Trial Summary
What is the purpose of this trial?3-arm type 1 pilot implementation-efficacy trial for people with alcohol use disorders to examine the preliminary effectiveness and feasibility of an adapted 2-session, computerized and person delivered relapse prevention intervention.
Is Relapse Prevention Intervention a promising treatment for alcoholism?Yes, Relapse Prevention Intervention is a promising treatment for alcoholism. It has been shown to be generally effective, especially for alcohol problems. It helps people understand and change their behavior to prevent relapses, and it is often used in combination with other treatments to improve results.146810
What safety data exists for relapse prevention treatments for alcoholism?The studies reviewed focus on the efficacy of various relapse prevention methods, including Mindfulness-Based Relapse Prevention (MBRP) and standard Relapse Prevention (RP), rather than directly addressing safety data. However, these treatments are widely used and researched, suggesting a level of safety accepted in clinical practice. MBRP integrates mindfulness and cognitive-behavioral techniques, which are generally considered safe. The meta-analysis indicates RP is effective, especially for alcohol problems, but does not specifically discuss safety. Overall, while efficacy is well-documented, specific safety data is not detailed in these abstracts.178910
What data supports the idea that Relapse Prevention for Alcoholism is an effective treatment?The available research shows that Relapse Prevention for Alcoholism is generally effective. A meta-analysis of 26 studies with 9,504 participants found that this treatment works well, especially for alcohol problems. It is even more effective when combined with medication. Another study compared Mindfulness-Based Relapse Prevention (MBRP) to regular treatment and found that MBRP led to lower rates of substance use and reduced cravings over four months. This suggests that Relapse Prevention, including mindfulness-based approaches, can be a successful way to help people stay sober after completing intensive treatment.12357
Do I have to stop taking my current medications for the trial?The trial protocol does not specify whether you need to stop taking your current medications.
Eligibility Criteria
This trial is for adults over 18 with HIV who are patients at Johns Hopkins HIV Clinic. They must have a history of alcohol use disorder, varying drinking patterns, and currently be abstinent or drinking minimally. Non-English speakers, those acutely suicidal or unable to consent are excluded.Inclusion Criteria
I have been diagnosed with HIV.
I am 18 years old or older.
Exclusion Criteria
I speak English.
Treatment Details
The study tests an adapted relapse prevention intervention for alcohol use disorders in people with HIV. It's a pilot trial comparing three groups: one gets computerized sessions, another person-delivered sessions, and the third group might receive usual care.
3Treatment groups
Experimental Treatment
Active Control
Group I: Person delivered RPIExperimental Treatment1 Intervention
2 session counselor delivered counseling to prevent relapse to hazardous drinking
Group II: Computer delivered RPIExperimental Treatment1 Intervention
2 session computer delivered counseling to prevent relapse to hazardous drinking
Group III: Treatment as UsualActive Control1 Intervention
Counseling for alcohol use available in clinic as treatment as usual
Find a clinic near you
Research locations nearbySelect from list below to view details:
Johns Hopkins School of MedicineBaltimore, MD
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Who is running the clinical trial?
Johns Hopkins UniversityLead Sponsor
National Institute on Alcohol Abuse and Alcoholism (NIAAA)Collaborator
References
Efficacy of relapse prevention: a meta-analytic review. [2019]Although relapse prevention (RP) has become a widely adopted cognitive-behavioral treatment intervention for alcohol, smoking, and other substance use, outcome studies have yielded an inconsistent picture of the efficacy of this approach or conditions for maximal effectiveness. A meta-analysis was performed to evaluate the overall effectiveness of RP and the extent to which certain variables may relate to treatment outcome. Twenty-six published and unpublished studies with 70 hypothesis tests representing a sample of 9,504 participants were included in the analysis. Results indicated that RP was generally effective, particularly for alcohol problems. Additionally, outcome was moderated by several variables. Specifically, RP was most effective when applied to alcohol or polysubstance use disorders, combined with the adjunctive use of medication, and when evaluated immediately following treatment using uncontrolled pre-post tests.
[Relapse Prevention Program in German Alcoholics] [2019]Relapse prevention plays an important role in the treatment of alcoholics. Positive predictors are high self-efficacy and confidence in high-risk situations, positive outcome expectancies, sufficient coping-skills and low craving. We examined 64 primary German alcoholics. Each person met the criteria of alcohol dependence of DSM-IV and ICD-10. Subjects were included in an in-patient 4-step relapse prevention program. This manual-guided group psychotherapy is based on cognitive-behavioral approach focused on high-risk situations, phases of relapse, stress/relax and resources. Craving before and after treatment did not differ, so that using this kind of relapse prevention training might be suitable in both in- and out-patient programs. High values for insight, optimism, self-efficacy and confidence in high-risk situations might enhance individual coping-skills to balance patient's lifestyle focussing on an abstinent way of life.
