Practice Makes Perfect for Substance Abuse Mindfulness Relapse Program

Mindfulness is a therapeutic approach that teaches clients how to use breathing exercises, meditation, and awareness to overcome psychological problems. Mindfulness-based therapies have been shown to be highly effective at reducing symptoms of anxiety and depression, especially in people who are not able to see results with other forms of more traditional therapies. Mindfulness Based Relapse Prevention (MBRP) was created to help prevent relapse in people overcoming addictions. The evidence that exists suggests that this treatment works, but there is relatively little information about what factors influence the success of MBRP. Sarah Bowen of the Department of Psychology at the University of Washington recently conducted a study to see how between-session mindfulness practice and therapeutic alliance influenced the outcome of MBRP.

Bowen followed 93 individuals who were undergoing treatment for substance misuse as they embarked on 8 weeks of MBRP. She monitored the amount of between-session practice they engaged in and also interviewed them regarding the level of therapeutic alliance they experienced. The participants were assessed at the beginning of the treatment, at the end of the treatment, and again at 2 and 4 months follow-up. Bowen found that the level of between-session practice was directly predictive of outcome in the participants. The more practice, the better the participants responded to treatment. But Bowen discovered that the participants who practiced the most did not see better long-term outcomes than those who had less between-session mindfulness practice. However, the therapeutic bond, which did influence outcome immediately after the mindfulness treatment, also affected the long-term outcome of the participants.

Bowen believes that the effect of the mindfulness could decrease over time due to the impact of external conditions, such as life stressors and family members, but the effect of the therapeutic bond is maintained because that relationship is not affected by outside factors. To maintain the benefits achieved from between-session mindfulness, clients should focus on developing a support system of people who will encourage their mindfulness behaviors over time. Bowen added, “Future studies might offer further insight into how both mindfulness practice and therapeutic alliance are affecting changes in mindfulness and explore other factors influencing increases in and longer term maintenance of mindfulness in mindfulness-based therapies.”

Bowen, S., Kurz, A.S. Between-session practice and therapeutic alliance as predictors of mindfulness after mindfulness-based relapse prevention. Journal of Clinical Psychology 68.3 (2012): 236-45.

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  • Shara


    April 2nd, 2012 at 10:52 AM

    The bad thing is that most people, addicts or not, are looking for the quick fix. They don’t want to have to do the hard work, which is repetitive and something that they will have to work at.

    I genuinely think that this is where you lose a lot of patients in their path to recovery. No matter whether it is a drug addict or a drinker, a shopper or a porn addict or food addict, when they decide that they want to change, then they want it to happen in an instant. They forget that this kind of change has to be a work in progress for them to be the most successful. Most people will try something for a while, and if there are not immediate results, then eventually they will lapse right back into their old ways.

  • Carlton


    April 2nd, 2012 at 3:11 PM

    Mindfulness is indeed a powerful tool in this battle, but it does not have to lose its effectiveness if it can be taught and ingrained in the patient so that during those times of stress that you say could wear away its effectiveness, they are able to use that and come back to it to get centered once again. Make it a habit like exercise and sleep, and it is something that can be maintained over time.

  • patterson


    April 3rd, 2012 at 4:22 AM

    So how would one go about finding someone who could help you to facilitate this type of treatment as a part of your recovery?

  • danny


    April 3rd, 2012 at 8:17 AM

    incorporating mindfulness in between sessions seems like a good idea because the addiction is hardest to stay away from at the beginning and if this skill is taught in the beginning then it can be very helpful.

    mindfulness seems to be a great tool if you ask me.I have read quite a lot about it and really see promise in it.

  • Simone


    April 3rd, 2012 at 3:45 PM

    It’s great to see that the research is showing what practitioners generally know. That mindfulness is a useful skill to help with managing a range of mental health issues but that (a) like any skill, it requires practice and (b) that it isn’t a quick fix or cure-all.

    It’s not surprising to see that, once again, the therapeutic relationship is important. With research showing this time and time again, it’s disappointing that third party payer/managed care systems continue to focus on specific techniques, despite these contributing less than 15% to treatment outcome. By taking a reductionist medical model approach to working with the human psyche, important factors are overlooked.

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