Additionally, lab-based studies will be needed to capture dynamic processes involving cognitive/neurocognitive influences on lapse-related phenomena. Self-efficacy (SE), the perceived ability to enact a given behavior in a specified context 26, is a principal determinant of health behavior according to social-cognitive theories. Although SE is proposed as a fluctuating and dynamic construct 26, most studies rely on static measures of SE, preventing evaluation of within-person changes over time or contexts 43.
Relapse prevention for addictive behaviors
- Evidence of the abstinence violation effect appears when someone attributes a lapse and subsequent relapse to completely uncontrollable factors, such as a perceived character flaw or the inevitable nature of their condition.
- Cognitive Behavioral Therapy (CBT) offers some of the most powerful tools for taking apart the abstinence violation effect.
- The past 20 years has seen growing acceptance of harm reduction, evidenced in U.S. public health policy as well as SUD treatment research.
- In another recent study, researchers trained participants in attentional bias modification (ABM) during inpatient treatment for alcohol dependence and measured relapse over the course of three months post-treatment 62.
- Their role is to support you in activating your relapse prevention plan and getting back on track, not to shame you for a mistake.
Alternatively, researchers who conduct trials in community-based treatment centers will need to obtain buy-in to test nonabstinence approaches, which may necessitate waiving facility policies regarding drug use during treatment – a significant hurdle. Individuals with greater SUD severity tend to be most receptive to therapist input about goal selection (Sobell, Sobell, Bogardis, Leo, & Skinner, 1992). This suggests that treatment experiences and therapist input can influence participant goals over time, and there is value in engaging patients with non-abstinence goals in treatment. It is important to highlight that most of the studies cited above did not provide goal-matched treatment; thus, these outcomes generally reflect differences between individuals with abstinence vs. non-abstinence goals who participated in abstinence-based AUD abstinence violation effect treatment. These covert antecedents include lifestyle factors, such as overall stress level, one’s temperament and personality, as well as cognitive factors.
Eliminating Myths and Placebo Effects
It was noted that in focusing on Marlatt’s relapse taxonomy the RREP did not comprehensive evaluation of the full RP model 121. Nevertheless, these studies were useful in identifying limitations and qualifications of the RP taxonomy and generated valuable suggestions Oxford House 121. The following section reviews selected empirical findings that support or coincide with tenets of the RP model.
4.2. Negative impact on treatment retention and completion
At this point, the individual is likely in a vulnerable state, triggering the desire to use or engage in the behavior again. The combination of these negative emotions and beliefs can further exacerbate the degree of the lapse and derail from their recovery process. Without addressing the impact that AVE has, it can inhibit the ability to achieve recovery goals. In the journey of overcoming addiction and or abstaining from an unwanted behavior, individuals often encounter a psychological phenomenon known as the abstinence violation effect (AVE). AVE impacts those who are inspired to become abstinent but experience a setback, such as a lapse or relapse. The lapse can then trigger a surge of negative emotions such as a strong sense of guilt or failure.
- This type of policy is increasingly recognized as scientifically un-sound, given that continued substance use despite consequences is a hallmark symptom of the disease of addiction.
- The second is assessing coping skills of the client and imparting general skills such as relaxation, meditation or positive self-talk or dealing with the situation using drink refusal skills in social contexts when under peer pressure through assertive communication6.
- Little attention was given to whether people in abstinence-focused treatments endorsed abstinence goals themselves, or whether treatment could help reduce substance use and related problems for those who did not desire (or were not ready for) abstinence.