A qualitative analysis of the process leading to, during, ending and following a relapse drinking session in a UK clinical sample of problem drinkers

First published: 10 May 2019 | Last updated: 20 May 2019

Ms Yuko McGrath

Researcher in Drug Prevention


I am originally from Japan and came to this country in 1991. I developed an interest in psychology and gained a BSc from the University of Liverpool where I have recently also completed a Doctorate in Clinical Psychology. I have been a researcher in drug prevention at the National Collaborating Centre for Drug Prevention (Liverpool John Moore University) for a year and co-authored several reviews on drug misuse in young people. I have also worked as an assistant psychologist at the Windsor Clinic, Alcohol Treatment Unit in Liverpool for approximately 3 years and at this point started a part-time Ph.D. in psychology looking at impulsivity in problem drinking.

My interests

Addictions have been my longstanding clinical and research interest. In particular, I am interested in relapse in alcohol use.

Whilst a trainee clinical psychologist, I completed a specialist placement, as well as a research project on relapse for my dissertation, at the Windsor Clinic.

Future work

My intention for the future is to integrate clinical and research work as a clinical psychologist. Throughout my clinical training, I have seen many clients in non-addiction services who misused alcohol. This has convinced me that clinical and research experiences and skills that I have gained from working in the field of addictions are transferable to any heath care setting.

Aim: To describe themes before, during, at the end of and following a post-treatment drinking session.

Participants: Fifteen service users who reported a relapse whilst attending aftercare groups at an NHS alcohol treatment clinic.

Data: Semi-structured interviews were conducted approximately four weeks after relapse.

Analysis: The interviews were transcribed and analysed using thematic analysis.

Findings: Several themes were identified. ‘Public and private sides of relapse’ described the process before relapse. Despite participants feeling that their relapse was an inevitable response to powerful triggers, they appeared to demonstrate careful decision-making in beverage choice and strategies of maintaining their motivation to drink. ‘Enjoying expected positive pay-offs for me’ portrayed the early stage of the relapse process, which was predominantly a positive experience due to primary and/or secondary gains from drinking. ‘Reached perceived threshold for negative pay-offs’ described the process leading to the end of relapse. Participants were able to stop drinking when they became aware that further drinking would cause positive pay-offs to be far outweighed by negative pay-offs. ‘Build up my relapse knowledge-base and disseminate my story’ described the process following relapse. Negative consequences of drinking, if experienced, were short-lived. Participants communicated their lack of control in the relapse to others and this often elicited consolation.

Conclusions: Relapse appeared to be a choice based on ordinary decision-making. The benefits of challenging socially held constructions of relapse and the clinical implications for improving relapse prevention interventions in service provision are discussed.


Louise Roper; Simon Duff

Ms Yuko McGrath