In a quasi-experimental field study, two posttraining interventions composed of relapse prevention (RP) strategies were compared and tested for the effects on participant transfer outcomes. Participant retention of training content, skill maintenance, use of relapse prevention strategies, and self-efficacy served as the dependent variables. Self-efficacy was also tested as a mediator between the experimental treatment levels and both participant skill maintenance and participant use of RP strategies. Participants (n = 39) included managers, directors, and supervisors from various departments within a multi-national telecommunications organization located in a large southern city. After participating in a four-hour leadership development training, two of the three groups participated in a 30-40 minute training where they received one of two RP interventions. One intervention included the steps of (1) identifying potential obstacles to positive training transfer, (2) predicting the first lapse to pretraining behavior, and (3) applying relevant coping strategies to thwart a lapse. The alternative RP intervention included the same steps in addition to a goal setting step. Descriminant descriptive analysis was used to test for group differences across the response variables and to identify on which variables the groups differed. Three separate regression equations were used to test for the mediating relationship of self-efficacy between the RP treatment levels and participant skill maintenance and participant use of RP strategies. Results indicated minimal, but non-statistically significant results between treatment levels and each of the response variables. Self-efficacy was not found to mediate the relationship between RP treatment level and participant skill maintenance or participant use of RP strategies, but did function as a strong predictor of both variables. Suggestions for future research include using additional motivational and efficacy variables to better explore group differences and including efficacy-inducing methods both in training design and as part of a transfer intervention to enhance training transfer. Further, specific suggestions concerning conceptual and psychometric refinement of the RP construct are discussed.

Background: Despite their potential as low-threshold, low-cost and high-flexibility treatments of depression, behavioural activation and physical exercise have not yet been directly compared. This study will examine the effects of these interventions, administered via the Internet. The added effect of providing a treatment rationale will also be studied, as well as a relapse prevention program featuring cognitive behavioural therapy components. Methods/Design: This randomised controlled trial will include 500 participants meeting the diagnostic criteria for major depression, recruited in multiple cycles and randomised to either a waiting list control group with delayed treatment, or one of the four treatment groups: (1) physical exercise without a clear treatment rationale; (2) physical exercise with treatment rationale; (3) behavioural activation with treatment rationale; or (4) behavioural activation without a clear treatment rationale. Post treatment, half of the participants will be offered a relapse prevention program. Primary outcome measure will be the Patient Health Questionnaire 9-item. Secondary measures include diagnostic criteria for depression, as well as self-reported anxiety, physical activity and quality of life. Measurements done via telephone and the Internet -will be collected pre-treatment, weekly during treatment period, immediately post treatment and then monthly during a 24-month follow-up period. Discussion: The results of this study will constitute an important contribution to the body of knowledge of the respective interventions. Limitations are discussed.

Syftet med studien var att undersöka vilken grad av intern motivation och extern reglering till fysisk aktivitet som motionärer har, samt vilka barriärer de upplever till fysisk aktivitet och vilka strategier de använder sig av för att övervinna barriärerna. Bakgrunds variabler var kön och aktivitetsstadie. Försökspersonerna (n=199) i studien var män (n=96) och kvinnor (n=103) och samtliga medlemmar på träningsanläggningar i Halland. Högaktiva (n=165) och lågaktiva (n=34). Datainsamling skedde via ett testbatteri bestående av mätinstrumenten The Behavioral Regulation in Exercise Questionnaire-2, Physical Activity Stages of change och Motivation Till Upprätthållande Av Motionsvanor vilka delades ut på träningsanläggningarna. Resultatet visade att både högaktiva (n=165) och lågaktiva (n=34) har en högre grad av intern motivation än extern reglering. De mest frekventa barriärerna till fysisk aktivitet var stress/tidsbrist samt brist på motivation och de mest använda strategierna var tanken på känslan efteråt och tanken på förväntade resultat. Interventioner för att främja långsiktiga motionsbeteenden bör fokusera på att skapa glädje, välbefinnande och självbestämmande hos individen som leder till högre grad intern motivation som visat sig vara eftersträvansvärt för en fysiskt aktiv livsstil. Framtida studier skulle kunna fördjupa sig mer om hur motivation, barriärer och strategier skiljer sig åt beroende på aktivitetsstadie, genom att utföra ett träningsprojekt med en grupp lågaktiva individer för att kunna jämföra om inställningen skiljer sig åt ju mer fysiskt aktiva de blir. / The purpose of this study was to investigate the degree of internal motivation and external regulation for physical activity that athletes have, and what barriers they perceive to physical activity and what strategies they use to overcome barriers. Background variables were gender and activity stage. The subjects (n=199) in the study were men (n=96) and women (n=103) and all members of fitness centers in Halland. Highly active (n=165) and low-level (n=34). Data collection was done through a test battery consisting of measuring instruments The Behavioral Regulation in Exercise Questionnaire-2, Physical Activity Stages of Change and Exercise Adherence Questionnaire which were handed out at training facilities. The results showed that both high-level (n=165) and low-level (n=34) has a higher degree of internal motivation than external regulation. The most frequent barriers to physical activity were stress / time constraints, lack of motivation and the most frequently used strategies were the idea of feeling afterwards and the idea of expected results. Interventions to promote long-term exercise behaviour should focus on creating happiness, well being and autonomy of the individual that lead to greater internal motivation that proved to be desirable for a physically active lifestyle. Future studies could deepen more in how motivation, barriers and strategies differ depending on activity stage, by performing a training project with a group low-level to compare if the attitudes differ when they get more physical active.

