Reviewed by Vinsent Franke, MBA, AMFT, CADC-II, RA, Founder of iRely Recovery. Updated September 2026.
Intro
Mindfulness-Based Relapse Prevention (MBRP) gives people in recovery a research-supported set of skills to recognize relapse triggers, respond to cravings without acting on them and build a sustainable recovery.
At iRely Recovery (DHCS License #191516AP) in Los Angeles, MBRP is offered as part of a comprehensive addiction treatment program. Unlike traditional relapse prevention, it teaches you to sit with difficult emotions and cravings through mindfulness, a skill called urge surfing.
Key Points
- An 8-session group programDeveloped at the University of Washington, with about two hours per session.
- Built on urge surfingYou learn to ride out a craving without acting on it instead of avoiding it.
- Studied in a randomized trialA 2014 JAMA Psychiatry trial found fewer days of substance use than standard relapse prevention at 12 months.
- Insurance verificationWe verify benefits at no cost. Call 818-869-2112.
In Short
Mindfulness-Based Relapse Prevention at iRely Recovery is an 8-session group program that combines mindfulness, urge surfing and cognitive-behavioral relapse prevention skills, offered in our intensive outpatient and outpatient levels of care. Most insurance is accepted. Call 818-869-2112 to schedule an assessment.
What Is Mindfulness-Based Relapse Prevention (MBRP)?
Mindfulness-Based Relapse Prevention is an 8-session group psychotherapy program that teaches people in recovery to use mindfulness skills, including meditation, body awareness and urge surfing, to prevent relapse. It was developed by Sarah Bowen, Neha Chawla and G. Alan Marlatt at the University of Washington, integrating Mindfulness-Based Cognitive Therapy with evidence-based relapse prevention strategies.
MBRP differs from standard relapse prevention in one critical way. Rather than training you to escape or avoid high-risk situations, it teaches you to approach cravings and difficult emotions with curiosity and non-judgment. That shift from avoidance to acceptance is what makes it especially useful for people who have relapsed despite traditional relapse prevention.
Each session lasts about two hours and includes guided mindfulness practice, skills discussion and between-session homework. The group format also adds peer support as a protective factor. At iRely Recovery (DHCS License #191516AP), MBRP is part of a comprehensive addiction treatment program.
The 8 Sessions of MBRP: What to Expect
The protocol follows a structured curriculum. Each session builds on the last, developing your capacity to handle difficult internal experiences without turning to substances.
Session 1: Automatic Pilot and Relapse
You are introduced to automatic pilot, the habitual, unconscious behaviors that drive cravings and relapse, through a first mindfulness exercise that shows how attention can interrupt automatic reactions.
Session 2: Awareness of Triggers and Cravings
You identify personal triggers and learn SOBER Space (Stop, Observe, Breathe, Expand, Respond), a brief mindfulness intervention for high-risk moments.
Session 3: Mindfulness in Daily Life
Formal practices such as the body scan, sitting meditation and mindful walking extend into everyday activities, with non-reactive observation of thoughts and sensations tied to cravings.
Session 4: Mindfulness in High-Risk Situations
You map your personal high-risk situations, practice mindful responses to simulated triggers and learn urge surfing in depth.
Session 5: Acceptance and Skilled Action
You explore the difference between acknowledging a craving without fighting it and giving in to it, and practice acceptance-based coping through role-plays.
Session 6: Seeing Thoughts as Thoughts
Cognitive defusion skills from ACT help you observe thoughts about substance use as mental events rather than commands.
Session 7: Self-Care and Lifestyle Balance
You focus on sleep, movement and social connection, and build a personalized self-care plan using mindfulness principles.
Session 8: Social Support and Continuing Practice
The final session reviews all skills, plans for keeping up practice after the program and connects you with peer support groups and individual therapy.
Urge Surfing: The Core MBRP Technique
Urge surfing is the signature MBRP technique. You ride a craving like a surfer rides a wave, staying present on top of it instead of being pulled under. The key insight is that cravings are time-limited. They rise, peak and subside if you do not act on them.
1. Notice and Label
Notice the craving and name it: I am having a craving for alcohol.
2. Locate It in the Body
Observe where the craving is felt, such as tightness in the chest or restlessness in the hands.
3. Track the Intensity
Watch its intensity rise and fall without trying to suppress or escape it.
4. Breathe
Use slow, deliberate breathing to stay in the present moment.
5. Notice It Pass
Note when the craving passes without your having acted on it.
Repeated practice weakens the conditioned link between trigger and use, and urge surfing is portable: you can use it independently in any high-risk moment.
The Research Behind MBRP
MBRP is one of the most studied mindfulness-based interventions for substance use disorders. The most influential trial is Bowen and colleagues (2014), published in JAMA Psychiatry.
Bowen et al. (2014), JAMA Psychiatry
The trial randomly assigned 286 adults who had completed residential treatment to MBRP, standard relapse prevention or treatment as usual. At 12 months, MBRP participants reported fewer days of substance use and less heavy drinking than those in standard relapse prevention.
