Adherence to the mindfulness-based intervention for substance use, defined as the extent to which the clinician adhered to core treatment content, has been assessed in previous studies using observational rating scales. Higher clinician adherence was correlated with higher levels of mindfulness in patients.

Competence of the delivery of the mindfulness-based intervention for substance use, defined as the extent to which the clinician skillfully delivered core treatment content, has been assessed in previous studies using observational rating scales. Clinician competence did not appear to have a significant impact on patient outcomes.

Prior studies on mindfulness-based interventions for substance use have examined the acceptability of the intervention to patients using four different types of indicators:

1. Indicators of patient satisfaction
2. Indicators of patient retention in follow-up assessments
3. Evidence that the patient is using mindfulness practices
4. Patient attendance

A systematic review concluded that the lack of a standard definition makes it difficult to conclude that mindfulness-based interventions for substance use are acceptable to patients. However, a number of individual studies provide encouraging data. For instance, a study of Mindfulness-Oriented Recovery Enhancement (MORE) for patients with alcohol use disorder concluded that participants found the intervention to be acceptable, although several mentioned that they would like to see it implemented earlier in the recovery process to counteract initial feelings of guilt or shame. Other studies have also provided encouraging data suggesting that telehealth-delivered and self-guided mindfulness-based interventions are as acceptable to patients as traditional in-person delivered interventions.

Studies of mindfulness-based interventions often examine indicators of patient engagement in treatment. Meta-analytic reviews have found that the extent of mindfulness practice is significantly associated with improved health outcomes. By contrast, one study found that the total number of sessions patients attended of mindfulness-based relapse prevention (MBRP) did not have a main effect on their outcomes at the time of discharge, suggesting that out-of-session engagement in practice may be as or more important than attending sessions. A review of the state of mindfulness-based intervention research in the addiction field specifically pointed to the need for more “dose-response” research, examining the effects of the dose of mindfulness practice that the patient completes on outcomes.