Improve Leadership with Mindfulness

May 20, 2019 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Truth be told, most of the discussions we have with others aren’t really mindful. Mindful discussion means shedding attention and awareness on our words — it’s rarely what we do, as our ego is consistently involved.” – Elyane Youssef

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for not only to productivity in the workplace but also to our psychological and physical health. Mindfulness practices have been implemented in the workplace and they have been shown to markedly reduce the physiological and psychological responses to stress. This, in turn, improves productivity and the well-being of the employees. As a result, many businesses have incorporated mindfulness practices into the workday.

Mindfulness may also help to promote leadership in the workplace. It can potentially do so by enhancing emotion regulation, making the individual better able to recognize, experience, and adaptively respond to their emotions, and making the leader better able to listen to and to understand the needs and emotion of the workers they lead and to communicate effectively. There has been, however, little research attention to the effects of mindfulness on leadership and the ability of the leader to communicate.

In today’s Research News article “Mindfulness and Leadership: Communication as a Behavioral Correlate of Leader Mindfulness and Its Effect on Follower Satisfaction.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00667/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_951898_69_Psycho_20190404_arts_A), Arendt and colleagues recruited leaders and followers online from a variety of industries in Germany. Leaders completed an online measure of mindfulness. Their followers completed online measures of satisfaction with leader, follower satisfaction with leader’s communication, and follower’s perception of leader’s mindfulness in communications.

They found that the higher the leader’s mindfulness the higher the satisfaction with leader, follower satisfaction with leader’s communication, and follower’s perception of leader’s mindfulness in communications. A mediation analysis revealed that leader mindfulness was associated with higher follower’s perception of leader’s mindfulness in communications which, in turn, was associated with higher satisfaction with leader and follower satisfaction with leader’s communication.

These are interesting results but are correlative, so no definitive conclusions can be reached regarding causation. But the results suggest that mindfulness is an important characteristic for leaders in industry. When the leader is mindful, the followers find the leader’s communications mindful and when these communications are mindful they are associated with better overall satisfaction with the leader and the leader’s communication. These results, similar to prior research, suggest that mindfulness is important in the work environment, promoting well-being and productivity. This further suggests that “right communications” is important for leadership.

So, improve leadership with mindfulness.

“When you are talking mindfully, you are conscious of the words you choose. You think before you speak and make a conscious decision to use your best communication in a respectful manner, even if it is a difficult situation. You are also mindful of your intention and aware of expectations that may or may not be met. When there is a situation that needs to be addressed, being mindful can produce a better outcome and prevent the communication from getting out of control.” – Melinda Fouts

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Arendt JFW, Pircher Verdorfer A and Kugler KG (2019) Mindfulness and Leadership: Communication as a Behavioral Correlate of Leader Mindfulness and Its Effect on Follower Satisfaction. Front. Psychol. 10:667. doi: 10.3389/fpsyg.2019.00667

In recent years, the construct of mindfulness has gained growing attention in psychological research. However, little is known about the effects of mindfulness on interpersonal interactions and social relationships at work. Addressing this gap, the purpose of this study was to investigate the role of mindfulness in leader–follower relationships. Building on prior research, we hypothesize that leaders’ mindfulness is reflected in a specific communication style (“mindfulness in communication”), which is positively related to followers’ satisfaction with their leaders. We used nested survey data from 34 leaders and 98 followers from various organizations and tested mediation hypotheses using hierarchical linear modeling. Our hypotheses were confirmed by our data in that leaders’ self-reported mindfulness showed a positive relationship with several aspects of followers’ satisfaction. This relationship was fully mediated by leaders’ mindfulness in communication as perceived by their followers. Our findings emphasize the potential value of mindfulness in workplace settings. They provide empirical evidence for a positive link between leaders’ dispositional mindfulness and the wellbeing of their followers, indicating that mindfulness is not solely an individual resource but also fosters interpersonal skills. By examining leaders’ mindfulness in communication as an explanatory process, we created additional clarification about how leaders’ mindfulness relates to followers’ perceptions, offering a promising starting point for measuring behavioral correlates of leader mindfulness.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00667/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_951898_69_Psycho_20190404_arts_A

Improve Major Depression with Qigong Practice

May 18, 2019 psyjdc Leave a comment

Improve Major Depression with Qigong Practice

By John M. de Castro, Ph.D.

“One of the best things we can do for depressives is to give them hope. And there is abundant hope. Qigong provides a viable, practical, and economical solution to depression. It can also be used alongside traditional treatment methods.” – Sifu Anthony Korahais

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Mindful Movement practices such as Qigong and Tai Chi have been found to be effective for depression. Research has been accumulating. So, it is important to step back and examine what has been learned regarding the application of Qigong practice for major depression.

In today’s Research News article “Qigong-Based Therapy for Treating Adults with Major Depressive Disorder: A Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427394/), Guo and colleagues review, summarize and perform a meta-analysis of the effectiveness of Qigong practice in the treatment of major depression.

