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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
In cognitive–behavioral relapse prevention (CBRP), therapists utilize basic principles of cognitive–behavioral therapy in the assessment and treatment of addictive behavior problems. CBRP has been applied in the treatment of smoking, alcohol and substance abuse or dependence, compulsive gambling, deviate sexual behavior, and other behavioral problems with high relapse rates. The foundations of CBRP are drawn from social learning and self-management theory, cognitive psychology, and behavioral models of addiction. Addictive behavior is viewed as a biopsychosocial problem with multiple determinants, a view that can be considered as an alternative to the biological "disease" model of addiction. The focus of CBRP is on the process of relapse and recovery, including changes in cognition (expectancy of drug effects, self-efficacy for coping, attributions for success or setbacks), behavior (coping with high-risk situations, developing functional alternatives such as relaxation and exercise), and lifestyle (balanced lifestyle, social relationships and support, and spiritual life). CBRP is often applied in the maintenance or recovery stage of addiction treatment and has two primary goals:
CBRP interventions can be administered in various treatment formats. Often, CBRP is administered in the form of individual outpatient therapy—as a "stand-alone" treatment or as a program of aftercare following initial treatment (e.g., residential care or pharmacotherapy). The interventions can also be delivered in the form of structured group therapy. In working with dual-disorder clients (e.g., depression and alcohol dependence), CBRP offers a comprehensive and integrative treatment approach for clients who present with mixed problems of mental health and addiction. Therapists using CBRP adopt an empathic, client-centered approach characterized by acceptance and by meeting the clients "where they are" instead of imposing therapist goals or preconditions for treatment (e.g., insistence on abstinence as a condition for treatment). Therapists help clients to define their own goals with regard to addictive behaviors and then to achieve those goals through a combination of increased awareness, enhanced coping skills, and increased acceptance of personal responsibility and choice. CBRP is empirically based and has been found to be an effective intervention in the treatment of various addictive behavior problems in treatment outcome studies. Dr. Marlatt identifies his approach as "cognitive–behavioral relapse prevention." What does this imply to you? To be more specific, what do you expect of him? Will Dr. Marlatt be active or passive? Will the session be structured or unstructured? Directive or nondirective? Will it focus on the past or on the present? Will the session focus on behaviors, on thoughts, or on feelings? What do you expect to be the relative balance between attention to technique and the interpersonal interaction? Return to Cognitive–Behavioral Relapse Prevention for Addictions |
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