What It Adds
It shows that mindfulness-based skills can improve on standard relapse prevention in the year after treatment, supporting MBRP as a step-down option for people leaving higher levels of care.
Who Can Benefit From MBRP?
MBRP is appropriate for adults in recovery from any substance use disorder, including alcohol, opioid (including people on medication for opioid use disorder), stimulant and cannabis use disorders, and co-occurring substance use and mood disorders such as depression or anxiety. It is particularly well suited to people who:
- Have completed a residential or intensive outpatient program and are transitioning to outpatient care
- Have relapsed despite traditional relapse prevention
- Report stress, anxiety or emotional reactivity as relapse triggers
- Are interested in meditation or mindfulness practice
- Have used other mindfulness-compatible treatment, such as DBT, ACT or MBSR
MBRP is not a replacement for medical detox, medication management or individual therapy. At iRely it is offered as part of a comprehensive plan that may include individual, group and family therapy, medication management and experiential therapies.
MBRP at iRely Recovery: What Our Program Includes
Our MBRP program follows the University of Washington protocol and is delivered by licensed therapists with specialized MBRP training, as part of our Intensive Outpatient and Outpatient levels of care.
8 Structured Group Sessions
About two hours each, building skills week by week.
Guided Practice Every Session
Body scan, SOBER Space, urge surfing and mindful movement.
Between-Session Homework
Mindfulness practice with audio guides you can use at home.
Personal Relapse Prevention Plan
Written and tailored to your own trigger profile.
Integrated Care
Coordinated with individual therapy, family therapy and medication management as appropriate.
Continuing Care Planning
We coordinate your plan for after the program ends.
Insurance Accepted for MBRP in California
California SB 855 requires insurers to cover evidence-based mental health and substance use disorder treatment at the same level as medical treatment. Coverage varies by plan.
Call 818-869-2112 and our admissions specialists will conduct a no-cost benefits verification before your first appointment. If your plan is not shown, we can still check your coverage.
Relapse Prevention Strategies Used in MBRP
MBRP integrates mindfulness with relapse prevention strategies from cognitive behavioral therapy.
The 4 D’s
A quick reference for cravings: Delay, waiting 15 to 20 minutes because cravings peak and pass. Distract, shifting to a neutral or positive activity. De-escalate, using slow breathing or a brief mindfulness exercise. Decide, choosing on purpose in line with your recovery values.
HALT Check
A daily check for the four states that most raise relapse vulnerability: Hungry, Angry, Lonely, Tired. You learn to check your HALT status before entering high-risk situations.
Mindful Coping With Emotions
Instead of suppressing or escaping difficult emotions, you turn toward them with curiosity. That reduces emotional avoidance, a strong predictor of relapse, by building tolerance for distress.
Relapse Prevention Planning
You write a personal plan naming your triggers, warning signs and coping strategies, with emergency contacts, support group information and a step-by-step response for high-risk moments.
MBRP vs. Traditional Relapse Prevention
| Feature | Traditional Relapse Prevention | MBRP |
|---|---|---|
| Core strategy | Identify and avoid high-risk situations | Approach cravings with mindful awareness |
| Response to cravings | Distraction and avoidance | Urge surfing: ride the wave without acting |
| Format | Individual or group, varying by program | Structured 8-session group protocol |
| Evidence base | Strong, with decades of research | Strong, including a 2014 randomized trial in JAMA Psychiatry |
| Best for | Situation-specific high-risk patterns | Emotional avoidance and stress-driven relapse |
Related Services at iRely Recovery
MBRP works best as part of a comprehensive plan. It can be combined with individual therapy to address trauma and mental health, group therapy that complements the curriculum, family therapy to repair relationships and build support, experiential therapies such as art and music therapy, and coordination with our medical team for medication management when appropriate. It pairs naturally with DBT, which shares its emphasis on mindfulness and distress tolerance.
Frequently Asked Questions About MBRP
What is mindfulness-based relapse prevention (MBRP)?
MBRP is an 8-session group therapy program developed by Sarah Bowen, Neha Chawla and G. Alan Marlatt at the University of Washington. It combines relapse prevention skills with mindfulness practices, including meditation, body scan and urge surfing, to help people in recovery recognize and respond to cravings without acting on them.
What are the 4 D's of relapse prevention?
The 4 D’s are Delay, Distract, De-escalate and Decide. Delay means waiting 15 to 20 minutes before acting on a craving, since cravings peak and pass. Distract means shifting attention to another activity. De-escalate means using breathing or a brief mindfulness exercise to lower arousal. Decide means making an intentional, values-based choice instead of reacting automatically.
What is urge surfing in relapse prevention?
Urge surfing is the signature MBRP technique. Instead of fighting a craving or giving in to it, you ride it like a wave, noticing where it is felt in the body, tracking its intensity and breathing through it until it subsides. Cravings are time-limited and typically peak and then decrease if you do not act on them.