They reported on seven controlled trials. The research found that Qigong practice produces a significant reduction in depression compared to either active or passive control conditions. Qigong practice was also found to increase the response and remission rates for major depression. The research, however, did not identify how Qigong practice produces this relief of major depression. This will be for future research to investigate.

It is important to note that Qigong is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is also inexpensive, can be practiced virtually anywhere, at any time, alone or in groups, and does not require a trained therapist. Hence Qigong practice would appear to be an excellent non-pharmacological treatment for major depression.

So, improve major depression with Qigong practice.

“Qi Gong is one path for overcoming depression that has no harmful side effects. Furthermore, it can coincide with any other course of intervention or treatment.” – Lee Holden

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Lijuan Guo, Zhaowei Kong, Yanjie Zhang. Qigong-Based Therapy for Treating Adults with Major Depressive Disorder: A Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2019 Mar; 16(5): 826. Published online 2019 Mar 7. doi: 10.3390/ijerph16050826

Abstract

This current meta-analysis review was conducted to examine the effectiveness of Qigong-based therapy on individuals with major depressive disorder. Six electronic databases (PubMed, PsycINFO, Cochrane Library, and Web of Science, Chinese National Knowledge Infrastructure, and Wangfang) were employed to retrieve potential articles that were randomized controlled trials. The synthesized effect sizes (Hedges’ g) were computerized to explore the effectiveness of Qigong-based therapy. Additionally, a moderator analysis was performed based on the control type. The pooled results indicated that Qigong-based therapy has a significant benefit on depression severity (Hedges’ g = −0.64, 95% CI −0.92 to −0.35, p < 0. 001, I2= 41.73%). Specifically, Qigong led to significantly reduced depression as compared to the active control groups (Hedges’ g = −0.47, 95% CI −0.81 to −0.12, p = 0.01, I2 = 22.75%) and the passive control groups (Hedges’ g = −0.80, 95% CI −1.23 to −0.37, p < 0.01, I2 = 48.07%), respectively. For studies which reported categorical outcomes, Qigong intervention showed significantly improved treatment response rates (OR = 4.38, 95% CI 1.26 to 15.23, p = 0.02) and remission rates (OR = 8.52, 95% CI 1.91 to 37.98, p= 0.005) in comparison to the waitlist control group. Conclusions: Qigong-based exercises may be effective for alleviating depression symptoms in individuals with major depressive disorder. Future well-designed, randomized, controlled trials with large sample sizes are needed to confirm these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427394/

Shift Work Increases Stress, Psychopathology, and Family Conflict and Less Mindful Parenting

May 17, 2019 psyjdc Leave a comment

Shift Work Increases Stress, Psychopathology, and Family Conflict and Less Mindful Parenting

By John M. de Castro, Ph.D.

“When you work at night, you’re cut off from friends and family, you have little social support, your diet may not be as healthy.” – David Ballard

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological and physical health. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. Our work situation can have profound effects on the family and child rearing practices.

It has been shown that low workload and high sleep quality are important to high levels of mindfulness during work which, in turn leads to many benefits for the job and the employee. Keeping workload at a reasonable level should improve both sleep quality and mindfulness which should, in turn, promote better work. It should also promote better family life and more mindful parenting. But there is actually very little systematic research on the effects of the work environment and schedule on the individual’s family life and mindfulness.

In today’s Research News article “Work-Family Conflict and Mindful Parenting: The Mediating Role of Parental Psychopathology Symptoms and Parenting Stress in a Sample of Portuguese Employed Parents.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00635/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A), Moreira and colleagues recruited parents of children of any age up to 19 years online and had them complete an online questionnaire measuring type of employment, work schedule, hours worked per week, work-family conflict, anxiety, depression, parenting stress, and mindful parenting, including subscales of listening with full attention, compassion for the child, non-judgmental acceptance of parental functioning, self-regulation in parenting, and emotional awareness of the child.

They found that the higher the levels of mindful parenting, including each of the 5 subscales, the lower the levels of work-family conflict, anxiety, depression, and parenting stress. They also found that parents with a shift work schedule and also parents working full-time had significantly higher levels of work-family conflict. On the other hand, parents with flexible schedules had significantly higher levels of mindful parenting. In addition, path modelling revealed that higher levels of work-family conflict were indirectly associated with lower levels of mindful parenting through anxiety and depression symptoms and parenting stress. In other words, work-family conflict heightened anxiety and depression symptoms and parenting stress which in turn lowered mindful parenting.

These results are interesting but correlational, so no definitive conclusions regarding causation can be reached. But the results suggest that work scheduling has a large association with the mental health of the parents and as a result with mindful parenting. Shift-work is associated with greater parental mental health issues and lower mindful parenting while flexible work schedules have the opposite effect, being associated with better parental mental health and better mindful parenting.

