Session 9 Protocol: Elective Skill Topic 1

The counselor welcomes the client and provides an overview of the session. In this session, the counselor helps the client develop an emergency plan to follow in high-risk situations.

Explain the Effects of Major Life Changes

The counselor explains that life changes, both negative (e.g., health problems, unemployment, financial losses) and positive (e.g., a new job, graduating from school, moving to a new home) can threaten a client’s efforts to remain abstinent. In these situations, the client needs an emergency plan to cope with stressors. The counselor asks the client to consider possible highrisk situations and ways to address them.

Present Personal Emergency Plan: High-Risk Situation

The counselor gives the client Personal Emergency Plan: High-Risk Situation (form 9A), and together they review the form. The counselor and client fill out the form with the high-risk situations just identified in mind. The client might want to plan alternative enjoyable activities for high-risk times; the counselor can help the client with these plans. The counselor encourages the client to review compelling reasons for continued abstinence, as noted on the PFR (form AS8; see assessment session) or Future-Self Letter (form 4B).

Present Personal Emergency Plan: Lapse

The counselor explains that lapses are not uncommon and asks what might help the client leave a setting where a lapse occurred and whom he or she can call for immediate support.

The counselor presents Personal Emergency Plan: Lapse (form 9B) and asks the client to think of strategies to cope with a lapse. The counselor helps the client specify how the strategies would be carried out, such as how to dispose of the marijuana (e.g., throw it away, flush it down the toilet), how to challenge negative thoughts (e.g., I’ll quit again after I finish this stash; My life is just too stressful; I was so irritable when I quit last time, I should continue using because I’m nicer to be around). The client already should have removed paraphernalia from his or her home, but strategies may need to be reviewed.

Review Previous Skill Topics

The counselor and client discuss strategies from previous skill topics that the client found helpful (e.g., urge surfing, challenging negative thinking) and review Learning New Coping Strategies (form 1A), A Guide to Quitting Marijuana (form 1B), and the client’s Quit Agreement (form 1C).

Terminate Treatment

If this is the final treatment session with this client, the counselor discusses termination issues (see pages 18 and 131).