Mindfulness Based Relapse Prevention: Efficacy and Mechanisms
Condition: Substance Use Disorders
MeSH terms: Recurrence; Substance-Related Disorders
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      The broad, long-term objective of the proposed randomized clinical trial is to evaluate the
      efficacy, moderators and mechanisms of change of two cognitive-behavioral aftercare
      treatments for alcohol and other drug (AOD) use disorders in preventing AOD relapse compared
      to treatment as usual (TAU) offered in the community. The two cognitive-behavioral aftercare
      treatments are relapse prevention (RP) and Mindfulness-Based Relapse Prevention (MBRP), which
      integrates mindfulness meditation and RP aftercare components.
    

Detailed description: 
      Relapse to alcohol and other drug use (AOD) following treatment continues to be a costly
      problem for individual, society, and the substance abuse treatment community, and thus
      warrants the continued development of innovative and efficacious interventions designed to
      prevent AOD relapse. Mindfulness based relapse prevention (MBRP; Bowen, Chawla, & Marlatt,
      2008) is one such promising intervention: it incorporates mindfulness meditation on the
      foundation of cognitive-behavioral relapse prevention (RP;Daley & Marlatt, 2006). RP is an
      established substance abuse treatment, yet as treatment developers, we believe RP can
      continue to be enhanced. Based on the results of an initial pilot trial, MBRP has
      demonstrated both feasibility and empirical promise as an aftercare treatment for AOD
      disorders in further enhancing long-term behavior change and reducing risk of relapse and
      related consequences. In the proposed study, MBRP and RP will be compared to the treatment as
      usual (TAU) as delivered by the Recovery Centers of King County (RCKC), in a population of
      individuals who have received community-based intensive inpatient (IP) or outpatient (IOP)
      treatment. RCKC is a community treatment agency that provides a range of addiction treatment
      services and has previously supported our efforts to recruit and retain sufficient numbers of
      the target population. The proposed study will examine whether structured mindfulness
      practice results in fewer AOD use days and fewer problems related to AOD use compared to TAU
      over a longer-term followup than in the previous pilot study. Given the high prevalence of
      AOD abuse in the population and the high rates of relapse following AOD treatment, the
      proposed research will provide a valuable next step in evaluating the efficacy of MBRP as an
      aftercare treatment for AOD disorders and in understanding the mechanisms of treatment
      efficacy. To our knowledge, no prior substance abuse treatment studies have evaluated the
      effect of adding a mindfulness-based component (e.g., MBRP) to an existing empirically
      supported treatment (i.e., RP).
    

Intervention name(s): Mindfulness Based Relapse Prevention; Relapse Prevention; Treatment as Usual
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The MBRP intervention comprises 8 weekly, 2-hour sessions delivered in small group format (10-14 participants) by two therapists (Bowen, et al., 2009). In MBRP, therapists facilitate discussions and exercises and introduce the meditation practice component.Group sessions include discussions of mindfulness as a means of coping with craving and painful cognitions/sensations that precipitate relapse, role-playing exercises, meditation practice, and homework assignments.; intervention is composed of 8 weekly 2-hour sessions delivered in small group format (10-14 participants); All participants will be enrolled in continuing care services (including attendance at AA, NA, or other self-help groups) as recommended by their treatment providers. Thus, TAU participants will have ongoing support and monitoring by their continuing care providers on a regular basis.
Other intervention name(s): MBRP; RP; TAU
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: substance use; addiction; meditation; mindfulness; relapse prevention