Development and initial testing of mindful journey: a digital mindfulness-based intervention for promoting recovery from Substance use disorder

Abstract

Background/Objectives

There is a great unmet need for accessible adjunctive interventions to promote long-term recovery from substance use disorder (SUD). This study aimed to iteratively develop and test the initial feasibility and acceptability of Mindful Journey, a novel digital mindfulness-based intervention for promoting recovery among individuals with SUD.

Patients/Materials

Ten adults receiving outpatient treatment for SUD.

Methods

Phase 1 (n = 5) involved developing and testing a single introductory digital lesson. Phase 2 included a separate sample (n = 5) and involved testing all 15 digital lessons (each 30- to 45-minutes) over a 6-week period, while also receiving weekly brief phone coaching for motivational/technical support.

Results

Across both phases, quantitative ratings (rated on a 5-point scale) were all at or above a 4 (corresponding with ‘agree’) for key acceptability dimensions, such as usability, understandability, appeal of visual content, how engaging the content was, and helpfulness for recovery. Additionally, in both phases, qualitative feedback indicated that participants particularly appreciated the BOAT (Breath, Observe, Accept, Take a Moment) tool for breaking down mindfulness into steps. Qualitative feedback was used to iteratively refine the intervention. For example, based on feedback, we added a second core mindfulness tool, the SOAK (Stop, Observe, Appreciate, Keep Curious), and we added more example clients and group therapy videos. In Phase 2, 4 out of 5 participants completed all 15 lessons, providing initial evidence of feasibility. Participants reported that the phone coaching motivated them to use the app. The final version of Mindful Journey was a smartphone app with additional features, including brief on-the-go audio exercises and a library of mindfulness practices. Although, participants used these additional features infrequently.

Conclusions

Based on promising initial findings, future acceptability and feasibility testing in a larger sample is warranted. Future versions might include push notifications to facilitate engagement in the additional app features.

Keywords:

• Mindfulness-based relapse prevention
• mindfulness meditation
• digital interventions
• smartphone application
• substance use disorder

Acknowledgements

We would like to acknowledge Iya Hanik, Daniel Wang, and Kaiqi Zhang for their assistance developing the animated videos for the program.

Author contributions

CRR and HK played a lead role in all aspects of the study, including conceptualization and study design, funding acquisition, development of the digital intervention, data collection, data analysis, and writing the paper. BK and KMC played a leading role in conceptualization and study design and funding acquisition, and a supporting role in development of the digital intervention and writing the paper. MS, MK, ES, MJ, CJM, RP, JF, AH, DB, LF played supporting roles in conceptualization and study design, development of the digital intervention, and writing the paper. JB played supportive roles in all aspects of the study, including the grant application, intervention design, providing intervention content, study design, interpretation of study results, and writing the paper. SB and KW played leading roles in conceptualization and study design, funding acquisition, development of the digital intervention, and supporting roles in writing the paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data from this study are available by request from this first author CRR.

Additional information

Funding

CRR is supported by a grant from the National Center for Complementary and Integrative Health [K23AT011342].