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Cognitive behavioural interventions in addictive disorders PMC

Pijar NTT
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Counteracting the drinker’s misperceptions about alcohol’s effects is an important part of relapse prevention. To accomplish this goal, the therapist first elicits the client’s positive expectations about alcohol’s effects using either standardized questionnaires or clinical interviews. Positive expectancies regarding alcohol’s effects often are based on myths or placebo effects of alcohol (i.e., effects that occur because the drinker expects them to, not because alcohol causes the appropriate physiological changes).

abstinence violation effect

Efforts to evaluate the validity [119] and predictive validity [120] of the taxonomy failed to generate supportive data. 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 [121]. Results of a preliminary nonrandomized trial supported the potential utility of MBRP for reducing substance use. In this study incarcerated individuals were offered the chance to participate in an intensive 10-day course in Vipassana meditation (VM). Those participating in VM were compared to a treatment as usual (TAU) group on measures of post-incarceration substance use and psychosocial functioning.

Relapse Prevention in other areas

Exercise, listening to music, getting sufficient rest—all can have a role in taking the focus off cravings. Regarding setbacks as a normal part of progress enables individuals to broaden their array of coping skills, to engage in planning for problematic situations, and to devise strategies in advance for dealing with predictable difficulties. Among the most important coping skills needed are strategies of distraction that can be quickly engaged when cravings occur.

  • The RP model highlights the significance of covert antecedents such as lifestyle patterns craving in relapse.
  • The term relapse may be used to describe a prolonged return to substance use, whereas lapse may be used to describe discrete, circumscribed “slips” during sustained abstinence (Marlatt & Gordon, 1985, p. 32).

The therapist therefore planned to improve his motivation for seeking help and changing his perspective about his confidence (motivational interviewing). Each of the five stages that a person passes through are characterized as having specific behaviours and beliefs. The AVE describes the negative emotional response that often accompanies a failure to maintain abstinence from drugs or alcohol. In the multifaceted journey of overcoming addiction and living a healthier life, individuals often encounter a psychological phenomenon known as the (AVE). It sheds light on the challenges individuals face when attempting to maintain abstinence and how a single lapse can trigger a surge of negative emotions, potentially leading to a full relapse or a return to unhealthy living (Collins & Witkiewitz, 2013; Larimer, Palmer, & Marlatt, 1999).

3. Summary of the state of the literature

Here we provide a brief review of existing models of nonabstinence psychosocial treatment, with the goal of summarizing the state of the literature and identifying notable gaps and directions for future research. Previous reviews have described nonabstinence pharmacological approaches (e.g., Connery, 2015; Palpacuer et al., 2018), which are outside the scope of the current review. We first describe treatment models with an explicit harm reduction or nonabstinence focus. While there are multiple such intervention approaches for treating AUD with strong empirical support, we highlight a dearth of research testing models of harm reduction treatment for DUD. Next, we review other established SUD treatment models that are compatible with non-abstinence goals.

abstinence violation effect

As the client gains new skills and feels successful in implementing them, he or she can view the process of change as similar to other situations that require the acquisition of a new skill. The desire for immediate gratification can take many forms, and some people may experience it as a craving or urge to use alcohol. Although many researchers and clinicians consider urges and cravings primarily abstinence violation effect physiological states, the RP model proposes that both urges and cravings are precipitated by psychological or environmental stimuli. Ongoing cravings, in turn, may erode the client’s commitment to maintaining abstinence as his or her desire for immediate gratification increases. This process may lead to a relapse setup or increase the client’s vulnerability to unanticipated high-risk situations.

2. Relationship between goal choice and treatment outcomes

Central to the RP model is the role of cognitive factors in determining relapse liability. For example, successful navigation of high-risk situations may increase self-efficacy (one’s perceived capacity to cope with an impending situation or task; [26]), in turn decreasing relapse probability. Conversely, a return to the target behavior can undermine self-efficacy, increasing the risk of future lapses.

The statements were further classified by completing a cluster analysis with the coordinates of the statements. Statements that were closer to each other in the plot were sorted together more often (and vice versa). Additionally, IBM SPSS Statistics 26 was used to perform descriptive analysis on participants demographics.

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