Although an individual will start to experience greater self-efficacy as they abstain from using a substance, certain high-risk situations will pose a threat to the person's sense of control, which may lead them to relapse. Some characteristics of high-risk situations are:

- Negative emotional states
- Interpersonal conflict, which can lead to negative emotions
- Social pressure, both direct and indirect (for example, being around other people who are consuming alcohol)
- Positive emotional states
- Exposure to alcohol-related stimuli (for example, seeing an ad for alcohol)
- Attempts to test one's personal control/willpower

High Risk Situations and Relapse

Ultimately, it is the individual's response to the high risk situation that affects whether or not they will relapse. For example, a person who uses effective coping skills, such as leaving the situation or positive self talk, is less likely to relapse than someone who does not use effective coping skills. A person who has coped successfully with a high-risk situation will experience a greater sense of self-efficacy, thereby decreasing their chance of relapse in the future.

Coping Skills and Relapse

A person's likelihood of relapsing will change depending on their expected outcome of engaging in the addictive behavior. A person who only focuses on the positive effects of a behavior and discounts the negative effects is more likely to relapse, especially in high risk situations where the behavior may be perceived to help the individual cope with negative emotions. 

Outcome Expectancies and Relapse

The abstinence violation effect states that it is a person's emotional response to a single lapse in substance use which will determine whether or not they ultimately relapse. For example, someone who considers the lapse to be a personal failure is more likely to continue to engage in the addictive behavior to attempt to escape the feeling of failure, thereby leading to a full relapse. On the other hand, someone who considers the lapse to be an instance where they did not cope effectively is more likely to see the lapse as a single mistake they can learn from. 

Abstinence Violation Effect

The four immediate determinants of relapse are:

- High risk situations
- Coping skills
- Outcome expectancy
- Abstinence Violation Effect

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The relapse prevention model proposes that there are two types of factors that contribute to episodes of relapse. The two types are:

- Immediate determinants
- Covert antecedents

Factors that Contribute to Relapse

Larimer, M.E., Palmer, R.S., & Marlatt, G.A. (1999). Relapse prevention: An overview of Marlatt's cognitive behavioral model. Alcohol Research & Health, 23(2), 151-160. 

Relapse Prevention:  An Overview of Marlatt's Cognitive Behavioral Model

Immediate Determinants of Relapse

Covert antecedents are less apparent factors that can contribute to a person's likelihood of relapsing. The two covert antecedents are:

- Lifestyle factors
- Urges and cravings

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