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      Comparing Mindfulness-Based Group Therapy With Treatment as Usual for Opioid Dependents: A Pilot Randomized Clinical Trial Study Protocol

      brief-report

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          Abstract

          Background:

          In response to high burden of opioid abuse in Iran, Ministry of Health has launched a large-scale opioid maintenance treatment program, delivered through a network of certified drug treatment centers. To promote opioid pharmacotherapies, there is an urgent need to develop and introduce evidence-based psychosocial interventions into the network.

          Patients and Methods:

          This is a randomized clinical trial (RCT) to investigate feasibility and effectiveness of adding mindfulness-based group therapy to opioid pharmacotherapies as compared to opioid pharmacotherapies alone. The primary outcomes were treatment retention and percentage of weekly morphine, methamphetamine, and benzodiazepine negative tests.

          Discussion:

          This is the first RCT that explores the effectiveness of mindfulness-based relapse prevention group therapy among opioid dependent clients in Iran. The feasibility of group therapy and comparison of outcomes in intervention and control groups should be discussed in the outcome article.

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          Most cited references27

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          Using Mutivariate Statistics

          G. Tabachnick B., BG Tabachnick, BG TABACHNICK … (2007)
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            Psychometric properties of the Penn Alcohol Craving Scale.

            J R Volpicelli, J. Flannery, H Pettinati (1999)
            This study introduces the Penn Alcohol Craving Scale (PACS), which has been used in several clinical trials at the University of Pennsylvania's Treatment Research Center. The PACS is a five-item, self-report measure that includes questions about the frequency, intensity, and duration of craving, the ability to resist drinking, and asks for an overall rating of craving for alcohol for the previous week. Each question is scaled from 0 to 6. To examine the questionnaire's psychometric properties, we sampled responses from 147 individuals participating in a 9-month combined natrexone (100 mg/day)/psychotherapy trial. The psychotherapy consisted of weekly sessions of nurse-administered medication compliance and supportive treatment. The PACS proved to have excellent internal consistency. Predictive validity was demonstrated via a logistic regression analysis of craving during the 2nd week of the study on alcohol relapse during weeks 3-12 of the trial. Construct validity of the PACS was demonstrated via its convergence with two commonly used measures for assessing craving, the Obsessive Compulsive Drinking Scale and the Alcohol Urge Questionnaire. Lack of correlation between PACS scores and several other noncraving, self-report measures indicates that the PACS also had good discriminant validity. Additional analyses revealed that there were significant differences in craving scores during the initial 3 weeks of the trial among those who did and those who did not relapse during weeks 3-12. The PACS is a reliable and valid measure of alcohol craving and can predict which individuals are at risk for subsequent relapse.
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              Mindfulness-based cognitive therapy for generalized anxiety disorder.

              Susan J. Evans, Stephen Ferrando, Marianne Findler … (2008)
              While cognitive behavior therapy has been found to be effective in the treatment of generalized anxiety disorder (GAD), a significant percentage of patients struggle with residual symptoms. There is some conceptual basis for suggesting that cultivation of mindfulness may be helpful for people with GAD. Mindfulness-based cognitive therapy (MBCT) is a group treatment derived from mindfulness-based stress reduction (MBSR) developed by Jon Kabat-Zinn and colleagues. MBSR uses training in mindfulness meditation as the core of the program. MBCT incorporates cognitive strategies and has been found effective in reducing relapse in patients with major depression (Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V., Soulsby, J., & Lau, M. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 6, 615-623). Eligible subjects recruited to a major academic medical center participated in the group MBCT course and completed measures of anxiety, worry, depressive symptoms, mood states and mindful awareness in everyday life at baseline and end of treatment. Eleven subjects (six female and five male) with a mean age of 49 (range=36-72) met criteria and completed the study. There were significant reductions in anxiety and depressive symptoms from baseline to end of treatment. MBCT may be an acceptable and potentially effective treatment for reducing anxiety and mood symptoms and increasing awareness of everyday experiences in patients with GAD. Future directions include development of a randomized clinical trial of MBCT for GAD.
              Article 0 comments Cited 93 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Iran J Psychiatry Behav Sci
                Journal ID (iso-abbrev): Iran J Psychiatry Behav Sci
                Journal ID (doi): 10.17795/ijpbs
                Journal ID (publisher-id): Mazandaran University of Medical Sciences
                Title: Iranian Journal of Psychiatry and Behavioral Sciences
                Publisher: Mazandaran University of Medical Sciences
                ISSN (Print): 1735-8639
                ISSN (Electronic): 1735-9287
                Publication date (Electronic): 07 March 2015
                Publication date (Print): March 2015
                Volume: 9
                Issue: 1
                Electronic Location Identifier: e216
                Affiliations
                [1 ]Department of Clinical Psychology, Shahid Beheshti University, Tehran, IR Iran
                [2 ]Department of Clinical Psychology, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, IR Iran
                [3 ]Family Research Institute, Shahid Beheshti University, Tehran, IR Iran
                [4 ]Addictive Behaviors Research Center, Department of Psychology, University of Washington, Seattle, USA
                [5 ]Iranian National Center for Addiction Studies, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, IR Iran
                [6 ]School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
                Author notes
                [* ]Corresponding author: Alireza Noroozi, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-21-55421144, E-mail: a_r_noroozi@ 123456yahoo.com
                Article
                DOI: 10.17795/ijpbs216
                PMC ID: 4525448
                SO-VID: 83077b2e-b751-4294-a8e2-e8057350a6ac
                Copyright © Copyright © 2015, Mazandaran University of Medical Sciences.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                Date received : 11 January 2014
                Date revision received : 24 October 2014
                Date accepted : 29 January 2015
                Categories
                Subject: Brief Report

                Keywords: mindfulness,pharmacotherapies,therapy
                Data availability:
                Keywords: mindfulness, pharmacotherapies, therapy

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