Relapse Prevention Blueprint

When to Use

Use in the final phase of therapy to consolidate learning and prepare for the end of treatment. Given that depression has a 50-80% recurrence rate, relapse prevention is not optional but an essential component of any complete course of CBT for depression. Should be developed over 2-3 sessions and given to the client as a take-away document.

How to Introduce

Frame as the culmination of therapy: 'We've done a lot of important work together, and now we need to make sure you can keep hold of these gains after therapy ends. This plan is your personal manual for staying well and knowing exactly what to do if depression starts to creep back.'

Adaptations

For clients anxious about therapy ending, use the plan as evidence of their capability and the skills they have developed. For those with recurrent depression, include specific reference to their historical pattern and what was different this time. Consider involving a significant other or GP in the plan if the client consents.

Do not rush this component due to session limits; advocate for additional sessions if needed. Avoid creating a plan that the client has not contributed to meaningfully. Not a substitute for booster sessions in high-risk cases; consider building in planned follow-up appointments.

Clinical Tips

Include: a summary of what was learned in therapy, the formulation, key techniques that helped, early warning signs, an action plan for warning signs, a list of professional contacts, and a therapy blueprint the client can revisit. Make it specific and personal. A generic relapse prevention plan is almost useless; it must contain the client's own formulation, their own examples, and their own language.