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Intervention Summary

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Relapse Prevention Therapy (RPT)

Relapse Prevention Therapy (RPT) is a behavioral self-control program that teaches individuals with substance addiction how to anticipate and cope with the potential for relapse. RPT can be used as a stand-alone substance use treatment program or as an aftercare program to sustain gains achieved during initial substance use treatment. Coping skills training is the cornerstone of RPT, teaching clients strategies to:

  • Understand relapse as a process
  • Identify and cope effectively with high-risk situations such as negative emotional states, interpersonal conflict, and social pressure
  • Cope with urges and craving
  • Implement damage control procedures during a lapse to minimize negative consequences
  • Stay engaged in treatment even after a relapse
  • Learn how to create a more balanced lifestyle

Coping skills training strategies include both cognitive and bevarioral techniques. Cognitive techniques provide clients with ways to reframe the habit change process as a learning experience with errors and setbacks expected as mastery develops. Behavioral techniques include the use of lifestyle modifications such as meditation, exercise, and spiritual practices to strengthen a client's overall coping capacity.

Descriptive Information

Areas of Interest Substance abuse treatment
Co-occurring disorders
Outcomes Review Date: September 2008
1: Drinking behavior
2: Smoking abstinence
3: Cocaine use
4: Marital adjustment
5: Confidence in smoking cessation
Outcome Categories Alcohol
Drugs
Family/relationships
Tobacco
Ages 18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
Genders Male
Female
Races/Ethnicities White
Race/ethnicity unspecified
Settings Outpatient
Geographic Locations Urban
Suburban
Implementation History RPT was first implemented in 1977. Although the exact number of sites implementing RPT is unknown, a 1999 meta-analysis of the research literature reported 26 studies that evaluated the effectiveness of this therapeutic approach for substance abuse with more than 9,000 participants. Outside the United States, evaluations of RPT have been conducted in Canada and Scotland.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations RPT has been adapted for a prison-based population by the Federal Correctional Service of Canada in Ottawa, Ontario.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories IOM prevention categories are not applicable.

Quality of Research
Review Date: September 2008

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

O'Farrell, T. J., Choquette, K. A., & Cutter, H. S. (1998). Couples relapse prevention sessions after behavioral and marital therapy for male alcoholics: Outcomes during the three years after starting treatment. Journal of Studies on Alcohol, 59(4), 357-370.  Pub Med icon

O'Farrell, T. J., Choquette, K. A., Cutter, H. S., Brown, E. D., & McCourt, W. F. (1993). Behavioral marital therapy with and without additional couples relapse prevention sessions for alcoholics and their wives. Journal of Studies on Alcohol, 54(6), 652-666.  Pub Med icon

Study 2

Stevens, V. J., & Hollis, J. F. (1989). Preventing smoking relapse, using an individually tailored skills-training technique. Journal of Consulting and Clinical Psychology, 57(3), 420-424.  Pub Med icon

Study 3

Carroll, K., Rounsaville, B., Nich, C., Gordon, L., Wirtz, P., & Gawin, F. (1994). One-year follow-up of psychotherapy and pharmacotherapy for cocaine dependence: Delayed emergence of psychotherapy effects. Archives of General Psychiatry, 51(12), 989-997.  Pub Med icon

Supplementary Materials

Carroll, K. M., Rounsaville, B. J., Gordon, L. T., Nich, C., Jatlow, P., Bisighini, R. M., & Gawin, F. H. (1994). Psychotherapy and pharmacotherapy for ambulatory cocaine abusers. Archives of General Psychiatry, 51(3), 177-187.  Pub Med icon

Carroll, K. M., Rounsaville, B. J., & Nich, C. (1994). Blind man's bluff: Effectiveness and significance of psychotherapy and pharmacotherapy blinding procedures in a clinical trial. Journal of Consulting and Clinical Psychology, 62(2), 276-280.  Pub Med icon

Condiotte, M. M., & Lichtenstein, E. (1981). Self-efficacy and relapse in smoking cessation programs. Journal of Consulting and Clinical Psychology, 49(5), 648-658.  Pub Med icon

FRIENDS National Resource Center for Community-Based Child Abuse Prevention (CBCAP) (n.d.). Annotated description of the Marital Adjustment Scale (MAT). Available online at http://www.friendsnrc.org/download/outcomeresources/toolkit/annot/mat.pdf

Locke-Wallace Marital Adjustment Test (LWMAT). (2003). In Conceptualizing and measuring "healthy marriages" for empirical research and evaluation studies: A compendium of measures, Part 2 (pp. 201-202). Washington, DC: Child Trends.