[Relapse prevention group for alcohol dependent patients]. [2018]Relapse prevention plays an important role in the treatment of alcoholics. Positive predictors are high self-efficacy and confidence in high-risk situations, positive outcome expectancies, sufficient coping-skills and low craving. We examined 64 primary German alcoholics. Each person met the criteria of alcohol dependence of DSM-IV and ICD-10. Subjects were included in an in-patient 4-step relapse prevention program. This manual-guided group psychotherapy is based on cognitive-behavioral approach focused on high-risk situations, phases of relapse, stress/relax and resources. Craving before and after treatment did not differ, so that using this kind of relapse prevention training might be suitable in both in- and out-patient programs. High values for insight, optimism, self-efficacy and confidence in high-risk situations might enhance individual coping-skills to balance patient's lifestyle focussing on an abstinent way of life.
Exploratory findings from the Reasons for Drinking Questionnaire. [2022]Marlatt and Gordon's (1985) relapse prevention therapy has received widespread interest and application. The categorization of relapse precipitants was one of the original central features of this model. In more recent iterations of this therapy, increasing emphasis has been placed on coping strategies. In the present article, exploratory findings from a prospective naturalistic alcohol treatment study employing the Reasons for Drinking Questionnaire are reported. A relapse precipitants scoring algorithm is presented allowing relapses to be categorized as either negative affect relapses, social pressure relapses, or craving/cued relapses. Exploratory findings suggest that social pressure relapses are more likely to repeat, and that negative affect and craving/cued relapses are more severe. Perhaps most interestingly, craving/cued relapses appear to subside during the first 6 months following treatment initiation, but subsequent risk for this type of relapse returns if the client has relapsed. However, these findings are still early in a continuing exploration of these issues in relapse prevention.
Mindfulness-based relapse prevention for substance use disorders: a pilot efficacy trial. [2022]The current study is the first randomized-controlled trial evaluating the feasibility and initial efficacy of an 8-week outpatient Mindfulness-Based Relapse Prevention (MBRP) program as compared to treatment as usual (TAU). Participants were 168 adults with substance use disorders who had recently completed intensive inpatient or outpatient treatment. Assessments were administered pre-intervention, post-intervention, and 2 and 4 months post-intervention. Feasibility of MBRP was demonstrated by consistent homework compliance, attendance, and participant satisfaction. Initial efficacy was supported by significantly lower rates of substance use in those who received MBRP as compared to those in TAU over the 4-month post-intervention period. Additionally, MBRP participants demonstrated greater decreases in craving, and increases in acceptance and acting with awareness as compared to TAU. Results from this initial trial support the feasibility and initial efficacy of MBRP as an aftercare approach for individuals who have recently completed an intensive treatment for substance use disorders.
Relapse prevention for addictive behaviors. [2023]The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change.
Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. [2022]Relapse is highly prevalent following substance abuse treatments, highlighting the need for improved aftercare interventions. Mindfulness-based relapse prevention (MBRP), a group-based psychosocial aftercare, integrates evidence-based practices from mindfulness-based interventions and cognitive-behavioral relapse prevention (RP) approaches.
High risk situations predicting relapse in self-referred addicts to bushehr province substance abuse treatment centers. [2021]Relapse prevention is a medical intervention designed for educating cognitive and behavioral skills to avoid continued drug abuse and relapse.
[Mindfulness in addiction therapy]. [2015]Mindfulness based therapies are nowadays widely spread. During the last decades, several approches and specific programs have been scientifically challenged and developped. In the field of addictions the Mindfulness Based Relapse Prevention is the main reference program. Within this frame, mindfulness increases the awarness regarding triggers and automatic behavior related to drug abuse. It also has a favorable impact when dealing with craving. Currently, the scientific research has come to promissing conclusions as far as craving and relapse prediction are concerned.
Comparing the Efficacy of Mindfulness-Based Relapse Prevention Versus Relapse Prevention for Alcohol Use Disorder: A Randomized Control Trial. [2023]This study compared the efficacy of mindfulness-based relapse prevention (MBRP) with relapse prevention (RP) on reducing alcohol consumption. Secondary, exploratory aims assessed moderation of treatment effects by sex and cannabis use.