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Mindfulness Based Relapse Prevention (MBRP)

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MBRP Manual

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Professional Trainings

Professional MBRP training in Joshua Tree, CA, September 2009 (completed)
Professional MBRP training in Rochester, NY, May 2010 (completed)
Professional MBRP training in Joshua Tree, CA, Spring 2011
Professional MBRP training in Rochester, NY, fall 2011 (under development)

Current Randomized Controlled Trial
Mindfulness-Based Relapse Prevention: Efficacy and Mechanisms
Project Duration: 8/1/09-7/31/11
Sponsor: National Institute on Drug Abuse
Amount: $1,415,659

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 standard aftercare (SA) offered in the community. The two cognitive-behavioral aftercare treatments are relapse prevention (RP; Daley & Marlatt, 2006) and Mindfulness-Based Relapse Prevention (MBRP), which integrates mindfulness meditation and RP aftercare components. The proposed research plan will address three specific aims. The first aim is to examine the efficacy of MBRP and RP compared to SA in preventing AOD relapse following intensive inpatient (IP) and outpatient (IOP) AOD treatment. Participants will be recruited from IP and IOP treatment and randomized to 8 weeks of MBRP, RP or SA. Treatment efficacy, as defined by reductions in AOD use and related consequences, will be evaluated at posttreatment and 2, 4, and 6 month follow-up assessments. It is hypothesized that both MBRP and RP will result in significantly less AOD use and related consequences compared to SA. The second specific aim is to evaluate potential mediators of MBRP and RP treatment efficacy. It is proposed that the MBRP and RP interventions will be differentially effective in reducing AOD use and consequences based on the unique objectives of each treatment approach. It is therefore hypothesized that MBRP efficacy will be mediated by metacognitive processes, thought suppression, ability to cope with craving and negative affect, and intensity of meditation practice. It is further hypothesized that RP efficacy will be mediated by self-efficacy and coping abilities. The final aim is to test potential moderators of treatment efficacy, such as demographic variables, cognitive functioning, and severity of dependence. It is hypothesized that participants with higher cognitive functioning and less severe dependence will benefit more from the MBRP and RP treatments than those who are lower on these dimensions. In fulfilling these specific aims, the proposed research will address the NIDA mission by examining the efficacy and mechanisms of change of various AOD aftercare treatments.

Pilot Study (completed)

Efficacy of Mindfulness-Based Relapse Prevention.
Project duration: 6/2006-6/2008
Sponsor: National Institute on Drug Abuse
Award: $415,700

The broad, long-term objective of the current research is to improve treatment for alcohol and other drug (AOD) use disorders through development of an innovative alternative approach to preventing AOD relapse.

The specific aims of the research are 1) To develop a manual and therapist adherence/competence measures to standardize delivery of a Mindfulness-Based Relapse Prevention (MBRP) program for post-treatment relapse prevention of AOD problems, which will be patterned after Mindfulness-Based Cognitive Therapy for Depression (Segal, Teasdale & Williams, 2002) and incorporate cognitive-behavioral relapse prevention strategies (Daley & Marlatt, 1997); 2) To conduct a pilot randomized clinical trial to assess the feasability of recruiting and retaining individuals for a large scale study and to determine effect size of MBRP in comparison to cognitive-behavioral group relapse prevention based on Marlatt's Relapse Prevention model (RP) alone (Daley & Marlatt, 1997). Both MBRP and RP conditions will be compared to a treatment as usual control group (TAU) in a sample of participants enrolled in continuing care following Intensive Outpatient Treatment, at baseline, post-treatment, 2-, and 4-months following the baseline assessment; and 3) Evaluate potential mediators of MBRP and RP treatment efficacy. We hypothesize that both MBRP and RP will be more efficacious than TAU. We hypothesize MBRP efficacy will be mediated by meta-cognitive processes, thought suppression, locus of control, skills to cope with urges and cravings, negative affect and meditation practice. We hypothesize RP efficacy will be mediated by self-efficacy, negative affect and coping abilities.

This research builds on over 25 years of developing and implementing RP interventions. MBRP incorporates specific alcohol and drug-focused cognitive therapy techniques with an additional emphasis on mindfulness skills, and builds upon the Investigator's prior work on meditation-based interventions.