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Chapter 7: Relapse Prevention & Social Support
Act of eating is often✔✔a social activity with the client's social environment having a significant impact.
Social Support✔✔Family, friends, distant support buddy, club or organization, social support groups, Group classes
The benefits of having social support for making lifestyle changes?✔✔The positive effects of social support on health is that clients perceive a sense of support from others leading to a feeling of a more generalized sense of control. A greater sense of control often results in an increase in self efficacy.
Relapse Prevention✔✔systematic approach to maintaining a behavior change involving the identification of and preparation for high-risk situations
What are the 4 Immediate Determinants of a relapse?✔✔1. High-risk situations, 2. A person's lack of coping skills, 3. Overly positive outcome expectancies, and 4. Negative reaction to a lapse.
High Risk Situation✔✔Negative emotional stress, Interpersonal conflict, Social pressure, Positive emotional states
Coping Skills✔✔ability to cope with difficulty
Positive Outcome Expectations✔✔previous pleasurable experiences associated with foods and the significance of those perceptions can add to the desire to lapse.
Reaction to Lapse✔✔lapse is a single act but relapse is series of lapses
Covert Antecedent✔✔Not obvious factors like irreverent decisions, lifestyle imbalances, urges/cravings
Four covert antecedents of a relapse✔✔1. Apparently Irrelevant Decisions, 2. Stress Level, 3. Cognitions,
- Urges and Cravings
Apparently Irrelevant Decisions (AIDs)✔✔A series of seemingly harmless decisions can provide a conduit for a relapse. For example, buying a bag of potato chips for the "children" or a bag of cookies "in case guests stop by" creates conditions that can bring an individual to the brink of a relapse.
Stress Level✔✔A person experiencing a high degree of stress is automatically generating negative emotional states, thereby creating high-risk situations (see Exhibit 7.5). In addition, there is an increased desire to relapse and connect to the satisfying emotional states with previous unhealthy eating pleasures.
Cognitions✔✔Cognitive factors such as rationalization and denial set the stage for a relapse. For example, "I deserve a whole batch of brownies after this rejection." Here rationalization that the indulgence is justified adds to the creation of a relapsing environment.
Urges and Cravings✔✔The desire for immediate gratification can take the forms of urges, sudden impulses to indulge, or cravings, subjective desires to experience the effects of an indulgence.
PSYCH 489 Exam 3: Relapse Prevention Techniques Relapse is very common in three disorders (in the order of highest relapse rate to lowest)✔✔substance abuse > depression > panic disorder w/o agoraphobia
Relapse in the Black-and-White Model✔✔any use of substance is considered a relapse b/c client could be under either total abstinence or total relapse.
Relapse in Cognitive-Behavioral Model✔✔falling back to pre-treatment levels of use
Lapse in Cognitive-Behavioral Model✔✔single instance of use
Relapse Prevention is what type of treatment?✔✔cognitive-behavioral treatment
Relapse prevention helps to prevent two things✔✔occurrence of initial lapse; any lapse from escalating into a full-blown relapse
What is loss of control hypothesis✔✔1 drink means you are drunk
is loss of control hypothesis accurate?✔✔no
What is Drunken Comportment?✔✔Alcohol's influence is due to pharmacological effects only
Modification to Drunken Comportment✔✔Alcohol's influence is due to pharmacological effects and expectancy effects
Overview of Relapse Prevention Model - Effective coping response (4 steps)✔✔Negative/positive emotion; interpersonal conflict; social pressure (= high risk situation) -> effective coping response -> increased self-efficacy -> decreased probability of relpase
Overview of Relapse Prevention Model - Ineffective coping response (6 steps)✔✔Negative/positive emotion; interpersonal conflict; social pressure (= high risk situation) -> ineffective coping response -> decreased self-efficacy; positive outcome expectancy for effects of alcohol -> lapse -> abstinence violation effect -> increased probability of relpase
relapse prevention strategy for desire for indulgence✔✔substitute indulgence with recreational activity and massage
two relapse prevention strategies for urges and cravings✔✔urge management; stimulus control technique
example of urge management✔✔coping imagery e.g. urge surfing
example of stimulus control tecniques✔✔removal of all items associated with alcohol use
two relapse prevention strategies for rationalization, denial, and irrelevant decisions✔✔decision matrix; education about warning signs of relapse
3 examples of warning signs✔✔positive expectancy; lifestyle imbalance; irrelevant decision
example of irrelevant decision✔✔client tries to buy a bottle of drink just in case friend stops by
three types of junctions in the irrelevant decision map✔✔early warning; alternate route; last chance
3 relapse prevention strategies for irrelevant decision✔✔1) revised decision matrix 2) education about warning signs 3) analysis of high-risk situations and available choices for coping
1 relapse prevention strategy for high risk situation✔✔analysis of high-risk situation and available choice for coping
