Scenarios
“I had one lapse, so I failed. Since I've already messed up, I'm just going to continue my old behavior.” What could you say to this client to help prevent the lapse from becoming a full relapse (address current and future)?
Reframing the lapse as a learning experience, help combat the all-or-nothing thinking, identifying what about the situation contributed to the lapse, developing a coping strategy for the future
Your client identifies late-night studying as a high-risk situation because stress and fatigue often lead them to return to a problematic eating behavior. Name one specific coping strategy you would help the client develop for this situation.
Going for a short walk, mindfulness/meditation, positive self-affirmation, contacting a support person, mentally rehearsing how they will respond when the situation occurs
A client has been successfully following their nutrition goals for several weeks. They are invited to a holiday dinner where they know they will be around foods they have struggled with in the past. Before going, they think: “I'm probably going to lose control tonight anyway.” Which response BEST reflects relapse-prevention planning? Why?
A. Tell the client to avoid the holiday dinner entirely.
B. Tell the client that they need to rely on willpower and stay disciplined.
C. Identify the dinner as a high-risk situation and develop specific coping strategies before attending.
D. Wait until after the dinner to determine whether a lapse occurred.
C; focuses on building coping skills, rather than simply eliminating every potentially difficult situation.
A client has been working toward healthier eating behaviors for three months. During a stressful week, they binge one evening. The next morning, the client thinks: “I can't believe I did that. I've ruined all my progress. Since I already messed up, I might as well continue eating this way for the rest of the week.” Which sequence BEST describes what is occurring? At which point could relapse prevention intervene?
A. High-risk situation → effective coping → recovery
B. High-risk situation → lapse → maladaptive interpretation → increased risk for relapse
C. Relapse → high-risk situation → lapse
D. Lapse → self-efficacy → relapse prevention
B; There are several times- before the stressful week → anticipate the high-risk situation OR during the situation → use coping strategies OR after the lapse → reframe it and prevent escalation
Your client in recovery has been invited on a beach trip with their friends. They express concerns about feeling insecure in their swimsuit, and being judged while taking group photos and going out to dinner. Your client mentions that these emotions are triggering them to re-engage in disordered eating. Which behavioral strategies could you use in your session, and how?
"Passing" thoughts - let your client acknowledge the disordered thought, then have them list why they are engaging in positive behavior despite what they feel
Develop discrepancy - ask how disordered eating would affect their current recovery plan
Exposure techniques - encourage them to eat with a couple friends in a smaller, more private setting before the trip