", intense shame and guilt after first use, often drives continued use rather than stopping
- •Physical relapse does not mean recovery is over, it means the plan needs adjustment
"At Shine, we teach clients what to do if a physical relapse happens, because shame without a plan leads to continued use, while honesty and a clear next step leads back to recovery."
"The goal of RPT is not perfection. It is preparation, so that when the hard moments come, you are never facing them without tools."
How Relapse Prevention Therapy Works at Shine
Not a checklist. A personalized, clinically guided process built around your specific patterns and risks.
RPT at Shine is delivered in both individual and group settings across all levels of care. Your therapist works with you to build a relapse prevention plan that is specific to you, your triggers, your warning signs, your high-risk situations, and your personal coping strategies.
Personal Trigger Mapping
We identify your specific high-risk situations, the people, places, emotions, times of day, and circumstances most likely to trigger craving or relapse, and build awareness around each one.
Warning Sign Recognition
We work through the three stages of relapse with you, emotional, mental, and physical, so you can recognize your own early warning signs and intervene before the process completes.
Coping Strategy Development
For each high-risk situation and warning sign, we build concrete, personalized coping strategies, not generic advice, but specific tools that fit your life and your patterns.
Cravings Management
We teach evidence-based techniques for riding out cravings without acting on them, including urge surfing, distraction strategies, and the HALT check (Hungry, Angry, Lonely, Tired).
Relapse Response Planning
We plan for what happens if a slip occurs, because having a clear, shame-free response plan ready before it happens dramatically reduces the likelihood that a single use becomes a sustained relapse.
Support Network Building
RPT builds awareness of the people and resources that support recovery, and teaches how and when to reach out, including identifying the barriers that stop people from asking for help when they need it most.
Trauma-Informed Relapse Prevention
At Shine, all RPT is delivered through a trauma-informed lens, because trauma and relapse are deeply connected.
For many people, the emotional and mental stages of relapse are closely tied to trauma responses. Anxiety, isolation, emotional numbing, and the urge to escape are not just relapse warning signs, they are also trauma symptoms. Addressing relapse without addressing the trauma underneath it often means the plan fails when it is needed most.
At Shine, all relapse prevention work is delivered through a trauma-informed lens. This means your therapist understands the connection between your history and your relapse patterns, approaches that history with care, and builds your RPT plan with awareness of how trauma shapes your triggers, your coping responses, and your warning signs.
Trauma and the Emotional Stage
Many emotional relapse warning signs, isolation, bottling emotions, not asking for help, are also trauma responses. At Shine, RPT is delivered with an understanding of this overlap so the work addresses both.
Safety Before Skills
Before deep relapse prevention work begins, Shine's clinical team focuses on building safety, consistency, and trust, the foundation that makes skills-based work effective and lasting.
RPT Is Part of Every Level of Care at Shine
Whether you are in PHP, IOP, or Outpatient, relapse prevention is woven into your treatment from day one.
Partial Hospitalization Program (PHP)
Intensive RPT work begins in PHP, when clients are in the most critical early stage of recovery and relapse risk is highest. Multiple RPT-focused group and individual sessions per week build a strong foundation of awareness and skills.
View therapy details →Intensive Outpatient Program (IOP)
RPT continues in IOP as clients begin re-engaging with daily life, where real-world triggers and high-risk situations become more present and the relapse prevention plan is stress-tested and refined.
View therapy details →Outpatient Program (OP)
In our standard outpatient program, ongoing RPT work maintains and deepens relapse prevention skills as clients build long-term stability, updating the plan as life circumstances and risks evolve.
View therapy details →Frequently Asked Questions, Relapse Prevention Therapy
Medically reviewed by Joseph Papa, LICSW
Joe Papa is a Licensed Independent Clinical Social Worker and member of the Shine Wellness & Recovery clinical team. All clinical content on this site is reviewed by Joe to ensure accuracy and alignment with current evidence-based practice standards in addiction treatment and behavioral health.
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