Larimer M E, Palmer R S, Marlatt G A
Department of Psychology, University of Washington, Seattle, USA.
Alcohol Res Health. 1999;23(2):151-60.
Relapse prevention (RP) is an important component of alcoholism treatment. The RP model proposed by Marlatt and Gordon suggests that both immediate determinants (e.g., high-risk situations, coping skills, outcome expectancies, and the abstinence violation effect) and covert antecedents (e.g., lifestyle factors and urges and cravings) can contribute to relapse. The RP model also incorporates numerous specific and global intervention strategies that allow therapist and client to address each step of the relapse process. Specific interventions include identifying specific high-risk situations for each client and enhancing the client's skills for coping with those situations, increasing the client's self-efficacy, eliminating myths regarding alcohol's effects, managing lapses, and restructuring the client's perceptions of the relapse process. Global strategies comprise balancing the client's lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urge-management techniques, and developing relapse road maps. Several studies have provided theoretical and practical support for the RP model.
预防复发（RP）是酒精成瘾治疗的一个重要组成部分。马尔拉特和戈登提出的RP模型表明，直接决定因素（如高危情境、应对技能、结果预期和戒断违反效应）以及潜在的先行因素（如生活方式因素、冲动和渴望）都可能导致复发。RP模型还纳入了许多具体的和全面的干预策略，使治疗师和患者能够应对复发过程的每一个步骤。具体干预措施包括为每个患者识别特定的高危情境，并增强患者应对这些情境的技能，提高患者的自我效能感，消除有关酒精影响的误解，处理失误，以及重塑患者对复发过程的认知。全面策略包括平衡患者的生活方式，帮助他或她发展积极的成瘾行为，运用刺激控制技术和冲动管理技术，以及制定复发路线图。多项研究为RP模型提供了理论和实践支持。
