Objective: In people of color (POC) and from collectivist cultures, third-wave therapies utilizing mindfulness may be a more sensitive approach to substance use disorder (SUD) treatment, than cognitive behavioral therapy (CBT). This systematic review examined this hypothesis.
Method: We searched PsycINFO, Pubmed, and MEDLINE on December 23, 2021. Articles were included if they compared efficacy of third-wave therapies to therapies with only CBT elements and reported treatment outcomes for POC/people from collectivist cultures.
Results: We included eleven studies conducted in the United States (n = 5), Spain (n = 2), Brazil (n = 2), Hong Kong (n = 1), and Iran (n = 1). Third-wave therapies included mindfulness-based relapse prevention (n = 4), acceptance and commitment therapy (n = 3), yoga and breathing strategies (n = 2), and mindfulness/emotion regulation training (n = 2). The substance use outcomes measured included nicotine use (n = 6), opioid use (n = 1), and general SUDs (n = 4) using biological measures (n = 7), Timeline Followback (n = 4), and the Addiction Severity Index (ASI; n = 2) to measure substance use. Overall, eight studies reported greater improvements in the third-wave therapy group relative to the CBT group in POC, on at least one substance use outcome.
Conclusions: Findings suggest that relative to CBT, third-wave therapies are a promising modality in the treatment SUDs in POC and people and from collectivist cultures. However, studies are relatively sparse and carry a number of methodological problems. As such, there remains a need for further research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).