Mindfulness-Based Relapse Prevention (MBRP) integrates cognitive behavioral therapy, relapse prevention skills, and mindfulness meditation practice. It is based on Buddhist principles of psychology and aims to help people cope with urges and cravings that could trigger relapse into addictive behaviors. MBRP teaches clients to pay attention to the present moment non-judgmentally through mindfulness practices like meditation. These practices increase awareness of triggers and habitual reactions to develop new coping skills for high-risk situations.

1. Mindfulness-Based
Relapse Prevention
Presented by KJ Foster
March 31, 2015

2.  Largely inspired by and based on the work of Jon Kabat-Zinn
 Based on Buddhist principles of psychology
 Integrates:
 Cognitive Behavioral Therapy
 Relapse Prevention Skills
 Mindfulness Meditation Practice
 Method of coping with urges and cravings that might be
triggers for relapse across a variety of addictive behaviors.
(Bowen, Chawla & Marlatt, 2010)
MBRP

3. What is Mindfulness?
Mindfulness means paying attention
in a particular way:
on purpose,
in the present moment
and nonjudgmentally.
- Jon Kabat-Zinn

4. EXERCISE #1

5. What is Buddhist Psychology?
 Emphasizes acknowledging, feeling, and accepting discomfort
when it arises, and understanding the experience intimately, rather
than endlessly attempting to run away from it.
 This is a compassionate approach, emphasizing acceptance and
openness rather than guilt, blame, and shame about one’s
behavior.
 Mindfulness can provide a skillful means of coping with urges and
craving that involves observing them, without being wiped out or
consumed by them.
 Meta-cognition = big picture instead of giving in to one’s usual
conditioned, habitual behavior.

6. Four Noble Truths
 First Truth – Life is fraught with suffering, and this suffering
is caused by attachment or craving.
 Second Truth – This craving can take several forms and is
a form of aversion or struggling against “what is.”
 Third Truth – The good news! There is a way out of
suffering!!
 Fourth Truth – The “eight-fold path” is the way out of
suffering.

7. The Noble Eightfold Path
 A list of eight desirable behaviors (or what are termed in Buddhism
as “right” behaviors) as the way to the end suffering:
 Right view (understanding)
 Right intention
 Right speech
 Right action
 Right livelihood
 Right effort
 Right mindfulness
 Right concentration

10. Awareness
“Between stimulus and response, there
is a space. In that space is our power
to choose our response. In our
response lies our growth and freedom”
- Victor Frankel

11. Awareness
 Mindfulness practices increase awareness of this space and create
the opportunity to respond skillfully rather than react automatically
and habitually (e.g. Impulse control). Thus, when faced with trigger
for substance use, one can make a mindful choice that decreases
the likelihood of relapse.
 Mindfulness approach also helps reduce the tendency of the mind
to exacerbate negative emotional states, lowering the stigma,
shame, blame, and guilt commonly experienced by people who
struggle with addictive behaviors.

12. EXERCISE #2

13. PARADOX
It is a paradox that we encounter so much internal noise
when we first try to sit in silence.
It is a paradox that experiencing pain releases pain.
It is a paradox that keeping still can lead us
to fully into life and being.
Our minds do not like paradoxes. We want things
to be clear, so we can maintain our illusions of safety.
Certainty breeds tremendous smugness.
We each possess a deeper level of being, however
which loves paradox. It knows that summer is already
Growing like a seed in the depth of winter. It knows
that the moment we are born, we begin to die. It knows
that all of life shimmers, in shades of becoming –
that shadow and light are always together,
the visible mingled with the invisible.
When we sit in stillness we are profoundly active
Keeping silent, we can hear the roar of existence.
Through our willingness to be the one we are,
We become one with everything.

14. Relapse Prevention (RP)
 RP was developed by Marlatt & Gordan in 1985.
 MBRRP integrates mindfulness meditation practices and traditional
Relapse Prevention
 The most salient factor that serves to decrease the risk of relapse in
an otherwise high-risk situation, and which is at the core of the RP
Model, is access to alternative coping response.
 RP focuses on identifying high-risk situations and teaching coping
skills so as to increase self-efficacy and decrease the likelihood of
relapse.
 Results overall show that although RP does not result in higher
abstinence rates following treatment, it does significantly reduce the
frequency and intensity of relapse episodes, helping people get
“back on track” more quickly if they do fall off the wagon.

15. MBRP in Practice
 Consists of 8 weekly sessions conducted in a group
therapy format integrating cognitive-behavioral RP skills
with mindfulness practices.
Meditation
Relaxation Training
Exercise
 The purpose of these practices is to increase awareness
of triggers and habitual reactions, to develop a new
relationship with these experiences, and to learn
concrete skills to use in high-risk situations.

16. ADDICTION as DICTATION
 The words addiction and dictation have the same Latin stem:
dicere (“to impose or give orders with or as with authority”).
 MBRP teaches the client that we do not have to be dictated to by
our thoughts. I accept them and I let them pass.
 By moving from aversion to acceptance as a means of coping with
craving, recovery is facilitated on the basis of a new compassionate
approach.
G. Alan Marlatt

17. Questions & Discussion

18. CLOSING EXERCISE

19. References
Bowen, S. W., Chawla, N. and Marlatt, A. G. (2010) Mindfulness-Based
Relapse Prevention for Addictive Behaviors: A Clinician’s Guide.
New York: Guilford Publications, Inc.