Behavior Therapy (Theories of Psychotherapy) by Antony Martin M. & Roemer Lizabeth

Author:Antony, Martin M. & Roemer, Lizabeth [Antony, Martin M.]
Language: eng
Format: mobi
ISBN: 9781433809859
Publisher: American Psychological Association
Published: 2011-11-01T04:00:00+00:00

Relapse prevention is a behavioral approach that was initially developed as an adjunctive treatment to address the frequency of relapse among individuals who had been successfully treated for substance and alcohol use disorders (Marlatt & Gordon, 1985). Previously, treatments typically did not explicitly address ways to maintain behavior change when the client is no longer regularly attending treatment. Relapse prevention is now a common element of many treatments that address problems with self-control. The model and techniques for relapse prevention have also been incorporated into behavioral and cognitive–behavioral treatments for anxiety and mood disorders. For all behavioral treatments, it can be extremely helpful to explicitly address ways to maintain and regain improvements after treatment is terminated. These strategies should be considered adjunctive, however, and are not a full-scale treatment in and of themselves.

Marlatt and Donovan (2005) provided an extensive description of relapse prevention strategies and evidence for their efficacy, and Newring, Loverich, Harris, and Wheeler (2009) provided a briefer overview. A central element of relapse prevention is a distinction drawn between a lapse, which is a recurrence in a problematic behavior, and a relapse, which is a return to baseline levels of the target behavior. Teaching clients this distinction can help to address the abstinence violation effect, in which a single incidence of a problem behavior (like a dieter’s eating a piece of a chocolate cake) can seem like a such a severe threat to the behavior change that the person might as well give up efforts completely (and eat the entire cake). Although this model was developed for problems in behavioral control, it applies to clinical phenomena such as anxiety and depression as well. Clients may experience a single panic attack or a day of depressive feelings as evidence of failure and give up the strategies that have helped them to make important changes in their lives. Predicting this in advance and developing strategies to address lapses can help clients return to their effective strategies or develop new ones without giving up because an old behavior has reemerged temporarily.

Relapse prevention also involves predicting high-risk situations in which a lapse is likely to occur. Prevention includes identification of both internal and external cues that may trigger the problematic behavior to help the client predict when lapses may be likely and to prepare for or avoid them. This model also allows clients to use any lapses as new information to be analyzed to determine high-risk situations for the future. Therapists and clients work together to develop alternative behaviors at multiple points during the chain of behavior to avoid lapses and to recover from them. Relapse prevention also involves learning and practicing coping skills and strategies for achieving a balanced lifestyle.

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