Marlatt and Gordon’s Relapse Prevention Model

Marlatt and Gordon’s Relapse Prevention Model is an effective therapeutic alternative for people with an addictive disorder who are in the maintenance phase. It is mainly used to treat alcoholism, although it is also used for other substances.

It is based on a series of strategies for developing coping skills, cognitive restructuring and improving a healthy lifestyle.

    Marlatt and Gordon’s Relapse Prevention Model: Features

    Marlatt and Gordon’s relapse prevention model was developed by these two authors in 1985. It is part of cognitive behavioral therapy, called CBT, Intended to treat certain addictive disorders, such as alcohol dependence.

    Thus, CBT consists of two components: relapse prevention and social skills and adaptation training (CSST). However, Marlatt and Gordon’s relapse prevention model can also be applied in isolation.

    This model consists of an offshoot of cognitive-behavioral programs and more, is the treatment of choice for treating alcoholism, which in turn, includes different psychological techniques.

    The main objective of the model is teach, train and empower the patient to experience relapses as part of the detoxification process, And as another form of learning, which helps to acquire new healthy habits. In contrast, as the name suggests, and although relapses are “normal” and part of the process, the role of the model is to prevent them from recurring in the future.

      Drug relapses

      Thus, Marlatt and Gordon’s relapse prevention model focuses on relapses that typically occur during the maintenance phase of an addictive disorder, or, commonly referred to as the detox phase.

      But what exactly is relapse? Marlatt (1993) defined it as “a transient process, a series of events which may or may not be followed by a return to baseline levels of objective behavior observable before treatment”.

      In other words, it can be a point state, it does not always have to be a point of ‘no return’ during the detox process; nor does it necessarily imply going back to the treatment start box.

      cognitive factors

      According to Marlatt and Gordon’s relapse prevention model, in the relapse process inherent in addictions, 3 cognitive factors interact:

      • Self-efficacy: that is, the perceived ability to handle situations.
      • Expectations on the outcomes of consumer behavior.
      • Causal attributions.

      Abstinence Violation Effect (VAS)

      An essential concept, the so-called violation of abstinence (VAS) effect, is raised in Marlatt and Gordon’s relapse prevention model. this effect it occurs when the person decides to use again (In the case of alcoholism), that is, when a relapse occurs. He is formed, in his voice, of two cognitive-affective elements:

      1. An effect of cognitive dissonance.

      There is cognitive dissonance in the subject who is about to drink, or who drinks directly (but does not know if he should continue to do so), because his interests (achieving abstinence and recovery) are at stake. conflict with his desires (drinking). It’s cognitive dissonance.

      2. An effect of personal attribution

      If, once the subject falls, he attributes the occurrence of his drinking behavior (personal attribution) to stable, internal and global factors, then this decreases their resistance to future temptations to start over.

      That is, the loss of control that leads a person with an alcohol addiction to drink again is determined by the effect of the abstinence violation.

        training

        A few years after Marlatt and Gordon’s relapse prevention model in 1995, Marlatt himself developed alongside another author, Dimeff, specific training in relapse prevention, Closely linked to the initial model. This training differentiated two terms very well: “fall” and “relapse”, and based on this difference, it was developed through a sequence of steps:

        • Inform the subject that relapses are possible.
        • Know the difference between fall and fall. relapse.
        • Take on the role in the fall or relapse process.
        • Analyze the factors that caused you to fall or react.
        • Train specific coping skills in high risk situations.
        • Train in decision-making towards non-consumption in high-risk situations.
        • Learn comprehensive coping and lifestyle strategies to stay clean.

        Indications in therapy

        As we have seen, Marlatt and Gordon’s relapse prevention model is used to treat drug addiction disorder, mainly alcoholism (Where effective therapy has been demonstrated and of first choice).

        On the other hand, the model is also indicated to treat heroin addiction, and is probably considered effective for this type of disorder. In addition, in this case, the model adopts a multitude of formats in the literature. It is usually part of a larger cognitive behavioral therapy (as in the case of alcoholism).

        Bibliographical references:

        • Horse. (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Flight. 1 and 2.
        • Castella, P. (2016). The prevention of drug addiction relapses based on Marlatt’s model. Social work contributions. Social Work Today, 77: 109-133.
        • Marlatt, GA (1993). Prevention of relapses in addictive behaviors: a cognitive-behavioral treatment approach. In M. Cases and M. Gossop (Eds.), Relapse and rechute prevention (pp. 137-160). Sitges: editions in neuroscience.
        • Secades, R. and Ramón, J. (2003). Guide to effective psychological treatment for drug addiction: alcohol, cocaine and heroin.

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