Using a wave metaphor, urge surfing is an imagery technique to help clients gain control over impulses to use drugs or alcohol. In this technique, the client is first taught to label internal sensations and cognitive preoccupations as an urge, and to foster an attitude of detachment from that urge. The focus is on identifying and accepting the urge, not acting on the urge or attempting to fight it4.

Dynamic model

Relapse prevention is a cognitive-behavioral approach that teaches people to anticipate high-risk situations for returning to unwanted behaviors and to develop coping strategies in advance. A good treatment program should explain the difference between a lapse and relapse. It should also teach a person how to stop the progression from a lapse into relapse. In order to understand AVE, it is important to realize the difference between a lapse and relapse.

• Relapse prevention includes understanding what triggers substance abuse, which varies from person to person.
• Probably the most common misinterpretation of complete honesty is when individuals feel they must be honest about what is wrong with other people.
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• They are sometimes reluctant to even mention thoughts of using because they are so embarrassed by them.
• Regard Healthcare offers 100% confidential substance abuse assessment and treatment placement tailored to your individual needs.
• The initial trigger is a lapse—breaking a rule you set for your own abstinence.

Identifying and coping with high-risk situations

In bargaining, individuals start to think of scenarios in which it would be acceptable to use. A common example is when people give themselves permission to use on holidays or on a trip. It is a common experience that airports and all-inclusive resorts are high-risk environments in early recovery. Another form of bargaining is when people start to think that they can relapse periodically, perhaps in a controlled way, for example, once or twice a year. Bargaining also can take the form of switching one addictive substance for another. Being able to understand how your thoughts, emotions, and behaviors play off of each other can help you to better control and respond to them in a positive way.

🧠 Understanding Baseline Functioning in Therapy

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What Is ERRT Therapy? How Exposure, Relaxation, and Rescripting Heal Nightmares

In a subsequent meta-analysis by Irwin, twenty-six published and unpublished studies representing a sample of 9,504 participants were included. Results indicated that RP was generally effective, particularly for alcohol problems. Specifically, RP was most effective when applied to alcohol or polysubstance use disorders, combined with the adjunctive use of medication, and when evaluated immediately following treatment. Moderation analyses suggested that RP was consistently efficacious across treatment modalities (individual vs. group) and settings (inpatient vs. outpatient)22.

But all that harsh self-criticism does is reinforce feelings of hopelessness, making it that much harder to get back on your feet. Let’s imagine someone from our community in Massachusetts who has been sober for six months. They go to a family cookout in Plymouth, feel a moment of weakness, and have just one beer. “I’ve ruined everything. All that hard work is down the drain. I’m a complete failure.” abstinence violation effect One of the most notable developments in the last decade has been the emergence and increasing application of Mindfulness-Based Relapse Prevention (MBRP) for addictive behaviours. Lapse management includes drawing a contract with the client to limit use, to contact the therapist as soon as possible, and to evaluate the situation for factors that triggered the lapse6.

Specific Intervention strategies in Relapse Prevention

The abstinence violation effect (AVE) refers to the negative cognitive and affective responses that an individual experiences after the return to substance abuse after a period of abstinence. Prolonged use of a substance causes a level or physical tolerance but after a period of abstinence that tolerance declines substantially. The AVE was introduced into the substance abuse literature within the context of the “relapse process” (Marlatt and Gordon 1985, p. 37). Relapse has been Substance abuse variously defined, depending on theoretical orientation, treatment goals, cultural context, and target substance (Miller 1996; White 2007). It is, however, most commonly used to refer to a resumption of substance use behavior after a period of abstinence from substances (Miller 1996).