A randomized controlled trial compared mindfulness-based relapse prevention (MBRP) to 12-step facilitation (TSF) as aftercare for veterans who completed intensive substance use disorder (SUD) treatment. Both groups maintained reductions in alcohol and illicit substance use during aftercare. Nineteen participants (11%) reported returning to alcohol use during treatment, with no difference between MBRP (9%) and TSF (13%). Thirteen participants (7.5%) reported illicit substance use, again similar between groups (MBRP 5.4% vs. TSF 10.3%). Days of drinking and illicit substance use also did not differ. Although low treatment retention limits interpretation, both approaches helped sustain treatment gains.
Post-traumatic stress disorder (PTSD) and substance use disorders (SUD) often co-occur, leading to more complex symptoms and worse outcomes than either disorder alone, and untreated PTSD can predict relapse to substance abuse. Integrated treatments can safely address both disorders together, but dropout and relapse rates remain high. Mindfulness-based approaches, particularly Mindfulness-based Relapse Prevention (MBRP), which combines cognitive-behavioral relapse prevention with mindfulness practices, may offer additional benefits. This paper presents the design of a Stage 1b behavioral development study that modifies MBRP for women with comorbid PTSD and SUD in a community setting. The study involves revising an existing manual, piloting the intervention, and testing it in a randomized controlled pilot trial.