Relapse Prevention

Most applications of CBT for alcohol dependence include relapse prevention as a core component. Relapse is a common problem in alcohol treatment. Most people with alcohol dependence relapse to problematic drinking within the first few months (often weeks) of treatment. 

Specific situations or mood states are often associated with relapse, including: 

• Negative emotional states (frustration, anger, anxiety, depression, or anger)  
• Interpersonal conflict (relationships with partner, work colleagues, friends)  
• Direct or indirect social pressure to drink. 

Relapse prevention is not so much a specific intervention but rather a set of strategies that aim to help the patient maintain treatment gains. Strategies may include a number of cognitive and behavioural techniques that help prevent lapses becoming relapses, such as: 

• Learning to identify situations that have been associated with excessive drinking and to use appropriate cognitive and behavioural strategies to cope effectively 
• Constructively appraising lapses, thereby reducing fear of failure, guilt, shame and hopelessness and preventing a lapse from becoming a relapse 
• Learning, through careful forward planning, to avoid unnecessary risk and deal positively and confidently with inevitable risk. 

All alcohol dependent patients should be offered the opportunity to learn relapse-prevention strategies as part of a broader CBT program. Relapse prevention addresses itself to maintaining change and to developing self-efficacy and coping skills.