MINDFULNESS BASED RELAPSE PREVENTION FOR ADULT SUBSTANCE ABUSERS

The role of mindfulness (defined as the gentle effort to be continuously present with experience) based treatment approaches for psychiatric disorders seems to be increasing. I have previously blogged about the benefit of mindfulness approaches to reduce stress in elementary age children.  Brown, et al. JAMA Psychiatry 2014 Mar 19 reported on their randomized clinical trial evaluating the benefit of 8 weekly group sessions of mindfulness based relapsed prevention (MBRP)compared to COGNITIVE-behavioral relapse prevention (RPT), and treatment as usual (TAU) that included a 12 step program.  Studies have shown that 40-60% of people with substance use disorders (SUD) relapse by 1 year after treatment. The studies cite interactions between personal motivation, coping skills, peer influences, and substance availability as leading to relapses.  Relapse prevention programs focus on identifying situations that trigger craving and how to avoid them while enhancing skills to help avoid substance use. 286 people with SUD's ( 74% male; 39% ethnic minority and average age =38) we're randomized to participate in one of the three treatment groups.  The focus of RPT and TAU was on avoidance of high risk situations and reducing disphoria that can both lead to relapse by providing support and cognitive restructuring.  The MBRP treatment teaches tolerance of dysphoric feelings and the different setbacks that life presents, reducing the need to use substances to reduce stress.  MBRP also encouraged emotional flexibility ways to accept daily problems.  After three months there was no difference in outcomes across the three groups.  After 6 months, both MBRP and RPT showed significantly fewer relapses.  After one year, only MBRP was associated with significantly fewer relapses.

So it seems that an ancient (2500 year old) meditative practice that has been updated in the last century is now helping people of all ages to reduce their stress level and learn new and positive coping skills...all by calmly, with slow even breaths, staying in the moment and experiencing life without judgment or anxiety.  Give it a try.

JUST BREATHE REVISITED

Previously I blogged about the stress relieving benefit of slow, even breathing.  Since then it continues to come up directly or indirectly with different approaches to stress management.  It is frequently referred to as "mindfulness."  This has been defined as consciousness without thought.  I wonder if it may be better defined as a calm, alert state with active efforts to clear one's mind from worries, future events, past events, etc., so that we are open to what life might bring us.  Being aware of our breathing as we focus on it becoming slow and even, is one way to achieve this state of "mindfulness" that is available to anyone who commits to practicing this type of breathing on a daily basis.  Intrerestingly, it seems to be an important part of the brain training treatments for ADHD and PTSD as well as a way to improve working memory and reading levels in people.  The latter reference is to studies involving mindfulness training undertaken by Michael Mrazek and his colleagues at UC-Santa Barbara who are introducing mindfulness practices into elementary schools. 

The benefits of meditation, mindfulness and breathing practices have been well established.  It seems like a number of treatments represent attempts to achieve a meditative/mindful state more quickly by reinforcing certain brain wave patterns that are associated with being calm and alert and focused. These same brain wave patterns can be achieved through breathing exercises and other meditative practices. I am eager to learn the results of Dr. Mrazek and colleagues attempts to implement mindfulness practices in elementary level school systems.  This could have a significant positive impact on the lives of these children and possibly spread to their family members.  

As I ended the other blog about breathing, I will end this one the same way.  JUST BREATHE.