Open Access Highly Accessed Review

Relapse prevention for addictive behaviors

Christian S Hendershot12*, Katie Witkiewitz3, William H George4 and G Alan Marlatt4

Author Affiliations

1 Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, M5S 2S1, Canada

2 Department of Psychiatry, University of Toronto, 250 College St., Toronto, ON M5T 1R8, Canada

3 Department of Psychology, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA, 98686, USA

4 Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA

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Substance Abuse Treatment, Prevention, and Policy 2011, 6:17  doi:10.1186/1747-597X-6-17

Published: 19 July 2011


The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change.

Alcohol; cognitive-behavioral skills training; continuing care; drug use; psychosocial intervention; substance use treatment