Adapting and Pilot Testing Mindfulness-Based Relapse Prevention for Substance Use Peer Workers

About This Grant

ABSTRACT Peer workers (PWs) are essential frontline workers addressing the opioid epidemic, yet their effectiveness is impeded by high rates of occupational burnout and relapse. Approximately 70% of PWs report elevated levels of burnout, and up to 40% of addiction professionals in recovery have relapsed. Further, the United States is experiencing a substance use workforce crisis due to staff shortages and high turnover rates. Interventions tailored to the unique needs of PWs to support workforce retention and long-term recovery are urgently needed. To date, there are no interventions that prevent burnout and relapse due to occupational stress among PWs. This K01 research and training award addresses this gap by being the first to adapt and test the acceptability and effectiveness of Mindfulness-Based Relapse Prevention (MBRP) for substance use PWs. A three-phase approach to adapt, refine, and pilot test the intervention will be conducted across three study aims: Aim 1 will include in-depth qualitative interviews with PWs to understand their experiences related to occupationally triggered substance use relapse and perspectives on intervention characteristics to optimize the effectiveness of MBRP for PWs. Aim 2 will include manual development, interventionist training, field testing, and further manual refinement. Aim 3 will include a small, 2-armed (intervention vs. standard of care) pilot hybrid type 1 randomized controlled trial with 80 PWs to assess preliminary effectiveness and implementation outcomes of the adapted MBRP intervention. Feasibility, acceptability, and preliminary indication of improvement in relapse risk and burnout symptoms will be examined in 1-, 3-, and 6-month follow-ups. The long-term goal of this work is to improve the retention and effectiveness of the peer workforce by reducing occupational burnout and substance use relapse. To enable the PI to pursue this long-term research agenda, she will work with experienced mentors to build four areas of expertise: (1) skills in intervention development and testing via randomized controlled trial design and execution, (2) proficiency in workforce development for the substance use disorder peer workforce, (3) expertise in longitudinal and multi-level statistical analysis methods, and (4) proficiency in dissemination and implementation science frameworks and hybrid implementation-effectiveness designs. This K01 proposal addresses a key priority in strengthening the nation’s substance use peer recovery support workforce, and it will fully prepare the PI for an independent research career as an addiction recovery behavioral intervention scientist, leading innovative research that advances the field and ultimately improves the addiction recovery system of care. This proposal directly aligns with NIDA’s Strategic Plan of improving the implementation of evidence-based strategies in real-world settings and identifying approaches to develop personalized interventions informed by people with lived experience and workforce development.