A significant number (16-69%) of soldiers returning from deployment struggle with the dual challenges of PTSD and alcohol use disorder. However, 50% of affected veterans do not seek treatment, and 57% of those who begin treatment discontinue it early. There is a need for treatment options that are accessible, acceptable, and effective for veterans with dual diagnoses. 

Mindfulness-based interventions have been shown to be of some benefit in reducing PTSD severity and substance use urges, but often present significant barriers to access. Mobile apps are more accessible, yet sustaining motivation to continue their use can be challenging. In a pilot study, Davis et al. [Journal of Clinical and Consulting Psychology] compared their newly developed mindfulness app (Mind Guide) to a stress management control app in veterans with PTSD and alcohol use symptoms. The researchers aimed to compare acceptability, usage, and efficacy across apps.

The researchers randomly assigned 201 military veterans (average age = 23; 84% male; 53% White) who scored high on self-report measures of alcohol use and PTSD symptoms to either the Mind Guide app or a stress management app. Mind Guide is a 16-module, self-guided training program that includes audio-based mindfulness exercises, self-assessments, journaling, goal setting and relapse prevention. Participants were instructed to complete two modules per week over eight weeks, with periodic text and email reminders from a program coordinator.

The stress management control app included an eight-week psychoeducational program focusing on stress, sleep, the immune system, time management, nutrition, and exercise. 

Participants were assessed at baseline, 4 weeks, 8 weeks, and on 1-and 2-month follow-ups on primary outcome measures of PTSD symptoms and alcohol use. Most veterans completed at least half of the Mind Guide modules, with 32% completing at least 75%. On average, veterans spent five hours logged into the app. 

The results showed that the Mind Guide group reported significantly reduced PTSD symptoms compared to the control group at weeks 8 (d=-0.25) and 16 (d=-0.36). Alcohol cravings and alcohol drinking days improved within each group, but without any between-group differences. In a post-hoc analysis of PTSD checklist subscales, hyperarousal and avoidance symptoms improved, but not re-experiencing symptoms.

This pilot study suggests that using Mind Guide can lead to small-to-moderate reductions in the hyperarousal and avoidance symptoms of PTSD for up to 16 weeks. While it also reduces alcohol use and cravings, it does not do so better than the control app. The study revealed that nearly one-third of Mind Guide users completed at least 75% of its modules - a rate higher than that of many similar apps.

The study is limited by its reliance on self-reported PTSD and alcohol use screening measures, the absence of a biochemical measure of abstinence, and the lack of participant ratings on app acceptability and satisfaction.

Reference:

Davis, J. P., Pedersen, E. R., Borsari, B., ... Canning, L. (2025). Effects of a mobile mindfulness smartphone app on posttraumatic stress disorder symptoms and alcohol use problems for veterans: A pilot randomized controlled trial. Journal of Consulting and Clinical Psychology. https://doi.org/10.1037/ccp0000940