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Relationship between the five facets of mindfulness on mood and

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784961
research-article2018
FISXXX10.1177/1044389418784961Families in SocietyTemme and Wang

Article
Families in Society: The Journal of
Contemporary Social Services
Relationship Between the Five 2018, Vol. 99(3) 209­–218
© The Author(s) 2018
Facets of Mindfulness on Mood Article reuse guidelines:
sagepub.com/journals-permissions
and Substance Use Relapse DOI: 10.1177/1044389418784961
https://doi.org/10.1177/1044389418784961
journals.sagepub.com/home/fis

Leslie J. Temme1 and Donna Wang2

Abstract
This study examined which particular facets of mindfulness (nonreactivity, observing thoughts
and feelings, acting with awareness, describing experience, and nonjudging of experience)
accounted for improvements in mood and warning signs of relapse in an adult population. This
exploratory study examined the impact of the five facets of mindfulness on both warning signs
of relapse and mood in a primarily minority adult population in a residential substance abuse
treatment facility. Results showed that all five facets were significantly correlated with mood
and warning signs at the bivariate level. When considering the facets together, observing and
nonjudging were related to mood, and acting with awareness and nonjudging were related to
warning signs. Implications for future research and practice are offered.

Keywords
mindfulness, substance use, relapse, mood, addiction treatment

Manuscript received: February 19, 2018; Revised: May 9, 2018; Accepted: May 24, 2018

Disposition editor: Sondra J. Fogel

Substance abuse continues to be one of the system (Mark, Levit, Vandivort-Warren,

