Relapse Prevention Approach

1. Relapse Prevention Approach A Trainee-Centered Empowerment Strategy for Transfer of Training 9 JAN 2001

2. Classification of Intervention Relapse Prevention (RP) interventions are part of a class of transfer supporting mechanisms that are directed at the trainee. These can be done before, during or after training. If they are done during the training period, they are not an integral part of instruction (those are termed �teaching-for-transfer� techniques).

3. Different Types of Interventions Briefings - with supervision before & after training. Goal-Setting - involves turning learnings into operationalized goals for the workplace. Self-Management -involves goal-setting and skills to help the trainee manage themselves. Relapse Prevention - combines self-management with coping skills to prevent relapses into old behaviors.

4. Timing Most of the RP programs have been delivered after training has taken place. This is so that targeted skills and goals can be more easily identified once the trainee is familiar with them.

5. Addictive Origins The RP program originated in 1980 when clinical psychologist were trying to prevent cocaine addicts from relapsing after completing their institutional programs.

6. First Transfer Model An educator named Robert Marx borrowed the clinical RP model and adapted it for educational purposes--supporting transfer of training by preventing relapses to old ways. His original article came out in 1982 and his full-blown model appeared in 1986. We will use his 1986 RP model for our program, with some modifications suggested by Broad & Newstrom (1992).

7. Managers Only? It should be noted that from the beginning that Marx saw this as a technique to help those in management�not workers. Few studies have involved workers with this model.

8. Marx�s Seven-Step RP Model 1. Identify a skill to be transferred. 2. Set a retention goal & define slips & relapses 3. Discuss pros & cons of new behavior; make a commitment. 4. Learn the 14 RP strategies (next slides) 5. Predict circumstances of the first lapse. 6. Practice coping skills to deal with these obstacles (aka �fire-drills�). 7. Monitor target behavior on the job.

9. Marx�s 14 RP Strategy Groups These strategies can be grouped into four major categories: 1. Anticipate & Monitor Difficulties (1-7) 2. Strategies to Increase Rational Thinking (8-9) 3. Strategies to diagnose & practice related support skills (10-12) 4. Strategies to provide appropriate consequences for behavior (13-14)

10. Anticipate & Monitor Difficulties 1) understand the relapse process 2) recognize differences between training & work settings 3) create an effective support network on the job 4) expect sub-ordinates to be skeptical of the new behaviors of the manager 5) identify high risk situations 6) avoid implementing new skills in overwhelming situations 7) recognize seemingly unimportant behaviors that can lead to errors

11. Strategies to Increase Rational Thinking 8) reduce emotional reactions that interfere with learning (especially after making a �slip�) 9) retain self-confidence after making temporary errors (slips are natural)

12. Strategies to diagnose & practice skills 10) diagnose specific support skills necessary to retain new behavior 11) review life-style patterns that interfere with skill retention 12) schedule time to mix required & desirable activities (this comes from his �should/want ratio,� which states that life should have pleasurable activities and not be all work)

13. Strategies to provide appropriate consequences for behavior 13) identify organizational. supports for skill retention 14) create meaningful rewards/punishments when they do not exist naturally that will be self-administered

14. Conditions that Warrant a RP Use either of the two rules below: 1. Any transfer factor that the trainee directly controls. 2. Any transfer factor that the trainee can influence or negotiate.

15. Data Collection To design the RP Program tailored to the needs of the trainees, there should be a needs assessment of the trainee�s coping skills and work environment. Typical instruments include... Surveys that are completed by the trainee or supervisor Semi-structured interviews Direct observations of trainee and work site dynamics

16. RP Workshop In the RP workshop the first supportive intervention is made with the trainee Read the RP Workshop Outline for more details of its structure.

17. RP Workshop Delivery It is recommended that the workshop be given either� 1. 2/3rds of the way through training (for long courses)--or 2. Within a week of the completion of a course, but before trainees return to work, if possible.

18. How Long? The duration of the RP workshop can be from 3-4 hours to a full day This depends on needs, resources, and schedules. Practice time for �fire-drills� (coping skills) is very important.

19. Follow-up Support for Trainees Once the trainee is back at the workplace they will need support The Workplace Stakeholder Roles handout details the roles and some suggestions for supporting the trainee

20. Monitoring Behavior Remember that trainees need to monitor their performance. Slips and relapses should be discussed with the supervisor and trainer.

21. Partnership = Success When the RP approach is applied as a partnership between trainer, trainee, and supervisor, it has the best chance for success.

22. References Broad, M. L., & Newstrom, J. W. (1992). Transfer of training: Action-packed strategies to ensure high payoff from training investments. Reading, MA: Addison-Wesley Publishing Company. Marx, R.D. (1982). Relapse prevention for managerial training: a model for maintenance of behavior change. Academy of Management Review. 7, 433-441. Marx, R.D. (1986). Improving management development through relapse prevention strategies. Journal of Management Development. 5, 27-40.