DESCRIPTION (provided by applicant): The long-term objective of this study is to improve women's substance use disorder (SUD) treatment. The immediate project goal is to test the efficacy of an innovative mind-body intervention, Mindful Awareness in Body-Oriented Therapy (MABT) to reduce substance use relapse among women in SUD treatment. A novel mind-body approach, MABT combines a hands-on (manual) approach with mind-body psycho-education approaches of interoceptive training and mindfulness to develop somatically-based self-care skills and to facilitate emotion regulation. A three-group, randomized clinical trial using repeate measures, this project will enroll and randomize 225 women to one of three groups, MABT + Treatment-as-usual (TAU) (n=75), TAU only (n=75), and Women's Health Education (WHE) + TAU (to control for time and attention) (n=75). Study conditions will be compared at baseline, post-intervention, and at 6 and 12 month follow-up. The primary aim is to test the hypothesis that MABT will result in reduced substance use and related health outcomes compared to TAU and to WHE+ TAU at 12 month follow-up. The second aim is to examine hypothesized underlying mechanisms of MABT. The third aim is to explore an interoceptive biomarker as a predictor of treatment outcome. Female outpatients in two diverse community treatment facilities, serving racially diverse patients, will be recruited for study participation. This stud builds on promising preliminary evidence of MABT feasibility and acceptability in substance use disorder treatment for women, and addresses the need for more clinical research aimed at improving SUD treatment outcomes for women.

PUBLIC HEALTH RELEVANCE: The relevance of this research to public health is that it is aimed at improving treatment outcomes for women in substance use disorder (SUD) treatment. Relapse rates post-treatment are high, and the negative consequences of drug and alcohol addiction include emotional, financial, medical and legal costs to individuals and society. The proposed Mindful Awareness in Body-oriented Therapy (MABT) intervention uniquely addresses aspects of awareness, interoception, and regulation that may be associated with behavioral control and brain function abnormalities in alcohol and drug addicted individuals that increase risk of relapse. MABT has shown promising pilot results in a prior NIDA-funded study and this proposal is needed to determine MABT efficacy, explore economic outcomes, and examine MABT underlying mechanisms. Alternative and adjunctive approaches are of critical importance to improve SUD treatment outcomes for women.