There is a need in future research to manipulate work scheduling to observe its causal impact. But tentatively, the current research suggests that companies should investigate the implementation of more flexible work schedules for their employees. The improvement of their mental health and the consequent improvement of family life would likely make the employees, healthier, happier, and more productive and loyal to their employer. In addition, the improved mindful parenting would likely improve the well-being of the children.

“We leave decisions about flexibility and the organization of work to individual companies, which means that the decisions of first-line managers in large part create our national family policy.”- Fran Sussner Rogers

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Moreira H, Fonseca A, Caiado B and Canavarro MC (2019) Work-Family Conflict and Mindful Parenting: The Mediating Role of Parental Psychopathology Symptoms and Parenting Stress in a Sample of Portuguese Employed Parents. Front. Psychol. 10:635. doi: 10.3389/fpsyg.2019.00635

Aims: The aims of the current study are to examine whether parents’ work-family conflict, emotional distress (anxiety/depressive symptoms and parenting stress) and mindful parenting vary according to the type of employment (full-time, part-time, and occasional), the type of work schedule (fixed, flexible, and shift), and the number of working hours per week and to explore whether parental emotional distress mediates the association between work-family conflict and mindful parenting dimensions.

Methods: A sample of 335 employed parents (86.3% mothers) of children and adolescents between the ages of 1 and 19 years old completed a sociodemographic form and measures of work-family conflict, anxiety/depression symptoms, parenting stress, and mindful parenting. The differences in study variables among types of employment, work schedules and number of weekly working hours were analyzed. A path model was tested through structural equation modeling in AMOS to explore the indirect effect of work-family conflict on mindful parenting dimensions through anxiety, depression and parenting stress. The invariance of the path model across children’s age groups (toddlers, preschool and grade school children, and adolescents) and parents’ gender was also examined.

Results: Parents with a shift work schedule, working full-time and 40 h or more per week, presented significantly higher levels of work-family conflict than those with a fixed or flexible schedule, working part-time and less than 40 h per week, respectively. Parents with a flexible work schedule presented significantly higher levels of self-regulation in parenting and of non-judgmental acceptance of parental functioning than parents with a shift work schedule. Higher levels of work-family conflict were associated with lower levels of mindful parenting dimensions through higher levels of anxiety/depression symptoms and parenting stress. The model was invariant across children’s age groups and parents’ gender.

Discussion: Work-family conflict is associated with poorer parental mental health and with less mindful parenting. Workplaces should implement family-friendly policies (e.g., flexible work arrangements) that help parents successfully balance the competing responsibilities and demands of their work and family roles. These policies could have a critical impact on the mental health of parents and, consequently, on their parental practices.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00635/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A

Improve Children’s Generosity with Mindful Parenting

May 16, 2019 psyjdc Leave a comment

Improve Children’s Generosity with Mindful Parenting

By John M. de Castro, Ph.D.

“To bring mindful attention and awareness into your interactions with your child really seems to set the stage for you to be a good parent,” – Justin Parent

Raising children, parenting, is very rewarding. But it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. They demand attention and seem to especially when parental attention is needed elsewhere. They don’t always conform to parental dictates or aspirations for their behavior. The challenges of parenting require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves the ability to maintain attention and focus in the face of high levels of distraction.

Mindful parenting involves the parents having emotional awareness of themselves and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child. Mindful parenting has been shown to have positive benefits for both the parents and the children. So, it is important to further investigate the nature of the effects of mindful parenting on the behavior of children.

In today’s Research News article “The Role of Mindful Parenting in Individual and Social Decision-Making in Children.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00550/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A), Wong and colleagues recruited mothers and children who were 4 to 6 years old. The mothers completed a measure of mindful parenting. The children were asked to select a single toy from a chest containing a number of toys. They were rated for time to decision making, decision-related stress, doubt/indecisiveness, and confirmation seeking. The children were also examined for how many stickers that they were willing to share with a stuffed bunny character after the bunny shared some with them.

They found that there were no significant relationships between mindful parenting by the mother and any measure of the child’s decision making. But there was a significant relationship between mindful parenting and the child’s sharing behavior such that the greater the mother’s mindful parenting, the greater the sharing behavior by the child.

These are interesting findings that mothers who parent mindfully have children who share more generously. It is not known why this would be true. But it can be speculated that mindful parents are themselves more generous toward the child which affects the child’s generosity. Regardless, this higher sharing may result in greater prosocial behaviors as the children grow into adulthood. This is another example of the positive effects of mindful parenting.

So, improve children’s generosity with mindful parenting.