most far-reaching and devastating problems
within American society today. According to
the Substance Abuse and Mental Health Ser-
vices Administration’s 2014 National Survey
on Drug Use and Health, 8.1% of Americans
aged 12 or older had a substance use disorder
(SUD; Center for Behavioral Health Statistics
and Quality, 2015). The existence of this
problem impacts major health and welfare
institutions as well as the growth of our chil-
dren, families, and communities (National
Drug Intelligence Center, 2011). The National
Institute on Drug Abuse estimates that abuse
of substances costs more than $740 million in
crime, lost work productivity, and health care
(National Institute of Drug Abuse [NIDA],
2017). The consequences associated with
SUDs are amplified when working with insti-
tutional service providers such as health ser-
vices, social services, and the criminal justice
Buck, & Coffey, 2011; National Drug Intelli-
gence Center, 2011).
Given that an estimated 60% of SUD indi-
viduals return to substance use within 1 year
following treatment (McLellan, Lewis,
O’Brien, & Kleber, 2000), effective relapse
prevention is critical. Pruett, Nishimura, and
Priest (2007) asserted that the challenge of
treatment and recovery has not been ade-
quately addressed, and in light of the impact of
addiction on individuals, families, and society,
1
Department of Social Work, East Tennessee State
University
2
Department of Social Work, Long Island University,
Brooklyn Campus
Corresponding Author:
Donna Wang, PhD, LMSW, associate professor, Long
Island University, 1 University Plaza, Brooklyn, NY 11201.
Email: donna.wang@liu.edu
210 Families in Society: The Journal of Contemporary Social Services 99(3)
improved means of addressing substance use
are warranted.
In an effort to minimize relapsing and
improve client outcomes, SUD treatment pro-
grams have begun to introduce complemen-
tary and alternative medicine practices such as
yoga and mindfulness (Brewer, Elwafi, &
Davis, 2013; Garland, 2013; Khalsa, Khalsa,
Khalsa, & Khalsa, 2008; Khanna & Greeson,
2013). Mindfulness is believed to effect
change physiologically, psychologically, and
cognitively, which may be extremely benefi-
cial in preventing substance use relapse. For
example, mindfulness practices may interrupt
the use of maladaptive behaviors (such as sub-
stance use), and craving may be ameliorated as
one learns not to react but act with awareness
(Marcus & Zgierska, 2009). The physiological
mechanisms gained from mindfulness affect-
ing responses related to physical or emotional
states include self-arousal and modified auto-
nomic nervous system activity (Cahn & Pol-
ich, 2006). The psychological mechanisms
include counterconditioning, deautomatiza-
tion, and cognitive connections (Brown &
Ryan, 2004), and the cognitive mechanisms
include self-monitoring, self-control, and self-
acceptance (Baer, 2003).
Thus, increasing mindfulness through
mindfulness-based treatment approaches has
been incorporated into a broad range of inter-
ventions (Williams, Dalgleish, Karl, &
Kuyken, 2014) and is growing in popularity
among substance use professionals (Fernan-
dez, Wood, Stein, & Rossi, 2010; Witkiewitz,
Bowen et al., 2014). A systematic review of
24 mindfulness-based intervention studies for
SUDs found that these practices reduced alco-
hol, marijuana, tobacco, and opiate use as
well as reduced cravings for these substances
(Chiesa, Serretti, & Jakobsen, 2013). This
review of completed studies found that
although there were some questions about
small sample sizes and methodology, there is
still substantial evidence that increasing mind-
fulness and mindfulness-based interventions
is a viable complement for SUD treatment.
However, the distinctions between mind-
fulness and related concepts were unclear
(Hayes & Wilson, 2003). Thus, initial research
regarding the measurement of mindfulness
was centered on identifying the constructs that
underlie mindfulness (Baer, 2003; Bishop
et al., 2004; Brown & Ryan, 2004), and hence,
Baer, Smith, Hopkins, Krietemeyer, and Toney
(2006) identified five interpretable facets of
mindfulness: (a) nonreactivity (i.e., refraining
from impulsive reactions to an experience), (b)
observing thoughts and feelings, (c) acting
with awareness, (d) describing experience, and
(e) nonjudging of experience (i.e., refraining
from judgment or self-criticism of an experi-
ence). Table 1 presents the descriptions of each
of the five facets provided by Baer et al. (2008)
and some example items.
These facets of mindfulness represent what
one does when being mindful (observing,
describing, and acting with awareness) and
how one does it (nonjudgmentally and with
nonreaction). Kabat-Zinn (2003) as well as
Teasdale, Segal, and Williams (2003) suggest
that the elements of acceptance and nonreac-
tivity are central to the construct, however
Brown and Ryan (2004) later argue that
acceptance is important but is subsumed
within the construct of paying attention to the
present moment without reacting.
Empirical evidence regarding how these
concepts directly affect behaviors, exclusive
of other influences, has not yet been provided
(Brown & Ryan, 2004; Dakwar & Levin,
2009; Nyklicek & Kuijpers, 2008). Examina-
tion of the five facets of mindfulness may
yield useful information about the nature of
mindfulness and its relationship with other
constructs. One or more facets may be
strongly related to a particular variable, while
other facets may not. Thus, using a total score
may provide a distorted view of the relation-
ship (Eisenlohr-Moul, Walsh, Charnigo,
Lynam, & Baer, 2012). Therefore, the mea-
surement of constructs at the facet level is
important for clarifying relationships between
these constructs and other variables. Although
the examination of specific facets and their
relation to substance use in general popula-
tions have begun (Eisenlohr-Moul et al., 2012;
Fernandez et al., 2010), there is a need to
examine them specifically within an SUD
population.
Temme and Wang 211

Table 1.  Descriptions of Each of the Five Facets and Example Items.

