Adapting the CENAPS Model of Relapse Prevention Therapy to managed care.

It is a logical fit, but requires more thinking through of the options available

This past January 10-16, PacifiCare of Oklahoma, Behavioral Health Services trained thirty of their preferred providers and three of their clinical case managers in the CENAPS Model of Relapse Prevention Therapy. The model is designed specifically to help relapse-prone, chemically dependent patients to identify and interrupt the warning sign patterns which could result in an unnecessary relapse. it is also useful in assisting a patient undergoing a first treatment to develop a strong relapse prevention continuing care plan. In short, its incorporation in a managed care model of treatment delivery makes sense, even though it does present some difficulties.

The Need

PacifiCare's interest in the CENAPS model grows out of the need to provide appropriate chemical dependency services while insuring some cost containment. Premiums on group insurance policies increased 352 percent between 1970 and 1980, and traditional non-managed benefit plans do not offer cost containment.[1] The cost of behavioral health care (mental health and chemical dependency) has increased anywhere from 20 to 40% annually (depending on the source quoted); for medical benefit packages, the annual cost increases have been considerably less.[2] Placing a relapse-prone chemically dependent patient back in the same primary treatment setting not only fails to address the special needs of the patient, it drives up the escalating costs of behavioral health care.

Michael Freeman, M.D., President, Institute for Behavioral Healthcare, stressed the importance of Relapse Prevention Therapy in a recent personal interview: "Relapse Prevention Therapy can prevent …