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Understanding the Abstinence Violation Effect and its role in Relapse Prevention Treatment Western Undergraduate Psychology Journal

By November 24, 2020November 3rd, 2023No Comments

Abstinence violation effect may cause us to feel these way about urges and cravings as well. We feel an urge or encounter a trigger, and suddenly we decide that our attempts at recovery have failed. It doesn’t seem logical that we would still experience cravings when we were only just recently hurt by a relapse.

Ongoing use of the substance can be caused by feelings of personal failure. This strongly held belief increases the likelihood of relapse more than once. A person’s guilt is a difficult emotion to carry, one that can constantly replay in their minds, causing them to use substances again to ease their guilt. Many people can relate to this feeling of guilt when they use a substance, like alcohol or marijuana, after promising themselves they wouldn’t.

Overcoming Abstinence Violation Effect

Researchers continue to evaluate the AVE and the efficacy of relapse prevention strategies. Motivational Interviewing (MI) and motivational enhancement therapy (MET) are approaches that target motivation and decisional balance of the patient. Although MI incorporates the principles of the trans theoretical model, it has been distinguished from both trans theoretical model and CBT21. Motivation enhancement therapy (MET) abstinence violation effect definition is a brief, program of two to four sessions, usually held before other treatment approaches, so as to enhance treatment response24. MET adopts several social cognitive as well as Rogerian principles in its approach and in keeping with the social cognitive theory, personal agency is emphasized. The neurobiological basis of mindfulness in substance use and craving have also been described in recent literature40.

  • Engaging in self-care may sound like an indulgence, but it is crucial to recovery.
  • They may not recognize that stopping use of a substance is only the first step in recovery—what must come after that is building or rebuilding a life, one that is not focused around use.
  • John joined Amethyst as a behavioral health technician where he quickly developed strong personal relationships with the clients through support and guidance.
  • These approaches have shown promise, and more recently the neurobiological underpinnings of mindfulness strategies have been studied.
  • He reported difficulty sleeping if he did not drink, could not get past the day without drinking or thinking about his next drink (establishment of a dependence pattern).
  • Oxford English Dictionary defines motivation as “the conscious or unconscious stimulus for action towards a desired goal provided by psychological or social factors; that which gives purpose or direction to behaviour.

Harm reduction therapy has also been applied in group format, mirroring the approach and components of individual harm reduction psychotherapy but with added focus on building social support and receiving feedback and advice from peers (Little, 2006; Little & Franskoviak, 2010). These groups tend to include individuals who use a range of substances and who endorse a range of goals, including reducing substance use and/or substance-related harms, controlled/moderate use, and abstinence (Little, 2006). Additionally, some groups target individuals with co-occurring psychiatric disorders (Little, Hodari, Lavender, & Berg, 2008). Important features common to these groups include low program barriers (e.g., drop-in groups, few rules) and inclusiveness of clients with difficult presentations (Little & Franskoviak, 2010). They may not recognize that stopping use of a substance is only the first step in recovery—what must come after that is building or rebuilding a life, one that is not focused around use.

Behavioural interventions

A common pattern of self-regulation failure occurs for addicts and chronic dieters when they ‘fall off the wagon’ by consuming the addictive substance or violating their diets [5]. Marlatt coined the term abstinence violation effect to refer to situations in which addicts respond to an initial indulgence by consuming even more of the forbidden substance [11]. In one of the first studies to examine this effect, Herman and Mack experimentally violated the diets of dieters by requiring them to drink a milkshake, a high-calorie food, as part of a supposed taste perception study [27]. Although non-dieters ate less after consuming the milkshakes, presumably because they were full, dieters paradoxically ate more after having the milkshake (Figure 1a). This disinhibition of dietary restraint has been replicated numerous times [20,28] and demonstrates that dieters often eat a great deal after they perceive their diets to be broken.

CBT comprises of heterogeneous treatment components that allow the therapist to use this approach across a variety of addictive behaviours, including behavioural addictions. Relapse prevention programmes addressing not just the addictive behaviour, but also factors that contribute to it, thereby decreasing the probability of relapse. Addictive behaviours are characterized by a high degree of co-morbidity and these may interfere with treatment response. The current review highlights multiple important directions for future research related to nonabstinence SUD treatment. Overall, increased research attention on nonabstinence treatment is vital to filling gaps in knowledge. For example, despite being widely cited as a primary rationale for nonabstinence treatment, the extent to which offering nonabstinence options increases treatment utilization (or retention) is unknown.

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