Global self-management strategy involves encouraging clients to pursue again those previously satisfying, nondrinking recreational activities. In addition, relaxation training, time management, and having a daily schedule can be used to help clients achieve greater lifestyle balance. Jim is a recovering alcoholic who successfully abstained from drinking for several months. One day, when he was faced with a stressful situation, he felt overwhelmed, gave in to the urge, and had a drink. The abstinence violation effect might induce Jim to think, “I have failed.

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• Global strategies comprise balancing the client’s lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urge-management techniques, and developing relapse road maps.
• A person who can execute effective coping strategies (e.g. a behavioural strategy, such as leaving the situation, or a cognitive strategy, such as positive self-talk) is less likely to relapse compared with a person lacking those skills.
• Critical for craving and relapse is the process of associative learning, whereby environmental stimuli repeatedly paired with drug consumption acquire incentive-motivational value, evoking expectation of drug availability and memories of past drug euphoria15.

Individuals are encouraged to be completely honest within their recovery circle. As clients feel more comfortable, they may choose to expand the size of their circle. In late stage recovery, individuals are subject to special risks of relapse that are not often seen in the early stages.

Relapse Triggers

In RP client and therapist are equal partners and the client is encouraged to actively contribute solutions for the problem. Client is taught that overcoming the problem behaviour is not about will power rather it has to do with skills acquisition. Another technique is that the road to abstinence is broken down to smaller achievable targets the abstinence violation effect refers to so that client can easily master the task enhancing self-efficacy. Also, therapists can provide positive feedback of achievements that the client has been able to make in other facets of life6. Interpersonal relationships and support systems are highly influenced by intrapersonal processes such as emotion, coping, and expectancies18.

The Stages of Recovery

Dealing with post-acute withdrawal is one of the tasks of the abstinence stage [1]. Post-acute withdrawal begins shortly after the acute phase of withdrawal and is a common cause of relapse [17]. Unlike acute withdrawal, which has mostly physical symptoms, post-acute withdrawal syndrome (PAWS) has mostly psychological and emotional symptoms. Its symptoms also tend to be similar for most addictions, unlike acute withdrawal, which tends to have specific symptoms for each addiction [1].

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Moreover, people who have coped successfully with high-risk situations are assumed to experience a heightened sense of self-efficacy4. Marlatt, based on clinical data, describes categories of relapse determinants which help in developing a detailed taxonomy of high-risk situations. These components include both interpersonal influences by other individuals or social networks, and intrapersonal factors in which the person’s response is physical or psychological. This article presents one influential model of the antecedents of relapse and the treatment measures that can be taken to prevent or limit relapse after treatment completion. This relapse prevention (RP) model, which was developed by Marlatt and Gordon (1985) and which has been widely used in recent years, has been the focus of considerable research.

Thus, this perspective considers only a dichotomous treatment outcome—that is, a person is either abstinent or relapsed. In contrast, several models of relapse that are based on social-cognitive or behavioral theories emphasize relapse as a transitional process, a series of events that unfold over time (Annis 1986; Litman et al. 1979; Marlatt and Gordon 1985). According to these models, the relapse process begins prior to the first posttreatment alcohol use and continues after the initial use. This conceptualization provides a broader conceptual framework for intervening in the relapse process to prevent or reduce relapse episodes and thereby improve treatment outcome. When people don’t understand relapse prevention, they think it involves saying no just before they are about to use.

• This shows our immediate need to develop a diversion plan to deal with cravings.
• It is remarkable how many people have relapsed this way 5, 10, or 15 years after recovery.
• We argue that these modifications have generally failed to characterize sexual offense relapse cycles accurately or comprehensively.
• Clinical experience has shown that when clients struggle with post-acute withdrawal, they tend to catastrophize their chances of recovery.
• This can be worked on by creating a decisional matrix where the pros and cons of continuing the behaviour versus abstaining are written down within both shorter and longer time frames and the therapist helps the client to identify unrealistic outcome expectancies5.
• The verdict is strongest for interventions focused on identifying and resolving tempting situations, as most studies were concerned with these24.

More on Substance Abuse and Addiction

Shaded boxes indicate steps in the relapse process and intervention measures that are specific to each client and his or her ability to cope with alcohol-related situations. White boxes indicate steps in the relapse process and intervention strategies that are related to the client’s general lifestyle and coping skills. High-risk situations are related to both the client’s general and specific coping abilities. Relapse prevention (RP) is an important component of alcoholism treatment.

But clients and families often begin recovery by hoping that they don’t have to change. They often enter treatment saying, “We want our old life back — without the using.” I try to help clients understand that wishing for their old life back is like wishing for relapse. Rather than seeing the need for change as a negative, they are encouraged to see recovery as an opportunity for change.