A feasibility trial of an instructed breathing course in prison to improve emotion regulation in people with substance use difficulties

Substance abuse can be associated with difficulties in emotion regulation. It has been proposed that advantageous emotion regulation is positively associated with heart rate variability, and that slow-paced breathing can increase values of heart rate variability. We explored the feasibility of delivering a six-week, slow-paced breathing intervention in a prison setting, and investigated the effects of the intervention on indices of emotion regulation. The final sample consisted of seven male prisoners with histories of illicit substance and alcohol abuse who were identified as presenting with difficulties in emotion regulation. During the instructed breathing sessions, a device provided a visual aid to encourage a cycle of breathing that corresponds to six breaths per minute (i.e., 0.1 Hz). Changes in scores for psychometric measures were analysed with the Reliable and Clinically Significant Change Statistic. Most participants reported improvements in scores for depression, anxiety, and stress. A qualitative account of interviews with participants and factors influencing successful delivery of sessions was also included for the purposes of triangulation and to inform on feasibility. It is concluded that further evaluation of the intervention is feasible, and that the intervention offers promise for improving emotion regulation in offenders with histories of substance use difficulties.