Willpower building: a new element in relapse prevention (original) (raw)
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Strong-willed but not successful: The importance of strategies in recovery from addiction
Introduction Philosophers, cognitive and social psychologists and laypeople often subscribe to the view that willpower is central to recovery from addiction. But there are reasons to suspect that willpower is much less important to explaining recovery than this view suggests. Methods Here we report findings from a qualitative longitudinal study on how substance dependent people see their agency and self-control, and how their self-control develops over time. 69 opioid, alcohol and methamphetamine dependent people were interviewed over a 3 year period. Results Most of the participants described themselves as strong willed; in fact, as very strong willed. However, there seemed no correlation between having a (self-assessed) strong will and recovery status. Rather, the number of strategies cited by participants distinguished those in stable recovery from those who were not. Participants in recovery were also more enthusiastic about strategies than those who have not succeeded in controlling substance use. Willpower remained important, but was itself used strategically. Conclusions People with addiction seem not to be short on willpower; rather, recovery is dependent on developing strategies to preserve willpower by controlling the environment.
Addictive behaviour constitutes a serious enigma to action and moral philosophy as to theories of rational choice. How is it possible that someone pursues a desire that has been repeatedly experienced and reinforced as contrary to one's better judgement? According to a general view, addiction stems from the loss of self-control attributed to its increasing undermining by strong cravings. However, in both substance and behavioural addiction, one's ability to make choices is not entirely impaired. One is able to pursue some intentions, despite of the fact that addiction leads to a derailment from normal life, undermining relations and roles constitutive of identity and agency. Therefore, it seems that self-control is not completely absent but it becomes somehow " errant " , not oriented by an adequate appraisal of the future, and even maintained in order to fulfil what has become an overwhelming need. This has recently been explored as an unbalance between motivational and evaluative assessment, i.e., a particular form of weakness of will. After determining the specific kind of weakness of will associated with addiction, I will try to understand in what terms can self-control be conceived in order to produce therapeutic outcomes. The case of alcoholic dependence will serve me to illustrate the concurrent forms of self-control subscribed by both sciences and therapies of addiction.
Relapse Prevention: A Critique and Proposed Reconceptualisation
Behaviour Change, 2010
Relapse prevention (RP) plays a significant role in current treatments and post-treatment approaches to substance abuse problems. It is also widely used in a number of other problem areas, including other addictive behaviours and sexual offending. The widespread use of RP in various fields is due to both its clearly articulated theoretical basis, which has significant face validity, and its transferability into clinical practice. Also, there is a growing (though arguably still modest) body of empirical evidence that demonstrates its efficacy in a range of therapeutic contexts. However, arguably, in terms of both the theoretical underpinnings and the practical application of RP there is room for improvement. This article hypothesises that one of the key weaknesses of RP is that it takes a generally unconstructive approach to the therapeutic process through the use of negative concepts and avoidance goals. It is suggested that a ‘good lives’ framework of psychological wellbeing can pr...
Relapse prevention for addictive behaviors
Substance Abuse Treatment, Prevention, and Policy, 2011
The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulnessbased relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change.
Psychological Determinants of Relapse Prevention
Pakistan Journal of Psychological Research, 2020
The present research aimed to study self-reflection, self-importance of moral identity, self-forgiveness, and personal growth initiative as the psychological determinants of relapse prevention among the drug addicts. Study instruments include Self-Reflection and Insight. The whole study is divided into two phases. Phase I underlies translation and validation of the research instrument into Urdu language; such that, translated versions possess significant reliability and possess good construct validity. Phase II studies the relationship between self-reflection, self-importance of moral identity, self-forgiveness, personal growth initiative, and relapse prevention among 240 drug addicts (M = 29.3, SD = 8.2). Sample was approached at different rehabilitation centers of Islamabad and Rawalpindi. Results indicated that all translated instruments are valid for the sample. All the study variables are found to explain about 14% variance (R 2 = .14) in warning of relapse such that personal growth initiative is the most significant predictor. The values of total, direct, and indirect effects demonstrate existence of mediation; such that, self-importance of moral identity, self-forgiveness, and personal growth initiative act as serial mediators in order as mentioned for the relationship of self-reflection and warning of relapse.
SYSTEMATIC APPRAISAL OF SUBSTANCE ABUSE THEORIES AND MODELS OF RELAPSE PREVENTION
African Journal of Social and Behavioural Science. 14(4), 2024
Substance use disorder is recognized as a chronic, relapsing condition, with a significant percentage of individuals experiencing relapse within one year of treatment. Understanding the intricate factors contributing to relapse is paramount for developing effective prevention and intervention strategies. Various theoretical frameworks offer insights into addiction relapse, shedding light on its underlying mechanisms. Social learning theory underscores the influence of observational learning, modelling behaviours, and reinforcement on addictive behaviours, advocating for tailored interventions to enhance relapse prevention. Marlatt and Gordon's Relapse Prevention (RP) Model targets cognitive processes and behavioural strategies, offering a comprehensive approach that is effective for overcoming addiction, despite its complexity. The transtheoretical model (TTM) provides a dynamic framework, tailoring interventions to an individual's stage of change and emphasizing longterm behaviour maintenance. The biopsychosocial model considers biological, psychological, and social factors and advocates for a holistic and individualized approach to relapse prevention. While these models share the need for tailored interventions and recognition of relapse complexity, they differ in their emphasis and application, highlighting the necessity of integrating multiple perspectives for a comprehensive understanding of addictive behaviours and relapse prevention. Therefore, it is recommended that clinicians and experts in the field of substance abuse employ multiple perspectives in approaching substance abuse relapse interventions.
Relapse prevention: From radical idea to common practice
Addiction Research & Theory, 2012
The term ''relapse prevention'' drew great criticism and was not generally accepted when it was initially introduced in the early 1980s. The idea of talking with clients about the possibility of relapse was an incredibly radical idea until the pioneering work on relapse prevention by Alan Marlatt and his colleagues challenged the prevailing disease conceptualization of addictions and provided a revolutionary perspective that focused on understanding the factors contributing to and maintaining addiction. Today, relapse prevention is both a manualized treatment and a general treatment strategy that has been implemented in addiction treatment centers around the world. The theory and practice of relapse prevention has emerged as one of the most prominent and pervasive approaches in the treatment of addictive behaviors and stands as one of Alan Marlatt's most notable and longest-lasting contributions to the field. This article provides a review of the development, adaptation, and dissemination of relapse prevention over the past 30 years and also provides some ideas for the future of relapse prevention in research and treatment.