Efficacy of mindfulness-based relapse prevention in a sample of veterans in a substance use disorder aftercare program: A randomized controlled trial
Abstract
Background Complementary integrative medicine, such as mindfulness-based interventions, (MBI) have demonstrated efficacy in the treatment of depression, anxiety, substance use disorders (SUDs), and pain. Mindfulness-based relapse prevention (MBRP) is an aftercare intervention targeting SUD relapse that integrates cognitive-behavioral relapse prevention and mindfulness meditation practices, raising awareness of substance use triggers and reactive behavioral patterns. This study evaluated the efficacy of MBRP in reducing relapse in veterans following completion of an SUD treatment program.Methods This study was a two-site, randomized controlled trial comparing MBRP to 12-step facilitation (TSF) aftercare in military veterans following completion of intensive treatment for SUDs. The 8 weeks of 90-minute, group-based MBRP or TSF sessions were followed by 3-, 6- and 10-month follow-up periods with assessments of alcohol/substance use and secondary outcomes of depression, anxiety, and mindfulness.Results Forty-seven percent of veterans attended ≥75 % of sessions. Veterans in both the MBRP and TSF aftercare groups maintained reductions in alcohol and illicit substance use during the aftercare treatment. Nineteen participants (11 %; 19/174) reported returning to alcohol use during the study treatment period and the study found no difference between study groups [MBRP: 9 % vs. TSF 13 %; p = 0.42]. Thirteen participants (7.5 %; 13/174) reported a return to illicit substance use during study treatment [MBRP: 5.4 % vs. TSF 10.3 % p = 0.34]. The number of days of drinking and illicit substance use was not different between groups (alcohol, p = 0.53; illicit substance use, p = 0.28).Conclusion Although retention in treatment limits interpretation of the findings, both MBRP and TSF were effective in maintenance of treatment gains following an intensive treatment program for veterans with SUDs. Future studies should focus on strategies to improve treatment participation.
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The retention rate of the MBRP group was slightly lower than the TAU group but comparable to, or even better than, some previous MBRP studies.
“Although the retention rate of the MBRP group was slightly lower than the TAU group, it was comparable to, or even better than, some of the previous MBRP studies [17, 49, 52, 53].”
MBRP average attendance in this study (4.59 sessions) was comparable to other studies (4.2-6.45 sessions).
“MBRP average attendance in this study (4.59 sessions) was comparable to other studies (4.2–6.45 sessions) [17, 52, 53].”
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Folivi, F., Bravo, A. J., & Pearson, M. R. (2025) · Mindfulness · doi:10.1007/s12671-025-02544-5 · Cited by 3 · see citing works
Ting, K. T., Leung, I. C. H., Chan, D. C. C., Yu, K. O. T., Tang, W. K., Chan, F., Tang, A. K. L., Ma, H. S. W., Yip, B. H. K., Zhang, D. D., et al. (2026) · Addiction · doi:10.1111/add.70441 · Cited by 1 · see citing works
“MBRP average attendance in this study (4.59 sessions) was comparable to other studies (4.2 – 6.45 sessions) [ 17, 52, 53 ].”
InfluentialSelf-citationHascher, S., Ossmy, O., & Pontes, H. M. (2025) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-025-01553-8 · Cited by 1 · see citing works
Moniz-Lewis, D. I. K., & Witkiewitz, K. A. (2024) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2024.209537
Naeem, S., Rasheed, A., & Poonja, H. A. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-08330-4
- Authors
- Killeen, T. K., Baker, N. L., Davis, L. L., Bowen, S., & Brady, K. T.
- Affiliations
- Medical University of South Carolina (US)
- University of Alabama (US)
- Pacific University Oregon (US)
- Corresponding author
- Killeen, Therese K.
- Baker, Nathaniel L.
- Davis, Lori L.
- Bowen, Sarah
- Brady, Kathleen T.
- Venue
- Journal of Substance Use and Addiction Treatment
- Publisher
- Elsevier BV
- Published
- 2023-09
- Volume
- 152
- Pages
- 209116
- ISSN
- 2949-8759 (ISSN-L)
- OpenAlex
- W4381952743
- Cited by
- 4
- References
- 64
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Substance Use and Addiction Treatment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Veterans Health Administration Rehabilitation Research & Development Service (I01RX001292)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- mindfulness-based relapse prevention, veterans, 12-step facilitation, relapse prevention, alcohol consumption, illicit drug use, treatment retention, depression, anxiety, mindfulness
- MeSH terms
- Aftercare, Ethanol, Humans, Neoplasm Recurrence, Local, Veterans, Substance-Related Disorders, Secondary Prevention, Mindfulness
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