They may not recognize that stopping use of a substance is only the first step in recovery—what must come after that is building or rebuilding a life, one that is not focused around use. They may falsely believe that their recovery is complete, or that cravings are a sign of failure, when in fact it takes time to rebuild a life and time for the brain to rewire itself and learn to respond to everyday pleasures. In general, the longer a person has not used a substance, the lower their desire to use. Along with the client, the therapist needs to explore past circumstances and triggers of relapse. Also, the client is asked to keep a current record where s/he can self-monitor thoughts, emotions or behaviours prior to a binge. One is to help clients identify warning signs such as on-going stress, seemingly irrelevant decisions and significant positive outcome expectancies with the substance so that they can avoid the high-risk situation.
The first thing we must do after a relapse is check our thinking for signs of irrationality. Sometimes we must be hard on ourselves, but we must never view ourselves through a lens of hatred and self-loathing. Marlatt notes that one of the most important aspects of handling abstinence violation effect is the need to develop our coping mechanisms. Several behavioural strategies are reported to be effective in the management of factors leading to addiction or substance use, such as anxiety, craving, skill deficits2,7. Explore the benefits of an individualized treatment plan for addiction counseling and why it’s a game-changer on the path to recovery. Attending or resuming attending meetings of some form of mutual support group can be extremely valuable immediately after a lapse or relapse.
Understand The Relapse Process
It encourages people to see themselves as failures, attributing the cause of the lapse to enduring and uncontrollable internal factors, and feeling guilt and shame. Shiffman and colleagues describe stress coping where substance use is viewed as a coping response to life stress that can function to reduce negative affect or increase positive affect. They assume a distinction between stress coping skills, which are responses intended to deal with general https://ecosoberhouse.com/ life stress, and temptation coping skills, which are coping responses specific to situations in which there are temptations for substance which could contribute to relapse13. These covert antecedents include lifestyle factors, such as overall stress level, one’s temperament and personality, as well as cognitive factors. These may serve to set up a relapse, for example, using rationalization, denial, or a desire for immediate gratification.
Patients may also require communication skills to deal with interpersonal conflicts. Cue exposure is another behavioural technique based on the classical conditioning theory and theories of cue reactivity and extinction12,13. The technique involves exposure to a hierarchy of cues, which signal craving and subsequently substance use. These are presented repeatedly without the previously learned pattern of drinking so as to lead to extinction. Despite work on cue reactivity, there is limited empirical support for the efficacy of cue exposure in recent literature14. The first step in planning a cognitive behavioural treatment program is to carry out a functional analysis to identify maintaining antecedents and set treatments targets, select interventions.
Critiques of the RP Model
This can include abstinence from substance abuse, overeating, gambling, smoking, or other behaviors a person has been working to avoid. Cognitive restructuring can be used to tackle cognitive errors such as the abstinence violation effect. Clients are taught to reframe their perception of lapses, to view them not as failures but as key learning opportunities resulting from an interaction between various relapse determinants, both of which can be modified in the future. Interpersonal relationships and support systems are highly influenced by intrapersonal processes such as emotion, coping, and expectancies18. Approach coping may involve attempts to accept, confront, or reframe as a means of coping, whereas avoidance coping may include distraction from cues or engaging in other activities. Approach oriented participants may see themselves as more responsible for their actions, including lapse, while avoidance-based coping may focus more on their environment than on their own actions14.