Facet Description Example Items

Observing Noticing or attending to internal
and external experiences, such as
sensations, cognitions, emotions,
sights, sounds, and smells
Describing Labeling internal experiences with
words
Acting With Awareness Attending to one’s activities of
the moment. Contrasted with
behaving mechanically while
attention is focused elsewhere
(“automatic pilot”)
Nonjudging Nonevaluative stance towards
thoughts and feelings
Nonreactivity Tendency to allow thoughts and
feelings to come and go, without
getting up or carried away by
them
When I am walking, I deliberately
notice the sensations of my body
moving
I pay attention to how my emotions
affect my thoughts and behavior
I’m good at finding words to describe
my feelings
I can easily put my beliefs, opinions,
and expectations into words
When I do things, my mind wanders
off and I’m easily distracted
I find it difficult to stay focused on
what’s happening in the present
I criticize myself for having irrational
or inappropriate emotions
I tell myself I shouldn’t be feeling the
way I do
I perceive my feelings and emotions
without having to react to them
When I have distressing thoughts or
images, I just notice them and let
them go

Both mood and awareness of risks for
relapse are critical to recovery. First, mood is
believed to directly and indirectly affect
relapse, in that negative mood increases the
chance of use and also decreases emotional
sensitivity and awareness (Temme, Fenster, &
Ream, 2012). For example, if a person is
depressed, he or she may be more “numb,” or
unaware of the signals of relapse. Second, the
actual awareness of warning signs of relapse
provides an opportunity for individuals to be
proactive in their care and treatment. Increased
awareness of particular cues and signals that
are related to relapse may result in increased
abstinence and relapse prevention.
Thus, this study sought to examine the five
facets of mindfulness as described by Baer
et al. (2006) and how they are related to mood
and warning signs of relapse among adults who
were in a residential facility for the treatment of
an SUD. The aim of this study was to explore if
and how each of the five facets of mindfulness
were related to negative mood and warning
signs of release. Because mindfulness increases
positive mood and is also thought to bring
awareness to behavior, we hypothesized that all
five facets of mindfulness would be negatively
correlated to both negative mood and aware-
ness of relapse. We also hypothesized that non-
judgment and nonreaction would predict mood
and awareness of relapse given the distinction
that these two facets are central to the construct
of mindfulness (Kabat-Zinn, 2003; Teasdale
et al., 2003).
Methods
Participants and Procedure
This study was cross-sectional in design using
postintervention data extracted from a larger
meditation study. The study was conducted in
a long-term residential substance abuse treat-
ment facility that treats both men and women
ages 21 years and older, in Brooklyn, New
York. Approvals from the first author’s Insti-
tutional Review Board and the facility were
received prior to the commencement of the
212 Families in Society: The Journal of Contemporary Social Services 99(3)
study. The facility typically has approximately
80 to 100 residents, the majority of which are
male. Most of the clients are court-mandated
to receive treatment and are required to stay in
the residential facility between 9 and 12
months. All study participants met the criteria
for SUD as specified in the American Psycho-
logical Association’s Diagnostic and Statisti-
cal Manual of Mental Disorders (5th ed.;
DSM-5; American Psychiatric Association,
