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Improve Quality of Life with Migraine Headaches with Mindfulness

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Improve Quality of Life with Migraine Headaches with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Be mindful of your breathing. If you notice that your respirations are fast and shallow, concentrate on taking slower, deeper and longer breaths. As your breathing slows, your body will begin to relax. Tensions and stress slowly will ebb from your body, allowing you to release the some of the pain and discomfort associated with your headaches.” – National Headache Institute

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

In today’s Research News article “Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/ ), Tavallaei and colleagues recruited women suffering with migraine headaches and randomly assigned them to receive either an on-line mindfulness training based upon the Mindfulness-Based Stress Reduction (MBSR) program or medical treatment as usual. The mindfulness training program was presented over the internet in 8 weekly sessions and included meditation, body scan, and didactic presentation. The participants were measured before and after treatment for mindfulness, migraine disability, pain, and distress including depression, anxiety, and stress.

 

They found that in comparison to the baseline and the treatment-as-usual control group that the group who received mindfulness training had significantly lower levels of migraine disability, distress, and pain and significantly higher levels of mindfulness. They found that the reductions in pain were due to changes in the emotional reactions to pain and not the sensory experiences of pain. So, the pain was perceived normally but the women did not react to the sensations emotionally and this resulted in a lower impact of the headache pain.

 

The results suggest that mindfulness training increases the quality of life and reduces the psychological distress of women with migraine headaches. Similar findings have been reported in other prior research studies. The importance of the present study resides in the presentation of the program over the internet. Presentation over the internet is important as in-person programs are inconvenient and expensive. Presentation over the internet allows for widespread, convenient, and inexpensive distribution of the therapy to affected populations. This makes mindfulness training more readily available to migraine sufferers.

 

So, improve quality of life with migraine headaches with mindfulness.

 

“mindfulness has been examined as a treatment for chronic pain and pain-related conditions, finding positive results such as reduction in medication usage, improved physical functioning, and physical-health-related quality of life.” – Monika Tomova

 

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

 

Tavallaei, V., Rezapour-Mirsaleh, Y., Rezaiemaram, P., & Saadat, S. H. (2018). Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy. European Journal of Translational Myology, 28(2), 7380. http://doi.org/10.4081/ejtm.2018.7380

 

Abstract

Our aim was to investigate effectiveness of mindfulness by bibliotherapy on disability, distress, perceived pain and mindfulness in women with tension headaches and migraines. Primary headaches have been of great interest to mental health researchers because of the high prevalence, as well as significant disability and distress in the affected people. Despite the promising results of in-person treatment and some limitations that such interventions may cause, patients may be encountered with problems when using health care services. The present study is a quasi-experimental randomized design with pre-test, post-test, and control group. The study population consisted of 1396 women with migraine headache referring to headache clinic of Baqiyatallah Hospital in Tehran. Of these, 30 patients (including tboh experimental and control group) were selected by objective sampling method and were randomly assigned to the two groups. The experimental group, in addition to medical treatment as usual, was treated for a period of 8 sessions by Mindfulness-based Stress Reduction Internet-based Bibliotherapy, but the control group used only the medical treatment. The sample had no attritions. Data were collected by the four scales of (DASS-21), Migraine Disability Assessment Test (MIDAS), McGill’s Short Form Questionnaire (MPQ-SF), and Mindfulness Inventory (MAAS). We used covariance analysis to analyze the findings in the measured scales. MBSR-IBB treatment had no significant effect on pain sensory dimension (P <0.44), despite improvement of mindfulness (P <0.0001). In contrast, the greatest effect was on the level of disability (P <0.0001). We observed also a significant improvement in distress (P <0.0001). In conclusion, in spite of the presence of headaches, the mindfulness improved the quality of life and reduced the level of mental distress. In addition, using the Internet-based bibliotherapy method, these services can be used with easier access, lower cost, and more flexibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/

 

Rumination and Worry Interfere with the Development of Mindfulness

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Rumination and Worry Interfere with the Development of Mindfulness

 

By John M. de Castro, Ph.D.

 

“Worry and rumination are forms of persistent negative thinking. They involve a predominance of verbal thoughts, and can be likened to a negative inner-speech. Worry is concerned with the possibility of threats in the future and ways to effectively avoid or deal with them whilst rumination is concerned more with things that happened in the past.” – MCT Institute

 

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. Techniques such as 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 particularly effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness. One way they may do this is by disrupting the development of mindfulness. In today’s Research News article “Barriers to Mindfulness: a Path Analytic Model Exploring the Role of Rumination and Worry in Predicting Psychological and Physical Engagement in an Online Mindfulness-Based Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968050/ ), Banerjee and colleagues had adult volunteers participate in a 2-week, once a day, online Mindfulness-based self-help program. They were measured before and after the program for mindfulness, including the observe, describe, acting with awareness, non-judging, and non-reacting facets, rumination, worry, beliefs about rumination, beliefs about worry, physical engagement, and psychological engagement. The measures were intercorrelated and their relationships were assessed with a path analysis.

 

They found that the higher the levels of both rumination and worry, the lower the levels of physical and psychological engagement in the mindfulness program. The path models revealed that rumination and worry were associated with reduced physical and psychological engagement in the program and these were, in turn, associated with reductions in four of the mindfulness facets of describe, acting with awareness, non-judging, and non-reacting.

