G. Alan Marlatt

Marlatt, Witkiewitz, Relapse Prevention for Alcohol and Drug Problems. Blume, de la Cruz, Relapse Prevention among Diverse Populations. Kadden, Cooney, Treating Alcohol Problems. Shiffman, Kassel, Gwaltney, McChargue, Relapse Prevention for Smoking. Carroll, Rawson, Relapse Prevention for Stimulant Dependence. Haug, Sorensen, Gruber, Song, Relapse Prevention for Opioid Dependence. Roffman, Stephens, Relapse Prevention for Cannabis Abuse and Dependence. Kilmer, Cronce, Palmer, Relapse Prevention for Abuse of Club Drugs, Hallucinogens, Inhalants, and Steroids. Collins, Relapse Prevention for Eating Disorders and Obesity. Shaffer, LaPlante, Treatment of Gambling Disorders. Wheeler, George, Stoner, Enhancing the Relapse Prevention Model for Sex Offenders: Adding Recidivism Risk Reduction Therapy to Target Offenders' Dynamic Risk Needs. Zawacki, Stoner, George, Relapse Prevention for Sexually Risky Behaviors.

R. Lorraine Collins State University of New York at Stony Brook George A. Parks and G. Alan Marlatt University of Washington Two studies were conducted to assess variables related to the social determinants of alcohol consumption. In Study 1, moderate- and heavy-drinking male under- graduates were paired with confederates who behaved in a sociable or unsociable manner while modeling either light or heavy consumption. Modeling occurred in the sociable conditions but not in the unsociable conditions, where subjects tended to drink heavily. In Study 2, a similar group of subjects was exposed to one of three social status conditions crossed with light versus heavy consumption. The results indicated a modeling effect in all social status conditions. These studies provide further support for the existence of a modeling effect that can be disrupted by a lack of rapport between drinking partners. This latter finding has implications for the etiology of problem drinking because it suggests that increased alcohol consumption may serve as a strategy for coping with aversive social interactions. Initial research on the effect of modeled consumption rates on social drinking (Caudill & Marlatt, 1975) suggested that heavy-drink- ing men tended to match the consumption of their drinking partner whether his con- sumption was heavy or light. Subsequent examinations of this phenomenon replicated these findings in laboratory analogue drinking tasks such as the taste-rating task (Cooper, Waterhouse, & Sobell, 1979; Hendricks, So- bell, & Cooper, 1978; Lied & Marlatt, 1979; Watson & Sobell, 1982), natural bar settings (Reid, 1978), and seminaturalistic bar settings (Caudill & Lipscomb, 1980). Much of the research concerning the mod- eling of alcohol consumption has focused on manipulating characteristics of the model, including the nature of the social interaction between the model and the subject. The effects of manipulating social interaction are unclear. In the Caudill and Marlatt study, model's drinking rate (light vs. heavy) and a

ABSTRACT. " This article examines relapse by integrating knowledge from the addictive disorders of alcoholism, smoking, and obesity. Commonalities across these areas suggest at least three basic stages of behavior change: motivation and commitment, initial change, and maintenance. A distinction is made between lapse and relapse, with lapse referring to the process (slips or mistakes) that may or may not lead to an outcome (relapse). The natural history of relapse is discussed, as are the consequences of relapse for patients and the professionals who treat them. Information on determinants and predictors of relapse is evaluated, with the emphasis on the interaction of individual environmental, and physiological factors. Methods of preventing relapse are proposed and are targeted to the three stages of change. Specific research needs in these areas are discussed. The problem of relapse remains an important challenge in the fields dealing with health-related behaviors, particularly the addictive disorders. This is true for areas of

Relapse prevention, based on the cognitive-behavioral model of relapse, has become an adjunct to the treatment of numerous psychological problems, including (but not limited to) substance abuse, depression, sexual offending, and schizophrenia. This article provides an overview of the efficacy and effectiveness of relapse prevention in the treatment of addictive disorders, an update on recent empirical support for the elements of the cognitive-behavioral model of relapse, and a review of the criticisms of relapse prevention. In response to the criticisms, a reconceptualized cognitive-behavioral model of relapse that focuses on the dynamic interactions between multiple risk factors and situational determinants is proposed. Empirical support for this reconceptualization of relapse, the future of relapse prevention, and the limitations of the new model are discussed.