Mindfulness and Depression

1. Depression, and
Mindfulness-
Based Relapse
Prevention
Claudia L. Chandler

2. The Process
 Depression Craving and Relapse
 Mindfulness-Based Relapse Prevention
 Method
 Intervention
 Clinical Implications

3. Depression, Craving, and
Relapse
 Addiction has generally been characterized as a
chronic and relapsing condition.
 Risk Factors: negative affect, craving or urges,
interpersonal stress, motivation, self-efficacy, and
ineffective coping skills in high-risk situations
 Negative affect has been shown to be a prominent
cue for craving in both laboratory and clinical studies
 Relation between depression and substance abuse

4. Longtime Users
 Are particularly susceptible to increased
depressive symptoms, which heighten
their motivation to seek relief which
increase the intensity of their craving

5. Mindfulness-Based Relapse
Prevention (MBRT)
 Targets negative mood, craving, and their
roles in the relapse process
 Based on MBCT - identifying high-risk
situations, coping skills training and
mindfulness meditation.
 30–45 min in session and 45/day
meditation with CD.

6. In Session
 Observe physical, cognitive, emotional, or
craving states without “automatically”
reacting.
 They learn to “investigate” the emotional,
physical, and cognitive components of
experience, rather than to immediately
attempt to escape them.
 Repeated exposure depressive states in the
absence of substance use weaken the
response of craving.

7. Method
 Sample: Participants recruited from an
inpatient/outpatient rehab.
 Measures: self-reports via
 Penn Alcohol Craving Scale
 Beck Depression Inventory
 Substance Use Follow Back

8. Intervention
 2 Therapists
 Groups of 6–10 participants.
Met weekly for (8) x 2-hr sessions.
 In session: guided meditations,
experiential exercises, and discussion.
 Daily exercises to practice between
sessions and were given CDs for daily
meditation practice.
 Relapse prevention practices integrated.

9. Clinical Implications and
Future Directions
 Moderated mediation effect
 Influences cognitive and behavioral
responses to depressive symptoms.
Wants to incorporate mindfulness training
as part of substance use treatment
 Could help clients cope more effectively
with affective discomfort during early
abstinence.

10. References
Witkiewitz, K., & Bowen, S. (2010).
Depression, craving, and substance use
following a randomized trial of
mindfulness-based relapse prevention.
Journal Of Consulting And Clinical
Psychology, 78(3), 362-374.
doi:10.1037/a0019172