Case Conceptualization:
Cognitive-behavioral model of relapse (Marlatt & Gordon, 1985)
                          Effective Coping
                             Response:                                                         Decrease Probability
                                                              Increased Self-                        of Relapse
                          Increased opioid                                                     Treatment engagement,
                           use, particularly                     Efficacy
                                                              Treatment from                     ongoing support of
                         injection, to gain a                                                     younger brother
                         sense of power and                 rehabilitation center
                                                                                                  decrease relapse
                          eliminate sexual
                                desires.
    High-risk situation:
  sexual desires + cravings
+Conflict and arguments with
  elder brothers leading to
substance use + father’s death
                                                      Decreased Self-
                                                      Efficacy+Positie
                                                      Outcome
              Ineffective Coping                      Expectancies                                Initial Use of
           Response due to High-                      family blame and lack                         Substance
                risk Situation                        of belief decrease self-                   Influenced from
             Escalated opioid use                     efficacy.                                 friends and father
             through sniffing and                     client associates opioid
            injection to cope with                    use with numbing the
              emotional pain and                      brain and feeling free
                  numbness.                           from problems
                                                                         Abstinence Violation Effect +
                      Increased Probability of                           Perceived Effect of Substance
                               Relapse
                                                                        Relapse heightened craving, client
                      Peer influence, unresolved
                                                                        associates opioids with enhanced
                      conflicts, craving ,lack of
                                                                          stamina and the fulfillment of
                    family support increase relapse
                                                                                  sexual desires