Marlatt and Gordon’s Relapse Prevention Model consists of 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 useful for other substances.
It is based on a series of strategies to work on coping skills, cognitive restructuring and promoting a healthy lifestyle.
Marlatt and Gordon’s relapse prevention model: characteristics
The Marlatt and Gordon Relapse Prevention Model was developed by these two authors in 1985. It is part of a cognitive-behavioral therapy, called CBT , aimed at treating some addictive disorders, such as alcohol addiction.
Thus, CBT consists of two components: relapse prevention and coping / social skills training (CSST). However, Marlatt and Gordon’s Relapse Prevention Model can also be applied in isolation.
This model consists of a branch of cognitive-behavioral programs and is the first choice treatment for alcoholism, which in turn includes different psychological techniques.
The main objective of the model is to teach, train and empower the patient to live through the relapses as part of the process of uninhabiting , and as a further form of learning, which makes it possible to acquire new healthy habits. On the other hand, as its name indicates, and although relapses are “normal” and part of the process, the model has the mission of preventing them from reappearing in the future.
Thus, Marlatt and Gordon’s Relapse Prevention Model focuses on relapses that often occur during the maintenance phase of an addictive disorder, or, commonly called, the detoxification phase.
But what exactly is the relapse? Marlatt (1993) defined it as “a transitory process, a series of events that may or may not be followed by a return to baseline levels of observable objective behavior prior to treatment.
In other words, it can be a point state, does not always have to be a point of “no return” during the detoxification process ; nor does it necessarily have to involve returning to the treatment start box.
According to Marlatt and Gordon’s Relapse Prevention Model, 3 cognitive factors interact in the relapse process of addictions :
- Self-efficacy: that is, the perceived ability to cope with situations.
- Expectations of the results of the consumption behavior.
- Causality attributions.
Effect of Abstinence Violation (EVA)
In Marlatt and Gordon’s Relapse Prevention Model, an essential concept is raised, the so-called Abstinence Violation Effect (AVE). This effect arises when the person decides to use again (in the case of alcoholism), that is, when a relapse occurs. It is formed, in his voice, by two cognitive-affective elements:
1. A cognitive dissonance effect
Cognitive dissonance occurs in the subject who is about to drink, or who directly drinks (but does not know whether to continue to do so), as his interests (achieving abstinence and recovery) conflict with his desires (drinking). This is a cognitive dissonance.
2. A personal attribution effect
If, once the subject relapses, he attributes the occurrence of his drinking behavior (personal attribution) to stable, internal, global factors, then his resistance to future temptations to drink again decreases .
That is, the loss of control that leads a person with an alcohol addiction to drink again is determined by the withdrawal violation effect.
A few years later, in 1995, Marlatt and Gordon’s Relapse Prevention Model , Marlatt himself, together with another author, Dimeff, developed specific training in relapse prevention , which is closely related to the initial model. This training differentiated very well between two terms: “fall” and “relapse”, and based on this difference, it was developed through a sequence of steps:
- Inform the subject that relapses are possible.
- Differentiating fall vs. relapse.
- Assume the role in the process of falling or relapsing.
- Analyze the factors that have led you to fall or react.
- Train specific coping skills for high-risk situations.
- Train you in decision making towards non-consumption in high risk situations.
- Train you in comprehensive coping and lifestyle strategies to maintain abstinence.
Indications in therapy
As we have seen, Marlatt and Gordon’s Relapse Prevention Model is used to treat substance (drug) addiction disorders, mainly alcoholism (where effective, first-choice therapy has been demonstrated).
On the other hand, the model is also indicated for treating heroin addiction, and is probably considered effective for this type of disorder. Furthermore, in this case, the model adopts a multitude of formats in the literature. It is usually part of a broader cognitive-behavioral therapy (as in the case of alcoholism).
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- Castilla, P. (2016). The prevention of relapses in drug addiction from the Marlatt model. Contributions from social work. Social work today, 77: 109-133.
- Marlatt, G. A. (1993). Relapse prevention in addictive behaviors: A cognitive-behavioral treatment approach. In M. Casas and M. Gossop (Eds.), Relapse and relapse prevention (pp.137-160). Sitges: Eds. in Neurosciences.
- Secades, R. and Ramón, J. (2003). Guide to effective psychological treatments for drug addiction: alcohol, cocaine and heroin.