Marlatt, G. A., Parks, G. A., & Witkiewitz, K. (2002). Clinical guidelines for implementing Relapse Prevention Therapy: A guideline developed for the Behavioral Health Recovery Management Project. Seattle: University of Washington, Addictive Behaviors Research Center.

McLellan, A. T. (2003). Addiction Severity Index (ASI). In J. P. Allen & V. B. Wilson (Eds.), Assessing alcohol problems: A guide for clinicians and researchers (2nd ed.; NIH Publication No. 03–3745, pp. 245-257). Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism. Available online at http://pubs.niaaa.nih.gov/publications/Assesing%20Alcohol/

Parks, G. A., & Marlatt, G. A. (2000). Relapse Prevention Therapy: A cognitive-behavioral approach. The National Psychologist, 9(5). Available online at http://nationalpsychologist.com/articles/art_v9n5_3.htm

Sobell, L. C. (2003). Alcohol Timeline Followback (TLFB). In J. P. Allen & V. B. Wilson (Eds.), Assessing alcohol problems: A guide for clinicians and researchers (2nd ed.; NIH Publication No. 03–3745, pp. 301-305). Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism. Available online at http://pubs.niaaa.nih.gov/publications/Assesing%20Alcohol/

Witkiewitz, K., & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. American Psychologist, 59(4), 224-235.  Pub Med icon

Outcomes

Outcome 1: Drinking behavior
Description of Measures Drinking behavior was measured using the Timeline Followback (TLFB) method. The TLFB method asks clients to retrospectively estimate their daily alcohol consumption over a period ranging from 7 days to 24 months prior to the interview. In this study, clients retrospectively estimated their daily alcohol consumption as none, less than 3 ounces, or more than 3 ounces and reported any days spent in jail, or in the hospital for alcohol-related reasons. To establish confidence in the accuracy of the self-reports, spouses were interviewed separately about their husband's drinking using the same method, and client and spouse reports were combined after reconciliation of discrepancies. Percent days abstinent--defined as not drinking at all, not in jail, and not hospitalized for alcohol-related reasons--was calculated for the 12 months prior to study entry, the 4-6 months during which clients received the initial treatment, each 90-day period during the 12-month relapse prevention phase, and each 90-day period in the subsequent follow-up phase, up to 30 months following the end of initial treatment.
Key Findings In a randomized clinical trial (RCT), couples with an alcoholic husband participated in 4-6 months of behavioral marital therapy (BMT) and then were randomly assigned to 1 of 2 conditions: up to 18 sessions of conjoint Relapse Prevention (RP) over the next 12 months or no further treatment (BMT only). BMT consisted of 6-8 sessions with individual couples followed by 10 group sessions with multiple couples. Follow-up RP sessions took place with individual couples for 50-75 minutes and were scheduled biweekly for the first 3 months, monthly for the next 3 months, and every 1.5 months for the final 3 months. Additionally, RP therapists could schedule up to 3 additional crisis sessions at any time during the 12-month period. Data were analyzed at 8 points: pre-BMT (baseline), post-BMT, and at 3, 6, 12, 18, 24, and 30 months post-BMT. Among the findings from this trial:

  • The BMT plus RP participants reported significantly more days abstinent than BMT-only participants at the 6-month (p = .027), 12-month (p = .028), and 18-month (p = .05) follow-ups. These differences were associated with medium effect sizes (eta-squared = 0.0625 to 0.0841).
  • Study participants in both conditions (BMT plus RP and BMT only) reported significantly more abstinent days at follow-up assessments compared with the year prior to study entry (p < .001).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.5 (0.0-4.0 scale)
Outcome 2: Smoking abstinence
Description of Measures Smoking abstinence was measured using monthly, mail-in postcards that asked clients to report their "current number of cigarettes per day" and "total number of cigarettes for the month." Clients who did not return postcards were contacted by telephone by staff blinded to group assignment. Abstinence was defined as smoking five cigarettes or less in any given month. Clients lost to follow-up were assumed to have relapsed and were considered smokers.

