The effects of Mindfulness training people recovering from alcohol dependence.

INTERVENTION: While effective treatments are available for mild levels of alcohol and drug dependence the repeated and persistent, long lasting nature of the disorder often involves people attending groups to prevent relapse. One type of approach considers whether by learning to accept and just notice the cravings for substances, instead of trying to suppress or fight off the cravings, makes it easier for people to use different or opposing behaviours to prevent relapse. This study examines the effect of an eight session programme designed to disrupt thoughts, feelings, and bodily functions implicated in stress‐initiated relapse to alcohol consumption. The intervention will compare a Mindfulness based intervention adapted from Mindfulness‐Based Cognitive Therapy for Depression (Segal et al . 2002) with a standard alcohol support group (ASG) treatment. Participants will be randomly assigned to one of two conditions: Mindfulness groups: 8 x 1.25 hr /week of mindfulness training (n=14, 2 groups, Total n=28) ASG Groups: 8 x 1.25 hr /week of ASG (n=14, 2 groups, Total =28) Session‐Specific Description of Mindfulness and ASG Interventions Session Mindfulness Based Intervention 1. Discussion of mindfulness and automatic drinking; mindfulness of craving; mindful breathing and body scan 2. Discussion of cognitive reappraisal; practice of mindful de‐centring and mindful breathing 3. Discussion of attentional re‐orienting as means of coping with negative emotions and craving; mindful breathing; mindfulness of perceptions & sensations 4. Discussion of craving; practice of "urge surfing," mindfulness of craving, and contemplation of negative consequences of drinking; imaginal alcohol cue exposure; mindful breathing practice 5. Discussion of the relationship of the stress response to craving; imaginal stress exposure; mindful breathing 6. Discussion of thought suppression, aversion, and attachment; exercise in the futility of thought suppression; mindful breathing and acceptance 7. Discussion of relational triggers for relapse; mindful communication; compassion meditation 8. Breathing Review; discussion of how to maintain mindfulness practice; development of mindful relapse prevention plan; imaginal rehearsal of mindful relapse prevention; mindful breathing Session: ASG treatment 1. Discussion of triggers for alcohol dependence relapse 2. Discussion of justifications for relapse and using alcohol to mask one's emotions 3. Discussion of how participants cope with emotions of anger and sadness 4. Discussion of how participants cope with craving and managing compulsive behavior 5. Discussion of stress and methods participants use to relax without alcohol 6. Discussion of the attempt to maintain control and loss of control 7. Discussion of physical health promotion and ways to recreate without alcohol 8. Discussion of co‐dependence relationships and the challenge of forming friendships without alcohol CONDITION: Alcohol dependence PRIMARY OUTCOME: Alcohol craving frequency and intensity Penn Alcohol Craving Scale (Flannery et al., 2001) ; Brief Symptom Inventory (Derogatis & Melisaratos, 1983) measures the degree to which participants are distressed by psychiatric symptoms. ; Impaired Alcohol Response Inhibition Scale (Guardia et al., 2007) ; SECONDARY OUTCOME: Attitudes Towards Treatment Questionnaire (Borkovec & Nau, 1972) ; Kentucky Inventory of Mindfulness Skills Questionnaire(Baer et al., 2004). Perceived Stress Scale (Cohen, Kamarck & Mermelstein, 1983) ; Psychophysiological cue‐reactivity:(HRV recovery, that is, changes in HRV between alcohol cue exposure and the recovery period) using Emwave finger sensors. ; ; ; White Bear (thought) Suppression Inventory (Wegner & Zanakos, 1994) a measure of thought suppression to avoid or repress undesired cognitions and emotions. ; INCLUSION CRITERIA: Participants must be 18 years of age or older (male or female) Residents of the therapeutic community Meet (DSM‐IV) alcohol dependence criteria