Improve Mental Health with On-line Mindfulness Training
By John M. de Castro, Ph.D.
“Mindfulness meditation is known to improve symptoms of many physical and mental health conditions. However, the group settings in which mindfulness meditation typically is taught can be problematic for many participants, either because of inconvenient scheduling or because people are averse to sharing in public.” – eMindful
Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.
The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules. As a result, there has been attempts to develop on-line mindfulness training programs. These have tremendous advantages in decreasing costs and making training schedules much more flexible. But, the question arises as to whether these programs are as effective as their traditional counterparts. Many believe that the presence of a therapist is a crucial component to the success of the programs and the lack of an active therapist in on-line programs may greatly reduce their effectiveness.
In today’s Research News article “The Efficacy of Internet-Based Mindfulness Training and Cognitive-Behavioral Training With Telephone Support in the Enhancement of Mental Health Among College Students and Young Working Adults: Randomized Controlled Trial.” See summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382258/
Mak and colleagues recruited college students and young working adults and randomly assigned them to receive an 8-week on-line therapy program of either mindfulness training or Cognitive Behavioral Therapy aimed at improving physical and psychological health. Treatments were delivered in 8, 30-45 minute, on-line modules and included home practice. To help insurance compliance, all participants were phoned weekly by a trained treatment support specialist to answer questions and encourage compliance. They completed measurements before and after training and 3 months later of mental well-being, psychological distress, satisfaction with life, energy, sleep, pain, and their expectancies regarding the treatments.
They found that both the on-line mindfulness training and Cognitive Behavioral Therapy groups showed significant improvements in mental well-being, psychological distress, satisfaction with life, energy, sleep, and pain after training that was maintained at the 3-month follow-up. Hence, they did not find a difference between the therapies with participants in both groups showing significant improvements in mental and physical health.
The weakness of the study is that regardless of treatment all participants improved and there was not a no-treatment control condition. So, it is impossible to determine if the results were due to the therapy or to a placebo effect, the passage of time, experimenter bias, etc. In other words, it is clear that the participants improved but it is not clear that the therapies were responsible.
On the other hand, the strength of the study is that it involved therapies implemented on-line. This allows for widespread, inexpensive, and convenient distribution of the treatment programs thereby opening up treatment to individuals who live in remote areas, cannot afford traditional therapist led treatment, or do not have the time to come repeatedly to a clinic during the workday. In addition, the study found benefits to the physical and mental health of otherwise healthy young adults. So, the treatment is not just for the sick, but also produces benefits for the healthy.
So, improve mental health with on-line mindfulness training.
“there is emerging evidence that online MBIs have the potential to improve mental health outcomes, most notably stress.” – M.P.J. Spijkerman
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Winnie WS Mak, Floria HN Chio, Amy TY Chan, Wacy WS Lui, Ellery KY Wu. The Efficacy of Internet-Based Mindfulness Training and Cognitive-Behavioral Training With Telephone Support in the Enhancement of Mental Health Among College Students and Young Working Adults: Randomized Controlled Trial. J Med Internet Res. 2017 Mar; 19(3): e84. Published online 2017 Mar 22. doi: 10.2196/jmir.6737
Abstract
Background
College students and working adults are particularly vulnerable to stress and other mental health problems, and mental health promotion and prevention are needed to promote their mental health. In recent decades, mindfulness-based training has demonstrated to be efficacious in treating physical and psychological conditions.
Objective
The aim of our study was to examine the efficacy of an Internet-based mindfulness training program (iMIND) in comparison with the well-established Internet-based cognitive-behavioral training program (iCBT) in promoting mental health among college students and young working adults.
Methods
This study was a 2-arm, unblinded, randomized controlled trial comparing iMIND with iCBT. Participants were recruited online and offline via mass emails, advertisements in newspapers and magazines, announcement and leaflets in primary care clinics, and social networking sites. Eligible participants were randomized into either the iMIND (n=604) or the iCBT (n=651) condition. Participants received 8 Web-based sessions with information and exercises related to mindfulness or cognitive-behavioral principles. Telephone or email support was provided by trained first tier supporters who were supervised by the study’s research team. Primary outcomes included mental and physical health-related measures, which were self-assessed online at preprogram, postprogram, and 3-month follow-up.
Results
Among the 1255 study participants, 213 and 127 completed the post- and 3-month follow-up assessment, respectively. Missing data were treated using restricted maximum likelihood estimation. Both iMIND (n=604) and iCBT (n=651) were efficacious in improving mental health, psychological distress, life satisfaction, sleep disturbance, and energy level.
Conclusions
Both Internet-based mental health programs showed potential in improving the mental health from pre- to postassessment, and such improvement was sustained at the 3-month follow-up. The high attrition rate in this study suggests the need for refinement in future technology-based psychological programs. Mental health professionals need to team up with experts in information technology to increase personalization of Web-based interventions to enhance adherence.