Lapse / Addiction Relapse Consequences Agreement
Below, you will find a blank form for the Lapse, Addiction Relapse Consequences Agreement which is discussed in detail in chapter eight:
The behavior to be avoided:_________________________________________________
________________________________________________________________________
________________________________________________________________________
First lapse consequences:___________________________________________________
________________________________________________________________________
________________________________________________________________________
Second lapse consequences:_________________________________________________
________________________________________________________________________
________________________________________________________________________
Third lapse consequences:__________________________________________________
________________________________________________________________________
________________________________________________________________________
Signed by:_______________________________________________________
This is a very powerful tool to prevent lapse, addiction relapse. Make sure that you fill it out early on in the addiction treatment process, before a relapse occurs. It can be very effective, especially if both the addict and family member work with a counselor/sponsor to fill it out and come to a mutual agreement on the specific consequences at each level of re-use.
Enterhealth creates individualized alcohol addiction treatment and drug addiction rehabilitation plans because we know your unique situation calls for an effective one-of-a-kind solution.
Contact Enterhealth today at 800.388.4601 to schedule an admission or email us at info@enterhealth.com for more information.