Additionally, at a face-to-face, 12-month postintervention assessment, clients were asked about their tobacco use in the previous 6 months and provided a saliva sample that was tested for thiocyanate concentrations at or above 80 ug/ml, a biochemical marker of smoking exposure in the past 10 to 14 days. Since thiocyanate may also reflect dietary and other nontobacco sources of cyanates, saliva samples testing positive were then tested for cotinine. Clients with cotinine levels at or above 5 ng/ml were considered smokers, regardless of self-report. Clients who did not attend the 12-month follow-up were contacted by mail or telephone by staff blinded to group assignment. If abstinence was reported, the client was asked to provide a saliva sample, collected at either the home or workplace. Clients reporting abstinence but refusing to provide a saliva sample and clients lost to follow-up were considered smokers.
Key Findings In an RCT, smokers participated in a 4-day series of 2-hour group sessions for smoking cessation that provided training on the use of more than 40 behavioral and cognitive smoking cessation techniques such as changing daily routines, deep breathing, and relaxation exercises. Clients abstinent from smoking (i.e., with no carbon monoxide in breath samples) at the 1-week follow-up session were randomly assigned to 1 of 3 conditions: a RP skills-training program in which clients actively developed and rehearsed specific coping strategies, a discussion control condition that basically offered social support, or a no-treatment control condition with no additional client meetings. Both the RP skills-training and discussion group conditions met weekly for 3 more weeks in a small group format. Among the findings from this trial:

  • At the 1-month postintervention follow-up, self-reported continuous smoking abstinence rates were 83.6% for the RP skills-training participants, 77.4% for discussion group participants, and 65.4% for the no-treatment participants (p < .001).
  • Significantly more participants in the RP skills-training condition reported sustained smoking abstinence over the 12 months of follow-up, with a lower rate of relapse relative to participants in both the discussion group and the no-treatment condition (p = .04). Participants assigned to either the discussion group or no-treatment condition were 23% more likely than participants assigned to the RP skills-training condition to report smoking relapse during the 12 months of follow-up (RR = 1.23), a difference that was associated with a small effect size.
  • Significantly more participants in the RP skills-training condition (41.3%) reported sustained smoking abstinence (biochemically verified) at the 12-month follow-up compared with either the discussion group (34.1%) or no-treatment (33.3%) conditions (RP skills-training vs. discussion and no-treatment conditions combined, p < .05).
Studies Measuring Outcome Study 2
Study Designs Experimental
Quality of Research Rating 2.8 (0.0-4.0 scale)
Outcome 3: Cocaine use
Description of Measures Cocaine use was assessed by (1) a composite cocaine subscale derived from a modified version of the Addiction Severity Index (ASI) and (2) self-reported days of cocaine use in the prior month, verified at each follow-up assessment by urinalysis. The standard ASI provides composite scores for seven domains: medical, legal, employment, drug, alcohol, family, and psychological functioning. Composite scores on the subscales vary from 0 to 1, with higher scores indicating greater severity and need for treatment. For this study, the ASI's drug composite subscale was broken into two subscales, "cocaine use only" and "other drugs," by adding items on the quantity and frequency of use, the duration of consecutive periods of abstinence, and the level and type of treatment involvement in the month prior to the assessment.
Key Findings In a double-blind RCT, cocaine-dependent clients (DSM-III-R criteria) seeking outpatient treatment were randomly assigned to one of four treatment conditions: RP plus desipramine, clinical management plus desipramine, RP plus placebo, and clinical management plus placebo. The RP condition emphasized skills training to help clients identify high-risk situations for relapse and use more effective coping strategies. The clinical management condition provided a supportive doctor-patient relationship, education, empathy, and medication management that included monitoring the client's clinical status and treatment response. Clinical evaluators carried out assessments before treatment, weekly during the 3 months of treatment, at treatment termination, and at 1, 3, 6, and 12 months after treatment termination. Findings from this study included:

