CBT Relapse Prevention & Maintenance Strategies 2 — Questions and Answers
Question 1: Mindfulness-Based Cognitive Therapy (MBCT) was specifically designed to prevent relapse of which condition?
- Schizophrenia spectrum disorders
- Recurrent major depressive disorder (Correct answer)
- Bipolar I disorder
- Borderline personality disorder
Correct answer: Recurrent major depressive disorder
MBCT was developed by Segal, Williams, and Teasdale specifically to prevent relapse in patients with recurrent major depressive disorder, particularly those with three or more previous episodes.
Question 2: The concept of 'seemingly irrelevant decisions' (SIDs) in relapse prevention refers to:
- Decisions made while in a dissociative state
- Small, apparently harmless choices that chain together and lead a client toward high-risk situations (Correct answer)
- Decisions made during an acute crisis episode
- Choices that appear relevant to therapy but are not clinically significant
Correct answer: Small, apparently harmless choices that chain together and lead a client toward high-risk situations
Seemingly irrelevant decisions are small, apparently innocuous choices that progressively bring a client closer to high-risk situations without their full awareness.
Question 3: Which of the following is a key component of a CBT maintenance plan?
- A comprehensive list of all past traumas in chronological order
- Early warning signs, personalized coping strategies, and an action plan for setbacks (Correct answer)
- A medication schedule provided by the prescribing psychiatrist
- A list of all avoided situations that should never be confronted
Correct answer: Early warning signs, personalized coping strategies, and an action plan for setbacks
A comprehensive maintenance plan includes identifying personal early warning signs, coping strategies tailored to the individual, and a clear action plan to implement if setbacks occur.
Question 4: When a client experiences a lapse after completing CBT treatment, the most therapeutically appropriate response is to:
- Immediately restart the full original course of treatment
- Normalize the lapse, analyze what happened, and reinforce existing coping skills (Correct answer)
- Increase medication dosage in consultation with the prescriber
- Discharge the client and provide a referral to a specialist
Correct answer: Normalize the lapse, analyze what happened, and reinforce existing coping skills
Normalizing the lapse, conducting a functional analysis of contributing factors, and reinforcing coping strategies helps prevent the lapse from escalating into a full relapse.
Question 5: What is the 'lifestyle imbalance' concept in Marlatt's relapse prevention model?
- An unhealthy diet that directly contributes to psychiatric symptoms
- An excess of obligations over pleasurable activities that creates deprivation and craving (Correct answer)
- A mismatch between work demands and family responsibilities
- Inconsistent sleep patterns that disrupt emotional regulation
Correct answer: An excess of obligations over pleasurable activities that creates deprivation and craving
Lifestyle imbalance refers to a chronic excess of 'shoulds' (obligations) over 'wants' (pleasurable activities), creating deprivation that increases craving and relapse vulnerability.
Question 6: In CBT for relapse prevention, 'coping imagery' is best described as:
- Using visual art therapy to process underlying trauma
- Mentally rehearsing successful coping with anticipated high-risk situations before they occur (Correct answer)
- Creating a vision board of recovery goals and aspirations
- Reviewing photographs that trigger emotional responses for exposure purposes
Correct answer: Mentally rehearsing successful coping with anticipated high-risk situations before they occur
Coping imagery involves mentally rehearsing how to successfully handle anticipated high-risk situations, building confidence and preparedness before actual exposure to those situations.
Question 7: Which of the following best describes the appropriate role of the therapeutic relationship during the maintenance phase of CBT?
- It should be terminated abruptly to force client independence
- It should be gradually tapered while fostering the client's self-efficacy and autonomous use of skills (Correct answer)
- It should remain equally intensive regardless of client progress
- It is clinically irrelevant once core CBT techniques have been taught
Correct answer: It should be gradually tapered while fostering the client's self-efficacy and autonomous use of skills
During maintenance, the therapeutic relationship is gradually tapered in a planned way to promote the client's independent use of skills and build self-efficacy for managing future challenges.
CBT Relapse Prevention & Maintenance Strategies 2
Mindfulness-Based Cognitive Therapy (MBCT) was specifically designed to prevent relapse of which condition?