 

These results are interesting and suggest that the individual’s levels of worry and rumination before engaging in mindfulness training tend to interfere with the development of mindfulness. They appear to do so by interfering with the individual’s engagement in the program, that is by promoting disengagement. It should be kept in mind that these findings are correlational, so no conclusions about causation are warranted. But, the results suggest that training in mindfulness should take into consideration the psychological state of the participant at the beginning of the program. Perhaps, programs can be tailored for the participants state taking into consideration their levels of worry and rumination. They may, thereby, be more effective in promoting mindfulness and all of its benefits.

 

“repeated practice in noticing, observing with curiosity and compassion, and shifting perspective helps participants to realise that their thoughts, emotions and sensations are just thoughts, emotions and sensations, rather than ‘truth’ or ‘me’. They learn to see more clearly the patterns of the mind, and to recognise when mood is beginning to dip without adding to the problem by falling into analysis and rumination – to stand on the edge of the whirlpool and watch it go round, rather than disappearing into it.” – B. J. Bidushi

 

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

 

Banerjee, M., Cavanagh, K., & Strauss, C. (2018). Barriers to Mindfulness: a Path Analytic Model Exploring the Role of Rumination and Worry in Predicting Psychological and Physical Engagement in an Online Mindfulness-Based Intervention. Mindfulness, 9(3), 980–992. http://doi.org/10.1007/s12671-017-0837-4

 

Abstract

Little is known about the factors associated with engagement in mindfulness-based interventions (MBIs). Moreover, engagement in MBIs is usually defined in terms of class attendance (‘physical engagement’) only. However, in the psychotherapy literature, there is increasing emphasis on measuring participants’ involvement with interventions (‘psychological engagement’). This study tests a model that rumination and worry act as barriers to physical and psychological engagement in MBIs and that this in turn impedes learning mindfulness. One hundred and twenty-four participants were given access to a 2-week online mindfulness-based self-help (MBSH) intervention. Self-report measures of mindfulness, rumination, worry, positive beliefs about rumination, positive beliefs about worry and physical and psychological engagement were administered. A path analysis was used to test the linear relationships between the variables. Physical and psychological engagement were identified as two distinct constructs. Findings were that rumination and worry both predicted psychological disengagement in MBSH. Psychological engagement predicted change in the describe, act with awareness, non-judge and non-react facets of mindfulness while physical engagement only predicted changes in the non-react facet of mindfulness. Thus, rumination and worry may increase risk of psychological disengagement from MBSH which may in turn hinder cultivating mindfulness. Future suggestions for practice are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968050/

 

Improve Student Mental Health with a Mindfulness App

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Improve Student Mental Health with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Students who had been practising mindfulness had distress scores lower than their baseline levels even during exam time, which suggests that mindfulness helps build resilience against stress.” – Julieta Galante

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school.

 

The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede performance. A better tactic may be the development of mindfulness skills with contemplative practices. These practices and high levels of mindfulness have been shown to be helpful in coping with the school environment and for the performance of both students and teachers. So, perhaps, mindfulness training may provide the needed edge in college academic performance.

 

The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This produces costs that many students and counseling centers 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 and at locations that may not be convenient. As an alternative, Smartphone Apps 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 these Apps.

 

In today’s Research News article “Evaluation of an mHealth App (DeStressify) on University Students’ Mental Health: Pilot Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801522/ ), Lee and Jung recruited university students and randomly assigned them to either a wait-list condition or to work with a mindfulness app (DeStressify) for a month, 5 days per week for 3 to 20 minutes per day. They were measured before and after the training period for perceived stress, anxiety, depression, sleep quality, health-related quality of life, work productivity, and app use.

 

They found that after mindfulness app training the students reported significant reductions in perceived stress, fatigue, and anxiety and significant increases in general health-related quality of life, energy, and productivity. A lack in the study was that mindfulness was not measured. So, it cannot be concluded that improvements in mindfulness produced by the App was responsible for the benefits. Nevertheless, these are interesting and potentially important results. They suggest that the use of a mindfulness app by university students can provide improvements in physical and mental health and productivity. This can be important for the students’ success in school by making them more energetic and healthy and with less emotional disruption.

 

This is particularly important as the app does not require expensive staff time. It can be used at the busy students’ convenience in both location and time. And it is very easy and inexpensive to use and can be distributed widely. Given the mindfulness app can also improve the students’ well-being, it would seem ideal for use by college students.

 

So, improve student mental health with a mindfulness App.

 

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge

 

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

 

Lee, R. A., & Jung, M. E. (2018). Evaluation of an mHealth App (DeStressify) on University Students’ Mental Health: Pilot Trial. JMIR Mental Health, 5(1), e2. http://doi.org/10.2196/mental.8324

 

Abstract

Background

One in five Canadians experience mental health issues with those in the age range of 15 to 24 years being most at risk of a mood disorder. University students have shown significantly higher rates of mental health problems than the general public. Current university support services are limited by factors such as available staff and finances, and social stigma has frequently been identified as an additional barrier that prevents students from accessing these resources. Mobile health (mHealth) apps are one form of alternative health support that is discrete and accessible to students, and although they are recognized as a promising alternative, there is limited research demonstrating their efficacy.

