EMDR, Relapse Prevention, and Long-Term Recovery
Recovery from substance use is not a single decision. It is an ongoing process that requires vigilance, support, and a clear plan. EMDR and Substance Use treatment can be especially powerful when integrated with relapse prevention strategies. Through Addiction Focused EMDR, clinicians can target the memories, triggers, and beliefs that drive relapse, while also strengthening adaptive coping and resilience.
If you’re integrating EMDR into relapse prevention planning and recovery work, the next step often depends on where you’re focusing:
If you’re trying to understand what contributes to relapse → focus on identifying warning signs and patterns that inform relapse prevention planning and guide EMDR target selection
If you’re working to reduce relapse risk → integrate EMDR protocols into relapse prevention planning to target craving memories, triggers, and future risk scenarios
If your client is in maintenance or long-term recovery → focus on strengthening relapse prevention planning by reinforcing coping strategies, support systems, and future templates
In this blog, we’ll explore how EMDR and Addiction Treatment Planning incorporates relapse prevention, how EMDR Target Selection and Sequencing can address relapse memories, and how protocols like DeTUR, CravEx, FSAP, and Future Templates support long-term recovery.
Why Relapse Prevention Matters in EMDR and Addiction
Relapse rates in substance use disorders are high, with studies showing up to 37% relapse within six months and up to 78% within a year post-treatment (del Palacio-González et al., 2024). Witkiewitz & Marlatt (2004) emphasized that relapse is a process that unfolds over time, influenced by both long-term vulnerabilities and immediate triggers.
For EMDR and Addiction Treatment Planning, this means relapse prevention must be part of Phase 1 History Taking and Treatment Planning. Clinicians need to assess relapse history, identify warning signs, and integrate relapse prevention strategies directly into the EMDR Master Treatment Plan.
Relapse Warning Signs and EMDR Target Selection
Gorski & Miller (1986) outlined a widely used framework for relapse warning signs, including:
Change in attitude
Elevated stress
Return of denial
Recurrence of post-acute withdrawal symptoms (PAWS)
Behavior change
Loss of structure
Social breakdown and isolation
In EMDR Target Selection, these warning signs can guide which memories and triggers to process. For example:
Trauma-related stressors that elevate relapse risk can be targeted with standard protocol.
Denial and avoidance may be explored using Two-Hand Interweave to address ambivalence.
Post-acute withdrawal experiences can be processed through CravEx if they triggered relapse episodes.
This approach allows relapse prevention to be woven into EMDR Target Sequencing as part of the overall treatment plan.
Addiction Focused EMDR Protocols for Relapse Prevention
Several EMDR protocols are particularly effective in relapse-focused work:
CravEx (Hase, 2009; Hase et al., 2008): Targets relapse episodes and craving memories directly, reducing the intensity of urges.
DeTUR (Popky, 2005; Bae & Kim, 2012; Bae et al., 2015): Focuses on external triggers that often precede relapse, desensitizing them while reinforcing positive recovery goals.
FSAP (Miller, 2012, 2016): Addresses the internal feeling states that fuel relapse, such as the desire for confidence, belonging, or calm.
Flashforward (Logie & de Jongh, 2014): Helps clients address feared future outcomes, such as failing in sobriety, which can increase relapse vulnerability.
Idealization (Mosquera & Knipe, 2017): Challenges glamorized memories of substance use that may resurface during maintenance.
These interventions allow relapse prevention to be proactive rather than reactive. Instead of waiting for relapse to occur, clinicians can use EMDR Target Selection and Sequencing to address the risk factors in advance.
Even with this level of planning, clinicians still need a clear way to translate these decisions into concrete relapse prevention strategies that clients can use between sessions.
If you’re working with clients in early recovery or preparing to begin deeper EMDR work, having a structured way to identify triggers, build coping strategies, and support initial stability can make this much more manageable.
This plan provides a structured way to support relapse prevention planning so you can reduce risk and guide next steps in treatment:
→ Relapse Prevention: Safety & Harm Reduction Plan
Once clients have established stability and are working to maintain long-term recovery, the next step is reinforcing relapse prevention planning over time by strengthening coping strategies and support systems.
This plan provides a structured way to sustain progress and reduce long-term relapse risk:
→ Relapse Prevention: Maintenance & Recovery Plan
Research on EMDR and Relapse Prevention
Recent research supports the integration of EMDR into relapse prevention plans:
Hase, Schallmayer, & Sack (2008): EMDR reduced cravings and relapse rates compared to treatment-as-usual in inpatient alcohol treatment.
Logsdon, Cornelius-White, & Kanamori (2023): A meta-analysis found EMDR significantly improved treatment engagement and reduced severity of substance use.
