Mindfulness-Based Relapse Prevention (MBRP)
Mindfulness-based relapse prevention (MBRP) is a structured programme that combines mindfulness practice with relapse prevention, so that a person learns to notice cravings, hard emotions and body sensations without automatically acting on them. It was developed by Sarah Bowen, Alan Marlatt and colleagues for people who have finished the first phase of addiction treatment and want to stay well. At Calida Rehab, mindfulness-based relapse prevention is part of care at our Pune centre and our Mumbai Region – Karjat centre, serving patients across Pune and the Mumbai region.
- Best for: people whose cravings, stress or racing thoughts pull them back towards the substance, and who want a calmer way to respond
- Approach: short mindfulness practices such as breath awareness, body scan and urge surfing, joined with relapse prevention planning
- Format: the full model is an eight-week group programme built around guided practice, discussion and short daily home practice
- Care setting: residential (inpatient) care and aftercare planning at our Pune centre and our Mumbai Region – Karjat centre
- Works alongside: detoxification, medical and psychiatric care, counselling and relapse prevention therapy, never in place of them
- Support: 24/7 free, confidential helpline
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What Is Mindfulness-Based Relapse Prevention?
Mindfulness means paying attention to the present moment on purpose, without judging what you notice. Relapse prevention is a well-established approach, shaped by the work of Alan Marlatt, that teaches people to spot high-risk situations, cope with cravings and plan for a lapse. Mindfulness-based relapse prevention (MBRP) brings the two together. It was designed as an aftercare programme for people who have already completed the first phase of treatment, and it is set out in a clinician’s guide by Bowen, Chawla and Marlatt (2011).
Why does this matter in addiction? Relapse often happens on autopilot. A trigger appears, such as stress, an argument, a familiar place or a wave of boredom. A craving rises, and the person acts before they have really noticed what is going on. MBRP trains attention so that the gap between the urge and the action becomes wider, and in that gap there is room to choose a different response. It builds on the skills taught in relapse prevention therapy, sits comfortably beside cognitive behavioral therapy, and is used in the care of substance use disorder.
MBRP is not about emptying the mind or feeling calm all the time. It is about noticing what is happening in the body, thoughts and feelings, and learning that an urge is a passing experience and not an order.
From autopilot to a pause
The aim is not to push cravings away. People practise watching a craving rise, peak and fade, and then choosing what to do next. Over time, many people find that they trust more and more that they can get through a hard moment without using.
Core practices in mindfulness-based relapse prevention
| Practice | What it is | How it helps in recovery |
|---|---|---|
| Awareness of triggers | Noticing the people, places, feelings and moments that start the chain towards using | Spots the early signs of a craving while there is still time to act |
| Body scan and breath awareness | Slowly paying attention to the breath and to sensations through the body | Builds the habit of noticing, and shows where stress and cravings are felt in the body |
| Urge surfing | Watching a craving rise, peak and pass without acting on it | Teaches by experience that cravings are temporary |
| SOBER breathing space | A short pause: Stop, Observe, Breathe, Expand awareness, Respond | Creates a gap between the urge and the action in a high-risk moment |
| Mindful movement and self-care | Gentle stretching, plus planning rest, healthy routines and support | Stops stress and tiredness from building into relapse risk |
How Mindfulness-Based Relapse Prevention Helps With Cravings, Stress and Hard Emotions
Cravings rarely come alone. They are often tangled up with stress, tension, worry and self-critical thoughts, and these can make a lapse feel like the only relief. MBRP works at that level, helping people notice what they feel and respond more calmly. It is used after treatment for alcohol and drug dependence, and the same attention skills are also used to cope with everyday stress and low mood that appear alongside it.
