The social learning perspective on alcohol abuse has spawned theoretical analyses to explain etiology as well as intervention methods to guide treatment. Despite scattered empirical support for constituent components of this approach, tests of a comprehensive social learning model of abuse have been lacking. The model proposed here postulates that alcohol abuse can be predicted from a causal chain that includes alcohol consumption and "drinking to cope" as proximal determinants and general coping skills and positive alcohol expectancies as more distal determinants. To evaluate this model in a way that permits simultaneous consideration of its multiple determinants and control for demographic influences, path analytic techniques were applied to data from problem and nonproblem drinkers drawn from a general population sample. The hypothesized model accounted for significant variance in abuse status. Drinking to cope emerged as the most powerful predictor, exerting influence via direct and indirect pathways. Coping styles indicative of avoidance of emotion emerged as more important predictors of abuse than problem-focused coping. The predictive value of coping was moderated by alcohol expectancies such that avoidant styles of coping with emotion were predictive of abuse status only among drinkers expressing greater belief in alcohol's positive reinforcing properties. These findings both support and refine the social learning perspective on alcohol abuse. Theoretical and treatment implications are considered.
Summary As an introductory overview of the Relapse Prevention (RP) model, this article briefly describes the conceptual and clinical features of the RP approach to altering excessive or addictive behaviour patterns. In contrast with traditional approaches that overemphasize initial habit change, RP focuses more on the maintenance phase of the habit change process. From this perspective, relapse is not viewed merely as an indicator of treatment failure. Instead, potential and actual episodes are key targets for both proactive and reactive intervention strategies. RP treatment procedures include specific intervention techniques designed to teach the individual to effectively anticipate and cope with potential relapse situations. Also included are more global lifestyle interventions aimed at improving overall coping skills and promoting health and well being. Important questions raised by this relatively recent alternative to traditional approaches are discussed.
The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change.
As an introductory overview of the Relapse Prevention (RP) model, this article briefly describes the conceptual and clinical features of the RP approach to altering excessive or addictive behaviour patterns. In contrast xuith traditional approaches that overemphasize initial habit change, RP focuses more on the maintenance phase of the habit change process. From this perspective, relapse is not viewed merely as an indicator of treatment failure. Instead, potential and actual episodes are key targets for both proactive and reactive intervention strategies. RP treatment procedures include specific intervention techniques designed to teach the individual to effectively anticipate and cope with potential relapse situations. Also included are more global lifestyle interventions aimed at improving overall coping skilk and promoting health and well being. Important questions raised by this relatively recent alternative to traditional approaches are discussed.
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