Objective

The aim of this study was to evaluate a mindfulness-based app’s (“DeStressify”) efficacy on stress, anxiety, depressive symptomology, sleep behavior, work or class absenteeism, work or school productivity, and quality of life (QoL) among university students.

Methods

Full-time undergraduate students at a Canadian university with smartphones and Internet access were recruited through in-class announcements and on-campus posters. Participants randomized into an experimental condition were given and instructed to use the DeStressify app 5 days a week for 4 weeks. Control condition participants were wait-listed. All participants completed pre- and postintervention Web-based surveys to self-assess stress, anxiety, depressive symptomatology, sleep quality, and health-related QoL.

Results

A total of 206 responses were collected at baseline, with 163 participants completing the study (86 control, 77 experimental). Using DeStressify was shown to reduce trait anxiety (P=.01) and improve general health (P=.001), energy (P=.01), and emotional well-being (P=.01) in university students, and more participants in the experimental condition believed their productivity improved between baseline and postintervention measurements than the number of participants expected to believe so randomly by chance (P=.01). The app did not significantly improve stress, state anxiety, physical and social functioning, and role limitations because of physical or emotional health problems or pain (P>.05).

Conclusions

Mindfulness-based apps may provide an effective alternative support for university students’ mental health. Universities and other institutions may benefit from promoting the use of DeStressify or other mindfulness-based mHealth apps among students who are interested in methods of anxiety management or mindfulness-based self-driven health support. Future steps include examining DeStressify and similar mHealth apps over a longer period and in university staff and faculty.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801522/

 

Improve Psychological Health with Mindfulness Smartphone Aps

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Improve Psychological Health with Mindfulness Smartphone Aps

 

By John M. de Castro, Ph.D.

 

“With apps reaching more people than face-to-face teaching can, he says, “nothing will influence how mindfulness is perceived and practised in our culture more in the next 20 years”. – Amy Fleming

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in 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 and at locations that may not be convenient. As an alternative, Apps for smartphones 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 these Apps in inducing mindfulness and improving psychological health.

 

In today’s Research News article “Efficacy of a Mindfulness-Based Mobile Application: a Randomized Waiting-List Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770479/ ), van Emmerik and colleagues recruited adults who had an interest in mindfulness and spirituality through social media and randomly assigned them to either a mindfulness App group or a wait-list control group.

 

The mindfulness App participants were directed to download from the App Store of Google Play Store the VGZ Mindfulness Coach App and complete the 5-week program consisting of 25 exercises including “breathing exercises, attention exercises, body scan exercises, guided meditation exercises, visualization exercises, mantra exercises, and yoga exercises.” The participants were measured before the program and 8 and 20 weeks later for mindfulness, including the observing, describing, non-reacting, non-judging, and acting with awareness facets, quality of life, including physical health, psychological health, social relationships and environment, psychiatric symptomology, self-actualization, and satisfaction with the App.

 

They found that the App produced large significant increases in mindfulness including all five facets, psychological health, social relationships and environment, and decreases in psychiatric symptomology. In addition, the participants reported a high degree of satisfaction and engagement with the App. Hence, the mindfulness App group evidenced marked improvement in mindfulness and psychological health.

 

The results need to be interpreted with caution as the study did not contain an active control condition. This leaves open the possibility that the results were affected by biases such as placebo effects, demand characteristics, experimenter bias, etc. Nevertheless, with these caveats in mind, the results suggest that mindfulness can be increased with a smartphone app which may, in turn, improve psychological health in otherwise healthy individuals. This is exciting as the low cost, convenience, and ease of use, of such Apps allows for widespread applicability. This may provide a low-cost means of improving the mindfulness and psychological health of large swaths of the general population.

 

So, improve psychological health with mindfulness smartphone Aps.

 

“Every app uses varying voices, work flow styles, and types of guided meditation. . . At the end of the day, the most important thing is that you feel drawn to practice everyday.” – Marylyn Wei

 

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

 

Arnold A. P. van Emmerik, Fieke Berings, Jaap Lancee. Efficacy of a Mindfulness-Based Mobile Application: a Randomized Waiting-List Controlled Trial. Mindfulness (N Y) 2018; 9(1): 187–198. Published online 2017 Jun 21. doi: 10.1007/s12671-017-0761-7

 

Abstract

Although several hundreds of apps are available that (cl)aim to promote mindfulness, only a few methodologically sound studies have evaluated the efficacy of these apps. This randomized waiting-list controlled trial therefore tested the hypothesis that one such app (the VGZ Mindfulness Coach) can achieve immediate and long-term improvements of mindfulness, quality of life, general psychiatric symptoms, and self-actualization. One hundred ninety-one experimental participants received the VGZ Mindfulness Coach, which offers 40 mindfulness exercises and background information about mindfulness without any form of therapeutic guidance. Compared to 186 control participants, they reported large (Cohen’s d = 0.77) and statistically significant increases of mindfulness after 8 weeks and small-to-medium increases of the Observing, Describing, Acting with awareness, Nonjudging, and Nonreactivity mindfulness facets as measured with the Five Facet Mindfulness Questionnaire (Cohen’s d = 0.66, 0.26, 0.49, 0.34, and 0.43, respectively). Also, there were large decreases of general psychiatric symptoms (GHQ-12; Cohen’s d = −0.68) and moderate increases of psychological, social, and environmental quality of life (WHOQOL-BREF; Cohen’s d = 0.38, 0.38, and 0.36, respectively). Except for social quality of life, these gains were maintained for at least 3 months. We conclude that it is possible to achieve durable positive effects on mindfulness, general psychiatric symptoms, and several aspects of quality of life at low costs with smartphone apps for mindfulness such as the VGZ Mindfulness Coach.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770479/

