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Randomized Controlled Trial
. 2016 Feb:77:7-16.
doi: 10.1016/j.brat.2015.11.012. Epub 2015 Nov 27.

Mindfulness-Oriented Recovery Enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial

Eric L Garland  1 , Amelia Roberts-Lewis  2 , Christine D Tronnier  3 , Rebecca Graves  4 , Karen Kelley  4
Affiliations
Randomized Controlled Trial

Mindfulness-Oriented Recovery Enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial

Eric L Garland et al. Behav Res Ther. 2016 Feb.

Erratum in

Abstract

In many clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. Novel therapies are needed to address these co-occurring issues efficiently. The aim of the present study was to conduct a pragmatic randomized controlled trial comparing Mindfulness-Oriented Recovery Enhancement (MORE) to group Cognitive-Behavioral Therapy (CBT) and treatment-as-usual (TAU) for previously homeless men residing in a therapeutic community. Men with co-occurring substance use and psychiatric disorders, as well as extensive trauma histories, were randomly assigned to 10 weeks of group treatment with MORE (n = 64), CBT (n = 64), or TAU (n = 52). Study findings indicated that from pre-to post-treatment MORE was associated with modest yet significantly greater improvements in substance craving, post-traumatic stress, and negative affect than CBT, and greater improvements in post-traumatic stress and positive affect than TAU. A significant indirect effect of MORE on decreasing craving and post-traumatic stress by increasing dispositional mindfulness was observed, suggesting that MORE may target these issues via enhancing mindful awareness in everyday life. This pragmatic trial represents the first head-to-head comparison of MORE against an empirically-supported treatment for co-occurring disorders. Results suggest that MORE, as an integrative therapy designed to bolster self-regulatory capacity, may hold promise as a treatment for intersecting clinical conditions.

Keywords: Addiction; Emotion regulation; Mindfulness; PTSD; Reappraisal; Savoring; Transdiagnostic.

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Conflict of interest statement

Conflict of interest: The first author (ELG) developed the Mindfulness-Oriented Recovery Enhancement (MORE) intervention, and has received income from the MORE treatment manual (Garland, 2013) and therapist trainings.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
The indirect effect of Mindfulness-Oriented Recovery Enhancement on craving (Figure 2a) and post-traumatic stress symptoms (Figure 2b) through increasing dispositional mindfulness was statistically significant.
See this image and copyright information in PMC

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