Relapse Prevention and Cognitive Therapy of Substance Abuse as Drug Addiction Treatment

3418 Public Works Drive Knoxville, Tn, (PressExposure) May 12, 2009 -- Different approaches to drug addiction have long been used by a number of adult and adolescent drug rehab across the United States. Part of these approaches involved psychological treatments such as the Twelve-Step program founded by Alcoholics Anonymous (AA), the Client-Centered approach by psychologist Carl Rogers, and the Psychoanalytic approach proposed by Sigmund Freud which was later on modified by his followers. These three approaches theorized the methods on how to successfully treat a patient of his/her addiction. Other psychological approaches to drug treatment emphasize on the recovery process of the patient. Treatment includes several cognitive models of addiction recovery such as the Relapse Prevention by Alan Marlatt and Cognitive Therapy of Substance Abuse offered by Aaron Beck.

Relapse Prevention

An influential cognitive-behavioral approach to addiction recovery and therapy practiced by many adolescent drug rehab has been Alan Marlatt’s (1985) Relapse Prevention approach. Marlatt describes four psychosocial processes relevant to the addiction and relapse processes: self-efficacy, outcome expectancies, attributions of causality, and decision-making processes.


Self-efficacy refers to one’s ability to deal competently and effectively with high-risk, relapse-provoking situations.


Outcome expectancies refers to an individual’s expectations about the psychoactive effects of an addictive substance.


Attributions of causality refers to an individual’s pattern of beliefs relapse to drug use is a result of internal, or rather external, transient causes.


Decision-making processes are implicated in the relapse process as well.

Substance use is the result of multiple decisions whose collective effects result in consumption of the intoxicant. Furthermore, Marlatt stresses some decisions referred to as apparently irrelevant decisions may seem inconsequential to relapse, but may actually have downstream implications that place the user in a high-risk situation.

Cognitive Therapy of Substance Abuse

An additional cognitively-based model of substance abuse recovery practiced by many adolescent drug rehab has been offered by Aaron Beck, the father of cognitive therapy and championed in his 1993 book, Cognitive Therapy of Substance Abuse. This therapy rests upon the assumption addicted individuals possess core beliefs, often not accessible to immediate consciousness (unless the patient is also depressed).

These core beliefs, such as “I am undesirable,” activate a system of addictive beliefs that result in imagined anticipatory benefits of substance use and, consequentially, craving. Once craving has been activated, permissive beliefs (“I can handle getting high just this one more time”) are facilitated. Once a permissive set of beliefs have been activated, then the individual will activate drug-seeking and drug-ingesting behaviors. The cognitive therapist’s job is to uncover this underlying system of beliefs, analyze it with the patient, and thereby demonstrate its being dysfunctional.

As with any cognitive-behavioral therapy, homework assignments and behavioral exercises serve to solidify what is learned and discussed during treatment.

About Self-employed

Donna Sparks is a Professor and a Consultant Physician. Other than her clinical and local teaching commitments, she also continues to enjoy the privileges of research, writing and lecturing.

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Press Release Submitted On: May 11, 2009 at 11:01 pm
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