Mindfulness-Based Relapse Prevention
Mindfulness-Based Relapse Prevention is a contemplative group program developed by Sarah Bowen, Neha Chawla and G. Alan Marlatt, whose manual appeared in 2010. Its core mechanism: mindfulness practice builds awareness of triggers, craving, and habitual reaction patterns; decentering from substance-related thoughts and urge surfing break the automaticity of relapse cycles. This catalogue links it to substance use, typically in group (8-12) format, short-term (8-week group).
Related condition topics
These links support exploration. They do not establish that Mindfulness-Based Relapse Prevention is effective or recommended for each condition.
How Mindfulness-Based Relapse Prevention works
Mindfulness practice builds awareness of triggers, craving, and habitual reaction patterns; decentering from substance-related thoughts and urge surfing break the automaticity of relapse cycles
Ontology
Relapse is driven by automatic cognitive-affective-behavioral chains: craving triggers habitual responding before conscious choice can intervene; mindfulness inserts a gap between stimulus and response
Therapeutic Voice
"You're not trying to make it go away. You're staying with it while it moves. Where is it right now, still building or already coming down?"
View of the Person
An addicted being whose relapse is driven by automatic reactivity to craving: mindfulness reveals the impermanent nature of urges and creates space for conscious choice
Epistemology
Evidence
3 source checks available
An overall effectiveness assessment has not been completed. This describes the state of our review, not whether the approach works.
Guidelines and official sources (3)
3 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Clinical Practice Guideline for the Management of Substance Use Disorders
Insufficient evidence for or against
VA/DoD finds insufficient evidence for or against mindfulness-based therapies. It discusses MBRP directly, but does not make a positive recommendation for it.
Scope: Mindfulness-based therapies, including MBRP, for substance-use disorders.
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
Discussed in the source
Mindfulness-based relapse prevention is discussed within the reviewed psychosocial interventions. WHO conditionally recommends structured psychosocial treatment as a group, with low-certainty evidence, while noting uncertainty about individual therapy types versus usual care.
Scope: Adults with alcohol dependence.
- Clinical Practice Guideline for Tobacco Use Treatment
Discussed in the source
VA/DoD weakly recommends against standalone mindfulness for this cessation goal. This is category-level guidance; MBRP is not separately graded, and the statement does not address adjunctive use or other conditions.
Scope: Mindfulness used as a standalone treatment for abstinence from tobacco or nicotine.
Recorded material under review
The existing notes below are retained separately from assessment records. These recorded claims await source checking, including study design, recommendations and numerical estimates.
3+ RCTs (Bowen et al., 2009; 2014; Witkiewitz et al., 2014)
Included in mindfulness-for-addiction meta-analyses; Grant et al. (2017)
Integrates Marlatt's cognitive-behavioral relapse prevention with MBSR-style mindfulness training. Specifically targets the automaticity of addictive behavior. Growing evidence base. 2014 JAMA Psychiatry RCT showed comparable outcomes to gold-standard relapse prevention at 12-month follow-up.
Training and certification
Licensed clinician with addiction treatment experience. Personal mindfulness practice required. MBRP facilitator training through UW team (Bowen, Chawla, Marlatt).
UW MBRP team: facilitator training. Personal practice prerequisite similar to MBSR/MBCT teacher training.
5 days intensive + personal practice commitment + supervised group facilitation
$1.5K–3K for training; retreat/practice costs additional
Clinical cautions and blind spots
Assessment and precautions
Active psychosis, acute intoxication, clients who have not achieved initial sobriety/reduction, severe dissociation where mindfulness triggers depersonalization, situations requiring immediate medical detoxification
Blind spots
Requires sustained meditation practice many clients find difficult; built as aftercare, so it assumes a period of stabilization rather than meeting people mid-crisis; 8-week group format may miss individual complexity; the mindfulness component has to be delivered by someone with a practice of their own, which limits how far it can be disseminated
Philosophical roots
Buddhist psychology (impermanence of craving, mindfulness as investigation); Marlatt (cognitive-behavioral relapse prevention model); Kabat-Zinn (MBSR); Teasdale (decentering, metacognitive awareness); Segal (cognitive reactivity)
Compared with other approaches
Test Yourself
What is urge surfing?
Show answer
A technique where the person observes craving as a wave (rising, cresting, and falling) without acting on it. Builds tolerance for discomfort and demonstrates the impermanent nature of urges.