Martínez-Fernández et al. (2024): EMDR significantly reduced cravings across multiple studies, confirming its role in reducing relapse risk.
del Palacio-González et al. (2024): Identified psychological predictors of relapse, many of which can be addressed through EMDR Target Selection, including stress, trauma history, and poor coping.
These findings reinforce that Addiction Focused EMDR addresses both trauma healing and the processes that support long-term recovery.
Integrating EMDR into Long-Term Recovery Plans
To embed EMDR into relapse prevention and recovery:
Use Phase 1 assessments to identify relapse warning signs and integrate them into treatment planning.
Target relapse memories (first, worst, recent) using CravEx to disrupt relapse patterns.
Install relapse prevention strategies (coping skills, support networks) as future templates in Phase 2 and Phase 8.
Address ambivalence with Two-Hand Interweave and Flashforward, particularly in contemplation and maintenance stages.
Reinforce identity in recovery by targeting positive future goals and adaptive beliefs.
This integrated approach helps clients achieve and maintain sobriety, building resilience against high-risk situations and emotional vulnerabilities.
Conclusion
Relapse prevention is a central part of EMDR and substance use treatment. By using EMDR Target Selection and EMDR Target Sequencing to address relapse episodes, craving memories, and maladaptive beliefs, clinicians can help clients build sustainable recovery pathways.
Addiction Focused EMDR protocols like CravEx, DeTUR, FSAP, Flashforward, and Idealization provide powerful tools for relapse prevention. Research confirms their value in reducing cravings, strengthening treatment engagement, and lowering relapse risk (Hase et al., 2008; Martínez-Fernández et al., 2024; Logsdon et al., 2023).
In EMDR Phase 1 History Taking and Treatment Planning, relapse prevention is integrated from the beginning of care. Thoughtful planning and protocol integration support clients in building stability early in recovery while also strengthening the foundation needed for sustained, long-term change.
Relapse prevention planning is one part of a broader approach to EMDR and substance use treatment. If you want to see how readiness, cultural factors, protocol selection, and target sequencing all fit together into a structured system, you can start here:
→ Addiction Treatment & Recovery Hub
If you want a more structured, step-by-step approach to applying EMDR in substance use treatment, including how to assess readiness, integrate relapse prevention planning, select and sequence protocols, and build a cohesive treatment plan while earning continuing education credit, this is covered in depth in the course:
→ Applying EMDR to Substance Use Disorder Treatment
References
Bae, H., & Kim, D. (2012). Desensitization of triggers and urge reprocessing for an adolescent with Internet addiction disorder. Journal of EMDR Practice and Research, 6(2), 73–79. https://doi.org/10.1891/1933-3196.6.2.73
Bae, H., Han, C., & Kim, D. (2015). Desensitization of triggers and urge reprocessing for pathological gambling: A case series. Journal of Gambling Studies, 31(1), 331–342.del Palacio-González, A., Thylstrup, B., & Thomsen, K. R. (2024). Psychological factors predicting patients' risk of relapse after enrollment in drug use treatment: A systematic review. Journal of Substance Use and Addiction Treatment, 161, 209354. https://doi.org/10.1016/j.josat.2024.209354
Gorski, T. T., & Miller, M. (1986). Staying sober: A guide for relapse prevention. Independence Press.
Hase, M. (2009). CravEx: An EMDR approach to treat substance abuse and addiction. In M. Luber (Ed.), EMDR scripted protocols: Special populations (pp. 467–488). Springer Publishing Company.
Hase, M., Schallmayer, S., & Sack, M. (2008). EMDR reprocessing of the addiction memory: Pretreatment, posttreatment, and 1-month follow-up. Journal of EMDR Practice and Research, 2(3), 170–179. https://doi.org/10.1891/1933-3196.2.3.170
Logsdon, E., Cornelius-White, J. H. D., & Kanamori, Y. (2023). The effectiveness of EMDR with individuals experiencing substance use disorder: A meta-analysis. Journal of EMDR Practice and Research, 17(1). https://doi.org/10.1891/EMDR-2022-0046
Martínez-Fernández, D. E., Fernández-Quezada, D., Garzón-Partida, A. P., Aguilar-García, I. G., García-Estrada, J., & Luquin, S. (2024). The effect of eye movement desensitization and reprocessing (EMDR) therapy on reducing craving in populations with substance use disorder: A meta-analysis. Brain Sciences, 14(11), 1110. https://doi.org/10.3390/brainsci14111110
Witkiewitz, K., & Marlatt, G. A. (2004). Modeling the complexity of post-treatment drinking: It's a rocky road to relapse. Clinical Psychology Review, 24(4), 593–609. https://doi.org/10.1016/j.cpr.2004.03.001