“Mindful mornings may be less efficient, but they’re more pleasurable. ‘What’s happening right now is all there is. Why make everybody unhappy? If we’re five minutes late to preschool it doesn’t change anything. What changes things is the frustration, and the stress that builds up and then everything unravels.’” – Juliann Garey

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Wong K, Hicks LM, Seuntjens TG, Trentacosta CJ, Hendriksen THG, Zeelenberg M and van den Heuvel MI (2019) The Role of Mindful Parenting in Individual and Social Decision-Making in Children. Front. Psychol. 10:550. doi: 10.3389/fpsyg.2019.00550

Children are confronted with an increasing amount of choices every day, which can be stressful. Decision-making skills may be one of the most important “21st century skills” that children need to master to ensure success. Many aspects of decision-making, such as emotion regulation during stressful situations, develop in the context of caregiver-child interactions. This study examined whether mindful parenting predicts children’s individual and social decision-making. The current study included 63 mother-child dyads from The Netherlands (Child Mage = 5.11, SD = 0.88, 50.8% girls). Mothers completed the Dutch version of the Interpersonal Mindfulness in Parenting Scale (IM-P). A “Choice Task” was developed to measure individual decision-making skills, and a “Sharing Task” was created to measure social decision-making in young children. Higher maternal mindful parenting significantly predicted more sharing after controlling for covariates (child age, sex, SES, maternal education level; Wald = 4.505, p = 0.034). No main effect of maternal mindful parenting was found for any of the individual decision-making measures. These findings suggest that mindful parenting supports children’s social decision-making. Future research should investigate if the combination of mindful parenting and children’s early decision-making skills predict key developmental outcomes.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00550/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A

Reduce Cell Phone Dependence in Adolescents with Mindfulness

May 15, 2019 psyjdc Leave a comment

Reduce Cell Phone Dependence in Adolescents with Mindfulness

By John M. de Castro, Ph.D.

“With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another. Perhaps it can keep us connected, even though we might only be feet away from one another as we tap out texts, emails ,or check up on our “social” life on social media.” – Mitch Abblett

Over the last few decades cell phones have gone from a rare curiosity to the dominant mode of electronic communications. They have also expanded well beyond a telephone and have become powerful hand-held computers known as smartphones. In fact, they have become a dominant force in daily life, occupying large amounts of time and attention. We have become seriously attached. They have become so dominant that, for many, the thought of being without it produces anxiety. Many people have become addicted. It is estimated that about 12% of the population is truly “addicted,” developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived of them.

Recent surveys and studies paint a vivid picture of our cell phone addiction: we feel a surge of panic when we are separated from our beloved cell phones. This phenomenon is so new that there is little understanding of its nature and causes. In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00598/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A), Li and colleagues examine the relationships of parental attachment, alexithymia, and mindfulness with cell phone dependence in adolescents. They recruited adolescents (average age 14.9 years) and had them complete scales measuring parental attachment, alexithymia, mindfulness, and mobile phone dependence.

They found that the higher the levels of mindfulness and parental attachment the lower the levels of mobile phone dependence and that the higher the levels of alexithymia the lower the levels of parental attachment and the higher the levels of mobile phone dependence. In a mediational analysis they found that the relationship between parental attachment and mobile phone dependence was moderated by mindfulness such that the higher the levels of mindfulness the greater the impact of parental attachment on lowering the levels of mobile phone dependence. Similarly, they found that the relationship between alexithymia and mobile phone dependence was moderated by mindfulness such that the higher the levels of mindfulness the less the impact of alexithymia on heightening the levels of mobile phone dependence.

These findings suggest that youth with secure attachment to their parents become less dependent on their mobile phones and that this association is strengthened by mindfulness. In other words, mindful youths are more highly impacted by their attachment to their parents. Alexithymia “is characterized by reduced capacity to identify, analyze and express emotions, restricted imagination, and an externally oriented thinking.” Hence, the findings also suggest that youth with poor emotion regulation become more attached to the mobile phones and that mindful youths are less impacted by their lack of emotion regulation. So, mindfulness is associated with lower dependence on mobile phones by moderating the associations of parental attachment and alexithymia on mobile phone dependence.

Since mobile phone dependence is becoming more and more of a problem it is important to find antidotes. Mindfulness may be just such an antidote. The present results, though, are correlational and causation cannot be determined. So, it remains to be seen if mindfulness training can, in fact, alter the relationships of parental attachment and alexithymia with mobile phone dependence. This will be important to determine in the future as mindfulness training may be used to lower the dependence of youths on mobile phones and thereby improve their connections with other people and their environment, improving their well-being.

So, reduce cell phone dependence in adolescents with mindfulness.