2013), however the facility transfers all indi-
viduals who are admitted with co-occurring
disorders (i.e., dual diagnosis).
The principal investigator was responsible
for recruitment and made presentations to the
residents to explain the study, answer ques-
tions, and enroll participants in the study. All
residents who were available at the time (i.e.,
not at a doctor’s appointment) and willing
were gathered to learn about the study. In
total, over a course of three recruitment peri-
ods, 68 people were recruited to participate in
the meditation intervention. With attrition and
excluding those who did not participate in
more than eight sessions, we ended up with 51
individuals in the analyses.
Individuals who consented to complete the
survey instrument were given paper-and-pen-
cil packets to complete the measures. The
principle investigator and staff were present to
be available to answer questions but did not
assist in the completion of the measures. The
instrument took about 10 to 15 minutes for the
individuals to complete, and no incentives for
participation were offered.
Measures
We included three measures in our analyses:
(a) the Profile of Mood States (POMS;
McNair, Lorr, & Droppleman, 1971), (b)
Assessment of Warning Signs of Relapse
Scale (AWARE; Miller & Harris, 2000), and
(c) the Five Facet Mindfulness Questionnaire
(FFMQ; Baer et al., 2006).
POMS. We used the 65-item POMS, which
asked participants to assess if they have felt a
certain way (i.e., friendly, listless, grouchy)
over the past week using a 5-point Likert-type
scale, with 0 = never and 4 = extremely
(McNair & Heuchert, 2007). To score the
measure, positive items were reverse-coded,
resulting in a possible range of 0 to 260, with
a higher number indicating a more negative
mood. The POMS is a highly used measure,
and there is a considerable amount of data to
support the measure’s psychometric proper-
ties (Alterman et al., 2010). For our study,
Cronbach’s α was estimated at .75.
AWARE.  The AWARE scale is a 28-item scale
(Miller & Harris, 2000) developed to identify
the attitudes and beliefs identified as warning
signs of relapse by Gorski and Miller (1986).
Items include statements such as “I feel ner-
vous or unsure of my ability to stay sober” and
“My drinking and/or drug use is out of con-
trol.” In order to maintain consistency with
the other scales used in this study, the original
7-point Likert-type scale was adapted to 5
points, ranging from 1 (never) to 5 (very often
or always). A 5-point Likert-type scale was
adapted in the past to minimize participant
frustration and to increase readability and
response rate (Babakus & Mangold, 1992).
Thus, the possible range of AWARE was 28 to
140, with a higher number indicating a higher
risk of relapse vis-à-vis these warning signs.
Miller and Harris (2000) found a high internal
consistency level, with Cronbach’s alpha
reported at .92. For our study, Cronbach’s α
was estimated at .74.
FFMQ. The FFMQ, a 39-item scale, was
designed to measure five constructs found to
be associated with mindfulness: (a) observ-
ing, (b) describing, (c) acting with awareness,
(d) accepting without judgment, and (e) and
nonreactivity to inner experience (Baer et al.,
2006). Respondents were asked to report their
level of agreement for each of the statements,
such as “In difficult situations, I can pause
without immediately reacting” and “I pay
attention to how my emotions affect my
thoughts and behavior,” using a 5-point Lik-
ert-type scale ranging from 1 (never or very
rarely) to 5 (very often or almost always). To
score this scale, negative items are reverse-
coded so that a higher number indicates a
Temme and Wang 213

