On the one hand, it can serve as a valuable learning opportunity, highlighting the triggers and situations that lead to relapse or rule violation. This awareness can aid in the development of effective coping strategies and relapse prevention techniques. On the other hand, if individuals perceive the Abstinence Violation Effect as a sign of personal failure or lack of self-control, it may diminish their self-efficacy and motivation to continue pursuing behavior change. It has also been used to advocate for managed alcohol and housing first programs, which represent a harm reduction approach to high-risk drinking among people with severe AUD (Collins et al., 2012; Ivsins et al., 2019). Because relapse is the most common outcome of treatment for addictions, it must be addressed, anticipated, and prepared for during treatment. The RP model views relapse not as a failure, but as part of the recovery process and an opportunity for learning.
Specific Intervention strategies in Relapse Prevention
- In psychotherapy, an abstinence violation effect refers to the negative cognitive and affective reactions one experiences after returning to substance use after a period of abstinence.
- Additionally, individuals may engage in cognitive distortions or negative self-talk, such as believing that the relapse is evidence of personal weakness.
- When people don’t have the proper tools to navigate the challenges of recovery, the AVE is more likely to occur, which can make it difficult to achieve long-term sobriety.
- Twelve-step can certainly contribute to extreme and negative reactions to drug or alcohol use.
Ark Behavioral Health offers 100% confidential substance abuse assessment and treatment placement tailored to your individual needs. Instead, if the individual had considered their behavior a simple lapse as opposed to a full-blown violation of abstinence, they may have been able to use the situation to learn from their mistakes and move on. Marlatt considered the abstinence violation affect a serious risk factor for relapse that could be avoided by understanding the difference between a slip and a full-blown violation of one’s commitment to recovery. While he considered 12-Step programs and other similar approaches to recovery to be useful, he also believed that the notions of a lapse and relapse were not realistically conceived by many recovery programs. There are many relapse prevention models used in substance abuse treatment to counter AVE and give those in recovery important tools and coping skills.
Study setting and participants
The abstinence violation effect (AVE) occurs when an individual, having made a personal commitment to abstain from using a substance or to cease engaging in some other unwanted behavior, has an initial lapse whereby the substance or behavior is engaged in at least once. The AVE occurs when the person attributes the cause of the initial lapse (the first violation of abstinence) to internal, stable, and global factors within (e.g., lack of willpower or the underlying addiction or disease). As the number of people needing to quit is increasing, there is an urgent need for low-cost, accessible, and effective interventions with lasting effects 20. This study was conducted to investigate the effect of cognitive-behavioral intervention on relapse prevention. The sample size was calculated 130 participants in each group considering 10% attrition. The individuals who were referred to these centers were recruited until reaching the required sample size for each group (See Fig. 1).
- We want to give recovering addicts the tools to return to the outside world completely substance-free and successful.
- AVE can be observed in various areas, including addictions, dietary restrictions, and impulse control.
- The abstinence violation effect (AVE) refers to the negative cognitive and affective responses that an individual experiences after the return to substance abuse after a period of abstinence.
- There was also a significant difference in the control group, but the results indicated a higher effectiveness of the cognitive-behavioral-based intervention compared to the routine intervention.
- You are not unique in having suffered a relapse and it’s not the end of the world.
Abstinence Violation Effect: How Does Relapse Impact Recovery?
It’s important to challenge negative beliefs and cognitive distortions that may arise following a relapse. Another possible outcome of a lapse is that the client may manage to abstain and thus continue to go forward in the path of positive change, “prolapse”4. Many researchers define relapse as a process rather than as a discrete event and thus attempt to characterize the Sobriety factors contributing to relapse3.
More and more, behavioral health organizations are moving away from “kicking people out of treatment” if they return to substance use. This type of policy is increasingly recognized as scientifically un-sound, given that continued substance use despite consequences is a hallmark symptom of the disease of addiction. As a reminder, in an era of very potent opioids, this can lead to fatal results. The abstinence violation effect, described by the famous substance abuse researcher Alan Marlatt, occurs when someone who was made a commitment to abstinence suffers an initial lapse that they define as a violation of their abstinence. This perceived violation results in the person making an internal explanation to explain why they drank (or used drugs) and then becoming more likely to continue drinking (or using drugs) in order to cope with their own guilt.
He was hoping that he could get back together with her, but realized that this was impossible. Thus, despite various definitional issues in the research, the above definitions will guide this article and discussing the issue of relapse. How one defines relapse may be an important influence on determining what happens when one suffers a lapse or slip. For instance, one interesting manifestation of a lapse is something termed the abstinence violation effect. However, there are some common early psychological signs that a relapse may be abstinence violation effect on the way.
In a review of controlled clinical trials, Carroll found the strongest support for Marlatt-based relapse prevention when it was applied to smoking cessation 18. Given the serious health consequences of smoking and the rapid relapse upon quitting, the present study aimed to assess the effectiveness of cognitive-behavioral interventions based on Marlatt’s model on relapse prevention of people who smoke. To the best of our knowledge, this is the first study in Iran assessing the effectiveness of relapse prevention intervention based on Marlatt’s model. Cognitive-behavioral intervention is effective in reducing cigarette smoking, high-risk situations of smoking, abstinence violation effect, positive outcome expectation of smoking lapse and relapse and increasing self-efficacy, coping skills, and quitting smoking.