The Marlatt and Gordon Relapse Prevention Model It 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 used 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 Relapse Prevention Model: Features
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 is made up of two components: relapse prevention and training in social and coping skills (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 also the first choice treatment for treating alcoholism, which in turn includes different psychological techniques.
The main objective of the model is teach, train and empower the patient to experience relapses as part of the weaning process, and as another 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 are 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 usually appear during the maintenance phase of an addictive disorder, or, commonly called, the detoxification phase.
But what exactly is relapse? Marlatt (1993) defined it as “a transient process, a series of events that may or may not be followed by a return to baseline levels of objective behavior observable before treatment.”
That is, it may be a specific state, It does not always have to be a point of “no return” during the detox process ; Nor does it necessarily imply returning to the starting point of the treatment.
Cognitive factors
According to the Marlatt and Gordon Relapse Prevention Model, In the relapse process typical of addictions, 3 cognitive factors interact:
Abstinence violation effect (EVA)
In Marlatt and Gordon’s Relapse Prevention Model, an essential concept is proposed, the so-called Abstinence Violation Effect (VAE). This effect arises when the person decides to use again (in the case of alcoholism), that is, when a relapse occurs. It is made up, in his opinion, of two cognitive-affective elements:
1. A cognitive dissonance effect.
A cognitive dissonance occurs in the subject who is about to drink, or who directly drinks (but does not know whether to continue doing so), since their interests (achieving abstinence and recovery) conflict with their 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 again (personal attribution) to stable, internal and global factors, then decreases your resistance to future temptations to do it again
That is, the loss of control that leads a person with an alcohol addiction to drink again is determined by the Abstinence Violation Effect.
Training
A few years after Marlatt and Gordon’s Relapse Prevention Model, in 1995, Marlatt himself developed specific relapse prevention training together with another author, Dimeff, closely related to the initial model. This training very well differentiated two terms: “fall” and “relapse”, and based on this difference, it was developed through a sequence of steps:
Indications in therapy
As we have seen, the Marlatt and Gordon Relapse Prevention Model It is used to treat addictive disorders to certain substances (drugs), mainly alcoholism (where an effective and first choice therapy has been demonstrated).
On the other hand, the model is also indicated to treat heroin addiction, and is considered probably 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).
Horse. (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Vol. 1 and 2.
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). Preventing relapses in addictive behaviors: A cognitive-behavioral treatment approach. In M. Casas and M. Gossop (Eds.), Relapse and relapse prevention (pp.137-160). Sitges: Editions in Neurosciences.
Secades, R. and Ramón, J. (2003). Guide to effective psychological treatments for drug addiction: alcohol, cocaine and heroin.
