Friday, September 17, 2010

Mindfulness-Based Relapse Prevention: An Introduction

The other day I came across a new article about an important emerging mindfulness-based treatment that we haven’t written about in SM yet: Mindfulness-Based Relapse Prevention (MBRP). MBRP came out of the lab of Dr. Alan Marlatt at the University of Washington. Dr. Marlatt is well-known for his substance abuse research, and he has had a personal and professional interest in mindfulness and meditation since he was a young professor decades ago. I first encountered mention of MBRP 5 years ago in a paper co-authored by Dr. Marlatt with Dr. Katie Witkiewitz, who was a student of Dr. Marlatt’s and is now at Washington State University-Vancouver.

My SC co-founder Jason Luoma and I are currently collaborating with Dr. Witkiewitz on a study of MBRP in a women’s inpatient substance abuse treatment program. During a meeting about the study, Dr. Witkiewitz talked about the genesis of MBRP. Marlatt’s lab had conducted a study of the impact of a 10-day Vipassana meditation course at a Washington jail. (The Vipassana retreat was in the style developed by S.N. Goenka.) Results of the study were extremely promising. Compared to inmates who didn’t participate in the Vipassana course, those who completed it showed significant reductions in substance use following release. Additionally, participants showed lower levels of psychiatric symptoms upon release.

Unfortunately, Marlatt’s lab couldn’t get funding for additional study of the Vipassana course. Apparently, it was considered a little unorthodox. In order to develop something that might be more palatable to potential grant reviewers, they took a cognitive behavioral Relapse Prevention program Dr. Marlatt had developed and combined it with Mindfulness-Based Cognitive Therapy, a well-supported mindfulness treatment for recurring depression. (MBCT in turn was based on Kabat-Zinn’s Mindfulness-Based Stress Reduction program.) In combining the treatments, Marlatt’s lab created MBRP!

MBRP is an 8-week group-based treatment. Participants are initially introduced to mindfulness through a body scan, a practice developed by Kabat-Zinn in his program. Sitting meditation is eventually introduced, and there is also some yoga. Throughout the treatment, participants learn to notice cravings for drugs and alcohol, identify triggers, and prepare for the possibility of relapse.

In my next post, I’ll write about a promising new study supporting the efficacy of MBRP. One article was just published in June in the Journal of Consulting and Clinical Psychology, an extremely prestigious publication. (UPDATE: click here for second post.)

For those interested, I’ve cited research I mention in this post. I’ve included links to PDF’s of the actual articles where possible. Specifically Bowen et al. (2006) and Simpson et al. (2007).


Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., Clifasefi, S., et al. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30(4), 295-305.

Witkiewitz, K., Marlatt, G. A., & Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 211-228.

Witkiewitz, K., & Bowen, S. (2010). Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. Journal of Consulting and Clinical Psychology, 78(3), 362-374.

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