A REVIEW OF RELAPSE PREVENTION MODELS: AN ACTIVE INTERACTIVE PROGRAM PROPOSED

Background and Aim : lapse, which precede relapse, stands as a significant challenge in the treatment of substance abuse disorders. By reviewing the strategies for the prevention of relapse, this study attempted to propose a program to prevent lapse, and ultimately relapse, in individuals with substance dependence.Methods : This review study incorporated articles in international databases, including Pubmed, Scopus, ScienceDirect, and ISI, as well as domestic databases of ISC and SID. The search was performed for the time period between June 2009 and March 2019 using the keywords relapse prevention, substance-related disorders, and lapse along with their Persian equivalents and their combinations. A total of 17 papers were reviewed.Results : In the present study, the efficacy of two relapse prevention approaches (Marlatt’s cognitive-behavioral model of relapse prevention and Witkiewitz and Marlatt’s newly developed mindfulness-based relapse prevention model) were assessed on the grounds of drug use outcomes, including craving, lapse, and relapse, in individuals with substance abuse and alcohol consumption. Evidence suggests that the cognitive-behavioral approach is more effective, both as a single treatment and as part of a combination therapy, due to a reduction in the frequency of relapse and lapse periods, increased refusal and restraint of the individual, and the long-term effects of this approach as compared with other active methods in subsequent follow-ups.Conclusion : The active lapse management program proposed by the researchers consists of three components: 1. Psychological training on lapse, craving , abstinence self-efficacy, and skills development (based on Marlatt’s model); 2. Lapse calendaring self-assessment technique, which is performed by the client on a wall calendar on a daily basis and is guided and supported by a counselor or psychologist to prevent slipping and recurrence; and 3. Follow-up and individual telephone counseling. The program emphasizes the active role of the client in refusal through self-assessment and constructive interaction with his/her counselor.

Keywords:

relapse prevention , substance-related disorders , lapse , abstinence self-efficacy , craving