Relapse prevention aproach to Addiction treatment, an overview of MARLATT'S cognitive behavioral model

1. Relapse Prevention
HATEM ABD AL-RAHMAN
An Overview of

2. Cognitive behavioural therapy
CBT is a TALKING THERAPY that can help to
MANAGE problems by changing the way of
THINKING and BEHAVING
National Health Service
(NHS)
UK

3. Cognitive behavioural therapy
CBT is based on the theory that most
EMOTIONAL and BEHAVIORAL reactions are
LEARNED and that new ways of reacting and
behaving can be LEARNED
Center for Substance Abuse Treatment (CSAT)
Substance Abuse: Clinical Issues in Intensive Outpatient Treatment
Treatment Improvement Protocol (TIP) Series 47

4. Relapse Prevention
RP is a COGNITIVE BEHAVIORAL APPROACH with
the goal of IDENTIFYING and ADDRESSING HIGH-
RISK SITUATIONS for relapse, and ASSISTING
individuals in MAINTAINING desired behavioral
CHANGES
Dennis C. Daley ■ G. Alan Marlatt ■ Antoine Douaihy
Lowinson and Ruiz’s Substance Abuse
A comprehensive textbook.—5th ed.

5. Lapse & Relapse
initial episode of alcohol or other drug
use following a period of abstinence
failure to maintain behavior change over
time: “a breakdown or setback in the person’s
attempt to change or modify a target behavior”
Dennis C. Daley ■ G. Alan Marlatt ■ Antoine Douaihy
Lowinson and Ruiz’s Substance Abuse
A comprehensive textbook.—5th ed.
LAPSE:
RELAPSE:

6. Lapse & Relapse
the return to heavy alcohol or drug use
following a period of abstinence or
moderate use, occurs in many addicts
who have undergone addiction
treatment
Mary E. Larimer, Ph.D., Rebekka S. Palmer, and G. Alan Marlatt, Ph.D.
Relapse Prevention: Marlatt’s Cognitive-Behavioral Model
Alcohol Research & Health
RELAPSE:

7. Factors Contributing to Relapse
 High-risk situations
 Coping skills
 Outcome expectancies
 The abstinence
violation effect
Immediate Determinants Covert Antecedents
 Life style factors
 Urges
 Cravings

8. High-risk
situation
Effective coping
response
Increased
self-efficacy
Decreased
probability of
relapse
Ineffective
coping
response
Decreased
self-efficacy
and positive
outcome
expectancies
for effects of
alcohol
Lapse
(initial
use of
alcohol)
Abstinence
violation
effect and
perceived
positive
effects of
alcohol
Increased
probability
of relapse
Marlatt’s Cognitive–behavioral model of relapse:

9. RP Intervention Strategies
Specific
Intervention
Strategies
Global Self-
Management
Strategies

10. RP Intervention Strategies
Specific
Intervention
Strategies
 Identifying and Coping With High-
Risk Situations.
 Enhancing Self-Efficacy.
 Eliminating Myths and Placebo
Effects.
 Lapse Management.
 Cognitive Restructuring.

11. RP Intervention Strategies
Global Self-
Management
Strategies
 Balanced Lifestyle and Positive
Addiction.
 Stimulus-Control Techniques.
 Urge Management Techniques.
 Relapse Road Maps.

12. Helping Patients
 To Understand Relapse as a Process and as an Event
 To Identify and Manage Alcohol or Drug Cues & Triggers
 To Understand and Deal with Social Pressures to Use any
Substance
Time (days , weeks, months )
Initial lapse
Stop relapse
Full-blown relapse

13. Helping Patients
 To Develop and Strengthen a Supportive Recovery Social
Network
 To Identify and Develop Effective Coping Strategies
 To Manage Negative Emotional States
 To Identify and Learn Strategies to Cope with Cognitive
Distortions
 To Work Towards a Balanced Lifestyle

14. Special Considerations
 Using Pharmacologic Intervention as an Adjunct to
Psychosocial Treatment
 Assess Patients for Co-occurring Psychiatric Disorders and
Facilitate Specialized Treatment if Needed
 Facilitate the Transition to Follow-up Outpatient Treatment
For Patients Completing Residential or Hospital-Based
Treatment

15. THANK YOU FOR YOUR TIME
HATEM ABD AL-RAHMAN