UW/ABRC
The Effects of Vipassana Meditation The Effects of Vipassana Meditation on Alcohol & Drug Relapseon Alcohol & Drug Relapse
and Criminal Recidivismand Criminal Recidivism
G. Alan Marlatt, Ph.D.Addictive Behaviors Research Center
Department of PsychologyUniversity of Washington
VM: 206.685.1200 E-mail: [email protected]://depts.washington.edu/abrc/marlatt_presentations.htm
UW/ABRC
Project Choices TeamProject Choices Team
PRINCIPAL INVESTIGATOR G. Alan Marlatt, PhD
CO-PRINICIPAL INVESTIGATORSMary Larimer, PhD Arthur Blume, PhD Tracy Simpson, PhD
RESEARCH COORDINATORS George A. Parks, PhD Jessica M. Cronce
RESEARCH STUDY ASSISTANTSJames K. BuderTiara Dillworth
GRADUATE RESEARCH ASSISTANTS Laura MacPherson Katie Witkiewitz Sarah Bowen
UW/ABRC
IntroductionIntroduction
From 1970 to 1997, the number of substance-involved offenders has increased from 21,266 prisoners in the Federal Bureau of Prisons with 16% being drug offenders to 98,483 incarcerated individuals of which over 60% are drug offenders.
UW/ABRC
IntroductionIntroduction
There is evidence that other spiritual interventions besides AA, particularly meditation-based interventions, are associated with reduced alcohol and substance use.
UW/ABRC
IntroductionIntroduction
Two types of spiritually-based meditation techniques, Transcendental Meditation (TM), and to a lesser extent Vipassana meditation, have been evaluated as treatments for substance abuse, with encouraging results (Alexander et al., 1994; Marlatt, 1994; Marlatt & Kristeller, 1998).
UW/ABRC
IntroductionIntroduction
Marlatt et al. (1984) found that the meditation (CSM), progressive relaxation, and bibliotherapy all lead to significant reductions in alcohol consumption during the training period compared to the no-treatment control subjects.
UW/ABRC
IntroductionIntroduction
Vipassana meditation, the intervention addressed in this study, is rooted in traditional Buddhist teachings and has been made available to practitioners around the world by the revered Buddhist teacher, S. N. Goenka (Hart, 1987).
UW/ABRC
IntroductionIntroduction
Preliminary results from research with inmate populations in India indicate that Vipassana meditation helps in reducing recidivism, reducing psychopathological symptoms, and increasing more positive behaviors such as cooperation with prison authorities (Chandiramani et al., 1995; Kumar, 1995; and Vora, 1995).
UW/ABRC
IntroductionIntroduction
Vipassana has also been implemented in correctional facilities within the United States.
The first Vipassana course in a
North American correctional facility was conducted at the North Rehabilitation Facility (NRF) in Seattle, Washington in 1997.
UW/ABRC
IntroductionIntroduction
Prior to closing in the fall of 2002, NRF was a minimum-security jail facility with an adult male and female inmate population of approximately 300.
Between January 2001 and November 2002, nine ten-day courses were held at NRF and included in the study.
UW/ABRC
Research AimsResearch Aims
Document the effectiveness of a specific spiritual practice, Vipassana Meditation, for reducing alcohol and drug relapse, alcohol-related negative consequences, and criminal recidivism in a correctional population.
Evaluate several domains of spirituality as mediators and moderators of the effectiveness of Vipassana meditation on alcohol and drug relapse, criminal recidivism, mental health, and spiritual outcomes in this population.
Evaluate participant characteristics as predictors of willingness to participate in Vipassana meditation.