Depression has been cited as the most prevalent of the Axis I disorders affecting upward of 16% of American adults in their lifetimes (Kessler et al., 2005). The literature on effective treatments for depression is substantial, however the follow-up literature that speaks to what happens after treatment ends is much smaller. This thesis describes two studies. The first is an overview of reviews of post-treatment outcomes for adults treated for major depressive disorder (MDD). The second is a narrative systematic review of studies of long-term (at least 12 months) post-treatment outcomes after the completion of treatment for major depressive disorder (MDD). These studies synthesize the available evidence concerning post-treatment outcomes and discuss the limitations of these data. Relapse is a significant issue for many people who respond to treatment with upwards of 50% of people relapsing within a year of the end of treatment, depending on the type of treatment. Some treatments have significant relapse prevention effects, including continued medication treatment, acute and continuation phase CBT, and variations of CBT designed specifically for addressing residual symptoms after acute treatment or specifically aimed at relapse prevention. Given that the risk of relapse after treatment is significant, it should be discussed during acute treatment, as should approaches to reducing the risk of relapse. Recommendations for future research are discussed. Within the overview of reviews, there was considerable consistency across reviews which aided in the formulation of practical recommendations for clinicians and for patients. Examples include provision of education about the probability of relapse and planning for relapse prevention during acute phase treatment. Engaging in continuation and maintenance treatments that are aimed at reducing relapse, and whenever possible, continuing treatment until patients are considered to be in recovery, and not just for a certain period of time, or until the point of remission of symptoms are also recommended to reduce rates of relapse.

Depression has been cited as the most prevalent of the Axis I disorders affecting upward of 16% of American adults in their lifetimes (Kessler et al., 2005). The literature on effective treatments for depression is substantial, however the follow-up literature that speaks to what happens after treatment ends is much smaller. This thesis describes two studies. The first is an overview of reviews of post-treatment outcomes for adults treated for major depressive disorder (MDD). The second is a narrative systematic review of studies of long-term (at least 12 months) post-treatment outcomes after the completion of treatment for major depressive disorder (MDD). These studies synthesize the available evidence concerning post-treatment outcomes and discuss the limitations of these data. Relapse is a significant issue for many people who respond to treatment with upwards of 50% of people relapsing within a year of the end of treatment, depending on the type of treatment. Some treatments have significant relapse prevention effects, including continued medication treatment, acute and continuation phase CBT, and variations of CBT designed specifically for addressing residual symptoms after acute treatment or specifically aimed at relapse prevention. Given that the risk of relapse after treatment is significant, it should be discussed during acute treatment, as should approaches to reducing the risk of relapse. Recommendations for future research are discussed. Within the overview of reviews, there was considerable consistency across reviews which aided in the formulation of practical recommendations for clinicians and for patients. Examples include provision of education about the probability of relapse and planning for relapse prevention during acute phase treatment. Engaging in continuation and maintenance treatments that are aimed at reducing relapse, and whenever possible, continuing treatment until patients are considered to be in recovery, and not just for a certain period of time, or until the point of remission of symptoms are also recommended to reduce rates of relapse.

It has in this review article been cited several different studies and sources, all concerning the prevention of relapse of schizophrenia and related psychotic disorders; The different approaches to treatment (programs, type of psychotherapy etc.) have been discussed according to evidence based research and randomized controlled trials. Although some explanations have been given about terms used in the literature, as well as some definitions to enable classifications in future studies, it has been focused only on the preventive measures used in schizophrenia; a detailed description of different subgroups of schizophrenia, as well as detailed descriptions of pharmacology in euroleptics is beyond the scope of this article. The recognition of relapse symptoms was first considered and defined, and the different approaches was then discussed; Outpatient treatment plans and relapse prevention plans, as well as the impact of cognitive behavioral therapy and psychotherapy have been discussed in subsequent chapters. In this section, it was especially focused on the ITAREPS program and its impact on the relapse prevention. The role of medications was then defined and supported with clinical studies and trials.

