RELAPSE PREVENTION MODELS
There are a number of relapse prevention models. These models are adopted for the individualized patient depending on their needs and situation. The non relapse prevention models are: Marlatt and Gordon’s Relapse Prevention Therapy model, Gorski’s Center for Applied Sciences (CENAPS) model, Wallace’s relapse prevention materials for crack cocaine users, Annis’s relapse prevention approach for alcoholism, Rofman and colleagues’ relapse prevention for marijuana dependence, Carroll and colleagues’ relapse prevention for cocaine abuse, McAuliffe and colleagues’ Recovery Training and Self-Help (RTSH) model, Washton’s intensive outpatient model, and Rawsom and colleagues’ matrix neurobehavioral model.
The Relapse Prevention Therapy (RPT) is a cognitive-behavioral approach to the treatment of addictive behaviors that specifically addresses the nature of the relapse process and suggest coping strategies useful in maintaining change. The basis of this model is that addictive behaviors have been acquired over time and have become over-learned habits with biological, psychological, and social determinants and consequences. With changing these behaviors, the connection between pleasure seeking and/or pain reduction and substance abuse will discontinue and be replaced with healthy coping behaviors. This model begins with the assessment of a client’s potential interpersonal, intrapersonal, environmental, and physiological risks for relapse and the individual’s specific set of factors and situations that may directly lead to relapse. Once these are identified, the cognitive and behavioral techniques are enabled, such as the specific interventions to prevent lapses or manage them and to address lifestyle balance, craving, and cognitive distortions that might set one up for high-risk situations where relapse most likely will occur. The other aim with RPT is to boost self-efficacy to where the patient feels capable in all that they do.
Gorski’s developmental model of recovery (DMR) provides a cognitive-behavioral view. The focus of his work has focused on alcohol and cocaine addiction. The model addresses client responsibility in terms of awareness of relapse triggers, the process of relapse, and comping behaviors other than the use of alcohol/drugs. This model uses elements of the 12-step recovery program, which is why is it used in private chemical dependency treatment centers. Gorski’s model includes six stages: transition, stabilization, early recovery, middle recovery, late recovery, and maintenance. His nine principles of relapse prevention work is: self-regulation, integration, understanding, self-knowledge, coping skills, change, awareness, maintenance and relapse prevention plan updating.
The CENAPS Model of Relapse Prevention Therapy (CMPRT) is a widely used method for preventing drug addicts and alcoholics from going back to drug using and alcoholic type behavior after they finish a drug or alcohol residential program. The main objetives of the CMRPT are to analyze global lifestyle patterns that contribute to relapsing by doing a self assessment addiction, life and relapse history; complete a list a warning signs that may lead someone to relapse; create a structured recovery plan and develop a relapse early intervention plan that will provide the client and significant others with step-by-step instructions to interrupt alcohol and other drug use should it recur. The five primary components consist of assessment, warning sign identification, warning sign management, recovery planning, and relapse early intervention training. CMRPT integrates the fundamental principles of Alcoholics Anonymous (AA) with professional counseling and therapy to meet the needs of relapse-prone clients. The CMRPT can be described as the third stage of chemical addiction treatment. The first phase is the introduction of the twelve steps, the second phase is the integration of AA with professional treatment into a model known as the Minnesota Model. CMRPT, the third phase integrates knowledge of chemical addiction into a biopsychosocial model and 12-step principles with advanced cognitive, affective, behavioral, and social therapy principles to produce a model for both primary recovery and relapse prevention (RP).