While problematic substance use transcends geographic regions, rural communities appear to be especially impacted. More prevalent problematic substance use and associated problems in these areas are exacerbated by lack of consistent access to evidence-based practices. Mindfulness-Based Relapse Prevention (MBRP) combines standard cognitive-behavioral relapse prevention with formal and informal mindfulness training, and may be a novel and effective treatment approach for substance use disorders (SUD) in these isolated areas. The current study explored feasibility and acceptability, and potential differences in variance accounted for by group randomization on substance use and secondary outcomes, between MBRP and treatment as usual (TAU) in a rural treatment setting, as well as the impact of a specially designed mobile application on treatment engagement and enactment. No differences were observed in variance of substance use or secondary outcome by groups; however, participants in TAU vs. MBRP were more likely to drop out of treatment against medical advice. The mobile application did not appear to impact treatment engagement or enactment. Implications and limitations are discussed.
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