“To say we are addicted to our phones is not merely to point out that we use them a lot. It signals a darker notion: that we use them to keep our own selves at bay. Because of our phones, we may find ourselves incapable of sitting alone in a room with our own thoughts floating freely in our own heads, daring to wander into the past and the future, allowing ourselves to feel pain, desire, regret and excitement.” – Stephany Tlalka

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Li X and Hao C (2019) The Relationship Between Parental Attachment and Mobile Phone Dependence Among Chinese Rural Adolescents: The Role of Alexithymia and Mindfulness. Front. Psychol. 10:598. doi: 10.3389/fpsyg.2019.00598

Mobile phone has experienced a significant increase in popularity among adolescents in recent years. Findings indicate dependence on mobile phone is related to poor parent-child relationship. However, previous research on mobile phone dependence (MPD) is scant and mainly focus on adult samples. In this view, the present study investigated the association between parental attachment and MPD as well as its influence mechanism, in sample of adolescents in rural China. Data were collected from three middle schools in rural areas of Jiangxi and Hubei Province (N = 693, 46.46% female, Mage = 14.88, SD = 1.77). Participants completed the Inventory of Parent and Peer Attachment (IPPA), the twenty-item Toronto alexithymia scale (TAS-20), the Mindful Attention Awareness Scale (MAAS) and the Mobile Phone Addiction Index Scale (MPAI). Among the results, parental attachment negatively predicted MPD and alexithymia were exerting partial mediation effect between parental attachment and MPD. Further, mindfulness acted as moderator of the relationship between alexithymia and MPD: The negative impact of alexithymia on MPD was weakened under the condition of high level of mindfulness. Knowledge of this mechanism could be useful for understanding adolescents’ MPD in terms of the interaction of multiple factors.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00598/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_943967_69_Psycho_20190326_arts_A

Improve Resilience in First-Responders with a Smartphone Mindfulness App

May 14, 2019 psyjdc Leave a comment

Improve Resilience in First-Responders with a Smartphone Mindfulness App

By John M. de Castro, Ph.D.

“The mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

First responders such as firefighters and police experience a great deal of stress and frequent traumatic events and as a part of their jobs. The first-responders need to be resilient in the face of these difficult circumstances to cope with the stress. It is possible that mindfulness training might help. Mindfulness has been shown to increase resilience and reduce the psychological and physiological responses to stress. So, it is reasonable to infer that mindfulness training may help to develop resilience in first-responders and be of benefit to their mental health.

In today’s Research News article “Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/), Joyce and colleagues examine the ability of mindfulness training delivered with a smartphone app to increase the levels of resilience in first-responders. They recruited Primary Rescue and Hazmat firefighters and randomly assigned their stations to either receive 6, 20-25 minute, sessions of mindfulness training or to an Healthy Living control condition. The mindfulness training was based upon Acceptance and Compassion Therapy (ACT) and emphasized mindfulness, self-acceptance, and compassion. Both programs were delivered through a smartphone app. The first-responders were measured before and after training and 6 months later for mindfulness, resilience, cognitive fusion, experiential avoidance and psychological inflexibility, self-compassion, optimism, coping orientation, and life purpose.

They found that in comparison to baseline and the control condition, participation in the mindfulness training resulted in a significant increase in adaptive resilience and mindfulness which continued to increase over the 6-month follow-up period. Significant differences in optimism, and the use of instrumental and emotional support were present at the end of training but were not sustained at follow-up. Interestingly, there were no significant differences in “bounce-back” resilience.

Adaptive resilience involves the ability to adapt to stressful life circumstances and events. It involves the “individual’s ability to tolerate experiences such as change, personal problems, illness, pressure, failure, and painful feelings.” On the other hand, “bounce-back” resilience involves the ability to recover from stressful events. Since mindfulness focuses the individual on the present moment, it would be expected that it would influence the experience and coping with stressful events as they’re occurring. This is the case with adaptive resilience. On the other hand, mindfulness moves attention away from past events and would thus not be expected to influence coping with past stressful events as is the case with “bounce-back” resilience. Hence, it makes sense that mindfulness training would affect adaptive resilience and not “bounce-back” resilience.

It is important for the well-being of first responders that they be able to cope with the, at times, intense stress and trauma involved in their jobs. Hence, mindfulness training may be very beneficial as the present results suggest. This may help to prevent illness, burnout, and post-traumatic stress disorder (PTSD). In addition, the fact that mindfulness was taught with a smartphone app is important as it makes the training convenient and adaptable to the individual’s schedule. It is also highly scalable allowing for inexpensive widespread availability of the training.

So, Improve Resilience in First-Responders with a Smartphone Mindfulness App.

“Because PTSD is an anxiety disorder, episodes of distress occur when a person begins to worry about the future based on previous painful, intense or stressful memories. Meditation can help bring that person’s attention back to the current moment, which reduces or eliminates anxiety.” – Erin Fletcher

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Joyce, S., Shand, F., Lal, T. J., Mott, B., Bryant, R. A., & Harvey, S. B. (2019). Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. Journal of medical Internet research, 21(2), e12894. doi:10.2196/12894

Abstract

Background

A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.

Objective

This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.

Methods

We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.

Results

Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).

Conclusions

The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/

Lower PTSD Symptoms and Risk of Suicide in Firefighters are Associated with Mindfulness

May 13, 2019 psyjdc Leave a comment

Lower PTSD Symptoms and Risk of Suicide in Firefighters are Associated with Mindfulness

By John M. de Castro, Ph.D.

