Implicit in the RP approach is that the initiation and maintenance of behavior change represent separate processes governed by unique contingencies [12,28]. Thus, specific cognitive and behavioral strategies are often necessary to maintain initial treatment gains and minimize relapse likelihood following initial behavior change. RP strategies fall into two broad categories: specific intervention techniques, often designed to help the patient anticipate and cope with high-risk situations, and global self-control approaches, intended to reduce relapse risk by promoting positive lifestyle change. An essential starting point in treatment is a thorough assessment of the client's substance use patterns, high-risk situations and coping skills. Other important assessment targets include the client's self-efficacy, outcome expectancies, readiness to change, and concomitant factors that could complicate treatment (e.g., comorbid disorders, neuropsychological deficits). Using high-risk situations as a starting point, the clinician works backward to identify immediate precipitants and distal lifestyle factors related to relapse, and forward to evaluate coping responses [16,24]. Ideally, this approach helps clients to recognize high-risk situations as discriminative stimuli signaling relapse risk, as well as to identify cognitive and behavioral strategies to
