Psychology ETDs

Publication Date

Spring 7-1-2018

Abstract

Background: Relapse following treatment is common among individuals with substance use disorder (SUD) and effective treatments that support long-term recovery are needed. Mindfulness-based relapse prevention (MBRP; Bowen, Chawla, & Marlatt, 2011) is a promising intervention, yet there is a lack of evidence on how MBRP can be effectively disseminated and adapted for different real-world treatment settings. MBRP has most commonly been delivered as a closed-cohort group among individuals receiving aftercare treatment. It is unclear whether MBRP can be effectively delivered as a rolling admission group and among individuals at earlier stages in the recovery process. Additionally, there is a need to better understand how and why MBRP works, which can inform the refinement of MBRP. Study Aims: This study was a non-randomized, open trial to evaluate the feasibility, acceptability, and mechanisms of behavior change (MOBC) related to a manualized rolling admission version of MBRP that was offered to individuals with substance use disorder (SUD) who had just completed medical detoxification and who were starting a 21-day inpatient treatment program. Methods: The rolling MBRP treatment was developed over several years through an iterative process and the final version used in this study consisted of eight one-hour modules. Study participants included 109 adults (46% female, 74.3% racial/ethnic minorities, mean age = 36.40) enrolled in an inpatient SUD treatment program. The rolling MBRP group was offered to all patients in the inpatient program. Patients who enrolled in the study completed a baseline assessment at admission and a post-assessment right before discharge from the inpatient treatment program. Attendance at each MBRP session was tracked. Results: Individuals attended an average of 3.69 sessions (SD=2.12), out of three to six possible sessions (depending on length of stay), indicating feasibility. Regarding acceptability, participants reported high satisfaction ratings. Total number of sessions attended did not predict MOBC. However, attending two or more sessions (versus one or none) predicted better mental health and higher mindfulness at post-assessment, and these effects were mediated by informal and formal mindfulness practice. Also, total number of sessions attended had numerous indirect effects, via frequency of informal and formal mindfulness practice, on post-assessment MOBC (craving, confidence in achieving valued goals, mental health, regulatory flexibility, self-compassion, and mindfulness). Conclusions: Findings provide preliminary evidence that MBRP can be effectively delivered as a rolling admission group among individuals who have just completed medical detoxification and are starting an inpatient treatment program. Rolling MBRP may be particularly effective in improving mental health and dispositional mindfulness. Findings also suggest that both informal and formal mindfulness practice may be key in facilitating changes in MOBC. Regulatory flexibility and self-compassion were both significantly predicted by mindfulness practice, suggesting that these constructs are worthy of further investigation as MOBC in MBRP. Future research on rolling MBRP is warranted and has the potential to make MBRP more accessible and available in a diverse range of treatment settings.

Degree Name

Psychology

Level of Degree

Doctoral

Department Name

Psychology

First Committee Member (Chair)

Katie Witkiewitz

Second Committee Member

Sarah Bowen

Third Committee Member

Kevin Vowles

Fourth Committee Member

Matthew Pearson

Language

English

Keywords

Mindfulness-Based Relapse Prevention; Substance Use Disorder; Rolling Admission Adaptation, Residential Treatment

Document Type

Dissertation

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