High-Risk Situations: A Threat to Sobriety

Over time, aspects of a certain situation, such as a person, place, activity, or sound, can create strong desires or cravings to use drugs or alcohol. When a person continuously reacts to these situations and uses an addictive substance to avoid or escape a problem, that behavior is reinforced and the individual is more likely to use substances again in the future when faced with a similar situation.

In recovery, we call situations or events that may pose a threat to an individual’s sobriety “high-risk situations.” A primary role of cognitive behavioral therapy is to identify high-risk situations and modify the individual’s response to them to decrease the likelihood of relapse in the future.

What may be a high-risk situation for one person may not be for another and is largely dependent on the individual’s thoughts, behaviors, and beliefs. As a result, the client and therapist must work together to identify situations that could threaten the client’s ongoing sobriety. This can be achieved with other cognitive behavioral therapy techniques such as self-monitoring.

Throughout the process of addiction recovery, the goal is to help the client develop and use coping skills that will address the demands of high-risk situations without resorting to drug and alcohol use.

Examples of High-Risk Situations

A high-risk situation can be primarily emotional, situational, or interpersonal, and the presence or absence of an individual’s coping strategies will often determine how they react to the situation. Most high-risk situations can be categorized into one of the following types of occurrences:

• Negative emotional states – Stress, anger, anxiety, boredom, and sadness are all common emotional experiences that people in recovery will face. These feelings are often caused by a person’s perception or belief about a certain situation and if not properly managed, can lead to relapse.
• Positive emotional states – Just as negative emotions can put a person’s sobriety at risk, positive emotions have the potential to do the same. Celebrating a sobriety milestone, seeing a place that is reminiscent of drinking and having a good time with friends, or feeling confident about success at work may all cause a person to let their guard down and give themselves permission to use “just this once.”
• Interpersonal conflict – Having an argument with a spouse or loved one, ongoing marital problems, or financial disagreements are all common examples of interpersonal conflict that could result in negative emotional states and increase a person’s risk for relapse.
• Social pressure – Social situations involving direct or indirect pressure also have the potential to test one’s self-control. Examples of this include going to parties where alcohol or drugs are present, watching others use drugs or drink alcohol, or being offered drugs while walking down the street.

The Role of Self-Efficacy in Recovery

Self-efficacy refers to an individual’s confidence in his or her ability to control their motivation, behavior, and social environment. As a person progresses through drug and alcohol rehab, they will gain many valuable skills and tools that can be used to maintain their sobriety on a long-term basis. This process of personal growth will increase the belief that they have the ability to respond to high-risk situations appropriately and protect their sobriety.

Conversely, if a person lacks the necessary coping skills to deal with high-risk situations, their self-efficacy will deteriorate and they will become more susceptible to relapse. For example, if a person maintains thoughts like, “There’s nothing I can do to stop using these drugs” or “I’ve always been an addict, I can’t change” they will inevitably be overcome by any high-risk situation they face.

On the other hand, if the person maintains thoughts such as, “I have the power to walk away at any time” or “I don’t need this alcohol to deal with the conflict I’m facing” they are much more likely to walk away from the situation without compromising their sobriety. Even those who do relapse but possess a high level of self-efficacy are more likely to view the slip as a temporary setback instead of a complete failure and are more inclined to regain control and continue working to maintain their sobriety.

Developing self-efficacy is an essential part of the recovery process and can lead to positive treatment outcomes, including long-term or even lifelong sobriety.