  • At the end of treatment, clients reported less weekly cocaine use (confirmed by urinalysis, p < .001) and less cocaine and alcohol use and fewer family/social and psychological problems on the ASI (p < .01) relative to baseline, regardless of condition assignment. Client ASI cocaine and alcohol composite scores continued to decrease across follow-up assessments up to 12 months after treatment termination (p = .01).
  • Among clients assigned to the RP conditions, those with high levels of cocaine use at baseline (> 4.50 grams weekly) reported longer periods of sustained cocaine abstinence during treatment than those with low levels of cocaine use at baseline (1.00-2.50 grams weekly; p = .05) and remained in treatment longer (attended 8.6 vs. 6.0 sessions, respectively; p < .03).
  • Clients reporting 4 or more weeks of sustained cocaine abstinence during treatment (as opposed to less than 4 weeks) continued to report periods of sustained cocaine abstinence during follow-up (p < .001). This finding was independent of condition assignment, despite a nonsignificant trend favoring clients assigned to the RP conditions.
  • Exposure to treatment programs or services outside the study during follow-up was associated with lower self-reported cocaine use (p < .001). Even after controlling for this exposure, however, clients assigned to the RP conditions reported less frequent cocaine use in the prior month (p = .03) and fewer problems associated with cocaine use (ASI cocaine composite subscale score, p = .01) at the 6- and 12-month follow-ups compared with clients in the clinical management conditions.
  • In general, clients who received nonstudy treatment during the 12-month follow-up period were more likely to have completed treatment (p = .01) and to have lower ASI cocaine composite subscale scores at the end of treatment (p = .02), regardless of condition assignment.
Studies Measuring Outcome Study 3
Study Designs Experimental
Quality of Research Rating 3.5 (0.0-4.0 scale)
Outcome 4: Marital adjustment
Description of Measures Marital adjustment was measured using the Marital Adjustment Test (MAT), a 15-item self-report instrument administered to both the husband and wife. Eight of the items are rated on a 6-point scale ranging from 0 (always disagree) to 5 (always agree). Six of the items are presented with 2-4 response options. The 15th item is a line with 7 points ranging from "very unhappy" to "perfectly happy" on which respondents indicate their overall contentment with their marriage. Items on the MAT address issues such as family finances, recreation, affection, friends, sexual relations, philosophy of life, and dealing with in-laws. Scores range from 2 to 158; scores of 100 or higher for both partners indicate a well-adjusted marriage.
Key Findings In a RCT, couples with an alcoholic husband participated in 4-6 months of behavioral marital therapy (BMT) and then were randomly assigned to one of two conditions: up to 18 sessions of conjoint RP over the next 12 months or no further treatment (BMT only). BMT consisted of 6-8 sessions with individual couples followed by 10 group sessions with multiple couples. Follow-up RP sessions took place with an individual couple for 50-75 minutes and were scheduled biweekly for the first 3 months, monthly for the next 3 months, and every 1.5 months for the final 3 months. Additionally, RP therapists could schedule up to 3 additional crisis sessions at any time during the 12-month period. Data were analyzed at 8 points: pre-BMT (baseline), post-BMT, and at 3, 6, 12, 18, 24, and 30 months post-BMT. Among the findings from this trial:

  • Wives assigned to BMT plus RP reported significantly higher marital adjustment than BMT-only wives at all follow-up points except the 6-month assessment (p values ranging from less than .001 to .041). These differences were associated with medium to large effect sizes (eta-squared = 0.0784 to 0.1681).
  • Wives assigned to BMT plus RP who reported low marital adjustment before study entry reported higher marital adjustment at all follow-up points (p = .012), a difference that reflects a medium effect size (eta-squared = 0.1156).
  • Among wives who reported low marital adjustment before study entry, those assigned to BMT plus RP reported higher marital adjustment in months 18-30 following BMT than those assigned to BMT only (p = .032). BMT-only wives with low marital adjustment prior to study entry reported a steep decrease in marital adjustment in months 18-30 following BMT (p = .040). These differences were associated with medium effect sizes (eta-squared = 0.0784 to 0.090).
  • Couples (both husband and wife) assigned to BMT plus RP reported higher marital adjustment at the end of treatment and throughout the 24-month follow-up assessment than before study entry (p < .001).
  • In general, regardless of condition assignment, husbands' reports of marital adjustment at follow-up were directly related to their reported marital adjustment before study entry (p < .001); that is, if reported marital adjustment was low before the study, it remained low at each follow-up assessment, and conversely, if it was high before the study, it remained high through each follow-up. The change in husbands' reported marital adjustment from pre- to posttreatment was associated with a large effect size (eta-squared = 0.5329).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.5 (0.0-4.0 scale)
Outcome 5: Confidence in smoking cessation
Description of Measures Confidence or self-efficacy in smoking cessation was measured by client responses to the following item: "What is the likelihood that you will resume smoking again?" Responses were on a 5-point scale ranging from 1 (very unlikely to resume smoking) to 5 (very likely to resume smoking). This item was asked before study entry and at the end of treatment.
Key Findings In an RCT, smokers participated in a 4-day series of 2-hour group sessions for smoking cessation that provided training on the use of more than 40 behavioral and cognitive smoking cessation techniques such as changing daily routines, deep breathing, and relaxation exercises. Clients abstinent from smoking (i.e., no carbon monoxide in breath samples) at the 1-week follow-up session were randomly assigned to 1 of 3 conditions: an RP skills-training program in which clients actively developed and rehearsed specific coping strategies, a discussion control condition that basically offered social support, or a no-treatment control condition with no additional client meetings. Both the RP skills-training and discussion group conditions met weekly for 3 more weeks in a small group format. Findings from this trial included:

  • At the end of treatment, clients in both the RP skills-training and discussion group conditions reported higher confidence in being able to abstain from smoking than those in the no-treatment condition (p < .005). When clients who had relapsed in the treatment month were excluded, however, there were no significant differences between groups in this outcome; there was only a generalized increase in confidence ratings among all abstinent clients regardless of condition assignment (p < .0001).
Studies Measuring Outcome Study 2
Study Designs Experimental
Quality of Research Rating 2.4 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 26-55 (Adult)
55+ (Older adult)
50% Female
50% Male
Data not reported/available
Study 2 26-55 (Adult) 60% Female
40% Male
94% White
6% Race/ethnicity unspecified
Study 3 18-25 (Young adult)
26-55 (Adult)
73% Male
27% Female
54% Race/ethnicity unspecified
46% White

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Drinking behavior 4.0 4.0 1.8 4.0 3.0 4.0 3.5
2: Smoking abstinence 2.5 2.8 1.8 3.0 3.0 3.5 2.8
3: Cocaine use 3.5 3.5 3.5 3.5 3.0 4.0 3.5
4: Marital adjustment 4.0 4.0 1.8 4.0 3.0 4.0 3.5
5: Confidence in smoking cessation 1.5 2.5 1.8 2.0 3.0 3.5 2.4

Study Strengths

The Timeline Followback Method and the Marital Adjustment Test are widely used measurement instruments with strong psychometric support. The validity of the drinking behavior and marital adjustment outcomes was strengthened by convergence with other data sources (breath alcohol and spousal reports/ratings). The validity of smoking abstinence was strengthened by biochemical confirmation, and the validity of reported cocaine use was bolstered by urine toxicology at the follow-up assessments. The Addiction Severity Index is a well-known assessment instrument with strong psychometric properties. Two of the three studies had minimal attrition/missing data, and the third study addressed missing data using a strong random-effects regression approach. All three studies had strong, thorough, and detailed analyses appropriate to their study designs.

Study Weaknesses

The reliability and validity of the monthly postcard reports of smoking through the 12-month follow-up period are unknown. Self-reported confidence in smoking cessation was based on only one item, presumably derived from a larger scale with documented evidence of validity, but the psychometric properties underlying this single item in the present study are unclear. Two of the three studies had no measurement of treatment fidelity to evaluate the dose or content of the actual RP elements getting through to each client.

Readiness for Dissemination
Review Date: September 2008

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Alberta Alcohol and Drug Abuse Commission. (2007). Relapse prevention: Planning for success. Available from http://www.aadac.com/87_141.asp

Brandon, T. H., Vidrine, J. I., & Litvin, E. B. (2007, April). Relapse and relapse prevention. Annual Review of Clinical Psychology, 3, 257-284.

Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist, 41(7), 765–782. Retrieved from http://meagherlab.tamu.edu/M-Meagher/Health%20360/Psyc%20360%20articles/Psyc%20360%20Ch%203/Brownell.pdf

Carroll, K. M. (1998). A cognitive-behavioral approach: Treating cocaine addiction (NIH Publication No. 98-4308). Rockville, MD: National Institute on Drug Abuse.

Center for Substance Abuse Treatment (2007). Counselor's treatment manual: Matrix intensive outpatient treatment for people with stimulant use disorders (DHHS Publication No. SMA 07-4152). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http://www.kap.samhsa.gov/products/manuals/matrix/pdfs/counselor_treatment_manual.pdf

Daley, D. C., Marlat, A., & Spotts, C. E. (2003). Relapse prevention: Clinical models and intervention strategies. In A. W. Graham, T. K. Schultz, & B. B. Wilford (Eds.), Principles of Addiction Medicine (3rd ed., pp. 467-485). Chevy Chase, MD: American Society of Addiction Medicine.