How long is an MBRP program?
The standard protocol is 8 sessions of about two hours, typically weekly over 8 weeks. Each includes guided mindfulness practice, skills discussion and review of homework. At iRely, MBRP is part of our Intensive Outpatient and Outpatient levels of care. Call 818-869-2112 to learn about scheduling.
Is MBRP evidence-based?
Yes. The most influential study is Bowen and colleagues (2014) in JAMA Psychiatry, a randomized trial of 286 adults who had completed residential treatment. At 12 months, MBRP participants reported fewer days of substance use and less heavy drinking than those receiving standard relapse prevention.
Who developed mindfulness-based relapse prevention?
MBRP was developed by Dr. Sarah Bowen, Dr. Neha Chawla and Dr. G. Alan Marlatt at the University of Washington’s Addictive Behaviors Research Center. The full clinician manual was published by Guilford Press.
What are the different types of relapse prevention strategies?
Evidence-based strategies include MBRP, which emphasizes urge surfing and emotional acceptance; traditional relapse prevention, which focuses on identifying and avoiding high-risk situations; the HALT check for Hungry, Angry, Lonely and Tired states; DBT skills for distress tolerance and emotion regulation; and 12-step facilitation for peer support. Many programs, including iRely, combine several.
What are effective relapse prevention activities for group therapy?
Effective group activities in MBRP include body scan meditation, urge surfing in pairs, SOBER Space practice (Stop, Observe, Breathe, Expand, Respond), mindful walking, sharing personal high-risk situation maps, role-playing mindful responses to triggers and building group-supported relapse prevention plans. Groups also add peer accountability, which is protective in itself.
Does mindfulness help with addiction?
Research suggests mindfulness practice can reduce craving and emotional reactivity in people with substance use disorders, and MBRP is the most studied mindfulness-based addiction treatment. Mindfulness also helps with stress and depression, two major relapse risk factors.
Is MBRP covered by insurance in California?
California SB 855 requires health insurers to cover evidence-based mental health and substance use disorder treatment at parity with medical benefits. Coverage varies by plan. Call 818-869-2112 to verify your coverage, and our admissions team provides a no-cost benefits verification before your first appointment.
What is the difference between MBRP and MBSR?
Both are 8-week mindfulness programs with different purposes. MBSR was developed by Dr. Jon Kabat-Zinn for general stress reduction and chronic pain. MBRP was developed specifically for people in recovery and combines mindfulness with cognitive behavioral relapse prevention skills, including urge surfing, trigger mapping and personal relapse prevention planning.
How can I start the MBRP program at iRely Recovery?
Call 818-869-2112 or use our online contact form. Our admissions team will conduct a free insurance verification, answer your questions and schedule an initial assessment. MBRP is available as part of our IOP and Outpatient levels of care.
Sources
[1] Mindfulness Meditation: A Promising Remedy for Addiction and Chronic Pain | University of Utah Health | University of Utah Health. (2024, May 23). Uofuhealth.utah.edu. https://uofuhealth.utah.edu/newsroom/news/2024/05/mindfulness-meditation-promising-remedy-addiction-and-chronic-pain on May 22, 2025
[2] Penberthy, J. K., Konig, A., Gioia, C. J., Rodríguez, V. M., Starr, J. A., Meese, W., Worthington-Stoneman, D., Kersting, K., & Natanya, E. (2013). Mindfulness-Based Relapse Prevention: History, Mechanisms of Action, and Effects. Mindfulness, 6(2), 151 to 158. https://med.virginia.edu/perceptual-studies/wp-content/uploads/sites/360/2017/01/Mindfulness-based-prevention.pdf on May 22, 2025
[3, 5] Schwebel, F. J., Korecki, J. R., & Witkiewitz, K. (2020). Addictive Behavior Change and Mindfulness-Based Interventions: Current Research and Future Directions. Current Addiction Reports, 7(2). https://pmc.ncbi.nlm.nih.gov/articles/PMC7879483/ on May 22, 2025
[4] Budson, A. (2021, May 13). Can mindfulness change your brain? Harvard Health. https://www.health.harvard.edu/blog/can-mindfulness-change-your-brain-202105132455 on May 22, 2025
[+] Bowen, S., Witkiewitz, K., Clifasefi, S. L., et al. (2014). Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: A randomized clinical trial. JAMA Psychiatry, 71(5), 547 to 556.
[+] Bowen, S., Chawla, N., & Marlatt, G. A. (2010). Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. Guilford Press.
Start Your MBRP Program at iRely Recovery
If you are in recovery and looking for a skills-based program in Los Angeles, our MBRP therapists are here to help. Call 818-869-2112 or use our contact form to speak with admissions, verify your insurance and schedule an assessment. We are in the Sherwood Forest neighborhood of Los Angeles, serving the San Fernando Valley and Woodland Hills.