Treat Physical Health Conditions with Mindfulness

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Treat Physical Health Conditions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A growing body of research now links the Eastern practice to improved conditions for serious ailments, from diabetes to heart disease to cancer. How? By “treating the whole person… so they can live in greater health and joy.” – Shauna Shapiro

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health 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 and at locations that may not be convenient. As an alternative, on-line mindfulness training programs 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 these programs.

 

In today’s Research News article “Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599726/, Toivonen and colleagues review and summarize the published research literature on the effectiveness on on-line mindfulness training programs on the psychological and physical symptoms of chronic diseases. They report on 16 published studies.

 

They found that studies of on-line mindfulness training for the treatment of chronic pain conditions, including fibromyalgia, demonstrated significant effectiveness for pain coping and the psychological symptoms produced by chronic pain. But, the evidence was inconclusive regarding alterations of experienced pain. Studies of heart disease treatment with on-line mindfulness trainings demonstrated small improvements relative to usual care in exercise tolerance, heart rate, systolic blood pressure, and stress. Studies of Irritable Bowel Syndrome (IBS) demonstrated significant effectiveness of on-line mindfulness trainings for the symptoms, quality of life, and psychological distress produced by IBS. Studies of epilepsy demonstrated significant effectiveness of on-line mindfulness trainings for the depression accompanying epilepsy. Studies of Tinnitus demonstrated significant effectiveness of on-line mindfulness trainings for Tinnitus severity, depression, anxiety and perceived stress accompanying Tinnitus. Studies of acquired brain injury demonstrated significant effectiveness of on-line mindfulness trainings for the mental fatigue accompanying acquired brain injury. Studies of cancer survivors demonstrated significant effectiveness of on-line mindfulness trainings for the fatigue, depressed mood, and psychological distress accompanying cancer survival.

 

The published studies found that it did not make a significant difference if the on-line mindfulness training occurred through immediate interaction or with continuously available resources or whether there was an active facilitator or not. Hence, on-line training did not require active participation by a therapist. Effectiveness was present regardless. The materials and not the format or the therapist was important.

 

These are important and exciting results that demonstrate the effectiveness of on-line mindfulness training for the treatment of chronic diseases. Thus, mindfulness trainings can be implemented with high cost-effectiveness, to large numbers of people, without the necessity of a therapist’s involvement, and without the requirement for attendance at particular locations. The results suggest that mindfulness practices can be provided widely and inexpensively to relieve at least some of the suffering produced by a wide variety of chronic diseases.

 

“Other research has looked broadly at use of mindfulness-based group therapy compared to individual cognitive-behavioral therapy for patients with various conditions including depression, anxiety and stress and adjustment disorders. They found that the mindfulness group therapy as effective as the individual therapy.” – American Psychiatric Association

 

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

 

Toivonen, K. I., Zernicke, K., & Carlson, L. E. (2017). Web-Based Mindfulness Interventions for People With Physical Health Conditions: Systematic Review. Journal of Medical Internet Research, 19(8), e303. http://doi.org/10.2196/jmir.7487

 

Abstract

Background

Mindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date.

Objective

The objective of this paper was to review Web-based MBIs for people with physical health conditions and to examine all outcomes reported (eg, efficacy or effectiveness for physical changes or psychological changes; feasibility).

Methods

Databases PubMed, PsycINFO, Science Direct, CINAHL Plus, and Web of Science were searched. Full-text English papers that described any Web-based MBI, examining any outcome, for people with chronic physical health conditions were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included intervention characteristics, population characteristics, outcomes, and quality indicators. Intervention characteristics (eg, synchronicity and guidance) were examined as potential factors related to study outcomes.

Results

Of 435 publications screened, 19 published papers describing 16 studies were included. They examined Web-based MBIs for people with cancer, chronic pain or fibromyalgia, irritable bowel syndrome (IBS), epilepsy, heart disease, tinnitus, and acquired brain injury. Overall, most studies reported positive effects of Web-based MBIs compared with usual care on a variety of outcomes including pain acceptance, coping measures, and depressive symptoms. There were mixed results regarding the effectiveness of Web-based MBIs compared with active control treatment conditions such as cognitive behavioral therapy. Condition-specific symptoms (eg, cancer-related fatigue and IBS symptoms) targeted by treatment had the largest effect size improvements following MBIs. Results are inconclusive regarding physical variables.

