We can use our experiences to help others by telling them how relapse and abstinence violation effect caused us torment. If we can keep others from making the same mistakes, our experiences will serve a wonderful purpose. The memories of our slips may always sting a bit, but at least we can sleep easy at night knowing that we used them to do some good. In some cases, abstinence may have physiological effects, but misconceptions about the effects of abstinence on an individual’s body and mental state are also fairly common.

Third wave behaviour therapies are focused on improving building awareness, and distress tolerance skills using mindfulness practices. These approaches have shown promise, and more recently the neurobiological underpinnings of mindfulness strategies have been studied. The article provides an overview of cognitive behavioural approaches to managing addictions.

Cognitive behavioural interventions in addictive disorders

Asking clients questions designed to assess expectancies for both immediate and delayed consequences of drinking versus not drinking (i.e., using a decision matrix) (see table, p. 157) often can be useful in both eliciting and modifying expectancies. With such a matrix, the client can juxtapose his or her own list of the delayed negative consequences with the expected positive effects. Therefore, many of the techniques discussed under relapse prevention that aim at modification of dysfunctional beliefs related to outcomes of substance use, coping or self-efficacy are relevant and overlapping. An individual progresses through various stages of changes and the movement is influenced by several factors. Stages imply a readiness to change and therefore the TTM has been particularly relevant in the timing of interventions. Matching interventions to the stage of change at which an individual is, can maximize outcome.

The limit violation effect describes what happens when these individuals fail to restrict their use within their predetermined limits and the subsequent effects of this failure. These individuals also experience negative emotions similar to those experienced by the abstinence violators and may also drink more to cope with these negative emotions. In a similar fashion, the nature of these attributions determines whether the violation will lead to full-blown relapse. Being able to understand how your thoughts, emotions, and behaviors play off of each other can help you to better control and respond to them in a positive way. Acknowledging your triggers and developing the appropriate coping skills should be a part of a solid relapse prevention program. Lastly, treatment staff should help you to learn how to recognize the signs of an impending lapse or relapse so that you can ask for help before it happens.

11.4.2 Cognitive Behavioral Models

On the other hand, if the reason for the violation is attributed to external, unstable, and/or local factors, such as an extremely tempting situation, then the individual is more likely to recover from the violation and get back onto the path of abstinence. Each of the five stages that a person passes through are characterized as having specific behaviours and beliefs. Nurses are well placed to serve a key role in teams seeking to help individuals in recovery avoid relapses. Also, their ability to provide a wide range of interventions ranging from supportive therapy to medical interventions often proves to be a valuable asset to patients. Some researchers have differentiated a “lapse” (an initial use of the substance) from a “relapse” (uncontrolled use of the substance). However, this distinction may be detrimental to some individuals by helping them to minimize the impact of a lapse.

When abstinence is violated, individuals typically also have an emotional response consisting of guilt, shame, hopelessness, loss of control, and/or a sense of failure; they may use drugs or alcohol in an attempt to cope with the negative feelings that resulted from their abstinence violation. A person may experience a particularly stressful emotional event in their lives and may turn to alcohol and/or drugs to cope with these negative emotions. An abstinence violation can also occur in individuals with low self-efficacy, since they do not feel very confident in their ability to carry out their goal of abstinence.

Behavioural interventions

She is a current member of the Golden Key International Honor Society and the Delta Epsilon Iota Honor Society. Her over 15 years’ experience working in healthcare administration and management quickly launched her into abstinence violation effect definition a leadership role. Now serving as the Director of Human Resources since 2018, she leads our organization through the intricate requirements of recordkeeping, recruitment, staff development as well as compliance.

As the DSM criteria make clear, most individuals with a substance use disorder have difficulty controlling how much they use, resulting in the likelihood that one drink, for example, will lead to many more if not corrected. Cognitive restructuring, or reframing, is used throughout the RP treatment process to assist clients in modifying their attributions for and perceptions of the relapse process. In particular, cognitive restructuring is a critical component of interventions to lessen the abstinence violation effect.

Lastly, we review existing models of nonabstinence psychosocial treatment for SUD among adults, with a special focus on interventions for drug use, to identify gaps in the literature and directions for future research. We identify a clear gap in research examining nonabstinence psychosocial treatment for drug use disorders and suggest that increased research attention on these interventions represents the logical next step for the field. Despite the empirical support for many components of the cognitive-behavioral model, there have also been many criticisms of the model for being too static and hierarchical. In response to these criticisms, Witkiewitz and Marlatt proposed a revision of the cognitive-behavioral model of relapse that incorporated both static and dynamic factors that are believed to be influential in the relapse process.

Specifically, those participants who had a greater belief in the disease model of alcoholism and a higher commitment to absolute abstinence (who were most likely to experience feelings of guilt over their lapse) were most likely to experience relapse in that study. In a recent review of the literature on relapse precipitants, Dimeff and Marlatt (1998) also concluded that considerable support exists for the notion that an abstinence violation effect can precipitate a relapse. Marlatt and Gordon (1980, 1985) have described a type of reaction by the drinker to a lapse called the abstinence violation effect, which may influence whether a lapse leads to relapse.