“I’m convinced [mindfulness] could be a powerful antidote to what I see happening to my peers, both as retirees and active personnel. We have high rates of suicide and PTSD. It can lead you to some pretty dark places.” – Gary Gonzalez

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). It involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

First responders such as firefighters and police experience traumatic events as part of their jobs and many develop symptoms of PTSD. This is responsible for the fact that wore firefighters and police officers die by suicide than all line-of-duty deaths combined. 103 firefighters and 140 police officers died by suicide in 2017, compared to 93 firefighter and 129 officer line-of-duty deaths. Obviously, this is a troubling problem that needs to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective. Indeed, mindfulness has been shown to has been shown to reduce suicidality and to reduce the impact of trauma on the individual.

In today’s Research News article “Posttraumatic stress disorder symptoms and mindfulness facets in relation to suicide risk among firefighters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434694/), Stanley and colleagues examine the relationship of mindfulness to PTSD symptoms and suicide risk in firefighters. They recruited firefighters (94% male) and had them complete an online survey measuring mindfulness, lifetime exposure to trauma, PTSD symptoms, and suicide risk severity.

They found that the higher the levels of mindfulness the lower the levels of PTSD symptoms and suicide risk. They also found that the higher the levels of PTSD symptoms the higher the levels of suicide risk. A moderation analysis indicated that the effect of PTSD symptoms on suicide risk severity was lowered by mindfulness, particularly the mindfulness facets of acting with awareness and non-judging of inner experience.

It should be noted that these findings are correlations and thus there cannot be definitive conclusions about causation. Nevertheless, the results suggest that mindfulness is associated with lower Post-Traumatic Stress Disorder (PTSD) and lower risk of suicide among firefighters. In addition, being able to act with awareness and to experience feelings without judgement may be particularly strongly associated with a lower association between the symptoms of PTSD and the risk of suicide. These results suggest that a randomized clinical trial of the ability of mindfulness training to lower PTSD symptoms and suicide risk is warranted.

First responders have a tough job. They are not only exposed to immediate risks to their safety but also long-term risks associated with the trauma experienced in the course of their jobs. Mindfulness may be very helpful for firefighters. It may have the ability to help them withstand the long-term consequences of the trauma they experience. Perhaps mindfulness may make a tough, but important, job less costly for the firefighters mental health.

“Firefighters are more likely to die by suicide than to die on the job. We heavily invest in protective equipment to keep them physically safe – special masks, boots, jackets, pants. So why don’t we spend any money to protect their minds?” – Rich Landward

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Stanley, I. H., Boffa, J. W., Tran, J. K., Schmidt, N. B., Joiner, T. E., & Vujanovic, A. A. (2019). Posttraumatic stress disorder symptoms and mindfulness facets in relation to suicide risk among firefighters. Journal of clinical psychology, 75(4), 696–709. doi:10.1002/jclp.22748

Abstract

Objective:

Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk among firefighters. Few studies have examined modifiable factors, such as mindfulness facets, that might attenuate this association. This study examined the interactive effects of PTSD symptoms and mindfulness facets in relation to suicide risk among firefighters.

Method:

Overall, 831 career firefighters were assessed for PTSD symptoms, mindfulness facets, and suicide risk via the PTSD Checklist for DSM‐5, Five Facet Mindfulness Questionnaire, and Suicidal Behaviors Questionnaire—Revised, respectively.

Results:

Greater PTSD symptoms were associated with more severe suicide risk; however, higher levels of two specific mindfulness facets, acting with awareness and nonjudging of inner experience, attenuated this association. By contrast, higher levels of the observing facet of mindfulness potentiated the association between PTSD symptoms and suicide risk.

Conclusions:

Suicide prevention initiatives among firefighters, particularly those experiencing trauma‐related sequelae, might benefit from the inclusion of mindfulness‐based practices alongside frontline empirically‐supported approaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434694/

Reduce Stress and Enhance Academic Buoyancy in Adolescents with Online Acceptance and Commitment Therapy

May 11, 2019 psyjdc Leave a comment

Reduce Stress and Enhance Academic Buoyancy in Adolescents with Online Acceptance and Commitment Therapy

By John M. de Castro, Ph.D.

“In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.” – Julianne Garey

Adolescence is a time of mental, physical, social, and emotional growth. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms.

Mindfulness training in adults has been shown in adolescents to improve emotion regulation and to benefit the psychological and emotional health. A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

The original form of Acceptance and Commitment Therapy (ACT), however, required a certified trained therapist. This resulted in costs that many clients couldn’t afford. In addition, the participants had to be available to attend multiple sessions at particular scheduled times that were not always compatible with busy schedules and at locations that were not always convenient. As an alternative, mindfulness-based treatments delivered over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of ACT for adolescents when delivered over the internet.

