Relapse Prevention Model
This model was originally developed to better understand people’s difficulties with addictive behaviours (Marlatt and Gordon, 1985). It has also proved itself to be useful in understanding and intervening to increase exercise/physical activity levels. The main focus of this model is the maintenance of change over the long-term, which is of special relevance to physical activity/exercise to maintain health and fitness benefits.
This model suggests that it is necessary to identify situations that place a person at high risk for not being physically active or exercising (e.g. barriers such as home or work commitments, perceived lack of time, etc). From this, a ‘game plan’ is then developed to avoid or cope with each of these situations. If a person finds themselves in a situation in which they are at risk of not being physically active or exercising, they use their skills to overcome the temptation to be sedentary, thereby increasing their self-efficacy. In contrast, if they succumb to the temptation to be sedentary, then lower self-efficacy will probably result in similar situations in the future.
This model also distinguishes between lapses and relapses. A lapse could be not exercising for a few days, whereas a relapse is an extended period of no exercise or physical activity. This helps people avoid the abstinence violation effect, which refers to the reaction of a person to a ‘slip’ that influences the probability of returning completely to the old behaviour (relapse) (i.e. people’s tendency to give up altogether when they have ‘slipped’). For example, while on holiday for a couple of weeks and doing no exercise, a person may feel less motivated to resume their exercise programme when they return home as they feel out of their routine. By accepting such lapses as normal and only temporary glitches, they are more likely to think of this as a break from their routine, but now they are back home, it is time to resume their exercise programme. There are two main components to the abstinence violation effect:
- When the cause of the slip is attributed to an internal cause, such as a personal weakness or lack of will power, the person feels guilty and in conflict. Then there is a perceived loss of control, resulting in a reduction in self-efficacy.
- If the cause of the slip is attributed to external factors, such as a temporary lapse in coping with a particular high risk situation, then the abstinence violation effect will be low, the person will maintain a sense of control and self-efficacy will be stable.
There are several thoughts that can lead to relapse:
- Over-generalising: viewing the slip as evidence of complete failure
- Selective-abstraction: focusing excessively on the one recent failure and dismissing other successful experiences as having no importance
- Excessive responsibility: when the person assumes all responsibility for failures and uses them as evidence of personal weakness and misses the opportunity to learn from mistakes
- Catastrophising: exaggerating how bad the slip is.