Mindfulness-based relapse prevention

Domain II · Behavioural & cognitive · Bowen, Chawla, Grow · 2005

What it is

Mindfulness-Based Relapse Prevention (MBRP) is an aftercare group for people who have already started recovery from substance use or other addictive behaviours. It combines the meditation practices of MBSR and MBCT with the cognitive-behavioural relapse prevention (RP) model of Marlatt and Gordon.

Format

• Format. MBRP is a closed group of 8 weekly sessions of about 2 hours, with daily home practice supported by audio recordings. It has three components: formal practice, informal practice and coping strategies.
• Group size and staffing: in the pilot, 5–12 participants per group with two master's-level co-facilitators.

Who practises it, and how they are trained or regulated

• Facilitator training. The UC San Diego Center for Mindfulness pathway asks for the following:
• A mental-health degree, or current clinical training.
• The current 12-week online training is led by Bowen. Trials also used fidelity rating with the MBRP Adherence and Competence Scale and weekly supervision. The 2nd edition includes an MBRP Fidelity Scale.

Evidence status, as the guide reports it

• Version followed: the 8-session group programme in Bowen, Chawla, Grow & Marlatt, Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician's Guide, 2nd ed. (Guilford, 2021), using its session titles. The book text itself is not drawn on. Session-level practices come from published…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• moralising. Stay curious and nonjudgemental.
• cards that are never carried. Check in Session 8.
• anxiety about the group ending. Name aftercare options.
• isolated participants; link them to services. It is working when concrete contacts are named.
• hearing "accept" as "give in to using". Clarify that you accept the experience, not the action.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.