In today’s Research News article “Reducing Stress and Enhancing Academic Buoyancy among Adolescents Using a Brief Web-based Program Based on Acceptance and Commitment Therapy: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394525/ ), Puolakanaho and colleagues recruited adolescents in the 9^th grade and randomly assigned them to receive a 5-week online program of Acceptance and Commitment Therapy (ACT) or to a no-treatment control condition. They were measured before and after the program for academic skills, reading fluency, math skills, stress, school stress, and academic buoyancy. Academic buoyancy “refers to a student’s capacity to overcome everyday academic life setbacks and challenges successfully.”

They found that 76% of the participants completed the Acceptance and Commitment Therapy (ACT) program. They found that in comparison to baseline and the no-treatment controls that ACT produced a significant reduction in overall stress levels and a significant increase in academic buoyancy. These findings suggest that ACT can be taught online to adolescents and successfully promote their ability to withstand the stress of adolescence and to promote their ability to overcome the challenges of school.

So, reduce stress and enhance academic buoyancy in adolescents with online acceptance and commitment therapy.

“mindfulness is uniquely able to help adolescents navigate this time of growing autonomy, more complicated life challenges and heightened reactivity to stressors in their lives.” – Karen Pace

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Puolakanaho, A., Lappalainen, R., Lappalainen, P., Muotka, J. S., Hirvonen, R., Eklund, K. M., Ahonen, T., … Kiuru, N. (2018). Reducing Stress and Enhancing Academic Buoyancy among Adolescents Using a Brief Web-based Program Based on Acceptance and Commitment Therapy: A Randomized Controlled Trial. Journal of youth and adolescence, 48(2), 287-305.

Abstract

Acceptance and commitment therapy programs have rarely been used as preventive tools for alleviating stress and enhancing coping skills among adolescents. This randomized controlled trial examined the efficacy of a novel Finnish web- and mobile-delivered five-week intervention program called Youth COMPASS among a general sample of ninth-grade adolescents (n= 249, 49% females). The intervention group showed a small but significant decrease in overall stress (between-group Cohen’s d = 0.22) and an increase in academic buoyancy (d= 0.27). Academic skills did not influence the intervention gains, but the intervention gains were largest among high-stressed participants. The results suggest that the acceptance and commitment based Youth COMPASS program may be well suited for promoting adolescents’ well-being in the school context.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394525/

Improve Sleep and Reduce Insomnia with Mindfulness

May 10, 2019 psyjdc Leave a comment

Improve Sleep and Reduce Insomnia with Mindfulness

By John M. de Castro, Ph.D.

“Given the absence of side effects and the positive potential benefits of mindfulness that extend beyond sleep, we encourage people with chronic insomnia, particularly those unable or unwilling to use sleep medications, to consider mindfulness training.” – Cynthia Gross

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.

In today’s Research News article “The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393899/ ), Wang and colleagues review, summarize and perform a meta-analysis of the effects of mind-body practices on sleep. They uncovered 49 studies employing meditation, tai chi, qigong, and yoga practices and measuring sleep.

They report that the published studies found that meditation, tai chi, qigong, and yoga practices significantly reduced insomnia and improved the quality of sleep particularly when compared to no-treatment control groups. They also report that the benefits of the mind-body practices were greater in healthy individuals than in clinical populations. These significant effects were obtained by subjective reports, while objective sleep diary and actigraph measures were not significant.

These are interesting results that suggest that mind-body practices significantly improve the participants evaluations of the quality of sleep and insomnia. This is important as individuals in modern society tend not to get sufficient sleep and adequate sleep is important to the psychological and physical well-being of the individual and their performance during the day. Engaging in these mind-body practices of meditation, tai chi, qigong, and yoga practice have been shown to have many other benefits in addition to the improvement of sleep.

So, improve sleep and reduce insomnia with mindfulness.

“Insomnia is a disorder of cognitive and physiological hyperarousal, which mindfulness addresses.” – Aya Brackett

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Wang, X., Li, P., Pan, C., Dai, L., Wu, Y., & Deng, Y. (2019). The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2019, 9359807. doi:10.1155/2019/9359807

Abstract

Background/Purpose

Sleep plays an important role in individuals’ health. The functions of the brain, the cardiovascular system, the immune system, and the metabolic system are closely associated with sleep. As a prevalent sleep disorder, insomnia has been closely concerned, and it is necessary to find effective therapies. In recent years, a growing body of studies has shown that mind-body therapies (MBTs) can improve sleep quality and ameliorate insomnia severity. However, a comprehensive and overall systematic review has not been conducted. In order to examine the effect of MBTs on insomnia, we conducted a systematic review and meta-analysis evaluating the effects of MBTs on sleep quality in healthy adults and clinical populations.

Methods

PubMed, EMBASE, the Cochrane Library, and review of references were searched up to July 2018. English language studies of all designs evaluating the effect of MBTs on sleep outcomes in adults with or without diseases were examined. To calculate the SMDs and 95% CIs, we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant.

