Sometimes people relapse because, in their eagerness to leave addiction behind, they cease engaging in measures that contribute to recovery. Recently, Magill and Ray [41] conducted a meta-analysis of 53 controlled trials of CBT for substance use disorders. As noted by the authors, the CBT studies evaluated in their review were based primarily on the RP model [29]. Overall, the results were consistent with the review conducted by Irvin and colleagues, in that the authors concluded that 58% of individuals who received CBT had better outcomes than those in comparison conditions. In contrast with the findings of Irvin and colleagues [36], Magill and Ray [41] found that CBT was most effective for individuals with marijuana use disorders. The dynamic model of relapse assumes that relapse can take the form of sudden and unexpected returns to the target behavior.
Relapse to smoking
- Global self-management strategy involves encouraging clients to pursue again those previously satisfying, nondrinking recreational activities.
- Using a wave metaphor, urge surfing is an imagery technique to help clients gain control over impulses to use drugs or alcohol.
- The term relapse may be used to describe a prolonged return to substance use, whereas lapsemay be used to describe discrete,…
- In RP client and therapist are equal partners and the client is encouraged to actively contribute solutions for the problem.
In a prospective study among both men and women being treated for alcohol dependence using the Situational Confidence Questionnaire, higher self-efficacy scores were correlated to a longer interval for relapse to alcohol use8. The relationship between self-efficacy and relapse is possibly bidirectional, meaning that individuals who are more successful report greater self-efficacy and individuals who have lapsed report lower self-efficacy4. Chronic stressors may also overlap between self-efficacy and other areas of intrapersonal determinants, like emotional states, by presenting more adaptational strain on the treatment-seeking client4. When abstinence is violated, individuals typically also have an emotional response consisting of guilt, shame, hopelessness, loss of control, and/or a sense of failure; they may use drugs or alcohol in an attempt to cope with the negative feelings that resulted from their abstinence violation. A person may experience a particularly stressful emotional event in their lives and may turn to alcohol and/or drugs to cope with these negative emotions.
Relapse prevention for addictive behaviors
For instance, genetic factors could influence relapse in part via drug-specific cognitive processes. Recent studies have reported genetic associations with alcohol-related cognitions, including alcohol expectancies, drinking refusal self-efficacy, drinking motives, and implicit measures of alcohol-related motivation [51,52, ]. Overall, the body of research on genetic influences on relapse and related processes is nascent and virtually all findings require replication.
Neurobiology of cue-reactivity, craving, and inhibitory control in non-substance addictive behaviors
In RP client and therapist are equal partners and the client is encouraged to actively contribute solutions for the problem. Client is taught that overcoming the problem behaviour is not about will power rather it has to do with skills acquisition. Another technique is that the road to abstinence is broken down to smaller achievable targets so that client can easily master the task enhancing self-efficacy. Also, therapists can provide positive feedback of achievements that the client has been able to make in other facets of life6. Critical for craving and relapse is the process of associative learning, whereby environmental stimuli repeatedly paired with drug consumption acquire incentive-motivational value, evoking expectation of drug availability and memories of past drug euphoria15.
For example, an individual who has successfully abstained from alcohol, after having one beer, may drink an entire case of beer, thinking that since he or she has “fallen off the wagon,” he or she might as well go the whole way. When an abstinence violation occurs, the attributions an individual makes play an important part in determining the trajectory of subsequent use. When abstinence violation abstinence violation effect occurs, individuals typically enter a state of cognitive dissonance, defined as an aversive experience resulting from the discrepancy created by having two or more simultaneous and inconsistent cognitions. Abstinence violators realize that their actions (e.g. “I drank”) do not line up with their personal goal (e.g. “I want to abstain”) and feel compelled to resolve the discrepancy.
- The term relapse may be used to describe a prolonged return to substance use, whereas lapsemay be used to describe discrete, circumscribed…
- Engaging in self-care may sound like an indulgence, but it is crucial to recovery.
- Self-efficacy is defined as the degree to which an individual feels confident and capable of performing certain behaviour in a specific situational context5.
- Attending or resuming attending meetings of some form of mutual support group can be extremely valuable immediately after a lapse or relapse.
- By allowing our clients to choose their own path and accommodating them with individualized programs, we ensure the best route towards true success.