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Cognitive Behavioral Model Of The Relapse Process (1999)

Marlatt’s (1985) cognitive behavioral model of relapse conceptualizes relapse as a “transitional process, a series of events that unfold over time” (Larimer et al., 1999). This is in contrast to alternative models which view relapse as an end-point or ‘treatment failure’. Flexibility is a key advantage of such transitional models: they provide guidance and opportunities for intervening at multiple stages in the relapse process in order to prevent or reduce relapse episodes.

Marlatt’s full model provides a detailed taxonomy of the of factors which can lead to relapse episodes. Larimer et al (1999) describe how these factors fall into two core categories:

  1. Immediate determinants – such as high-risk situations, or an individual’s coping skills, and 
  2. Covert antecedents – such as an imbalanced lifestyle which leads to urges and cravings

The cognitive behavioral model of relapse helps clinicians to develop individualized treatment plans for clients at risk of relapse. Once the characteristics of each individual’s high risk situations have been assessed the clinician can:

  • work forwards by analyzing their client’s response to these situations, and 
  • work backward to examine factors that increase the individual’s exposure to high risk situations

With these individual difficulties formulated and understood, the clinician can help their client to broaden their repetoire of cognitive and behavioral strategies in order to reduce risk of relapse.

While the model was designed for working with clients struggling with alcohol problems it has been applied to addictive and impulsive behaviors more broadly (Marlat & Donovan, 2005) including problematic eating behaviors (Mines & Merrill, 1987)

This is a Psychology Tools information handout. Suggested uses include:

  • Client handout – use as a psychoeducation resource
  • Discussion point – use to provoke a discussion and explore client beliefs
  • Therapist learning tool – improve your familiarity with a psychological construct
  • Teaching resource – use as a learning tool during training
  • Larimer, M. E., & Palmer, R. S. (1999). Relapse prevention: An overview of Marlatt’s cognitive-behavioral model. Alcohol Research and Health, 23(2), 151-160.
  • Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention (1st ed., pp. 280–250). New York: Guilford Press.
  • Marlatt, G. A., & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford press.
  • Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (1st ed.). New York: Guilford Press.
  • Mines, R. A., & Merrill, C. A. (1987). Bulimia: Cognitive‐behavioral treatment and relapse prevention. Journal of Counseling & Development65(10), 562-564.

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