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This chapter focuses on randomized controlled clinical trials in order to examine the highest level of evidence for the use of meditation and relaxation as adjuncts to psychotherapy for common DSM conditions. It identifies a set of techniques that are either empirically supported or probably effective for specific problems. The strategy for reviewing the literature for this chapter involves searching the Medline, Cochrane, DARE, and PsychInfo databases for keywords such as meditation, mindfulness, TM, Zen, relaxation, relaxation techniques, and stress management. It then culled the results and extracted those that included randomized clinical trials (either by keyword or by perusal of the methodologies) or randomized trials with subjects who met interview or psychometric criteria of pathology (i.e., subjects recruited in the media who scored in clinical ranges of depression inventories). It then excluded studies of patients with primarily physical problems (i.e., interventions on pain in cancer patients). If relevant, it included studies referenced that did not appear in computer searches as long as they met the other inclusion requirements. It provides a set of randomized controlled trials on patients or subjects primarily with DSM axis 1 diagnoses.
Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs. The comprehensive search for and review of literature found over 2000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 randomized controlled trials, 7 controlled nonrandomized, 6 noncontrolled prospective, and 2 qualitative studies, and 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size were assessed. Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action.