M.A. / The treatment of substance abuse remains a challenging process with relapse an ever-present risk. For those offering treatment within this field, such as the South African National Council on Alcoholism and Drug Dependence (SANCA), it is of cardinal importance to evaluate the outcomes of their interventions. Currently, there is no quantifiable and standardised method that SANCA can use to establish and assess how the actual outcomes of their programmes compare to their intended programme goals. Kranz and O’Hare (2006) argue for the evaluation of substance abuse treatment programmes through the use of scales to quantify various aspects of the treatment process which can then serve as a measure of its effectiveness. Effectiveness in this instance refers broadly to a patient’s maintenance of his/her sobriety for a period of 12 months or more, combined with an increase in his/her general functioning. Therefore, this study aims to demonstrate the technically complex process of developing a content valid framework for a scale on behalf of SANCA that adheres to their requirements for programme evaluation. The study is guided by an adapted model of ecometric scale development presented schematically by Faul and Hudson (1999). Through the use of a grounded theory approach, the study shows how to identify the expectations for a scale in the organisation and organise SANCA’s treatment strategy into a framework within which the areas of measurement can be placed. The study then demonstrates the construction of operational assessment areas through empirical data collection that adequately reflects such expectations. It also serves to test for content validity of the assessment areas, through the application of domain sampling theory. The study reveals the process undertaken to convert those assessment areas into constructs by conceptualising and operationalising them into working definitions. Lastly, drawing on those defined constructs, it populates a series of exemplar items designed for illustrative purposes.

<p>Despite data suggesting that current substance use disorder treatments are largely effective in reducing substance use, most adolescents in SUD treatment experience relapse after finishing treatment. Understanding the factors proximal to relapse is crucial to understanding the course of substance use disorder and how best to improve recovery among adolescents. The current study represents part of a novel line of research using qualitative data analysis to examine these factors. Data for the present study were 200 de-identified node-maps, completed by high school students at Hope Academy, a recovery high school in Indianapolis, Indiana. The reported age in this sample ranged from 14-20 years (64.1% male, 89.1% White), with a mean age of 16.8 years (SD = 1.9 years). After a four-phase process of qualitative data sorting, primary people, places, and things most frequently described included using with others (n=153, 76.5%), away from home (n=156, 78.0%), and in response to negative affect (n=93, 48.4%). Eleven relapse pathways emerged: escaping (n=16), self-medicating (n=3), coping with tragedy (n=5), critical mass (n=6), unexpected activation (n=8), unexpected offer (n=22), planned use (n=19), resistant to recovery (n=5), not in recovery (n=22), passive agency (n=30), and acting out (n=15). Recovery is a system made up of many interrelated parts, including those related to the individual person in recovery, their thoughts, beliefs, feelings, and emotions; and those related to external factors, their environment, adverse life events, and the actions of other people. By considering the pathways together for their common features, they can each be said to represent one of three critical failures related to those three overarching facets of the system: failure to cope, failure to guard against temptation, and failure of belief. Identifying these overarching failures in the system is helpful because the failures contain in themselves the seeds of their solution, so by examining them as critical components to a relapse event, it may be possible to gain insight into how to prevent the same type of relapses from occurring in the future. </p>

This study evaluates the effectiveness of safe offender strategies (SOS) in comparison with relapse prevention (RP) in a sample of 91 inpatient males in a secure psychiatric setting. All men evidenced a history of violent sexual offending and were diagnosed with serious psychiatric disorders and/or intellectual disabilities. Participants who received SOS (n = 58) and RP (n = 33) were followed from 6 to 36 months post release. SOS clients were significantly less likely to be arrested (0%) or rehospitalized (5.2%) than RP clients (9% arrested; 54.5% rehospitalized). In addition, SOS clients were more likely to transition continuously to less restrictive alternatives, with no returns to high security, in comparison with RP clients. The authors discuss implications for use of SOS, a treatment that facilitates skills development and affects global self-regulatory functioning, particularly in sex offenders with serious mental illness or intellectual impairment, in promoting community reintegration and limiting returns to psychiatric settings.

The purpose of this study has been to gain an understanding of how drug addicts get out of an addiction from the perspective of people who have previously been addicted to narcotics. To achieve the purpose of this study we interviewed former addicts and social workers whose work is to help drug addicts. The interviews with the informants have been semi structured where as we had prepared some open questions but also as the interviews went on we thought of follow up questions to ask. The analysis was conducted with three theories: the turning point, natural recovery and social bond. The results show that there are different ways to reach a turning point when you decide to quit the habit and then there are various factors that facilitate a person of getting out of an addiction that also prevent relapse. Furthermore, the results show that their own perspective on what mattered the most during their way out of an addiction was the support of people who had gone through the same process of changing their lifestyle. They found that fellowship is essential to recovery and relapse prevention.