However, evidence regarding its superiority relative to other active treatments has been less consistent. Outcomes in which relapse prevention may hold particular promise include reducing severity of relapses, enhanced durability of effects, and particularly for patients at higher levels of impairment along dimensions such as psychopathology or dependence severity21. Many factors play a role in a person’s decision to misuse legal or illegal psychoactive substances, and different schools of thinking assign different weight to the role each factor plays.

It’s possible to predict that some events—parties, other social events—may be problematic. It’s wise to create in advance a plan that can be enacted on the spot—for example, pre-arranging for a friend or family member to pick you up if you text or call. A better understanding of one’s motives, one’s vulnerabilities, and one’s strengths helps to overcome addiction. The dynamic model of relapse takes many of the RREP criticisms into account. Ecological momentary assessment, either via electronic device or interactive voice response methodology, could provide the data necessary to fully test the dynamic model of relapse19.

Cognitive therapy for anorexia nervosa

The risk of relapse is greatest in the first 90 days of recovery, a period when, as a result of adjustments the body is making, sensitivity to stress is particularly acute while sensitivity to reward is low. It reflects the difficulty of resisting a return to substance use in response to what may be intense cravings but before new coping strategies have been learned and new routines have been established. For that reason, some experts prefer not to use the term “relapse” but to use more morally neutral terms such as “resumed” use or a “recurrence” of symptoms. Negative emotional states, such as anxiety, depression, anger, boredom are often dealt with by using substances, interpersonal conflicts that the person cannot cope with effectively or resolve and the social -pressure to use a substance31.

The revised dynamic model of relapse also takes into account the timing and interrelatedness of risk factors, as well as provides for feedback between lower- and higher-level components of the model. For example, based on the dynamic model it is hypothesized that changes in one risk factor (e.g. negative affect) influences changes in drinking behavior and that changes in drinking also influences changes in the risk factors. The dynamic model of relapse has generated enthusiasm among researchers and clinicians who have observed these processes in their data and their clients. Not all addictions can be treated with abstinence, and it is not always possible or healthy to avoid certain behaviors for the long term. Sometimes, “abstinence-based treatment” is used to refer to “drug free” treatment, with the ultimate goal of transitioning a person with substance misuse issues to stop using any drug. In extreme cases and in many cases of opioid addiction, this method has proven unreliable, as drugs such as Buprenorphine may be prescribed to help people abstain from the drug they misuse, allowing them to maintain a functional lifestyle.

Cognitive behavioural interventions in addictive disorders

The AVE was introduced into the substance abuse literature within the context of the “relapse process” (Marlatt & Gordon, 1985, p. 37). Relapse has been variously defined, depending on theoretical orientation, treatment goals, cultural context, and target substance (Miller, 1996; White, 2007). It is, however, most commonly used abstinence violation effect definition to refer to a resumption of substance-use behavior after a period of abstinence from substances (Miller, 1996). The term relapse may be used to describe a prolonged return to substance use, whereas lapsemay be used to describe discrete,… People in addiction recovery often experience drug cravings when they go through stress.

The transition from slip or lapse to relapse involves the “abstinence violation effect,” which results from a state of cognitive dissonance regarding the nonabstinent behavior and the individual’s image of being abstinent. This dissonance can be reduced by either changing the behavior or changing the image, and characteristically in this population is resolved by the latter. Internal and stable attributes for the slip also lead to further lapse behavior.