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Evidence-Based Complementary and Alternative Medicine
Volume 2017 (2017), Article ID 9716586, 12 pages
Research Article

Maintaining Treatment Fidelity of Mindfulness-Based Relapse Prevention Intervention for Alcohol Dependence: A Randomized Controlled Trial Experience

1School of Medicine and Public Health, Department of Family Medicine and Community Health, University of Wisconsin-Madison, 1100 Delaplaine Ct., Madison, WI 53715, USA
2Mayo Clinic, Department of Medicine, Division of Internal Medicine, 200 First St SW, Rochester, MN 55905, USA
3UnityPoint Health Meriter, 202 S Park St, Madison, WI 53715, USA
4University Hospital and Clinics, 600 Highland Ave, Madison, WI 53792, USA

Correspondence should be addressed to Aleksandra E. Zgierska

Received 4 December 2016; Revised 29 March 2017; Accepted 14 May 2017; Published 5 July 2017

Academic Editor: Mark Moss

Copyright © 2017 Aleksandra E. Zgierska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Treatment fidelity is essential to methodological rigor of clinical trials evaluating behavioral interventions such as Mindfulness Meditation (MM). However, procedures for monitoring and maintenance of treatment fidelity are inconsistently applied, limiting the strength of such research. Objective. To describe the implementation and findings related to fidelity monitoring of the Mindfulness-Based Relapse Prevention for Alcohol Dependence (MBRP-A) intervention in a 26-week randomized controlled trial. Methods. 123 alcohol dependent adults were randomly assigned to MM (MBRP-A and home practice, adjunctive to usual care; ) or control (usual care alone; ). Treatment fidelity assessment strategies recommended by the National Institutes of Health Behavior Change Consortium for study/intervention design, therapist training, intervention delivery, and treatment receipt and enactment were applied. Results. Ten 8-session interventions were delivered. Therapist adherence and competence, assessed using the modified MBRP Adherence and Competence Scale, were high. Among the MM group participants, 46 attended ≥4 sessions; over 90% reported at-home MM practice at 8 weeks and 72% at 26 weeks. They also reported satisfaction with and usefulness of MM for maintaining sobriety. No adverse events were reported. Conclusions. A systematic approach to assessment of treatment fidelity in behavioral clinical trials allows determination of the degree of consistency between intended and actual delivery and receipt of intervention.