Four everyday problems MBRP works on
| Problem | What it looks like | How it can feed relapse | What MBRP does |
|---|---|---|---|
| Strong cravings | A sudden urge that feels impossible to ignore | Acting on the urge quickly, before it has time to pass | Teaches urge surfing and the SOBER pause |
| Stress and tension | A tight body, poor sleep and irritability | Using the substance to switch off or relax | Builds body awareness and breathing skills for settling down |
| Racing or self-critical thoughts | Thoughts such as “one drink will not hurt” or “I have already failed” | Believing these thoughts as facts can push a person back to use | Practises seeing thoughts as passing events and not commands |
| Hard emotions | Boredom, anger, sadness, guilt or loneliness | Using to escape the feeling | Practises staying with the feeling, with kindness, until it shifts |
Mindfulness Practices Used in Relapse Prevention
MBRP sessions mix short guided practices with discussion. Practices are chosen to be simple and repeatable, and nobody is judged on how well they do. If a practice feels uncomfortable, it can be adapted. Practices often used in mindfulness-based relapse prevention include:
- Body scan: slowly moving attention through the body to notice tension, comfort and the physical side of a craving
- Mindfulness of breath: short guided practices that train attention and help the body settle
- Urge surfing: imagining a craving as a wave that rises, peaks and passes, so that you ride it out without acting
- SOBER breathing space: a brief pause to Stop, Observe, Breathe, Expand awareness and Respond, for use in the moment
- Mindful movement: gentle stretching and walking with attention on the body
- Trigger and autopilot awareness: mapping the situations, thoughts and feelings that lead towards use
- Group discussion: sharing what came up during practice and learning from others
- Home practice: short daily practices that build the habit between sessions
How a session might look
A session may begin with a short guided practice, followed by a talk about what you noticed, such as where the body held tension or how a thought came and went. A new skill is then introduced, for example urge surfing or the SOBER pause, and practised together. It ends with a small practice to try before the next session. Group sessions also remind people that others face the same struggles, which can ease shame and isolation.
What Does the Research Say About MBRP?
Mindfulness-based relapse prevention has been tested in a randomised clinical trial, though the research as a whole is still developing. In the main study, Bowen and colleagues followed 286 adults who had just completed addiction treatment. They were placed in one of three aftercare groups: MBRP, standard cognitive-behavioural relapse prevention, or usual aftercare based on a 12-step approach. MBRP and standard relapse prevention were each delivered as eight weekly group sessions of about two hours (Bowen et al., 2014).
At the six-month follow-up, both relapse prevention groups had a lower risk of relapse to drug use and heavy drinking than the usual aftercare group. At 12 months, people who had taken MBRP reported fewer days of drug use and were less likely to report heavy drinking than those who had taken standard relapse prevention. Commentators note that the study did not show a clear overall advantage for MBRP over standard relapse prevention, and the researchers stressed that mindfulness-based programmes are not meant to replace standard relapse prevention programmes (Bowen et al., 2014).
What this means for you
MBRP is best seen as a supportive part of a full programme, working beside medical care, counselling and relapse prevention, and not as a stand-alone treatment. We do not claim that it cures addiction or guarantees that relapse will not happen. What it can do is give you a practical way to meet cravings and stress with awareness, which is why we offer it as one part of care and not the whole of it.
Who Can Benefit from Mindfulness-Based Relapse Prevention?
MBRP is useful for many people in early and ongoing recovery, especially those who want a skill they can use anywhere. It may help if:
- Strong cravings or urges tend to catch you by surprise
- Stress, anger, boredom or loneliness have led you back to the substance before
- Past relapses felt as if they happened without any decision at all
- Racing, worried or self-critical thoughts keep you stuck
- You have completed detoxification and the first phase of treatment and want to protect your progress
- You prefer practical tools to long conversations about the past
- You want a way to cope that does not depend on a person, a place or a prescription
When another step may need to come first
Someone who is in active withdrawal, very unwell or in a mental health crisis needs medical stabilisation first, through detoxification and psychiatric care. Mindfulness practice begins when the person is steady enough to take part, and practices are adapted if sitting quietly feels unsafe or overwhelming, for example for people with a history of trauma.
Why Choose Calida Rehab for Mindfulness-Based Relapse Prevention?
Staying well is built from small moments of choice. What a person does when a craving arrives matters just as much as what happens in a therapy room. That is why mindfulness-based relapse prevention at Calida Rehab is planned into the residential routine and aftercare plan and not treated as an add-on.
- Part of one plan: mindfulness goals are set alongside medical, psychiatric and counselling goals, so that every part of care points the same way
- Practice in a structured setting: residential care gives a steady daily rhythm in which short practices can become a habit
- Skills for real life: urge surfing and the SOBER pause are practised for the situations you will meet at home and at work
- Joined up with other therapies: it works beside relapse prevention therapy, group therapy and individual counselling
- Families included: relatives are invited to understand the plan through family therapy
- Two centres: care is available at our Pune centre and our Mumbai Region – Karjat centre
- Support when you need it: a 24/7 free, confidential helpline
How Mindfulness-Based Relapse Prevention Works at Calida
Mindfulness-based relapse prevention at Calida Rehab follows a step-by-step path, adapted to each person. The steps below show the general path, and the pace depends on your health, your stage of recovery and your goals.
