The problem of relapse is undoubtedly the most important single challenge currently facing the field of addictions. Relapse rates for all forms of addiction remain alarmingly high at roughly between 75 to 90 per cent within twelve months of treatment (Hunt et al., 1971; Hunt and Matarazzo, 1973; Armor et al., 1978; Marlatt and Gordon, 1980, 1985; Gottheil et al., 1982; Hubbard and Marsden, 1986; Prochaska and DiClemente, 1988; Shiffman, 1987). In the past, relapse prevention has tended to involve either elaborating or extending treatment. For example, some clinicians have tried bringing their clients back for periodic ‘booster’ sessions in which the ground that was covered in treatment is rehearsed and reinforced (see for example, Lichtenstein, 1982; Wilson, 1985); others have tried ‘multimodal’ approaches like those referred to in the previous chapter, in which a wide range of treatments is administered in the hope of preparing clients for as many eventualities outside treatment as possible (see, for example, Sobell and Sobell, 1973; Hamburg, 1975; Caddy and Lovibond, 1976; Alden, 1978; Miller and Hester, 1986).
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