Authors: Adam Mohamed Saber Mohamed , Amira Gaber Ibrahim Mostafa , Moutaz Ali Kasasbeh , Mohammad Faris Hasan

Abstract

Background: Relapse remains one of the most persistent challenges in the treatment of substance use disorders (SUD), with regional readmission rates reaching approximately 30% within one year of discharge. Psychiatric nurses occupy a uniquely continuous position within inpatient rehabilitation settings, yet their lived experiences in relapse prevention remain almost entirely unexamined in the Saudi Arabian and wider Gulf Cooperation Council (GCC) context.

Objective: To explore and describe the lived experiences of psychiatric nurses in preventing relapse among patients with substance use disorders at a behavioral rehabilitation center in Riyadh, Saudi Arabia.

Methods: A qualitative, phenomenological design was employed. Semi-structured, individually conducted interviews using a 16-item guide spanning seven thematic domains were completed with 15 psychiatric nurses purposively sampled from a single behavioral rehabilitation center. Written participant responses were analyzed using the six-phase Thematic Analysis framework of Braun and Clarke.

Results: Nine major themes emerged: (1) enacting relapse prevention as an early and proactive role, (2) navigating patient-level, institutional, and social barriers, (3) emotional labor and professional resilience, (4) building trust-based therapeutic relationships, (5) confronting stigma and engaging in reflective practice, (6) experience-driven competence alongside identified training gaps, (7) hierarchical tension within multidisciplinary collaboration, (8) structured discharge preparation amid post-discharge continuity gaps, and (9) professional wisdom rooted in patience and non-judgmental care. Nurses overwhelmingly described relapse prevention as beginning "from day one" of admission (13/15) and identified trust-building through consistency and non-judgment (13/15) as foundational to therapeutic engagement.

Conclusion: Psychiatric nurses in this Saudi rehabilitation setting perform a central, often under-recognized role in relapse prevention, grounded in sustained therapeutic relationships and early intervention, but constrained by hierarchical team structures, discontinuous post-discharge follow-up, and gaps in specialized training. These findings offer the first empirically grounded account of addiction-nursing practice in the Saudi context and carry direct implications for workforce training and institutional protocol development.

Keywords: Psychiatric nursing, substance use disorder, relapse prevention, qualitative research, thematic analysis, Saudi Arabia.