MindfulnessandModificationTherapyforBehavioralDysregulation:Results From a Pilot Study Targeting Alcohol Use and Aggression in Women Peggilee Wupperman, 1,2 G. Alan Marlatt, 3 Amy Cunningham, 4 Sarah Bowen, 3 Matthias Berking, 5 Nicole Mulvihill-Rivera, 6 and Caroline Easton 2 1 John Jay College/City University of New York 2 Yale School of Medicine 3 University of Washington 4 University of Pennsylvania School of Medicine 5 Philipps-University Marburg, Germany 6 Southern Connecticut State University Objectives: Increasing evidence suggests that deficits in mindfulness (awareness, attentiveness, and acceptance of the present moment) play a role in a range of disorders involving behavioral dysregulation. This paper adds to that literature by describing a transdiagnostic psychotherapy (Mindfulness & Modification Therapy; MMT) developed to target behavioral dysregulation. Design: An open-treatment pilot-trial investigated the feasibility, acceptability, and pre-post effects of MMT targeting women (N=14) court-referred for alcohol abuse/dependence and aggression. Results: Pre- post comparisons revealed significant decreases in alcohol use, drug use, and aggression. In addition, the retention rate was 93%. Conclusion: Preliminary evidence suggests that MMT is a feasible and acceptable treatment that decreases dysregulated behaviors such as substance use and aggression, while also potentially increasing retention. & 2011 Wiley Periodicals, Inc. J Clin Psychol 68:50–66, 2012. Keywords: transdiagnostic; mindfulness; behavior dysregulation; substance; aggression; anger; intervention; emotion regulation Behavioral dysregulation is characterized by difficulty inhibiting harmful behavior (e.g., substance abuse, aggression, binge eating), which can lead to marked impairments in social, physical, and occupational functioning (see Mezzich et al., 1997). Although disorder- specific interventions have been developed for a range of dysregulated behaviors, treatment outcomes remain less than optimal, and relapse rates are often greater than 50% across disorders (McFarlane, Olmsted, & Trottier, 2008; McLellan, Lewis, O’Brien, & Kleber, 2000; Miller, Walters, & Bennett, 2001). In addition, individuals with one area of dysregulated behavior often also have another (e.g., alcohol abuse and gambling; Welte, Barnes, Wieczorek, Tidwell, & Parker, 2001) and/or tend to begin another once the previous behavior is addressed (e.g., someone quits smoking but begins overeating; Manley & Boland, 1983); however, disorder-specific interventions are highly limited in their ability to address such co-occurrence. Given that mindfulness deficits play a role in a range of disorders involving behavioral dysregulation (see below), the effectiveness of treatments for behavioral dysregulation might be improved by a transdiagnostic treatment that includes a focus on mindfulness. Mindfulness is a mental state that involves awareness, attentiveness, and acceptance of the present moment, without over-involvement in cognitive or emotional reactions (Kabat-Zinn, 1982). Mind- fulness levels are inversely associated with self-reports of physical and verbal aggression The authors thank the Donaghue Medical Research Foundation for their support. Correspondence concerning this article should be addressed to: Peggilee Wupperman, John Jay College/ City University of New York, Psychology Department, Second Floor, 445 W 59th St., New York, NY 10024; e-mail: pegwupp@hotmail.com JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 68(1), 50--66 (2012) & 2011 Wiley Periodicals, Inc. Published online in Wiley Online Library (wileyonlinelibrary.com/journal/jclp). DOI: 10.1002/jclp.20830