Effectiveness of mindfulness-based group therapy in relapse prevention for methamphetamine dependent males

Document Type : Research Paper


1 Associate professor of clinical psychology, Department of Educational Sciences, Faculty of Literature and Humanities, Hakim Sabzevari University, Sabzevar, Iran

2 MS. in clinical psychology, Islamic Azad University, Branch of Torbat-e-Jam, Torbat-e-Jam, Iran


Introduction: The present study was conducted to investigate the effectiveness of mindfulness-based group therapy ‎‎(MBGT) in relapse prevention for methamphetamine dependent males.
Materials and Methods: This clinical trial used pretest-posttest control group design. Of the methamphetamine-addicted individuals admitted to Pouyandegan-e-Hasti addiction treatment center in Mashhad in 2017, 40 subjects were selected through convenience sampling after the detoxification period and were randomly assigned into two experimental and control groups. The experimental group attended 9 sessions of mindfulness-based relapse prevention model training while the control group attended the usual group therapy program of the center. The two groups completed Relapse Prediction Scale (RPS) and Beck Depression Inventory, Second Edition (BDI-II) before and after treatment and also Clinical Global Impression Scale (CGI) and Client Satisfaction Questionnaire (CSQ) in the posttest. The data was analyzed using ‎one-way analysis of covariance (ANCOVA), independent t-test and chi-square test in SPSS-24. ‎
Results: The results demonstrated that MBGT causes decreased drug craving (P=0.001), likelihood of substance abuse (P=0.003) and ‎ depression (P=0.001) and overall improvement (P=0.032) of the experimental group compared to the control ‎group. Further, no significant difference was observed between the two groups in terms of treatment satisfaction ‎‎(P=0.893), but the number of people with relapses in the control group was more than twice as much as the ‎experimental group. ‎
Conclusion: It seems that mindfulness-based group therapy is effective in methamphetamine relapse prevention. ‎