UW/ABRC
ParticipantsParticipants
n=305, 244 men and 61 women recruited from NRF
61% Caucasian, 11% Native American, 7% Latino/Latina, 13% African-American, 2% Asian, 6% other
Average age 37.8 years old
56% employed at least part-time prior to incarceration
79% GED or high school diploma
58% Christian, 17% no formal religion, 25% other
26% attended religious services more than 1x month, 34% less than 1x month, 40% never
UW/ABRC
Most common charges/convictionsMost common charges/convictions(in order of frequency):(in order of frequency):
1. Driving Under the Influence of Intoxicants 2. Theft 3. Violation of the Uniform Controlled Substance Act
(VUCSA) 4. Driving with License Suspended (typically
suspended due to previous DUI) 5. Assault/Domestic Violence 6. Possession of Stolen Property 7. Harassment 8. Prostitution 9. Criminal Trespass 10. Hit and Run
UW/ABRC
ProcedureProcedure
Participants self-selected to participate in the 10-day Vipassana meditation course
Inmates could participate in the Vipassana course and not participate in the research study
Participants in both the Vipassana and control conditions completed baseline measures approximately 1 week prior to the first day of the Vipassana course
All participants completed a post-course assessment approximately 2-3 days after the last day of the Vipassana course while still incarcerated
UW/ABRC
ProcedureProcedure
Participants who completed both baseline and post-course were eligible for longitudinal follow-up (59 Vipassana; 107 control)
Follow-up assessments are administered onsite at the University of Washington 3- and 6-months post-release
Thus far, 49 Vipassana participants & 65 participants in the control group have completed the 3-month follow-up questionnaire, and 6-month follow-up is underway
Case-matching of Vipassana and control participants will occur after data collection is complete, prior to final data analysis
UW/ABRC
Pre-Course (Baseline) AssessmentParticipant Characteristics
Age Ethnicity Education Work status Religious background and practices Criminal history PTSD
UW/ABRC
LOT-Optimism RBBQ-Religious Beliefs and Behaviors
Questionnaire RCAS-Religious Coping Scale Meaning Scale DES-Daily Spiritual Experiences Scale
Pre-Course (Baseline) AssessmentSpiritual and Religious Domains
UW/ABRC
DDQ-R Daily Drinking Questionnaire Alcohol Q/F Index AUDIT-Screening ADS - Dependency DRIE – Locus of Control ICS – Impaired Control SIP-2R - Consequences
Pre-Course (Baseline) AssessmentAlcohol Use (90 days pre-NRF)
UW/ABRC
DDTQ – Daily Drug-taking Questionnaire
ASI – Quantity/frequency of AOD
DAST – Drug Dependency
Pre-Course (Baseline) AssessmentDrug Use (90 days pre-NRF)
UW/ABRC
Marlowe-Crown – Social Desirability
SRQ – Self-Regulation Questionnaire
WBSI – White Bear Suppression Inventory
RCQ – Readiness to Change Questionnaire
BSI – Psychopathology Screening
Pre-Course (Baseline) AssessmentThinking, Motivation, Distress
UW/ABRC
TLFB (90) – Timeline Followback
Criminal History/ Recidivism
Pre-Course (Baseline) AssessmentRecidivism and AOD Relapse
UW/ABRC
Post-Course Assessment: All measures except participant
characteristics and alcohol/drug items
3- & 6-month Follow Up Assessments: All measures except participant
characteristics Addition of TLFB for AOD Relapse and
Recidivism
Post-Course and Follow-up Assessments
UW/ABRC
Preliminary AnalysesPreliminary Analyses
These analyses only include a subset of the sample that has completed both baseline and 3-month follow-up. Additional research participants will be assessed at 3- and 6-months before final results are available.
The comparisons reported represent group mean differences from Time 1 (90 days prior to incarceration, retrospective) to Time 2 (3-months post-release) and were calculated before case matching could take place. Final results will include only Vipassana course completers and their case-matched controls.
UW/ABRC
Preliminary AnalysesPreliminary Analyses
Preliminary analyses of variance were conducted to explore the repeated measures effect of the meditation intervention on a variety of the psychosocial and alcohol/drug use dependent variables.
Recognizing that running multiple significance tests may inflate Type I error rates, future reports of the complete data set will use a Bonferroni corrected alpha level.
However, given the small sample size and exploratory nature of these analyses, results that were significant at p = .05 are reported.
