Mindfulness-Based Relapse Prevention and Intervention for Substance Use Disorder
The Addiction Research Foundation
Brandi McNeely
“Mindfulness” is a term that can be heard echoed throughout recent culture, bringing to mind different images and definitions for different people. Although ‘mindfulness” may be a broad and possibly misunderstood term, there have been movements to better integrate practices into mental health interventions. This movement is notably true within substance use disorder treatment and intervention. Mindfulness is being integrated into community treatment centers and group recovery programs for individuals suffering from substance use disorder. One example of this integration is mindfulness-based relapse prevention (MBRP) (Penberthy et al. 2015).
Mindfulness based relapse prevention was developed at the University of Washington for individuals struggling with, or in the process of recovering from addictive behaviors. According to the Mindfulness Based Relapse Prevention for Addictive Behaviors clinicians guide, MBRP is a combination of mindfulness and cognitive behavioral practices. It aims in helping individuals gain awareness of habitual thought patterns, habitual reactions and behaviors, and triggers (Bowen et al. 2010).
For an example of how these strategies are incorporated into recovery programs, Vrana et al. (2017) integrated mindfulness-based Relapse Prevention into a community-based treatment program for women suffering from both substance use disorder and pot-traumatic stress disorder. The study consisted of two groups of randomized participants, with the intervention group participating in an 8-week MBRP program, with PTSD symptom severity and substance use outcomes measured at baseline, throughout the intervention, and at 3- and 6-months post treatment for both groups. These women were taught mindfulness meditation as a substance use avoidance strategy, mindfulness techniques for approaching trauma thoughts, and participated in guided meditation exercises (Vrana et al. 2017).
Incorporating MBRP into an individual’s substance use disorder treatment may allow them to, “1. Develop awareness of personal triggers and habitual reactions and learn ways to create a pause in the seemingly automatic process. 2. Change our relationship to discomfort, learning to recognize challenging emotional and psychical experiences and responding to them in skillful ways. 3. Foster a nonjudgmental, compassionate approach toward ourselves and our experiences. 4. Build a lifestyle that supports both mindfulness practice and recovery” (Lucas, 2017). Since MBRP has been seen to help individuals deal with cravings and improve mindfulness, it is also important to examine the impact these strategies have on community and group-based recovery programs in order to better understand the influence of this type of intervention from a mezzo perspective.
Methods
The information for this paper was gathered through an extensive review of the literature on Mindfulness-Based Relapse Prevention being used on a mezzo level, for community or group-based recovery programs. Gender and type of substance use was not specific or exclusive criteria for the literature review. The University of Alabama at Birmingham Library database was used in order to obtain peer-reviewed, relevant, and recent articles. Various search term combinations were used in order to achieve a full overview of the available literature. These terms included “Mindfulness,” “substance abuse treatment,” group therapy,” “MBRP,” “meditation,” “community SUD treatment,” and “mezzo practice.” Articles were selected and results were examined in order to evaluate the impact of MBRP on the participant populations.
Results
According to Russell et al. (2016), mindfulness-based treatment techniques were integrated into a treatment program for young adult males suffering from substance use disorder. A within-subject study design was utilized, wherein all participants were able to participate in the mindfulness-based intervention and a questionnaire was used to compare each individual’s pre-intervention scores to their post treatment scores. According to the self-assessment questionnaire, positive treatment outcomes were statistically significant in post-treatment compared to pre-mindfulness-based treatment. Participant questionnaire answers also showed a statistically significant improvement in nonjudging and non-reactivity skills, post-treatment (Russell et al. 2016).
Davis et al. (2019), conducted a study examining the effects of MBRP intervention on young adults in a substance use disorder treatment facility. Approximately half (n = 45) of the participants were assigned to the intervention group and the other participants (n = 34) were assigned to the “treatment as usual” group, wherein they continued 12-step and self-help meeting related treatment. A 6-month-post treatment assessment was conducted as showed that individuals in the MBRP intervention group reported significantly improved perceived stress, craving, and substance use outcomes, compared to the “treatment as usual” group (Davis et al. 2019).
Bowen et al. (2014) performed a study where treatment results were examined 286 individuals who completed SUD treatment at a nonprofit treatment facility, undergoing 8 weekly groups sessions of MBRP, cognitive- behavioral relapse prevention (RP), or treatment as usual (TAU). Relapse, heavy drinking, and frequency of substance use was examined at baseline, 3-, 6-, and 12-month follow-up. According to self-report and uranalysis, MBRP significantly reduced relapse for drug use and drinking compared to TAU. Further, MBRP was shown to produce significant reductions in heavy drinking compared to TAU and RP.
Amaro et al. (2014) conducted a study that examined the impact of MBRP in a minority, low income, population of women in substance abuse treatment. A within subjects, repeated measures study design was conducted, wherein all participants were able to undergo the MBRP intervention and self-report data was compared pre-intervention and post-intervention. According to the self-report data, participant satisfaction for the intervention was high. Continually, MBRP was associated with reduced alcohol, drug severity, and perceived stress, within the participant population (Amaro et al. 2014).
Zullig et al. (2018) conducted a study measuring the results of integrating MBRP into treatment for individuals with opioid use disorder in an outpatient treatment, who are concurrently using medication-assisted treatment. A within-subjects study design was conducted, where each participant (n = 32) was able to undergo an 8-week MBRP intervention and their pre-intervention data was compared to post-intervention. According to post-treatment data, significant increases in mindfulness were reported and significant decreases in anxiety and depression were reported in the participant population compared to pre-intervention reports.
Discussion
Sancho et al. (2018) conducted a systematic review of articles examining mindfulness-based interventions (MBI) for the treatment of substance use disorder and found that mindfulness-based interventions were shown to be integrated into a large range of treatment programs, with MBRP being one of the most commonly used interventions. MBI’s were shown within the literature to reduce dependence and cravings, while improving mood states and emotional dysregulation among participants. MBRP is a useful intervention for SUD treatment.
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