Main Subjects

  1. McKetin R, Kelly E, McLaren J. The relationship between crystalline methamphetamine use and methamphetamine dependence. J Alcohol Substance Depend 2006; 85: 198-204.
  2. Semple S, Patterson T, Grant I. Methamphetamine use and depressive symptoms among heterosextual men and women. J Use 2005; 10(1): 31-47.
  3. Nordahl TE, Salo R, Leamon M. Neuropsychological effects of chronic methamphetamine use on neurotransmitters and cognition: A review. J Neuropsychiatr Clin Neurosci 2003; 15: 317-25.
  4. Parnian Khooy M, Bafandeh Gharamaleki H, Shalchi B. [Comparison of sustained attention between methamphetamine addicts, heroin addicts, and normal people]. Journal of research on addiction 2016; 10(39): 147-62. (Persian)
  5. Kirisci L, Tarter R, Ridenour T, Reynolds M, Homer M, Vanyukov M. Externalizing behavior and emotion dysregulation are indicators of transmissible risk for use disorder. JAddict Behav 2015; 42: 57-62.  
  6. Di Pierro R, Benzi I, Madeddu F. Difficulties in emotion regulation among inpatients with use disorders: the mediating effect of mature defenses mechanisms. J Clin Neuropsychiatry 2015; 4(12): 83-9.
  7. Mikaeli Mani F, Issazadegan A, Khalilzadeh N. [The relationship of emotional regulation and negative affect with craving for substance use with the mediating role of depression]. Journal of research on addiction 2017; 11: 197-212. (Persian)
  8. Noroozi MR, Naderi SH, Binazadeh M, Sefatiyan S. [­­­­­­A comprehensive guide to treat substance addiction]. 2nd ed. Tehran: Pishgamane Tosea; 2005. (Persian)
  9. Witkiewitz K, Marlatt G, Walker D. Mindfulness-based relapse prevention for alcohol and use disorders. J Cogn Psychother 2005; 19(3): 211-28.
  10. Wash J, Baliant MG, Smolira SJDR, Fredericksen LK, Madsen S. Predicting individual differences in mindfulness : The role of trait anxiety, attachment anxiety and attentional control. JPers Individ Dif 2009; 46: 94-9.
  11. Grow JC, Collins SE, Harrop EN, Marlatt GA. Enactment of home practice following mindfulness-based relapse prevention and its association with -use outcomes. J Addict Behav 2015; 40: 16-20.
  12. Zemestani M, Babamiri M, Sepyani A. [The effectiveness of mindfulness-based relapse prevention in abuse and the severity of comorbidity of depression and anxiety symptoms in the addicts of therapeutic community centers]. Journal of research on addiction 2016; 10: 180-94. (Persian)
  13. Seyed Asiaban S, Manshaee GR, Askari P. [Compare the effectiveness of schema therapy and mindfulness on psychosomatic symptoms in people with abuse stimulants]. Journal of research on addiction 2017; 10: 181-99. (Persian)
  14. Kiani A, Ghasemi N, Pourabbas A. [The efficacy of group psychotherapy based on acceptance and commitment therapy and mindfulness on craving and cognitive emotion regulation in methamphetamine addicts]. Journal of research on addiction 2012; 24(6): 27-36. (Persian)
  15. Witkiewitz K, Bowen S, Douglas H, Hsu Sh. Mindfulness-based relapse prevention for craving. J Addict Behav 2013; 38: 1563-71.
  16. Iranshahri B, Jenaabadi H. The effectiveness of mindfulness therapy in controlling under treatment addicts substance cravings. J  Med Psychol 2015; 4: 88-98.
  17. Corey MS, Corey G, Corey C. Groups: Process and practice. 9th ed. Pacific Grove, CA: Brooks/Cole; 2014.
  18. Delavar A. [Probability and applied statistics in psychology and educational sciences]. Tehran: Roshd; 2017. (Persian)
  19. Bowen S, Chawla N, Marlatt A. Mindfulness-based relapse prevention for addictive behaviors. New York: Guilford; 2011.
  20. Sayed Alitabar SH, Falahatpisheh M, Habibi Asgarabad M, Arvin M, Sarvestani A. [Psychometric properties of the problems assessment for using psychiatric patients]. Journal of community of health 2016; 3(1): 246-55. (Persian)
  21. Firoozabadi A, Ghanbari Hashemabadi BA, Tabatabaie M. [The efficacy of detached mindfulness and distraction techniques in craving and relapse rates in opiate dependent male subjects]. Journal of fundamentals of mental health 2010; 4: 292-301. (Persian)
  22. Kafi SM, Mollazadeh R, Nori M, Salehi I. [The effectiveness of transactional behavior analytic group therapy on the prevention of relapse among detoxified people]. Journal of new research of psychology 2011; 23: 116-37. (Persian)
  23. Thombs BD, Ziegelstein RC, Beck CA, Pilote L. A general factor model for the beck depression inventory-II: Validation in a sample of patients hospitalized with acute myocardial infarction. J Psychosom Res 2008; 65(2): 115-21.
  24. Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. J Rev Bras Psiquiatr 2013; 35(4): 416-31.
  25. Dabson K, Mohammadkhani P. [Research on beck depression questionnaire- II in a large sample of those afflicted with major depression]. Journal of rehabilitation of mental and illnesses disorders 2007; 29: 82-8. (Persian)
  26. Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client patient satisfaction: Development of a general scale. J Eval Program Plann 1979; 2: 197-207.
  27. McMurtry SL, Hudson WW. The client satisfaction inventory: Results of an initial validation study. J Res Soc Work Pract 2000; 5(10): 644-63.
  28. Shareh H. Validation and investigating the psychometric properties of The Client Satisfaction Questionnaire and Client Clinical Global Index in a sample of patients with Obsessive-Compulsive Disorder; 2017. (In press)
  29. Guy W. ECDEU Assessment Manual for Psychopharmacology Revised. US: Rockville, MD; 1976.
  30. Brewer JA, Elwafi HM, Davis JH. Craving to quit: Psychological model-mindfulness training as treatment for addictions. J Psychol Addict Behav 2013; 27(2): 366.
  31. Westbrook C, Creswell JD, Tabibnia G, Julson E, Kober H, Tindle HA. Mindful attention reduces neural and self reported cue-induced craving in smokers. J Soc Cognit Affect Neurosci 20013; 8(1): 73- 84.
  32. Dabbaghi P, Asgharnejad Farid A, Atef Vahid MK, Bolharie J. [Effectiveness of group cognitive therapy based on mindfulness and spiritual schema activation in the prevention of opioid abuse relapse]. Iranian journal of psychiatry and clinical psychology 2008; 13(4): 366-75. (Persian)
  33. Kaldavi A, Borjali A, Falsafi Nejad MR, Sohrabi F. [The effectiveness of mindfulness based relapse prevention model relapse prevention and motivation in subjects with opiate dependency]. Journal of clinical psychology 2012; 4(12): 69-79. (Persian)
  34. Salimi SH, Haghnazari A, Ahnadi Tahour Soltani M, Zohreh Vand M. [The effectiveness of mindfulness based cognitive therapy (MBCT) on substance craving in heroin addicts treated by methadone maintenance]. Journal of clinical psychology 2016; 8(2): 23-31. (Persian)
  35. Zeidan F, Johnson SK, Diamond BJ, David Z, Goolkasian P. Mindfulness meditation improves cognition: Evidence of brief mental training. Conscious Cogn 2012; 19: 597-605.
  36. Emanuel AD, Ciesla JA. The role of mindfulness facets in affective forecasting. J Pers Individ Dif 2010; 49: 815-18.
  37. Witkiewitz K, Bowen S. Depression, craving and use following a randomized trial of mindfulness based relapse prevention. J Consult Clin Psychol. 2010; 78(3): 362-74.
  38. Sattarpour F, Ahmadi E, Sadegzadeh S. [Effect of mindfulness trai­­ning on reduction of depressive symptoms among students]. Journal of Gorgan University of Medical Sciences 2015; 17(3): 81-8. (Persian)
  39. Azargoon H, Kajbaf M, Molavi H. [The effect of mindfulness training on mental rumination and depression of the students of Isfahan University]. Journal of clinical psychology and personality 2009; 1: 13-20. (Persian)
  40. Shapiro SL, Brown KW, Biegel G. Teaching self-care to caregivers: the effects of mindfulness-based stress reduction on the mental health of therapists in training. J Train Educ Prof Psychol 2007; 1: 105-15.
  41. Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress positive states, of mind, rumination, and distraction. J Ann Behav Med 2007; 33: 11-21.
  42. Nauman E. Three ways min­­­dfulness reduces depression. J Greater Good Magazine 2014; 8: 14-17.