🔍 RP L1 T3: Factors Contributing to Relapse

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Before we go in-depth, let us try to recall a few facts on “determinants” of relapse discussed in Lesson 1, Topic 1

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In this topic, we will understand the factors contributing to Relapse. The predominant focus is one Cognitive Behavioural model for relapse.

Factors contributing to relapse encompass a complex interplay of personal, environmental, and psychological elements that can pose challenges to individuals striving for sustained behavioral change. Recognizing and understanding these factors is pivotal in developing effective strategies for relapse prevention

.As per Psychological Theories, two types of expectancies can play a crucial role in relapse

Outcome Expectancies	An individual’s beliefs about the effects of a drug if it is used in a given situation
Self-efficacy Expectancies	An individual’s estimation that he or she can successfully enact a behavior in a given situation

Relapse process

Marlatt and his colleagues have provided the most discussed and clinically applied model of the relapse process. It was originally
summarized by Marlatt and Gordon (1985) and subsequently updated and revised in important ways by Witkiewitz and Marlatt (2004).

A central aspect of the Marlatt model (1985) is the detailed classification (i.e., taxonomy) of factors which can fall into two categories: immediate determinants (e.g., high-risk situations ⬇️, a person’s coping skills, outcome expectancies, and the abstinence violation effect) and covert antecedents (e.g., lifestyle imbalances and urges and cravings).

• Initiation of Abstinence: Marlatt hypothesized that starting abstinence boosts a sense of personal control and self-efficacy.
• Strengthening Self-Perceptions: These self-perceptions grow stronger as the period of abstinence extends.
• Encounter with High-Risk Situations: Over time, the individual is likely to face situations that increase the risk of relapsing into substance use.
• Central Feature of the Marlatt Model: High-risk situations are a key component of the Marlatt model of relapse.
• Antecedents of High-Risk Situations: These can vary but often involve cognitive and lifestyle factors that lead to high-risk circumstances.
• Coping and Behavioral Repertoire: If the person has effective coping strategies in their behavioral repertoire and uses them, it leads to a successful outcome.
• Enhancing Self-Efficacy: Successful coping reinforces self-efficacy (as per Bandura, 1977), which in turn reduces the likelihood of relapse in similar future situations.

Revised Conceptualization of Relapse process

In the previous topic, you came across two categories of situations where the relapse process can be initiated, i.e. Immediate determinants and Covert antecedents.

On the basis of new research relevant to the components of the original relapse prevention model, Witkiewitz and Marlatt (2004) provided a revised conceptualization of the relapse process. The new model i.e. Central Determinants of Relapse and Distal Risk factor for Relapse is below (Witkiewitz & Marlatt, 2007)

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