A few resources which everyone pondering mindfulness, clinical treatment and substance use should be reading.
Bowen S, Chawla N, Collins SE, Witkiewitz K, Hsu S, Grow J, et al. Mindfulness-based relapse prevention for substance-use disorders: A pilot efficacy trial. Substance Abuse, 30 (4), 295-305.
Quoted Abstract: The current study is the first randomized-controlled trial evaluating the feasibility and initial efficacy of an 8-week outpatient Mindfulness-Based Relapse Prevention (MBRP) program as compared to treatment as usual (TAU). Participants were 168 adults with substance use disorders who had recently completed intensive inpatient or outpatient treatment. Assessments were administered pre-intervention, post-intervention, and 2 and 4 months post-intervention. Feasibility of MBRP was demonstrated by consistent homework compliance, attendance, and participant satisfaction. Initial efficacy was supported by significantly lower rates of substance use in those who received MBRP as compared to those in TAU over the 4-month post-intervention period. Additionally, MBRP participants demonstrated greater decreases in craving, and increases in acceptance and acting with awareness as compared to TAU. Results from this initial trial support the feasibility and initial efficacy of MBRP as an aftercare approach for individuals who have recently completed an intensive treatment for substance use disorders.
Bowen, S., Witkiewitz, K., Dillworth, T.M., Chawla, N., Simpson, T.L., Ostafin, B., Larimer, M.E., Blume, A.W., Parks, & Marlatt, G.A. (2006). Mindfulness meditation and substance use in an incarcerated population. Psychology of Addictive Behaviors, 20(3), 343-347. PMCID: PMC1989113
Quoted Abstract: Despite the availability of various substance abuse treatments, alcohol and drug misuse and related negative consequences remain prevalent. Vipassana meditation (VM), a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. In this study, the authors evaluated the effectiveness of a VM course on substance use and psychosocial outcomes in an incarcerated population. Results indicate that after release from jail, participants in the VM course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. VM participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes. The utility of mindfulness-based treatments for substance use is discussed.
Bowen S, Witkiewitz K, Dillworth TM, Marlatt GA. The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addictive Behaviors.2007;32:2324–2328.
Quoted Abstract: Previous studies have demonstrated that attempts to suppress thoughts about using substances may actually lead to increases in substance use. Vipassana, a mindfulness meditation practice, emphasizes acceptance, rather than suppression, of unwanted thoughts. Bowen and colleagues (2006) studied the effects of a Vipassana course on substance use and in an incarcerated population, showing significant reductions in substance use among the Vipassana group as compared to a treatment as usual control condition (Bowen, Witkiewitz, Dillworth, Chawla, Simpson, Ostafin, et al., 2006). The current study further examines the mediating effects of thought suppression in the relationship between participation in the course and subsequent alcohol use in an incarcerated population. Those who participated in the course reported significant decreases in avoidance of thoughts when compared to controls. The decrease in avoidance partially mediated effects of the course on post-release alcohol use and consequences.
Hayes, S.C., Follette, V.M., & Linehan, M.M. (eds.). (2004). Mindfulness and acceptance: expanding the cognitive-behavioral tradition. New York: Guilford Press.
Quoted Description: This volume examines a number of increasingly popular therapies that have emerged over the last decade and that share an emphasis on such nontraditional themes as mindfulness, acceptance, relationship, values, and spirituality. Leading scientist-practitioners provide detailed descriptions of their respective approaches, discussing theoretical and empirical bases as well as clinical methods and goals. Promising applications are presented for treating a variety of challenging clinical issues and problems, including depression, anxiety, couple conflict, PTSD, eating disorders, and substance abuse. Illuminated are the ways in which indirect and experiential change strategies are being integrated with established cognitive and behavioral techniques–and what this means for the future of psychotherapy research and practice.
Hick S, Bien T, editors. Mindfulness and the therapeutic relationship. New York: Guilford Press; 2008. pp. 107–121.
Quoted Description: A number of books have explored the ways psychotherapy clients can benefit from learning and practicing mindfulness. This is the first volume to focus specifically on how mindfulness can deepen the therapeutic relationship. Grounded in research, chapters demonstrate how therapists’ own mindfulness practice can help them to listen more attentively and be more fully present. Leading proponents of different treatment approaches–including behavioral, psychodynamic, and family systems perspectives–illustrate a variety of ways that mindfulness principles can complement standard techniques and improve outcomes by strengthening the connection between therapist and client. Also presented are practical strategies for integrating mindfulness into clinical training. Contains a chapter on treatment of substance-abuse.
Lau MA, McMain S. F. Integrating mindfulness meditation with cognitive and behavioural therapies: The challenge of combining acceptance- and change-based strategies. Can J Psychiatry. 2005;50:863–869
Quoted Abstract: Recent innovations in psychological treatments have integrated mindfulness meditation techniques with traditional cognitive and behavioural therapies, challenging traditional cognitive and behavioural therapists to integrate acceptance- and change-based strategies. This article details how 2 treatments, mindfulness-based cognitive therapy and dialectical behaviour therapy, have met this challenge. We review the integration rationale underlying the 2 treatments, how the treatments combine strategies from each modality to accomplish treatment goals, implications for therapist training, and treatment effectiveness. In addition, we discuss the challenges of assessing the benefits of incorporating acceptance-based strategies. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive and behavioural therapies to create efficacious treatments.
Marlatt, G.A., & Chawla, N. (2007). Meditation and alcohol use. Southern Medical Journal, 100, 451-453.
Quoted Abstract: No abstract available.
- Meditation and mindfulness address experiences of craving, counteract conditioned automatic responses to use alcohol, and may create acceptance of one’s current experience.
- Ongoing meditation practice could also reduce relapse through an increase in self-efficacy.
- Results of one randomized trial comparing transcendental meditation with two control groups showed significant reductions in alcohol use and associated problems.
- The overall goal of Mindfulness-Based Relapse Prevention is the development of awareness and nonjudgemental acceptance of thoughts through the practice of mindfulness, and the practice of these skills as coping strategies to address urges and relapse triggers.
- Approaches that utilize meditation are promising and could provide low-cost treatment alternatives or supplements.
Pruett, J.M., Nishimura, N.I., & Priest, R. M. (2007). The role of meditation in addiction recovery. Counseling and Values, 52, 71-84.
Quoted Abstract: The authors examined the role of meditation as an important component in addiction recovery. Successful addiction recovery is often related to an individual’s ability to develop and use a repertoire of coping behaviors, including the ability to maintain an ongoing awareness of one’s vulnerability. These learned behaviors serve as reliable alternatives to the routine behavior patterns of individuals who are addicted, which, in the past, have led to often-repeated destructive outcomes. The authors contend that incorporating meditation into the lifestyle of individuals recovering from addiction provides a consistent means of preparing for inevitable, addiction-related life challenges and a coping skill that can help maintain equilibrium in living with ever-present peril. (Contains 4 figures.)
Witkiewitz K, Marlatt GA, Walker DD. Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy. 2005;19:221–228.
Quoted Abstract: Cognitive-behavioral approaches to alcohol and drug use disorders have received considerable empirical support over the past 20 years. One cognitive-behavioral treatment, relapse prevention, was initially designed as an adjunct to existing treatments. It has also been extensively used as a stand-alone treatment and serves as the basis for several other cognitive and behavioral treatments. After a brief review of relapse prevention, as well as the hypothesized mechanisms of change in cognitive and behavioral treatments, we will describe a “new” approach to alcohol and drug problems called mindfulness-based relapse prevention. Preliminary data in support of mindfulness-meditation as a treatment for addictive behavior are provided and directions for future research are discussed.