In a simple letter, outline the patient's need for support, highlighting this dependency as a serious issue. One or two follow-up visits with the physician in addition to regular visits with us can be very helpful. Success rates improve with the number of modalities used. This stage is easily neglected, as we sink back into our own complacency. Use role-play techniques.
Role playing difficult situations can help.
Alternative coping strategies need to be developed and practiced in session, if possible. Moderate exercise should be reinforced. This is a very delicate time. You probably will only get one opportunity to discuss failure at length with a tobacco user who has recently slipped. Proper focus is important.