Mindfulness-Based Relapse Prevention in a Jail Drug Treatment Program

Abstract

Background: More than half of prisoners in the United States are estimated to suffer from a substance use disorder. Mindfulness involves attention to the present moment, and nonjudgmental acceptance of sensations, thoughts, and emotional states. Mindfulness-based relapse prevention (MBRP) following substance use disorder treatment has been shown to reduce substance use. Objective: We sought to adapt and test MBRP for a jail substance use disorder treatment setting. Methods: We enrolled successive cohorts of incarcerated men participating in a drug treatment program in a large urban jail (n = 189) into six weekly sessions of either MBRP or an comparison communication skills intervention, between 2013 and 2015. MBRP was delivered by a culturally competent African–American trainer. Pre- and post-test measures included mindfulness, anxiety, posttraumatic stress disorder (PTSD), and drug craving. Results: At baseline, measures of mindfulness were significantly inversely correlated with anxiety, PTSD symptoms and drug cravings. Anxiety, PTSD symptoms and cravings declined significantly in both treatment arms, and mindfulness increased. Comparison of the two study arms using maximum likelihood estimation suggested a small but significantly greater increase in mindfulness in the treatment arm. Conclusions/Importance. An attention control trial of a mindfulness intervention, delivered by a culturally competent trainer, is feasible in a jail setting.

Keywords:

• Mindfulness
• correctional treatment
• meditation
• yoga
• relapse prevention

Acknowledgments

The authors are grateful to Michelle Champagne and Yirser Ra Hotep for outstanding group facilitation and research assistance. We thank our Advisory Board, especially Sarah Bowen, James Carmody, and Arthur Lurigo for their insights during study design and implementation; all errors and omissions are those of the authors. We also thank the WestCare Foundation for facilitating access to their program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Circuit Court of Cook County.

Notes

1  “In cases in which those studies require the assignment of prisoners in a manner consistent with protocols approved by the IRB to control groups which may not benefit from the research, the study may proceed only after the Secretary has consulted with appropriate experts, including experts in penology, medicine, and ethics, and published notice, in the FEDERAL REGISTER, of the intent to approve such research.” 46 Code of Federal Regulations 45, section 110(e)(iv).

Additional information

Funding

Research reported in this publication was supported in its entirety by a $1.9 million grant to Chicago State University from the National Institute on Drug Abuse of the National Institute of Health, under grant award R24DA03640.