Relapse prevention: Overview of research findings in the treatment of problem drinking, smoking, obesity and depression

The aim of this paper is to provide an overview of developments in the area of relapse prevention for selected psychological disorders: problem drinking; smoking; obesity; and depression Relapse prevention methods, including booster sessions, have been associated with mixed outcomes, although there are some encouraging findings, particularly in the treatment of obesity and alcohol problems. A number of recommendations are made for research and/or clinical practice. In the treatment of alcohol problems it is recommended that more attention be paid to reducing co-existent marital problems and mood disorders. In obesity, there is a need for evaluations of intensive, long-term therapist contact with the severely obese, particularly those with serious medical problems. Studies of the complete relapse prevention approach advocated by Marlatt and Gordon (1985) are needed in the evaluation of smoking cessation programmes. It is concluded that maintenance of gains in smoking, obesity and problem drinking comes at a considerable cost in time and therapist contact. To date, there has been little application of relapse prevention methods to depression, and further empirical work is needed to identify the determinants of relapse and the efficacy of specific maintenance-enhancement strategies. Consistent themes in the prediction of relapse are identified, including low social support, ongoing interpersonal difficulties, and low self-efficacy.