Relapse Prevention for Sexual Offenders: Considerations for the Abstinence Violation Effect Office of Justice Programs

Because the volume and scope of this work precludes an exhaustive review, the following section summarizes a select body of findings reflective of the literature and relevant to RP theory. The studies reviewed focus primarily on alcohol and tobacco cessation, however, it should be noted that RP principles have been applied to an increasing range of addictive behaviors [10,11]. The dynamic model of relapse assumes that relapse can take the form of sudden and unexpected returns to the target behavior.

The study of implicit cognition and neurocognition in models of relapse would likely require integration of distal neurocognitive factors (e.g., baseline performance in cognitive tasks) in the context of treatment outcomes studies or EMA paradigms. Additionally, lab-based studies will be needed to capture dynamic processes involving cognitive/neurocognitive influences on lapse-related phenomena. In a meta-analysis by Carroll, more than 24 RCT’s have been evaluated for the effectiveness of RP on substance use outcomes.

Relapse Prevention for Sexual Offenders: Considerations for the Abstinence Violation Effect

We also take the perspective that relapse is best conceptualized as a dynamic, ongoing process rather than a discrete or terminal event (e.g., [1,8,10]). Along with the client, the therapist needs to explore past circumstances and triggers of relapse. Also, the client is asked to keep a current record where s/he can self-monitor thoughts, emotions or behaviours prior to a binge. One is to help clients identify warning signs such as on-going stress, seemingly irrelevant decisions and significant positive outcome expectancies with the substance so that they can avoid the high-risk situation. The second is assessing coping skills of the client and imparting general skills such as relaxation, meditation or positive self-talk or dealing with the situation using drink refusal skills in social contexts when under peer pressure through assertive communication6. Outcome expectancies can be defined as an individual’s anticipation or belief of the effects of a behaviour on future experience3.

Although there is some debate about the best definitions of lapse and relapse from theoretical and conceptual levels, these definitions should suffice. Relapse poses a fundamental barrier to the treatment of addictive behaviors by representing the modal outcome of behavior change efforts [1-3]. For instance, twelve-month relapse rates following https://ecosoberhouse.com/ alcohol or tobacco cessation attempts generally range from 80-95% [1,4] and evidence suggests comparable relapse trajectories across various classes of substance use [1,5,6]. Preventing relapse or minimizing its extent is therefore a prerequisite for any attempt to facilitate successful, long-term changes in addictive behaviors.

Continued empirical evaluation of the RP model

However, many of the treatments ranked in the top 10 (including brief interventions, social skills training, community reinforcement, behavior contracting, behavioral marital therapy, and self-monitoring) incorporate RP components. One of the key distinctions between CBT and RP in the field is that the term «CBT» is more often used to describe stand-alone primary treatments that are based on the cognitive-behavioral model, whereas RP abstinence violation effect is more often used to describe aftercare treatment. Given that CBT is often used as a stand-alone treatment it may include additional components that are not always provided in RP. For example, the CBT intervention developed in Project MATCH [18] (described below) equated to RP with respect to the core sessions, but it also included elective sessions that are not typically a focus in RP (e.g., job-seeking skills, family involvement).