ERA-Institute — Evidence-based Recovery through Attention

The Approach

The layer underneath the protocols

Between 40 and 60 percent of people relapse after addiction treatment — a figure published in JAMA in 2000, and subsequent research continues to report substantial rates of return to use. Twenty-five years of better protocols, better medication and better cognitive-behavioural therapy have improved much, and have not noticeably moved that number.

Here is a capacity few protocols train explicitly or intensively: the moment after a craving arises — when a wave of urgency moves through the body and a person either becomes it, or watches it. Attentional practice builds that capacity — kind attention: meeting a craving as a passing event in the body rather than a command, without judging it, obeying it, or fighting it. One proposed mechanism is decentering — experiencing thoughts, sensations and cravings as events rather than commands. The people we work with describe it more simply. The wave passes. Something watched it pass. That something is who they are — and it was never in danger.

The mask was never a lie. It was a wave you mistook for a face. Attention shows you what has been underneath, watching, the whole time.

The research is settled that identity change drives recovery — the Social Identity Model of Recovery (Best et al., 2016) made the case. It describes trading one identity for another. We train the attention that finds who was doing the trading.

6 → 12

months: mindfulness-based relapse prevention matches standard relapse prevention at six months — and pulls ahead at twelve (Bowen et al., JAMA Psychiatry, 2014). Capacities compound; strategies fade.

42%

greater reduction in return to drug use when Mindfulness-Oriented Recovery Enhancement was added to methadone treatment — with 59% less dropout (Cooperman et al., JAMA Psychiatry, 2024)

45% vs 24%

no longer misusing opioids at nine months on Mindfulness-Oriented Recovery Enhancement, versus active group therapy (Garland et al., JAMA Internal Medicine, 2022)

These trials tested MBRP and MORE — established eight-week protocols that train the same capacity ERA trains. They are the evidence for the approach, not for our programme: Still·point and the ERA course have not themselves been evaluated in a randomized trial. ERA measures its own outcomes against your baseline, and is building a pathway to formal evaluation.

The 2024 figures are hazard-ratio reductions (HR 0.58 and 0.41) from a phase-2 trial of 154 participants against usual care; the authors call for phase-3 replication. Absolute differences were smaller.

Free for Everyone

Still·point — meet the wave, on your own device

Free · No account · No tracking

Still·point

A craving is a wave: it rises, crests and passes. Still·point guides four short practices in two groups: two for building capacity in calm moments — E·R·A and noting — and two for being with a craving as it rises — Being with Waves and RAIN. Before-and-after craving ratings give you your own practice data — a record of how your cravings respond to practice. Everything stays on your device. Crisis support is one tap away on every screen. It supports recovery; it never replaces treatment.

Open Still·point

On your phone, add it to your home screen so it opens full-screen and works offline — iPhone (Safari): Share button → Add to Home Screen. Android (Chrome): menu ⋮ → Add to Home screen.

Read the letter — an invitation to anyone looking for recovery →

On the first Wednesday of every month we host the Still·point Circle — a free 60-minute Zoom gathering to share how the practices are landing and shape what the app becomes. Details inside the app under Info.

Programmes

Three ways to work with us

For individuals

The Still·point Course

8 weeks online · €95 per person

Eight weekly 60-minute group sessions on Zoom, following the eight-week weekly structure of the randomized trials — with daily practice structured by the app.

Small groups, nervous-system-aware facilitation
From meeting mild cravings to resting as the one who watches them — the face under the mask
Your own before/after practice data by week eight
Crisis pathway and ongoing practice plan included

For treatment organisations

Attentional Training Programme

8-week implementation · priced per engagement

Train your clinicians to deliver the layer beneath your protocols — attentional training — with fidelity, supervision, and outcomes measured against your own baseline.

Foundation training: staff practice first (2 half-days)
6 weeks supervised delivery with fidelity checklists
Embedding, outcome review, internal champions
Evidence dossier for commissioners and boards

Book a free 45-min working session

For practitioners

Facilitator Certification

Opening 2027 · join the waiting list

Train-the-trainer certification in the Still·point method: your own practice, the six-week curriculum, nervous-system-aware delivery, and alumni meetings twice a year.

For clinicians, coaches and recovery workers
Licensed materials, manual and app integration
Fidelity standards that protect outcomes

Join the waiting list

Evidence & Writing

Read the argument, check the trials

Our founding article, What Is the Essence of the Craving Trap?, sets out the case in full: why the relapse ceiling has not moved in twenty-five years, what the randomized trials show — including the honest limitations of the research — and what changes when recovery stops being a repair project and becomes a recognition.

“No wave reaches it. The door was never locked — the fighting is what held it shut, and the capacity to see that was here all along.”
— What Is the Essence of the Craving Trap?, Paul du Buf, ERA-Institute

Read the article

The research on identity, and where we go further

The Social Identity Model of Recovery (Best, Beckwith, Haslam et al., 2016) established what practitioners had long observed: identity change is not a side-effect of recovery, it is the mechanism. Its account is social — recovery as a transition from networks organised around use to networks organised around recovery, with an addict identity supplanted by a recovery identity. We take that as established, and we ask one question further. A recovery identity is a better face than an addict identity. It is still a face. What we train is the attention that notices there is someone wearing it.

The evidence is real, and it is mixed

A 2021 Cochrane review of 40 randomized trials found that mindfulness-based interventions may slightly reduce days of substance use, with uncertain effects on abstinence and craving. Reviews consistently show stronger effects on craving than on abstinence, and the heterogeneity tracks the quality of delivery — the strongest trials involve the most skilled delivery. That is why we train fidelity, and why we measure against your own baseline rather than against someone else's trial.

Key sources: Bowen et al., JAMA Psychiatry 2014 · Brewer et al., Drug & Alcohol Dependence 2011 · Garland et al., JAMA Internal Medicine 2022 · Cooperman et al., JAMA Psychiatry 2024 · Garland et al., American Journal of Psychiatry 2024 · McLellan et al., JAMA 2000 · Best, Beckwith, Haslam et al., Addiction Research & Theory 2016 · Goldberg et al., Cochrane Database of Systematic Reviews 2021 · Hsiao et al., Mindfulness 2019. The full evidence dossier is available to organisations on request.

About

Founded on the work floor, not the whiteboard

Paul du Buf worked for decades as a registered nurse in addiction services in the Netherlands and the UK — prevention, treatment, aftercare, dual diagnosis. He is the author of Shadow Dancing: Embodied Recovery from Trauma and Addiction, and was recognised by the International Council of Nurses as a Certified Global Nurse Consultant.

ERA-Institute grew from a simple, uncomfortable observation: everything he was trained to offer taught clients to fight the craving, and the fight kept failing the people who fought hardest. ERA exists to train the other capacity — attention — in individuals, and in the organisations and cultures that support them. Nervous-system-integrated from the ground up.

Mission

We train attention as a capacity — in people living with cravings, and in the services that support them — because attention unveils the mask, and recognises who we are again.

Vision

We change addiction care at the identity level. The addiction was a mask that worked until it became the only face you could see. Connecting with who you are allows the mask to fall.

We change addiction care at the identity level.
The addiction was a mask. Connecting with who you are allows the mask to fall.