Conclusions

Preliminary evidence suggests that Web-based MBIs may be helpful in alleviating symptom burden that those with physical health conditions can experience, particularly when interventions are tailored for specific symptoms. There was no evidence of differences between synchronous versus asynchronous or facilitated versus self-directed Web-based MBIs. Future investigations of Web-based MBIs should evaluate the effects of program adherence, effects on mindfulness levels, and whether synchronous or asynchronous, or facilitated or self-directed interventions elicit greater improvements.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599726/

Reduce General Practitioner Burnout with On-Line Mindfulness

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Reduce General Practitioner Burnout with On-Line Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice — the cultivation of a focused awareness on the present moment — can improve physicians’ performance by not only preventing burnout, but also by helping them better connect with their patients.” – Carolyn Gregoire

 

“General Practitioners confront stress on a daily basis. Even moderate levels of stress when prolonged, all too frequently results in a professional burnout. This is the fatigue, cynicism, emotional exhaustion, and professional inefficacy that comes with work-related stress. Healthcare is a high stress occupation. It is estimated that over 45% of healthcare workers experience burnout. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses. Hence, preventing existing healthcare workers from burning out has to be a priority.

 

Mindfulness has been demonstrated to be helpful in coping with stress and in treating and preventing burnout. But, General Practitioners (GPs) are pressed for time and it is difficult for them to commit the time to mindfulness training on a schedule at a therapist’s location. Mindfulness training over the internet is an alternative training for people who find face-to-face training difficult and inconvenient. Online mindfulness training has shown great promise with effectiveness equivalent to face-to-face training.

 

In today’s Research News article “Impact of a Blended Web-Based Mindfulness Programme for General Practitioners: a Pilot Study.” (See summary below). Montero-Marin and colleagues recruited General Practitioners and provided them with on-line mindfulness training with both audio and video instruction in 45-minute sessions occurring twice a week for 4 weeks. Before and after training the GPs were measured for mindfulness, positive and negative emotions, resilience, and burnout.

 

They separated the GPs according to their participation rates into completers who completed two or more practices per week and non-completers who completed on average less than one practice per week. They found that the completers in contrast to the non-completers had significant increases in mindfulness and positive emotions. They also found that the amount of practice had a direct effect on positive emotions and also and indirect effect by increasing mindfulness which in turn increases positive emotions.

 

Hence, on-line mindfulness training appeared to enhance mindfulness and positive feelings in those GPs who completed the provided practices. To some extent the results were disappointing as there were a large proportion of the GPs who did not complete the program’s practice requirements (approximately 80% of those recruited). This could be due to the busy schedules of the GPs or that the program was not sufficiently engaging to motivate participation. In addition, there were no significant effects of the practice on negative emotions, resilience, or burnout. This may be due to the relatively small amount of practice. Perhaps a longer duration program might have more positive effects. Indeed, previous research has shown significant reductions in GP burnout with 8 weeks of in-person mindfulness training. Hence, it is possible that the program in the present study needs to be longer. It is also possible that on-line presentation is not effective for GP burnout.

 

The program, when completed, did produce greater mindfulness and positive emotions. So, there is reason to believe that it may be effective. This suggests that a modified more engaging and longer program should be developed and tested in a randomized controlled trial as an effective treatment for GPO burnout is sorely needed.

 

“When I talk or listen to peers and colleagues, I am amazed at how many healthcare professionals are already integrating mindfulness, meditation or relaxation techniques into their lives on a regular basis in order to ground themselves and find headspace and calm.” – Jon Kabat-Zin

 

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

 

Montero-Marin, J., Gaete, J., Araya, R. et al. Impact of a Blended Web-Based Mindfulness Programme for General Practitioners: a Pilot Study. Mindfulness (2017). doi:10.1007/s12671-017-0752-8

 

Abstract

General practitioners (GPs) report high levels of distress. This study examined whether a brief blended web-based mindfulness intervention could be effective at enhancing well-being for GPs and assessed the possible mediating role of awareness. An open uncontrolled trial, with pre-post measurements, was conducted. The programme comprised one face-to-face meeting (4 h) and eight online practice sessions with no support (two weekly sessions over 4 weeks). The primary outcome was positive affect (PANAS-positive). The secondary outcomes were as follows: negative affect (PANAS-negative), awareness (MAAS), resilience (CDRISC), and the burnout subtypes (BCSQ-12). Mixed-effects analysis for repeated measures and mediation analysis by regression models were performed. Two hundred ninety Spanish GPs took part in the study, attending the face-to-face meeting. Nearly one out 10 participants (n = 28) completed ‘one weekly practice’, and 10.4% (n = 30) accomplished ‘two or more weekly practices’. There were benefits for those with ‘two or more weekly practices’ in PANAS-positive (B = 2.97; p = 0.007), and MAAS (B = 4.65; p = 0.023). We found no benefits for those with ‘one weekly practice’ in any of the outcomes. There were mediating effects of MAAS in PANAS-positive (explaining a 60.8% of total effects). A brief blended mindfulness intervention, with minimum face-to-face contact and web-based practice sessions, seems to confer improvements in the well-being of Spanish GPs. The benefits may be mediated by awareness. The implementation of this kind of programme might enhance the well-being among GPs, but there is a need to improve adherence to practice. Further research using randomized controlled designs will be needed to support the evidence found in our study.