Donovan, D. M., & Marlatt, G. A. (2005). Assessment of addictive behaviors (2nd ed.). New York: Guilford Press.

Foxhall, K. (2001, June). Preventing relapse: Looking at data differently led to today's influential Relapse Prevention Therapy. Monitor on Psychology, 32(5).

Kadden, R., Carroll, K. M., Donovan, D., Cooney, N., Monti, P., Abrams, D., Litt, M., & Hester, R. (1994). Cognitive-Behavioral Coping Skills Therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence. Project MATCH Monograph Series, 3 (DHHS Publication No. 94-3724). Rockville, MD: NIAAA. Retrieved from http://pubs.niaaa.nih.gov/publications/MATCHSeries3/index.htm

Larimer, M. E., Palmer, R. S., & Marlatt, G. A. (1999). Relapse Prevention: An overview of Marlatt's cognitive-behavioral model. Alcohol Research and Health, 23(2), 151-160.

Marlatt, A. (n.d.). Urge surfing: Relapse prevention.

Marlatt, G. A., & Donovan, D. M. (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (2nd ed.). New York: Guilford Press.

Marlatt, G. A., Parks, G. A., & Witkiewitz, K. (2002). Clinical guidelines for implementing Relapse Prevention Therapy: A guideline developed for the Behavioral Health Recovery Management Project. Seattle: University of Washington, Addictive Behaviors Research Center.

Online bibliography: Relapse and relapse prevention. (2007). Retrieved from http://alcoholstudies.rutgers.edu/library/relapse.html

Parks, G. A. (2007, May). Relapse Prevention Therapy workshop: Days 1-5 [PowerPoint slides]. Seattle: University of Washington, Addictive Behaviors Research Center.

Parks, G. A. (2007, May). Relapse Prevention Therapy workshop materials. Seattle: University of Washington, Addictive Behaviors Research Center.

Parks, G. A., & Marlatt, G. A. (2000). Relapse Prevention Therapy: A cognitive-behavioral approach. The National Psychologist, 9(5).

Relapse Prevention Plan Reminder Card

Schuette, E. F. (Ed.). (2004, Fall). Relapse prevention: Enjoying the holidays. The Next Step, 17(2).

Shaner, A., Eckman, T., Roberts, L. J., & Fuller, T. (2003). Feasibility of a skills training approach to reduce substance dependence among individuals with schizophrenia. Psychiatric Services, 54(9), 1287-1289.

Steinberg, K. L., Roffman, R. A., Carroll, K. M., McRee, B., Babor, T. F., Miller, M., et al. (2005). Brief counseling for marijuana dependence: A manual for treating adults (DHHS Publication No. SMA 05-4022). Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. Retrieved from http://www.kap.samhsa.gov/products/brochures/pdfs/bmdc.pdf

Witkiewitz, K., & Marlatt, G. A. (2007). Therapist's guide to evidence-based relapse prevention. Burlington, MA: Academic Press.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.3 3.5 2.5 3.1

Dissemination Strengths

A large number of materials are available to support implementation, many of which are easily accessible through the Web. Clinical guidelines provide a clear rationale and sequence for implementing this intervention. A comprehensive training workshop program offers a wide array of information on substance abuse treatment for diverse populations coupled with clear guidance for the use of this intervention. Outcome measures and general evaluation guidance are available to support quality assurance.

Dissemination Weaknesses

The burden of identifying and selecting the essential materials from among the many available is placed on the implementer. Very little guidance is provided on the organizational, staffing, or supervision requirements for implementation. Beyond the training workshops, no ongoing coaching, booster training, or supervision training is available. Little guidance is provided on how to identify, use, and interpret the available outcome measures. No standard measures for assessing fidelity are provided. The fidelity checklists provided for review were designed for specific studies and may not be appropriate for general implementation.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
RPT manuals Contact developer for license No
Therapist guidebooks $20-$55 each No
Client workbooks $20-$40 each No
Client videos $100-$750 each No
2- to 5-day training and consultation workshops $4,000 per day No
Program development $4,000 per day No
Contact Information

To learn more about implementation, contact:
George A. Parks, Ph.D.
(206) 930-1949
geoaparks@earthlink.net

To learn more about research, contact:
Katie Witkiewitz, Ph.D.
(505) 925-2334
katiew@unm.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.