This is a comprehensive examination of an outcome measure of cognitive relapse stress appraisal (RSA) to be applied to chronic illness and tested on substance abusers who received eclectic treatment as a means of maintaining abstinence. This exploratory study describes and measures an implicit metacognitive process used to determine the efficacy of the treatment plan for relapse prevention. It is hypothesized that RSA improves with longer abstinence because the eclectic treatment plan selected a favorable idiosyncratic strategy that helped an individual to remain temperate when managing an induced thought of relapse, while still in treatment. Therefore,an individual's unique metacognitive processes revealed knowledge and awareness of utilizing adaptive problem-solving skills and experiencing less emotional negativity to successfully remain temperate.