An open trial of rolling admission mindfulness-based relapse prevention (Rolling MBRP): feasibility, acceptability, dose-response relations, and mechanisms.

Mindfulness-based relapse prevention (MBRP) is an effective treatment for substance use disorders (SUD). However, evidence is primarily based on studies of closed groups, and few studies support flexible formats of MBRP, such as rolling groups. This nonrandomized, open trial evaluated feasibility, acceptability, dose-response relations, and mechanisms of rolling admission MBRP ("Rolling MBRP") offered as part of short-term residential treatment for SUD. Rolling MBRP was developed prior to the trial through an iterative process over several years. Participants included 109 adults (46% female, 74.3% racial/ethnic minorities, mean age=36.40). Rolling MBRP was offered to all patients in the program 2x/week and attendance was tracked. Outcomes were craving, self-efficacy, mental health, mindfulness, and self-compassion at discharge. Self-reported out-of-session mindfulness practice was examined as a mediator of attendance-outcome relations. Analyses involved multiple regression and mediation models. Feasibility was demonstrated by good attendance rates. Acceptability was demonstrated by high engagement in mindfulness practice and high satisfaction ratings. Total sessions attended did not predict outcomes at discharge. However, attending 2+ sessions (versus 1 or none) significantly predicted better mental health and higher mindfulness at discharge, and these effects were mediated by informal and formal mindfulness practice. Total sessions attended had significant indirect effects on craving, self-compassion, mindfulness, and mental health, via mindfulness practice. Results support the feasibility and acceptability of Rolling MBRP and suggest mindfulness practice may be a key mechanism driving effects of MBRP on other key mechanisms during the recovery process, such as decreased craving and improved mental health.

Déclaration de conflit d'intérêts

Conflicts of Interests Drs. Bowen and Witkiewitz have conducted MBRP trainings for which they received monetary incentives, although the findings presented in this article have not yet been presented as part of these trainings. The current study is the dissertation of the first author, who led the data analysis and interpretation. The results and findings have been reported in the dissertation repository https://digitalrepository.unm.edu/psy_etds/260/. Drs. Bowen and Witkiewitz served on the dissertation committee and provided guidance throughout, but have not attempted to influence data interpretation or tone to highlight or overinterpret effectiveness of the program. No other authors have conflicts and there has been no significant financial support for this work that could have influenced its outcome.