The abstinence violation effect: investigating lapse and relapse phenomena using the relapse prevention model with domestically violent men Document Gale Academic OneFile

Thirty days after you begin treatment, you’ve only consumed twenty-five times. Social pressure, including both direct verbal or nonverbal persuasion and indirect pressure (e.g., being around other people who are drinking), contributed to more than 20 percent of relapse episodes in Marlatt’s study. People commonly confront relapse as a part of their process in achieving long-term sobriety. Perfection isn’t required by those in recovery, but rather a willingness to do their best each day with a supportive team backing their efforts.

• However, despite findings that coping can prevent lapses there is scant evidence to show that skills-based interventions in fact lead to improved coping .
• Thus, a person who can execute effective coping strategies (e.g., a behavioral strategy, such as leaving the situation, or a cognitive strategy, such as positive self-talk) is less likely to relapse compared with a person lacking those skills.
• Behavioral economists have long spoken about mental labor in terms of economics—people usually think of effort in terms of costs and payoffs.
• Although diets high in sugar are linked to many health complications, research finds that eating sugar does not impact the behavior of children.

The treatment is not lapse prevention; lapses are to be expected, planned for, and taken as opportunities for the client to demonstrate learning. Most often, relapse tends to be construed as a return to pretreatment levels of occurrence of the targeted behavior. Although there is some debate about the best definitions of lapse and relapse from theoretical and conceptual levels, these definitions should suffice. While he considered 12-Step programs and other similar approaches to recovery to be useful, he also believed that the notions of a lapse and relapse were not realistically conceived by many recovery programs. Quite frankly, studies that have attempted to look at lapse and relapse rates across different substances have discrepant findings because the terms are often defined differently. In addition, many individuals in recovery consider a single slip as a full-blown relapse.

Behavioral Treatments for Smoking

Related work has also stressed the importance of baseline levels of neurocognitive functioning (for example as measured by tasks assessing response inhibition and working memory; ) as predicting the likelihood of drug use in response to environmental cues. The study of implicit cognition and neurocognition in models of relapse would likely require integration of distal neurocognitive factors (e.g., baseline performance in cognitive tasks) in the context of treatment outcomes studies or EMA paradigms. Additionally, lab-based studies will be needed to capture dynamic processes involving cognitive/neurocognitive influences on lapse-related phenomena.

For example, it has been shown that self-efficacy for abstinence can be manipulated . Thus, one could test whether increasing self-efficacy in an experimental design is related to better treatment outcomes. Similarly, self-regulation ability, outcome expectancies, and the abstinence violation effect could all be experimentally manipulated, which could eventually lead to further refinements of RP strategies. These strategies also focus on enhancing the client’s awareness abstinence violation effect of cognitive, emotional, and behavioral reactions in order to prevent a lapse from escalating into a relapse. The first step in this process is to teach clients the RP model and to give them a “big picture” view of the relapse process. For example, the therapist can use the metaphor of behavior change as a journey that includes both easy and difficult stretches of highway and for which various “road signs” (e.g., “warning signals”) are available to provide guidance.

Theoretical and Practical Support for the RP Model

Another efficacy-enhancing strategy involves breaking down the overall task of behavior change into smaller, more manageable subtasks that can be addressed one at a time . Thus, instead of focusing on a distant end goal (e.g., maintaining lifelong abstinence), the client is encouraged to set smaller, more manageable goals, such as coping with an upcoming high-risk situation or making it through the day without a lapse. Because an increase in self-efficacy is closely tied to achieving preset goals, successful mastery of these individual smaller tasks is the best strategy to enhance feelings of self-mastery. A critical difference exists between the first violation of the abstinence goal (i.e., an initial lapse) and a return to uncontrolled drinking or abandonment of the abstinence goal (i.e., a full-blown relapse). Although research with various addictive behaviors has indicated that a lapse greatly increases the risk of eventual relapse, the progression from lapse to relapse is not inevitable.

Instead of learning and growing from their mistake, an individual may believe that they are unable to complete a successful recovery and feel shame and guilt. In addition to this, booster sessions over at least a 12 month period are advisable to ensure that a safety net is available since gamblers are renown for not recontacting sufficiently hastily when difficulties arise. Recontact contracts can also be useful where it is agreed in advance what the criterion will be for a time where a gambler should recontact the therapist. The guiding strategy here is to ensure that gamblers learn to cope with minor setbacks on their own but are able to recognise more major setbacks before they become fully blown relapses. A verbal or written contract will increase the chance that gamblers will recontact at an appropriate stage and therefore minimise the likelihood of a full blown relapse. I’ve been on and off drug for about 10 years, and managed to stay off of them for about a year or two.