Reduce Stress with Preventative On-line Mindfulness Training

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Reduce Stress with Preventative On-line Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness not only reduces stress but also gently builds an inner strength so that future stressors have less impact on our happiness and physical well-being.” – Shamash Alidina

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health 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.

 

In today’s Research News article “Effects of preventive online mindfulness interventions on stress and mindfulness: 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/PMC5199155/, Jayawardene and colleagues reviewed and conducted a meta-analysis of the published research literature on the effectiveness of preventative mindfulness training on-line with normal, non-clinical, individuals for the relief of stress effects. They found 8 published randomized controlled trials. Most used modifications of the Mindfulness-Based Stress Reduction (MBSR) program and lasted from 2 to 12 weeks. MBSR includes body scan, meditation, and yoga practices.

 

They found that the published studies report significant reductions in perceived stress of moderate effect sizes and increases of mindfulness of small effect sizes following mindfulness training in comparison to baseline and control conditions. These effects persisted up to several months after the end of training. They also found that the older the participant the larger the reduction in perceived stress produced by mindfulness training.

 

These results are significant but not unexpected as Mindfulness-Based Stress Reduction (MBSR) was developed specifically to target perceived stress. What is significant is that this effectiveness occurs even when the training occurs strictly over the internet and with normal, non-clinical, populations. This is important as it suggests that inexpensive mindfulness training can be offered to widespread audiences. In addition, online training is convenient for the participants, as they do not have to go to a practitioners site on a particular schedule. This, in turn, allows for the application of mindfulness training for the prevention and treatment of psychological and physical disorders with busy people, low income people, and even people in remote locations, thus greatly expanding the numbers of people who can benefit.

 

Mindfulness training has been shown to have a myriad of physical and psychological benefits. The present findings are exciting in that they suggest that mindfulness training can occur inexpensively to disparate populations. The on-line mindfulness training may then, by reducing stress effects in normal people, act to prevent the many physical and psychological problems that result from chronic stress, improving their health and well-being.

 

So, reduce stress with preventative on-line mindfulness training.

 

“These are difficult times right now for a lot of people. Learning to become more “present,” frees us to be more flexible and creative – and ultimately, more resilient, enjoying better health and well-being.’”– Elisha Goldstein

 

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

 

Jayawardene, W. P., Lohrmann, D. K., Erbe, R. G., & Torabi, M. R. (2017). Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials. Preventive Medicine Reports, 5, 150–159. http://doi.org/10.1016/j.pmedr.2016.11.013

 

Abstract

Empirical evidence suggested that mind-body interventions can be effectively delivered online. This study aimed to examine whether preventive online mindfulness interventions (POMI) for non-clinical populations improve short- and long-term outcomes for perceived-stress (primary) and mindfulness (secondary). Systematic search of four electronic databases, manuscript reference lists, and journal content lists was conducted in 2016, using 21 search-terms. Eight randomized controlled trials (RCTs) evaluating effects of POMI in non-clinical populations with adequately reported perceived-stress and mindfulness measures pre- and post-intervention were included. Random-effects models utilized for all effect-size estimations with meta-regression performed for mean age and %females. Participants were volunteers (adults; predominantly female) from academic, workplace, or community settings. Most interventions utilized simplified Mindfulness-Based Stress Reduction protocols over 2–12 week periods. Post-intervention, significant medium effect found for perceived-stress (g = 0.432), with moderate heterogeneity and significant, but small, effect size for mindfulness (g = 0.275) with low heterogeneity; highest effects were for middle-aged individuals. At follow-up, significant large effect found for perceived-stress (g = 0.699) with low heterogeneity and significant medium effect (g = 0.466) for mindfulness with high heterogeneity. No publication bias was found for perceived-stress; publication bias found for mindfulness outcomes led to underestimation of effects, not

studies. POMI had substantial stress reduction effects and some mindfulness improvement effects. POMI can be a more convenient and cost-effective strategy, compared to traditional face-to-face interventions, especially in the context of busy, hard-to-reach, but digitally-accessible populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199155/

Improve Exercise Capacity in Heart Disease with Mindfulness

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Improve Exercise Capacity in Heart Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Why bother to do a mindfulness practice in addition to regular workouts?” You know that exercise can clear your head and turn around a bad mood. But when you add mindfulness in to the mix, you add rocket fuel to these already valuable benefits.” – Belief net
Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” – Centers for Disease Control. A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. But, these treatments can be costly, invasive, have major side effects, and often don’t address the root causes of the disease. On the other hand, the safest effective treatments for heart disease are lifestyle changes.

 

It has been demonstrated that lifestyle is a major contributor to the development of heart disease. quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses have shown to be effective in treating heart disease. Contemplative practices such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health have also been shown to be safe and effective treatments. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of lifestyle changes needed such as smoking cessation, weight reduction, and stress reduction.

 

One problem with the employment of mindfulness treatment programs to treat disease is that they require patients to meet frequently with professional therapists in either individual or group settings. This can be inconvenient, costly, and time consuming and for many people who live in remote areas, unavailable. So, to overcome these problems, mindfulness based techniques have been successfully developed and delivered over the internet. In a study by Younge et al. it was demonstrated that a 12-week mindfulness intervention significantly improved exercise capacity and decreased heart rate and blood pressure. The study, however, did not include a long-term follow-up. So, it is unknown how long-lasting the effects of the mindfulness treatment may be. In today’s Research News article “Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423609/, Gotink and colleagues perform a 12-month follow-up of the patients included in the study by Younge et al.