UW/ABRC
Changes from Pre-Course to 3-month Follow-up:Changes from Pre-Course to 3-month Follow-up:
Main Effects for Time Main Effects for Time
Measure/Domain F p
Religious Coping Activities 5.55 .02
Meaning Scale 5.15 .03
Peak weekly alcohol use 30.95 .0005
Peak weekly heroin use 8.89 .004
UW/ABRC
Changes from Pre-Course to 3-month Follow-up:Changes from Pre-Course to 3-month Follow-up:
Group x Time Interaction Effects Group x Time Interaction Effects
Measure/Domain F pLocus of control (DRIE) 4.44 .04Impaired Control Scale 8.17 .006Thought suppression (WBSI) 4.57 .04Optimism (LOT) 13.53 .001Depression (BSI) 4.54 .04Hostility (BSI) 4.24 .04Alcohol consequences (SIP total) 3.95 .05Drug addiction (DAST) 6.28 .02Peak weekly tobacco use 5.46 .02Peak weekly powder cocaine use 9.80 .003Peak weekly crack cocaine use 4.82 .03Peak weekly marijuana use 4.21 .04
UW/ABRC
Changes from Pre-Course to 3-month Follow-up:Changes from Pre-Course to 3-month Follow-up: Alcohol Related Negative ConsequencesAlcohol Related Negative Consequences
SIP Total Score
3-monthsBaseline
Est
imat
ed M
argi
nal
Mea
ns22
20
18
16
14
12
10
8
Treatment Group
TAU control
Vipassana
SIP Total Score
UW/ABRC
Changes from Pre-Course to 3-month Follow-up:Changes from Pre-Course to 3-month Follow-up: Locus of ControlLocus of Control
3-monthsBaseline
Est
ima
ted
Ma
rgin
al M
ea
ns
.28
.26
.24
.22
.20
.18
.16
.14
.12
Treatment Group
Control (TAU)
Meditation (TAU+V)
DRIE Total Score
UW/ABRC
Changes from Pre-Course to 3-month Follow-up:Changes from Pre-Course to 3-month Follow-up: Drug Abuse/DependenceDrug Abuse/Dependence
3-monthsBaseline
Est
ima
ted
Ma
rgin
al M
ea
ns
16
15
14
13
12
11
10
9
8
Treatment Group
Control (TAU)
Meditation (TAU+V)
DAST Total Score
UW/ABRC
Changes from Pre-Course to 3-month Follow-up:Changes from Pre-Course to 3-month Follow-up: Psychopathology (Depression)Psychopathology (Depression)
3-monthsBaseline
Est
ima
ted
Ma
rgin
al M
ea
ns
7.0
6.5
6.0
5.5
5.0
4.5
4.0
3.5
3.0
Treatment group
Control (TAU)
Meditation (TAU+V)
BSI Depression Scale Score
UW/ABRC
DiscussionDiscussion
To be mindful is to be aware of the full range of experiences that exist, to bring one’s complete attention to the present experience on a moment-to-moment basis. This is consistent with the Buddhist view of transcendence as 'enlightened awareness of the true being' (Goldstein & Kornfield, 1987).
UW/ABRC
DiscussionDiscussion
Meditation or “Right Mindfulness” is presented a critical element in the Eight-Fold Path leading to the ultimate spiritual goal of enlightenment.
UW/ABRC
DiscussionDiscussion
Alcohol and drug addiction are described in the Buddhist literature as problems related to ego-attachment, with an emphasis on “craving” as the major process underlying the dynamic of the addictive process.
UW/ABRC
DiscussionDiscussion
Groves and Farmer (1994) write:
“From its beginning two and a half thousand years ago, the central concerns in Buddhism have been craving and attachment. …Buddhist teachings then constitute a rich source of etiological models and possible therapies for addictions.”
UW/ABRC
DiscussionDiscussion
Groves and Farmer (1994) describe Vipassana meditation as a means of overcoming addiction problems: “In the context of addictions, mindfulness might mean becoming aware of triggers of craving, and choosing to do something else which might ameliorate or prevent craving, so weakening this habitual response…”
UW/ABRC
DiscussionDiscussion
The process of meditation can thus lead to both the alleviation of addiction and the development of spiritual growth toward eventual enlightenment.
Thank You!