higher level of mindfulness. For our study, Table 2.  Summary Characteristics of the Sample
Cronbach’s α was estimated at .74 for the (N = 51).
entire FFMQ and .84 for observing, .82 for Variable M SD % N
describing, .83 for awareness, .73 for non-
judgement, and .83 for nonreactivity. The sub- Age (range 21–58) 36.9 10.8 51
scale for each facet was initially found to have Sex
an acceptable level of internal consistency.  Male 82.4 42
The following alpha values were obtained in  Female 17.6 9
the initial validation study: nonreactivity = Race/ethnicity
  African American 49.0 25
.75, observing = .83, acting with awareness =
 Hispanic 33.3 17
.87, describing = .91, and nonjudging = .87
 Mixed 9.8 5
(Baer et al., 2006). Fernandez et al. (2010)
 White 7.8 4
reported similar internal consistency and esti-
Number of times in treatment (including current)
mated each subscale at the following levels:  One 43.1 22
nonreactivity = .75, observing = .84, acting  Two 33.3 17
with awareness = .87, describing = .87, and  Three 11.8 6
nonjudging = .88. Eisenlohr-Moul et al.   Four or more 11.8 6
(2012) used three subscales and reported the Current length of stay
following levels of internal consistency:   ⩽ 30 days 2.0 1
observing = .76, nonjudging = .88, and nonre-   30–60 days 25.5 13
activity = .70.   60–90 days 15.7 8
  90 days 56.9 29
Data Analyses
Histograms were run to determine normality higher level of that facet. For the facet of non-
of distribution and showed that the distribu- reactivity, the possible range was 7 to 35, with
tions of these variables were normal with a higher number indicating a higher level of
some deviation. Negative mood and risk for nonreactivity.
relapse were slightly skewed in a positive
direction, showing that there was greater than
Results
average scores in this area. This is congruent
with the tendency of this population to have A total of 51 participants were included in
high levels of negative mood and be at higher these analyses. Table 2 illustrates the demo-
risk for relapse. Mindfulness was positively graphics of the study sample. The majority of
skewed, which might have indicated some the sample was male (82.4%) and African
change in participant levels of mindfulness American (49.0%). One third of the partici-
from less than average to more than average pants were Hispanic, with 9.8% being of
following the intervention. Because the mixed race and/or ethnicity, and 7.8% were
researcher was present during the data collec- White. The mean age was 36.8 years old
tion and checked the surveys as they were (±10.8), with 43.1% reporting the current stay
returned from the participants, there were no as their first-time treatment. The majority
missing data points. (56.9%) of our participants had been in the
We examined each of the five facets indi- facility for over 90 days.
vidually by combining their items to calculate Prior to running any multivariate analyses,
a score for each facet. With the exception of we also ran the bivariate correlations between
nonreactivity to inner experience, which con- each of the facets to determine if multicol-
sists of seven items, the constructs had eight linearity was present. According to the
items. Therefore, for the facets of observing, results, as seen in Table 3, there is no indica-
describing, acting with awareness, and accept- tion of multicollinearity. Each of the facets
ing without judgment, the possible range was was also run at the bivariate level to deter-
8 to 40, with a higher number indicating a mine if they were significantly related to
214 Families in Society: The Journal of Contemporary Social Services 99(3)