 

They recruited adult patients with existing, diagnosed heart disease and randomly assigned to a 12-week on-line mindfulness training or a usual medical care condition. The mindfulness training program included different meditations, self-reflection, yoga, and practical assignments and suggestions for using mindfulness in day-to-day life. After completion of the program the participants continued to receive biweekly reminders to continue practice. The patients were measured before and after training and 9-months later for exercise capacity measured with the 6-minute walk test, blood pressure, heart rate, respiratory rate, and cortisol levels, mental and physical functioning, anxiety and depression, perceived stress, and social support.

 

They found that similar to the benefits of mindfulness training documented at the end of training, 9-months later there were still small but significant improvements in the mindfulness group in exercise capacity, systolic blood pressure, mental functioning, and depression. These results are important in that they demonstrate that on-line mindfulness training can have lasting benefits for patients with heart disease. On-line training is inexpensive, convenient, and available to everyone with internet connections. It is effective for producing long-term improvements in exercise capacity in patients with heart disease allowing the patients to safely engage in beneficial exercise programs to strengthen the cardiovascular system. In addition, mindfulness training has been shown to help with producing other lifestyle changes that are beneficial for heart disease, Hence, it would be reasonable to suggest that on-line mindfulness training should be incorporated into standard  heart disease treatment programs.

 

So, improve exercise capacity in heart disease with mindfulness.

 

“There are well documented studies that show meditation reverses the physiologic manifestations of stress such as elevated blood pressure and heart rate.” – Joon Lee

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are

Improve Exercise Capacity in Heart Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Why bother to do a mindfulness practice in addition to regular workouts?” You know that exercise can clear your head and turn around a bad mood. But when you add mindfulness in to the mix, you add rocket fuel to these already valuable benefits.” – Belief net
Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” – Centers for Disease Control. A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. But, these treatments can be costly, invasive, have major side effects, and often don’t address the root causes of the disease. On the other hand, the safest effective treatments for heart disease are lifestyle changes.

 

It has been demonstrated that lifestyle is a major contributor to the development of heart disease. quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses have shown to be effective in treating heart disease. Contemplative practices such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health have also been shown to be safe and effective treatments. In addition, mindfulness practices have also been shown to be helpful for producing the kinds of lifestyle changes needed such as smoking cessation, weight reduction, and stress reduction.

 

One problem with the employment of mindfulness treatment programs to treat disease is that they require patients to meet frequently with professional therapists in either individual or group settings. This can be inconvenient, costly, and time consuming and for many people who live in remote areas, unavailable. So, to overcome these problems, mindfulness based techniques have been successfully developed and delivered over the internet. In a study by Younge et al. it was demonstrated that a 12-week mindfulness intervention significantly improved exercise capacity and decreased heart rate and blood pressure. The study, however, did not include a long-term follow-up. So, it is unknown how long-lasting the effects of the mindfulness treatment may be. In today’s Research News article “Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423609/, Gotink and colleagues perform a 12-month follow-up of the patients included in the study by Younge et al.

 

They recruited adult patients with existing, diagnosed heart disease and randomly assigned to a 12-week on-line mindfulness training or a usual medical care condition. The mindfulness training program included different meditations, self-reflection, yoga, and practical assignments and suggestions for using mindfulness in day-to-day life. After completion of the program the participants continued to receive biweekly reminders to continue practice. The patients were measured before and after training and 9-months later for exercise capacity measured with the 6-minute walk test, blood pressure, heart rate, respiratory rate, and cortisol levels, mental and physical functioning, anxiety and depression, perceived stress, and social support.

 

They found that similar to the benefits of mindfulness training documented at the end of training, 9-months later there were still small but significant improvements in the mindfulness group in exercise capacity, systolic blood pressure, mental functioning, and depression. These results are important in that they demonstrate that on-line mindfulness training can have lasting benefits for patients with heart disease. On-line training is inexpensive, convenient, and available to everyone with internet connections. It is effective for producing long-term improvements in exercise capacity in patients with heart disease allowing the patients to safely engage in beneficial exercise programs to strengthen the cardiovascular system. In addition, mindfulness training has been shown to help with producing other lifestyle changes that are beneficial for heart disease, Hence, it would be reasonable to suggest that on-line mindfulness training should be incorporated into standard  heart disease treatment programs.

 

So, improve exercise capacity in heart disease with mindfulness.

