Lecture 6- Relapse Prevention

Lecture 6- Relapse Prevention - Relapse Prevention and the...

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Unformatted text preview: Relapse Prevention and the Abstinence Violation Effect Transtheoretical Model to Relapse Prevention Preparation Contemplation Action Precontemplation Lapse or Relapse Maintenance What is a Lapse/Relapse? Example: Tim is an alcoholic. His alcoholism is causing problems with his marriage, job, family relationships, and health. Tim decides to stop drinking. Tim successfully refrains from drinking for 7 months. One day, Tim gets into a fight with his boss. When he comes home, his wife yells at him because the credit card bill is too high. His baby daughter is sick and screaming. There's no milk in the house for the baby. Tim continued Tim goes out into the snow to get some milk. He's so upset he can hardly think. Instead of going to the store, he drives to a bar. He ends up having 7 drinks at the bar and staying there for hours, complaining to some stranger about his life. After his drinking binge, Tim feels like a total failure. What has happened? What may happen next? Difference between a lapse and a relapse Lapse: a one-time "slip." Relapse: reverting to old behavior patterns. What is a relapse? Traditional definition A failure of treatment The person is not "cured" A dead end The disease has returned This definition may create a sense of hopelessness or lack of control which may lead the person to give up. Rates of Lapse/Relapse 50% of alcoholics have at least 1 drink in first 3 months 80% have at least 1 drink in first year. 60% of smokers relapse within 3 months 92% of methamphetamine users ever relapse Alternative definition of relapse The act or instance of backsliding or worsening A mistake, an error, a slip Not necessarily permanent, not necessarily fatal Even after relapsing, the person can still return to abstinence again Relapse Prevention Model (Marlatt & Gordon, 1985) A model to prevent relapse, based on behavioral and cognitive theory. Developed for use in treatment of addictive behaviors. The relapse process Before the person moves into the action stage he/ she has made a commitment to abstinence. Person experiences a sense of perceived control while maintaining abstinence. This lasts until the person encounters a high-risk situation for relapse. High Risk Situations Negative affective states such as stress, anxiety, or depression (Brandon, Copeland, & Saper, 1995). Associated with highest rates of relapse (50%) Environmental "cues" to your old behavior (Taylor, 1999). Social Pressure associated with 20% of relapses. Coping with high-risk situations If the person copes effectively without lapsing: the probability of relapse is decreased the person experiences increased selfefficacy Overview: positive Decreased Probability Of Relapse Increased Self-efficacy Effective Coping High Risk Situation Overview: Negative High Risk Situation Ineffective Coping Decreased Self-efficacy & positive outcome expectancy for negative behavior lapse Increased Probability of Relapse AVE Lapse leads to the Abstinence Violation Effect (AVE) Before the first lapse, the person has made a commitment to complete abstinence Once abstinence is violated, this commitment is broken. This leads to the Abstinence Violation Effect (AVE): Cognitive dissonance: behaviors are incongruent with self-image or core beliefs. Generates guilt. Negative self-attribution effect: "I'm a failure. I'll never be able to quit." Leads to decreased self-efficacy. Strategies to prevent relapse Since ineffective coping leads to relapse we want to promote effective coping skills 1. Anticipate and cope with the possibility of relapse (Cognitive Restructuring). Accept that lapses are probable. Understand that lapses don't mean complete failure. A lapse or high-risk situation is an opportunity to choose a new behavior pattern, not a trap. Strategies to prevent relapse 2. Recognize and cope with high-risk situations that may precipitate a lapse. Learn to recognize potentially risky situations as early as possible. Avoid being caught by surprise by risky situations. Self-monitoring: keep a record of behavior to identify the triggers. Strategies to prevent relapse 3. Learn skills to handle high-risk situations. Rehearsing responses to high-risk situations. Rehearsing ways to get out of high-risk situations. Meditation Strategies to prevent relapse 4. Lifestyle rebalancing. Create positive addictions such as.... In Class Activity Tony is a Philadelphia Eagles fan and is a recovering "rage-aholic" who was arrested at the end of last year's football season for picking a fight with an opposing fan. Please develop a personalized relapse prevention program that can help keep Tony from falling back into his old behavioral patterns. ...
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This note was uploaded on 09/24/2008 for the course HP 300 taught by Professor Riggs during the Spring '06 term at USC.

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