1. Assessment & Readiness
- A conversation about your history of use, your triggers, past relapses and what has helped before
- A check that you are medically and emotionally steady enough to take part in mindfulness practice
- A plain explanation of what mindfulness practice is, and what it is not
- Agreeing goals that matter to you, such as handling cravings, sleeping better or coping with stress
2. Learning Awareness Skills
- Learning breath awareness and the body scan in short, guided practices
- Noticing autopilot: the moments in a day when you act without really noticing
- Spotting your own triggers and the early body signs of a craving
- Talking through what came up, with no right or wrong answers
3. Practising With Urges
- Practising urge surfing, so that you learn that a craving rises, peaks and passes
- Learning the SOBER breathing space for use in a high-risk moment
- Rehearsing how you will use these skills in the situations you fear most
- Learning from slips and near misses in a safe setting, with feedback and no judgement
4. Thoughts, Emotions & Self-Care
- Seeing thoughts as passing events, and not as facts or commands
- Staying with hard feelings such as boredom, anger or guilt, with kindness, until they shift
- Mindful movement, rest and a balanced routine so that stress does not build up
- Building and using a circle of support, including family and peers
5. Planning the Return Home
- Writing a personal plan that lists your triggers, early warning signs and the practices you will use
- Agreeing who to call when an urge is strong and what to do after a lapse
- Linking with aftercare and follow-up so that practice continues after discharge
- Involving family in understanding the plan and their role in it
What to Expect in Your First MBRP Sessions
MBRP is collaborative. You will not be tested or graded, and there is no right way to feel during a practice. Your therapist guides each exercise and you decide together what makes sense for you. The pace varies from person to person, and the stages below are only a general guide.
| Stage | What happens | What you may notice |
|---|---|---|
| Early stage | Your therapist listens to your story, explains the practices and introduces simple ones such as breath awareness | Sitting still can feel strange or uncomfortable. A wandering mind is normal and is part of the practice |
| Building stage | You practise the body scan, urge surfing and the SOBER pause, in the group and on your own | Cravings may feel less sudden, and you may start to catch them earlier |
| Growing stage | You work with thoughts, hard emotions and high-risk situations, and use the practices outside sessions | More confidence in handling stress, and moments of noticing a craving pass |
| Preparing to return | You write your plan for home, talk through high-risk times and involve your family | A clearer plan, and some natural worry about leaving that you can talk through |
How Families Can Support Mindfulness-Based Recovery
Families often carry heavy feelings of their own: worry, anger, guilt and tiredness. They also have a big part in whether new habits last. Simple steps at home can make a real difference:
- Learn what urge surfing and the SOBER pause are, so that you recognise them when your relative uses them
- Keep a calm household routine with regular meals, sleep and quiet time
- Give space for short daily practice without teasing or checking on it
- Notice and praise effort, not only results
- Avoid planning events around alcohol, and stay calm when a craving or low mood comes up
- Talk about the plan together before discharge, including who to call if an urge feels too strong
Family members are welcome in family therapy sessions, where they can learn how to support the plan without taking over.
Myths and Facts About Mindfulness-Based Relapse Prevention
| Myth | Fact |
|---|---|
| MBRP means sitting silently for hours. | Practices are short and guided, mixed with gentle movement, discussion and everyday skills. |
| You have to clear your mind for it to work. | The practice is noticing thoughts and urges as they come and go, not removing them. |
| Mindfulness replaces counselling or medicines. | It does not. It works alongside medical care, psychiatric care, counselling and relapse prevention. |
| MBRP is a religious practice. | The practices have roots in meditation traditions, but MBRP teaches them as attention skills and does not ask you to adopt any belief. |
| MBRP guarantees that you will not relapse. | No therapy can promise that. MBRP is a skill that supports recovery, and learning it is a step, not a finish line. |
| You need to be good at meditation. | Nobody is graded. A busy or restless mind is normal, and noticing it is part of the practice. |
Mindfulness-Based Relapse Prevention in Our Programs
MBRP is not a one-time lesson. Its ideas run through every stage of care, from the first practices in residential treatment to planning how you will cope after discharge.
Inpatient Residential Program
Mindfulness practice begins once you are medically stable enough to take part. Short guided practices, urge surfing and the SOBER pause are built around your health and stage of recovery, and they sit alongside detoxification, psychiatric care, counselling and group sessions.
Aftercare & Follow-up
Recovery continues after discharge. We help clients and families keep short daily practice going, review the personal plan and know when to ask for help, so that the skills practised during residential care carry over into daily life at home.
When Mindfulness-Based Relapse Prevention Alone Is Not Enough
Mindfulness-based relapse prevention builds awareness, calm and coping skills. It does not treat withdrawal, it does not remove cravings on its own, and it is not enough for serious mental illness. Most people need several parts of care working together:
- Detoxification under medical supervision when withdrawal is a risk
- Psychiatric care and, where needed, medication-assisted treatment
- Talk therapies such as cognitive behavioral therapy and relapse prevention therapy
- Trauma therapy when past trauma is part of the picture
- Family therapy to repair relationships and share the plan
If you or someone close to you is in immediate danger, please call your local emergency number (112 in India) without waiting.
