Transcript Vipassana Meditation Presentation Slides

The Effects of Vipassana Meditation
on Alcohol & Drug Relapse
and Criminal Recidivism
UW/ABRC
G. Alan Marlatt, Ph.D.
Addictive Behaviors Research Center
Department of Psychology
University of Washington
VM: 206.685.1200 E-mail: [email protected]
http://depts.washington.edu/abrc/marlatt_presentations.htm
Project Choices Team
UW/ABRC
PRINCIPAL INVESTIGATOR
G. Alan Marlatt, PhD
CO-PRINICIPAL INVESTIGATORS
Mary Larimer, PhD
Arthur Blume, PhD
Tracy Simpson, PhD
RESEARCH COORDINATORS
George A. Parks, PhD
Jessica M. Cronce
RESEARCH STUDY ASSISTANTS
James K. Buder
Tiara Dillworth
GRADUATE RESEARCH ASSISTANTS
Laura MacPherson
Katie Witkiewitz
Sarah Bowen
Introduction
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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.
Introduction
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There is evidence that other spiritual
interventions besides AA,
particularly meditation-based
interventions, are associated with
reduced alcohol and substance use.
Introduction
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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).
Introduction
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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.
Introduction
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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).
Introduction
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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).
Introduction
UW/ABRC
 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.
Introduction
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 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.
Research Aims
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 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.
Participants
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 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
Most common charges/convictions
(in order of frequency):
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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
Procedure
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 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
Procedure
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 Participants who completed both baseline and postcourse 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
Pre-Course (Baseline) Assessment
Participant Characteristics
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Age
Ethnicity
Education
Work status
Religious background and practices
Criminal history
PTSD
Pre-Course (Baseline) Assessment
Spiritual and Religious Domains
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 LOT-Optimism
 RBBQ-Religious Beliefs and Behaviors
Questionnaire
 RCAS-Religious Coping Scale
 Meaning Scale
 DES-Daily Spiritual Experiences Scale
Pre-Course (Baseline) Assessment
Alcohol Use (90 days pre-NRF)
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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) Assessment
Drug Use (90 days pre-NRF)
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 DDTQ – Daily Drug-taking Questionnaire
 ASI – Quantity/frequency of AOD
 DAST – Drug Dependency
Pre-Course (Baseline) Assessment
Thinking, Motivation, Distress
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 Marlowe-Crown – Social Desirability
 SRQ – Self-Regulation Questionnaire
 WBSI – White Bear Suppression Inventory
 RCQ – Readiness to Change Questionnaire
 BSI – Psychopathology Screening
Pre-Course (Baseline) Assessment
Recidivism and AOD Relapse
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 TLFB (90) – Timeline Followback
 Criminal History/ Recidivism
Post-Course and Follow-up
Assessments
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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
Preliminary Analyses
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 These analyses only include a subset of the sample
that has completed both baseline and 3-month followup. 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.
Preliminary Analyses
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 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.
Changes from Pre-Course to 3-month Follow-up:
Main Effects for Time
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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
Changes from Pre-Course to 3-month Follow-up:
Group x Time Interaction Effects
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Measure/Domain
Locus of control (DRIE)
Impaired Control Scale
Thought suppression (WBSI)
Optimism (LOT)
Depression (BSI)
Hostility (BSI)
Alcohol consequences (SIP total)
Drug addiction (DAST)
Peak weekly tobacco use
Peak weekly powder cocaine use
Peak weekly crack cocaine use
Peak weekly marijuana use
F
4.44
8.17
4.57
13.53
4.54
4.24
3.95
6.28
5.46
9.80
4.82
4.21
p
.04
.006
.04
.001
.04
.04
.05
.02
.02
.003
.03
.04
Changes from Pre-Course to 3-month Follow-up:
Alcohol Related Negative Consequences
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SIP Total Score
SIP Total Score
22
20
18
16
14
12
10
8
Baseline
Treatment Group
TAU control
Vipassana
3-months
Changes from Pre-Course to 3-month Follow-up:
Locus of Control
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.28
DRIE Total Score
.26
.24
.22
.20
.18
.16
Treatment Group
Control (TAU)
.14
.12
Baseline
Meditation (TAU+V)
3-months
Changes from Pre-Course to 3-month Follow-up:
Drug Abuse/Dependence
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16
DAST Total Score
15
14
13
12
11
10
Treatment Group
9
8
Baseline
Control (TAU)
Meditation (TAU+V)
3-months
Changes from Pre-Course to 3-month Follow-up:
Psychopathology (Depression)
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7.0
BSI Depression Scale Score
6.5
6.0
5.5
5.0
4.5
4.0
Treatment group
3.5
3.0
Baseline
Control (TAU)
Meditation (TAU+V)
3-months
Discussion
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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-tomoment basis. This is consistent with
the Buddhist view of transcendence as
'enlightened awareness of the true
being' (Goldstein & Kornfield, 1987).
Discussion
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Meditation or “Right Mindfulness” is
presented a critical element in the
Eight-Fold Path leading to the ultimate
spiritual goal of enlightenment.
Discussion
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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.
Discussion
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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.”
Discussion
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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…”
Discussion
UW/ABRC
The process of meditation can thus
lead to both the alleviation of addiction
and the development of spiritual
growth toward eventual enlightenment.
Thank You!