All patients will relapse following their initial recovery.
Predicting and reframing the relapse ahead of time softens the blow of feeling strong negative feelings again, giving the client hope that they can defeat them using the initial plan that got rid of the negative emotions/thoughts in the first place.
If the client uses the same tools that helped them the first time, he’ll know he can use the same tools to break out of bad moods.
While the client is still feeling good about his progress would be the best time to do a Relapse Prevention. (Progress means the client scores between 0-1 in the Brief Mood Survey for depression, and anxiety.
Using the Burns Mood Log ...
1. The client will imagine waking up and feeling worse in terms of depression and
2. The client will complete a Burns Mood Log, circling whatever negative emotions they
might feel and how strong they might be.
3. Then the client writes down his negative thoughts and how true these thoughts might seem.
These thoughts usually include thoughts such as:
a) The relapse proves I am hopeless.
b) I didn’t really recover.
c) The therapy was just a fluke.
d) I never really improved – I was just fooling myself.
e) I am worthless after all.
f) Even if I do improve, it will just be temporary, and pretty soon I will fall back into this
horrible depression again.
g) The client writes down any other negative thoughts that he might imagine.
4. Have the client look for any cognitive distortions that might be in his thoughts.
5. Then have the client write a positive, realistic thought that would be close to or exactly
100% true. It would put the lie to the negative thought.
6. Then the therapist will play the negative thoughts and the client will play the positive
thoughts or Negative Client vs Positive Client. Reverse roles if the client is having
difficulty. Then reverse back so the client always ends up with the positive.
7. Then go back to the negative emotions and score how strong those emotions are now.