Table 3.  Correlations Between Each of the Five Facets.

Act With
Observe Describe Awareness Nonjudge Nonreact
Observe 1.00 .54* −.38* .09** .56*
Describe 1.00 −.10** .12** .54*
Act with awareness 1.00 .46* −.40*
Nonjudge 1.00 −.12**
Nonreact 1.00

*p < .001. **p < .05.

mood and warning signs of relapse. As seen Table 4.  Correlations of Five Facets With
in Table 4, our results show each of the five POMS and AWARE (N = 51).
facets was negatively correlated with both the
POMS Aware
POMS and AWARE.
We estimated multiple linear regressions to   r p r p
determine which of the five facets of mindful-
Observe −.59 .00 −.47 .00
ness contributed the most to reducing mood
Describe −.43 .00 −.48 .00
and warning signs of relapse. In order to Act with awareness −.57 .00 −.71 .00
determine if the five facets of mindfulness Nonjudge −.45 .00 −.54 .00
predicted mood (as seen in Table 5), only Nonreact −.38 .01 −.38 .01
observe and nonjudgment were significant,
with the overall model accounting for 55.1%
of the variance. In order to examine the Table 5.  Regression of Five Facets and POMS
research question of whether or not the five (N = 51).
facets of mindfulness predicted the warning
signs of relapse (as seen in Table 6), only act- B SE B b p
ing with awareness and nonjudgment were Observe −2.02 .56 −.44 .00
significant, with the overall model accounting Describe −.14 .82 −.03 .86
for 62.8% of the variance. Act with awareness −1.53 .80 −.25 .06
Nonjudge −1.53 .71 −.29 .01
Discussion Nonreact −.09 .91 −.01 .92
R2 .551
The results from this current study demon- F 11.04
strate that acting with awareness and nonjudg-
ment were related to changes in the warning
signs of relapse and that observing and non- were predicted by the increases in the observe
judgment were associated with changes in and the nonjudgment facets in this current
negative mood. Theoretically, this makes analysis, this evidence would support the idea
sense as observing is an internal process that that as an individual’s ability to nonjudgmen-
may help to regulate mood, while acting with tally be aware of negative mood states
awareness affects external behavior of sub- increases, there is a decrease in the impact of
stance use. the negative mood or the mood itself. In a
Baer et al. (2008) and Carmody and Baer mindfulness-based stress reduction group for
(2008) found that cultivating the ability to individuals dealing with stress-related prob-
remain aware of experiences in the present lems, illness, anxiety, and chronic pain, Car-
moment without judgment was the aspect of mody and Baer (2008) found large effect sizes
mindfulness that most strongly contributed to for the facets of observing and nonreactivity
well-being. As the changes in negative mood to inner experience and moderate effect sizes
Temme and Wang 215
Table 6.  Regression of Five Facets and AWARE
(N = 51).
B SE B b p
Observe −.43 .24 −.21 .08
Describe −.38 .35 −.15 .28
Act with awareness −1.15 .34 −.41 .00
Nonjudge −.91 .30 −.32 .00
Nonreact .02 .38 .01 .97
R2 .628
F 15.17
for the facets of describing, acting with aware-
ness, and nonjudging in relation to the out-
come of well-being.
Eisenlohr-Moul et al. (2012) described a
mindfulness approach to negative mood as
including a nonreactive observation of the
present-moment experience and a deliberate
choice of response rather than an automatic or
impulsive use of substances. Described as
behavioral self-regulation (Gratz & Roemer,
2004), this idea supports the theory elucidated
by Hayes, Luoma, Bond, Masuda, and Lillis
(2006) that sustained engagement in nonjudg-
mental observation of unpleasant thoughts
and feelings reduces reactivity and avoidant
behaviors. Witkiewitz, Warner et al. (2014)
state that the ability to become aware of, toler-
ate, and choose a response is an important
mechanism in mindfulness that may be
responsible for changes in outcomes among
SUD participants. The current study would
give evidence to support this idea, as our
results show that increases in awareness pre-
dicted decreased warning signs of relapse.
In examining the association between
awareness, nonjudgment, and alcohol use,
Fernandez et al. (2010) found a negative rela-
tionship between awareness and alcohol use
as well as nonjudgment and alcohol-related
consequences, which they assert supports the
theory that the ability to observe one’s
thoughts and feelings without judging them is
a marker of behavioral restraint. The current
analysis supports this idea, as we found that
nonjudgment and acting with awareness were
significant predictors of warning signs of
relapse. Our results further corroborate the
findings of Elwafi, Witkiewitz, Mallik,
Thornhill, and Brewer (2013), who reported
that nonjudgmental observation of cravings
decreased craving in cigarette smokers and
that these changes were significantly medi-
ated by factors specific to acceptance, non-
judgment, and awareness.
With regard specifically to substance use,
Fernandez et al. (2010) found that the facets
of describing experience (i.e., being able to
identify and label feelings) and acting with
awareness were both negatively associated
with alcohol consumption among a non-SUD
population of college students. Additionally,
describing experience and nonjudging were
negatively associated with alcohol-related
consequences (such as hangovers, driving
while intoxicated). Also, in another non-SUD
population of college students, Eisenlohr-
Moul et al. (2012) examined the five facets
and found significant interactions between
observing and nonreactivity facets. Further,
the observing subscale was negatively associ-
ated with substance use at higher levels of
nonreactivity but positively associated with
periods of substance use at lower levels of
nonreactivity. This current analysis and our
findings contradict the conclusions made by
Eisenlohr-Moul et al. (2012). Their research
found that the product of observing and non-
judging did not predict substance use, result-
