Relapse: a psychological perspective (original) (raw)
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Conceptual, methodological, and analytical issues in the study of relapse
Clinical Psychology Review, 2006
This article examines conceptual, methodological, and analytic issues in research on relapse to alcohol and other drug use. The review notes the continued move in relapse research from a primary reliance on retrospective assessment of factors surrounding the onset of relapse episodes to an increased focus on the use of new technologies to obtain bnear real timeQ data on proximal factors in relapses. Recent advances in neurobiology have yielded important gains in our understanding of vulnerability to relapse in alcohol and other drug abusers. New statistical techniques are also available to analyze data on relapse. From a theoretical standpoint, there has been an increasing appreciation for the complicated and dynamic interplay of distal and proximal factors in the relapse process. At this point, the strongest and most detailed data on factors in the onset and course of relapse have been generated by studies of smoking relapses that have made use of Ecological Momentary Assessment (EMA) technology. However, there is still limited bnear realQ time data on proximal factors in alcohol and other drug relapses, and no such data on factors that influence the course of these relapses, once they have begun. Nevertheless, important methodological advances have been and continue to be made in the study of relapse, and our knowledge about the nature and process of relapse has increased considerably over the past 10 years. D (J.R. McKay).
Conceptualizations of relapse: a summary of psychological and psychobiological models
Addiction, 1996
While suhstance use disorders have long been recognized as chronic relapsing conditions, it has mainly been in the last two decades that clinical researchers have been systematically attending to the nature and processes of relapse. These efforts have led to the development of a variety of psychological and psychobiological models of relapse. These models are summarized in the present article, with particular attention placed on each model's basic principles and on the predpitants of relapse predicted by the respective models. The delineation of these models may help facilitate subsequent cross-referencing and cross-fertilization of thinking in this important area.
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.
Relapse prevention model is cognitive-behavioural model for the management of addictive behaviour (Steckler et al., 2013) (G. A. Marlatt & Witkiewitz, 2005). The concepts of ‘‘lapse’’, ‘‘relapse’’, and ‘‘prolapse’’ are central to the RP model. These concepts introduced grey areas in the traditional model of addiction treatment that previously viewed the treatment outcome in rigid binary terms i.e as abstinence and relapse (Donovan, 1996, p.135). These terms are considered as possible outcomes of the attempt to change a problematic behaviour such as problematic drug use. The initial return to problematic drug use following abstinence attempt is known as lapse (Steckler et al., 2013) (G. A. Marlatt & Witkiewitz, 2005). The lapse progresses to relapse if the patient returns to the pre-abstinence level of problematic drug use (Steckler et al., 2013) (G. A. Marlatt & Witkiewitz, 2005). On the other hand, if the patient succeeds in maintaining a positive behaviour change, it would be characterised as prolapse (G. A. Marlatt & Witkiewitz, 2005).
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: Introduction and Overview of the Model
Addiction, 1984
Page 1. Bntishjoumalof Addiction79(1984), 261-273 © 1984 Society for the Study of Addiction to Alcohol and other Drugs. Relapse Prevention: Introduction and Overview of the Model G. Alan Marlatt and William H. George Department ...
Relapse in the addictive behaviors: Integration and future directions
Clinical Psychology Review, 2006
This paper identifies the major consistencies in substantive and methodological findings across the review papers in this special issue on relapse in the addictive behaviors. The papers were consistent in suggesting that there have been major methodological advances which have helped to move the field forward. Furthermore, the papers show the need for taking a biopsychosocial approach to the study of relapse and the major difficulty across addictive behaviors in creating an acceptable operational definition of relapse. Suggestions for future research directions that follow from the papers include deriving and evaluating relapse definitions, systematically developing and testing models and theories of relapse, and understanding and narrowing the relapse research-clinical practice gap. D
Relapse Precipitants in Addictions
Journal of Addictive Diseases, 2007
In this paper, a study examining high-risk situations for relapse is presented. The sample consisted of 72 participants (51 male and 21 female) who had relapsed after having received a residential psychological treatment for drug addition in a therapeutic community in Spain. In order to analyze what personal, environmental or social factors were the most immediate triggers of relapse, a personal interview, using the Relapse Interview, was administered to each one of the relapsed patients. Results showed that most of the relapses took place during the first year after completing the treatment program. Likewise, the factors most frequently cited for relapse were the following: to cope with negative emotional states (49.5%), to be unable to resist temptations or impulses to consume (17.5%), to test personal control (10.3%) and to cope with interpersonal conflicts (9.3%). Results indicate that most factors were of an intrapersonal nature. Implications of these results for further research and clinical practice are commented upon.
The Path to Treatment: Does It Matter? Relapse and the Reason for Seeking Treatment
Current Research in Psychology
Problem statement: Substance abuse is difficult to treat and many of those who struggle with substance abuse do not see treatment as necessary. Moreover, relapse is common among those who receive treatment. Family and friends of Individuals With Addictions (IWAs) sometimes use ultimatums to encourage the IWA to enter treatment. What is less clear is whether IWAs are more likely to relapse if they enter treatment due to an ultimatum as opposed to entering by their own choice. Exploring how effective IWAs perceive ultimatums to be in facilitating sustained sobriety based on their own personal experiences may help shed light on the utility of treatment obtained under these coerced conditions. Approach: IWAs were contacted through on-line support groups to participate in an internet based study exploring their substance abuse history and experiences with ultimatums. Eighty-one IWAs completed an on-line questionnaire designed to solicit quantitative and qualitative responses developed for the present descriptive study. Results: Three-fourths of participating IWAs who sought treatment due to an ultimatum subsequently relapsed and current length of sobriety was not related to sobriety attempts resulting from ultimatums. However, individuals who identified crack/cocaine as their substance of choice perceived ultimatums as more helpful than individuals who identified alcohol as their substance of choice. Emergent coding revealed that nearly half of participating IWAs reported that there were no benefits to ultimatums and 40% of those with personal experience with ultimatums reported no personal benefits. Conclusion/Recommendations: Overall, IWAs do not perceive ultimatums to be effective and they are likely to relapse when seeking treatment due to an ultimatum, though some IWAs believed ultimatums had benefits, suggesting that ultimatums may be more helpful depending on the particular characteristics of the IWA. Study findings suggested a need to identify other ways significant others can support IWAs in sobriety.