Subheadings:
-What is Relapse Prevention?
-Models of Relapse Prevention
-What is Abstinence?
-What is Addiction?
-Models of Addiction?
-How realistic is Abstinence?
What is Relapse Prevention?
Relapse prevention is a self-control programme
designed to teach individuals who are trying to change their behaviour how to
anticipate and cope with the problem of relapse. In a very general sense,
relapse refers to a breakdown or failure in a person’s attempt to change or
modify any target behaviour. Based on the principle of social learning theory,
relapse prevention is a psychoeducational programme that combines behavioural
skill-training procedures with cognitive intervention techniques.
Relapse Prevention Model: Because RP model combines
both behavioural and cognitive components, it is similar to other cognitive behavioural
approaches that have been developed as an outgrowth and extension of more
traditional behaviour therapy programmes.
The RP
model was initially developed as a behavioural maintenance programme for use in
the treatment of addictive behaviours. In addictions the typical goals of
treatment are either to refrain totally from performing a target behaviour (e.g.,to
abstain from drug use), or to impose regulatory limits or controls over the
occurrence of a behaviour(e.g., a diet as a means of controlling food intake. Over the decades, three main models have emerged to explain addiction:
the moral model, learning model, and medical model (Wilbanks, 1989). The main
differences that arise out of these models are the causes they attribute to
drug use and the role of free will.
What
is Addiction?
Models of addiction:
The moral model suggests that addiction is a
choice based on bad values (Wilbanks, 1989). On the other end, the medical
model views addiction as a compulsion that is completely out of the addict’s
control (Wilbanks, 1989).
The learning model contends that addiction is
influenced by environmental factors (Schaler, 1991: 44) and thus individuals
make choices in a predetermined or constrained setting.
According to Wilbanks (1989), the moral model
views addiction as a choice made by individuals with low moral standards.
Addicts are characterized as inherently bad people who do bad things that are
driven by their values. Naturally, treatment for addiction is argued to be
punishment (Schaler, 1991).
Moral model
·
America’s war on drugs is a good example of a
punitive method against addiction that is consistent with the moral model. The
war on drugs seeks harsh punishments for those involved with drugs rather than
rehabilitative methods. The underlying assumption is that those engaged in drug
related offences, including drug abuse, choose to behave that way. The
moral model of addiction emerged as a result of the major influences of
religion in people’s lives. Theologians and clergymen were highly respected and
viewed as very knowledgeable about human behaviours (Wilbanks, 1989: 408).
·
In a liberal society, free will and individual
autonomy are highly emphasized and valued ideals. The moral model appeals to
our common sense because it is consistent with these liberal views. Addicts are
conceived as free willed individuals making rational choices and the reason
they engage in drug use is because they have bad morals.
In the face of reality, the moral model is
insufficient to capture the phenomenon of drug addiction. It ignores factors
such as physiological effects of drugs and sociological backgrounds of addicts
that are likely to have an important impact on their drug use.
Disease
model:
The moral model began to lose its influence
when physicians and doctors were seen as having more expertise on humans than
theologians and religion began to fade into the backdrop of people’s lives
(Wilbanks, 1989: 408).
Initially, the disease model was integrated
with the moral model where addiction was seen as a problem for people with weak
morals (Wilbanks, 1989).
However, addiction affecting even those with
strong morals could not be ignored.
In order to account for this, the disease model
of addiction was fully adopted while the moral model was discarded. As a
result, the disease model of addiction became prominent.
In 1956, alcoholism was declared a disease by
the American Medical Association (Wilbanks, 1989: 410).
By 1960’s to 1970’s, research claimed that
alcoholism has a genetic disposition (Hirschman, 1995: 538).