Taxonomy of high-risk situations for alcohol relapse: evolution and development of a cognitive-behavioral model

Addiction. 1996 Dec;91 Suppl:S37-49.


The purpose of this paper is to provide an historical overview of the development of the taxonomy of high-risk situations for relapse in patients receiving abstinence-based treatment for alcoholism. Research conducted during the 1970s on determinants of relapse is briefly reviewed, beginning with a preliminary analysis of relapse patterns in alcoholics treated with aversion therapy. Theoretical foundations underlying the development of the taxonomy are then discussed with an emphasis on social-learning theory and its implications for cognitive-behavioral interventions for relapse prevention. Findings supporting the efficacy of coping-skills training for high-risk relapse situations, based on a prospective treatment outcome study for inpatient alcoholics, are also presented in support of the clinical validity of the relapse model. The paper concludes with a description of the refined and extended taxonomy of high-risk situations and the associated cognitive-behavioral model of relapse described in the Marlatt & Gordon (1985) text on relapse prevention.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adaptation, Psychological
  • Alcoholism / classification
  • Alcoholism / psychology
  • Alcoholism / rehabilitation*
  • Aversive Therapy
  • Cognitive Behavioral Therapy*
  • Humans
  • Outcome Assessment, Health Care
  • Recurrence
  • Risk Factors
  • Social Facilitation*