Results

49 studies covering 4506 participants published between 2004 and 2018 were identified. Interventions included meditation, tai chi, qigong, and yoga which lasted 4 to 24 weeks. The MBTs resulted in statistically significant improvement in sleep quality and reduction on insomnia severity but no significant effects on sleep quantity indices, which were measured by sleep diary or objective measures. We analyzed the effects of tai chi and qigong separately as two different MBTs for the first time and found that qigong had a slight advantage over tai chi in the improvement of sleep quality. Subgroup analyses revealed that the effect of MBTs on sleep quality in healthy individuals was larger than clinical populations. The effect of MBTs might be influenced by the intervention duration but not the frequency.

Conclusions

MBTs can be effective in treating insomnia and improving sleep quality for healthy individuals and clinical patients. More high-quality and well-controlled RCTs are needed to make a better conclusion in further study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393899/

Relieve Anxiety Disorders with Online Acceptance and Commitment Therapy

May 9, 2019May 9, 2019 psyjdc Leave a comment

Relieve Anxiety Disorders with Online Acceptance and Commitment Therapy

By John M. de Castro, Ph.D.

“The essential components of ACT include letting go of the struggle to control unwanted thoughts and feelings, being mindfully aware of the present moment, and committing to a course of action that is consistent with what you value most in life. . . Acceptance of your anxious thoughts and feelings allows you to focus more clearly on the present and to take the steps that move you closer to the life you truly want to live.” – AnxietyHappens

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

In today’s Research News article “Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371070/ ), Kelson and colleagues review and summarize the published research literature on the effectiveness of Acceptance and Commitment Therapy (ACT) delivered online for the treatment of Anxiety Disorders. They discovered 20 published studies.

They found that on average 81% of participants completed the online ACT program. They also found that the ACT program produced small to moderate significant reduction in anxiety. These include generalized anxiety disorder, social anxiety disorder, and illness anxiety disorder. Hence, the published research suggests that Acceptance and Commitment Therapy (ACT) delivered online is effective for the treatment of Anxiety Disorders. This adds to the list of mindfulness-based therapies that can be successfully delivered online. This is important as online presentation is inexpensive, convenient, and available to a very large population of anxiety disorder sufferers.

So, relieve anxiety disorders with online acceptance and commitment therapy

“Research has shown that ACT can produce symptom improvement in people with GAD, and it may also be a particularly good fit for older adults.” – Deborah Glasofer

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Kelson, J., Rollin, A., Ridout, B., & Campbell, A. (2019). Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review. Journal of medical Internet research, 21(1), e12530. doi:10.2196/12530

Abstract

Background

Anxiety conditions are debilitating and prevalent throughout the world. Acceptance and Commitment Therapy (ACT) is an effective, acceptance-based behavioral therapy for anxiety. However, there are treatment barriers (eg, financial, geographical, and attitudinal), which prevent people from accessing it. To overcome these barriers, internet-delivered ACT (iACT) interventions have been developed in recent years. These interventions use websites to deliver ACT information and skill training exercises on the Web, either as pure self-help or with therapist guidance.

Objective

This systematic review aimed to examine the therapeutic impact of iACT on all anxiety conditions.

Methods

The EMBASE, MEDLINE, ProQuest Central, PsycINFO, Scopus, and Web of Science databases were searched up to September 2018. The titles and abstracts of remaining records after deduplication were screened by 2 authors with a total of 36 full-text articles being retained for closer inspection next to eligibility criteria. Empirical studies of all designs, population types, and comparator groups were included if they appraised the impact of iACT treatment on any standardized measure of anxiety. Included studies were appraised on methodological quality and had their data extracted into a standardized coding sheet. Findings were then tabulated, and a narrative synthesis was performed because of the heterogeneity found between studies.

Results

A total of 20 studies met inclusion criteria. There were 11 randomized controlled trials (RCTs) and 9 uncontrolled pilot studies. Participants across all studies were adults. The anxiety conditions treated were as follows: generalized anxiety disorder (GAD), social anxiety disorder (SAD), illness anxiety disorder (IAD), and general anxiety symptoms, with or without comorbid physical and mental health problems. A total of 18 studies reported significant anxiety reduction after iACT treatment. This was observed in studies that delivered iACT with (n=13) or without (n=5) therapist guidance. The average attrition rate across all included studies during the active iACT treatment phase was 19.19%. In the 13 studies that assessed treatment satisfaction, participants on average rated their iACT experience with above average to high treatment satisfaction.

Conclusions

These findings indicate that iACT can be an efficacious and acceptable treatment for adults with GAD and general anxiety symptoms. More RCT studies are needed to corroborate these early iACT findings using empirical treatments in active control groups (eg, internet-delivered cognitive behavioral therapy). This would potentially validate the promising results found for SAD and IAD as well as address the full spectrum of anxiety disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371070/