ing in their conclusion that nonjudging is not
as important as nonreacting. However, the
results of the current study would indicate that
nonjudgment is an important factor in reduc-
ing warning signs of relapse as well as
decreasing negative mood.
It is interesting that nonjudgment is the
common facet between mood and relapse as
this is a facet that may help to cease substance
use. It should be noted that the subscale of
nonjudgment is noticeably absent from recent
literature regarding mindfulness-based inter-
ventions and their application for SUD treat-
ment (Chiesa & Serretti, 2014; Khanna &
Greeson, 2013), and given our finding, non-
judgment should be explored further.
Implications for Future Research
In terms of implications for research, our study
adds to the knowledge base concerning the
216 Families in Society: The Journal of Contemporary Social Services 99(3)
distinction of the five facets of mindfulness.
Baer et al. (2006) theorize that some factors of
the FFMQ may be more sensitive to medita-
tion experience than others. Therefore, rather
than using mindfulness as a catchall descrip-
tion, precise labeling of the phenomena being
described (as in the subscales of the FFMQ) is
important to help maintain a distinction
between characteristics related to mindfulness
and the construct itself (Witkiewitz, Warner
et al., 2014). Our study found that the only
facet related to both mood and relapse was
nonjudgment. It may be of value to examine
this further in terms of theoretical links and for
future research to determine if nonjudgment is
really indeed crucial to mood, awareness of
relapse, and other factors as well. Additionally,
it may be useful to further investigate if our
findings that both support and contradict past
findings are a product of target populations
(i.e., SUD and non-SUD populations).
Our study has a few limitations worth not-
ing. First, our sample size is relatively small,
thus limiting generalizability. Second, the pop-
ulation is already in treatment, and although we
consider it a strength to enhance programming
to those who may be vulnerable, these findings
may not be representative of general users of
substances. Additionally, as mentioned, 17 of
the participants withdrew from the study or did
not complete a majority of the sessions. Unfor-
tunately, it is unknown why these participants
chose to discontinue. Possible reasons could be
discharge from the facility or medical occur-
rences or it could have been negative reactions
to the program or a belief that the program was
not beneficial for them. If it were the latter,
then we cannot be sure that the programming is
appropriate, accessible, or of interest to all indi-
viduals in this target population. Lastly, because
the researcher and residential staff were present
during the data collection to assist with ques-
tions and increase the completion rate, subjects
may have felt pressure to answer questions in a
particular way.
Implications for Practice
Our study has several implications for practice.
First, the research was conducted with a pri-
marily minority substance-using population in
residential treatment that may be vulnerable.
Developing skills of mindfulness and reflec-
tion is a powerful response to the challenges
and opportunities presented by the residential
treatment setting. Although these settings pro-
vide a unique opportunity for self-growth, they
may pose some special challenges for adapta-
tion and limit self-determination. Due to the
stressors of being in a residential facility, devel-
oping self-awareness and self-regulation may
help engender positive outcomes, such as com-
pletion of treatment, relapse prevention, and
day-to-day management of daily triggers and
conflicts. The more we are able to examine the
needs and strengths of these individuals as well
as interventions and strategies that are effective
in increasing well-being and decreasing the
need for services, the more we empower these
individuals as well as their communities. Sec-
ond, if we can identify which aspects of mind-
fulness most directly support recovery, then
practitioners can focus on developing and
strengthening programs based on this. For
example, if we continue to see that nonjudg-
ment is strongly associated with awareness of
relapse, education and skill building on how to
remain nonjudgmental in treatment and of one-
self may be incorporated into programming.
For example, mindfulness practices that focus
on bodily scans or sensations and stress imper-
manence may train individuals not to react and
judge a particular experience or sensation and,
in the case of substance use, the sensation of
craving a particular substance. Also, practices
that focus on nonjudgmental acceptance could
be integrated into SUD treatment. Specifically,
loving-kindness meditations that involve
directing feelings of warmth and care inward
foster self-compassion and have been shown to
help individuals become less self-critical (Sha-
har et al., 2014). These messages of love and
compassion toward oneself may act as a self-
soothing tool that may be deficient in those
who are self-critical (Shahar et al., 2014).
It is important to continue to isolate which
factors are relevant to relapse and substance
use in order to enhance SUD programming. If
we are able to determine ways of developing
the significant factors (such as nonjudgment)
Temme and Wang 217
into other programming, in addition to medi-
tation and mindfulness practices, we have an
opportunity to strengthen the overall quality
of our service delivery to our clients.
Acknowledgments
The authors would like to thank the staff and resi-
dents at the agency for their cooperation with this
project.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of
interest with respect to the research, authorship,
and/or publication of this article.
Funding
The author(s) received no financial support for the
research, authorship, and/or publication of this article.
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