Sources and Further Reading
Clinical content pending review by Dr. Prashant Dasud, M.D. (Psychiatry). This page is for information and is not a substitute for medical advice.
- Bowen, S., Witkiewitz, K., Clifasefi, S. L., et al. (2014). Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry, 71(5), 547-556.
- Bowen, S., Chawla, N., and Marlatt, G. A. (2011). Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. Guilford Press.
- Witkiewitz, K., Marlatt, G. A., and Walker, D. (2005). Mindfulness-based relapse prevention for alcohol and substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 211-228.
- Marlatt, G. A., and Gordon, J. R. (Eds.) (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press.
Take the First Step - Contact Calida Rehab
If you or a loved one is struggling with cravings, stress or the fear of relapse, speak to our team for a confidential assessment. You do not have to be certain about the next step to make the call.
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Experts Who Will Guide Your Recovery
Dr. Prashant Dasud
Designation: M.D. (Psychiatry)
Experience: 14+
Illnesses:
Depression & Mood Disorders, Anxiety Disorders, Bipolar Disorder, Schizophrenia & Psychotic Disorders, OCD, Drug & Alcohol Addiction, Sleep Disorders
Geriatric Mental Health Issues
Dr. Santosh Pawar
Designation: M.D. (Radiodiagnosis)
Experience: 12+
Illnesses:
CT / MRI, Dementia & Memory Disorder, Neuro-radiological Evaluation, pine & Nerve Imaging,Head Injury & Neurological, Diagnostic Support for Mental Health
Dr. Neha Shetty
Designation: M.D. (Psychiatry)
Experience: 11+
Illnesses:
Depression, Anxiety Disorders, Bipolar Disorder, Schizophrenia & Psychosis, OCD, Drug Addiction,Mental Health Issues
Dr. Abhijit Bombe
Designation: MBBS, DPM
Experience: 10+
Illnesses:
Anxiety & Panic Disorders, Depression, Schizophrenia, Bipolar Disorder, OCD, Alcohol & Substance Use Disorders, Stress & Behavioral Problems
Mindfulness-Based Relapse Prevention at Calida Rehab - FAQs
What is mindfulness-based relapse prevention in simple words?
Mindfulness-based relapse prevention (MBRP) is a programme that teaches you to notice cravings, thoughts and feelings without acting on them straight away. It combines mindfulness practices, such as breath awareness and urge surfing, with relapse prevention planning, so that you can stay well after treatment.
Who developed MBRP?
MBRP was developed by Sarah Bowen, Alan Marlatt and colleagues, building on Marlatt’s earlier work on relapse prevention. It is set out in a clinician’s guide published in 2011.
How does MBRP help prevent relapse?
Relapse often happens on autopilot, when a trigger leads to a craving and the person acts before noticing what is going on. MBRP trains attention so that there is a pause between the urge and the action, and in that pause you can choose a different response.
What is urge surfing?
Urge surfing is a practice in which you watch a craving as if it were a wave that rises, peaks and passes, without acting on it or fighting it. It teaches by experience that cravings are temporary.
What is the SOBER breathing space?
SOBER is a short pause taught in MBRP: Stop, Observe, Breathe, Expand awareness, Respond. It can be used in the moment, when stress or a craving rises, to create a gap before you decide what to do.
Is MBRP effective?
MBRP has been tested in a randomised trial of 286 adults after treatment. Compared with usual aftercare, it was linked with lower relapse risk at six months, and at 12 months people who took MBRP reported fewer days of drug use and less heavy drinking than those who took standard relapse prevention. The research is still developing, and MBRP is best used as a supportive part of a full programme.
How is MBRP different from CBT-based relapse prevention?
Standard relapse prevention teaches you to spot high-risk situations and plan coping steps. MBRP keeps that planning and adds mindfulness practices that train attention and help you stay with urges and feelings. The two approaches support each other and are often used together.
Do I need to have meditated before?
No. Practices are short, guided and taught step by step. Nobody is graded, and a wandering or restless mind is normal and part of the practice.
Can MBRP be used with medicines?
Yes. MBRP works alongside medicines and does not replace them. It can also help you notice stress and cravings while you follow the treatment your doctor has prescribed.
How long does MBRP take?
The full MBRP model is usually run as an eight-week group programme. At Calida it is part of residential care and aftercare planning, and the pace depends on your health, your stage of recovery and your goals. Your team will review your progress with you.