 

“There are well documented studies that show meditation reverses the physiologic manifestations of stress such as elevated blood pressure and heart rate.” – Joon Lee

 

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

 

Gotink, R. A., Younge, J. O., Wery, M. F., Utens, E. M. W. J., Michels, M., Rizopoulos, D., … Hunink, M. M. G. (2017). Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial. PLoS ONE, 12(5), e0175923. http://doi.org/10.1371/journal.pone.0175923

 

Abstract

There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen’s D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05–0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423609/

also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Gotink, R. A., Younge, J. O., Wery, M. F., Utens, E. M. W. J., Michels, M., Rizopoulos, D., … Hunink, M. M. G. (2017). Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial. PLoS ONE, 12(5), e0175923. http://doi.org/10.1371/journal.pone.0175923

 

Abstract

There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen’s D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05–0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423609/

Improve Caregiving for Family Members with Mental Illness with On-Line Mindfulness Training

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Improve Caregiving for Family Members with Mental Illness with On-Line Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“When specifically used with family caregivers, MBSR improves overall mental health, reduces stress and decreases depression. “ – Jane Hamilton

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Providing care for a relative with mental illness can be particularly challenging. Mental illnesses can make it difficult to relate to the individual and receive the kind of positive feelings that can support caregiving. The challenges of caring for a relative with mental illness require that the individual be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction. So, it is not surprising that mindfulness improves caregiving and assists the caregiver in coping with the stress.

 

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. This is particularly true for caregivers where the demands on the individual are substantial. 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.

 

In today’s Research News article “Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408047/, Stjernswärd and Hansson recruited adult participants who have a family member with a diagnosed mental illness. They were randomized into a mindfulness training and a wait-list control group. Mindfulness training occurred on-line and consisted of audio/video files, descriptive text files, and instructions for daily mindfulness exercises, and self-compassion exercises. It was recommended that participants engage in the training twice a day for 10 minutes, six days per week for 8 weeks. recommended training was set to 2 × 10 min/day, 6 days/week for 8 consecutive weeks.

 

Participants were measured before and after training and 3-months later for mindfulness, caregiver quality of life, self-compassion, and perceived stress. They found that mindfulness training produced significant increases in mindfulness, self-compassion, and caregiver quality of life, including relational problems, mental health, and problems with daily activities and significant reductions in perceived stress.

 

These are interesting results but must be tempered with the knowledge that the control condition was a no-treatment, wait-list control. So, the results could be due to confounding factors such as placebo effects, experimenter bias, attention effects, etc. But, they suggest that mindfulness training for caregivers with family members with mental illnesses can be successfully delivered on-line. If the results are supported by better controlled trials, they could be important in that improvements in the mental health and quality of life can be offered to caregivers in a convenient and inexpensive format. This could be very helpful in relieving a difficult situation for the caregivers and result in improved caregiving.

 

So, improve caregiving for family members with mental illness with on-line mindfulness training.

 

“5 Steps to Avoid Caregiver Burnout

  1. Develop a mindfulness practice, whether it’s yoga, meditation, or Qigong.
  2. Incorporate mini-mindfulness moments. Set aside time several times a day to ground yourself and to be in the present moment.
  3. Learn to accept your emotions, both pleasant and unpleasant, rather than wishing them away.
  4. Recognize the need for self-care in caregiving. Taking time for yourself may be an old piece of advice but it’s essential.
  5. Find a support network that can help you build a mindfulness practice, whether it is your friend, the YMCA, or a meditation group.” – Jason Drwal

 

 

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

Stjernswärd, S., & Hansson, L. (2017). Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness. Mindfulness, 8(3), 751–764. http://doi.org/10.1007/s12671-016-0653-2

 

Abstract

Families living with mental illness express needs of support and experiences of burden that may affect their own health detrimentally and hence also their ability to support the patient. Mindfulness-based interventions have shown beneficial health effects in both clinical and healthy populations. The aim of the current study was to explore the effectiveness and usability of a web-based mindfulness program for families living with mental illness, which was first tested in a feasibility study. The study was designed as a randomized controlled trial with an experiment group and a wait-list control group with assessments on primary and secondary outcomes at baseline, post-intervention, and at a 3-month follow-up. Significant positive improvements in mindfulness and self-compassion, and significant decreases in perceived stress and in certain dimensions of caregiver burden were found, with good program usability. Easily accessible mindfulness-based interventions may be useful in addressing caregivers’ needs of support and in preventing further ill health in caregivers. Further studies are needed, among others, to further customize interventions and to investigate the cost-effectiveness of such programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408047/

Mindfulness Training is Effective when Learned over the Internet.

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Mindfulness Training is Effective when Learned over the Internet.

 

By John M. de Castro, Ph.D.

 

“online mindfulness/stress management programs can be as effective as real-world programs, delivered at a fraction of the cost. . . . online programs could make mindfulness more accessible to underserved populations—as long as they have a computer and an Internet connection.” – Hooria Jazaieri

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health 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 “Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/

Fish and colleagues review and summarize the published research literature on the effectiveness of mindfulness therapies delivered online. They identified 9 randomized controlled trials of web-based mindfulness training. “All interventions introduced participants to some form of mindfulness practice including body scans, mindfulness of breathing, mindful movement and loving kindness” meditation.

 

They found that the studies reported that mindfulness training resulted in large improvements in mindfulness, reductions in stress, and clinically significant reductions in depression and anxiety. A large proportion of participants, 83%, continued practice after training ceased and the beneficial effects of the practice were still significant as much as 6-months later. These are impressive results which are comparable to the effects reported for therapist guided mindfulness training for stress, anxiety, and depression.  The studies, however, generally used weak control conditions and there is a need to continue the research with stronger research designs.

 

These are important findings in that mindfulness therapies were successfully implemented on-line. Web-based therapy 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. Hence, mindfulness training can be provided at low cost to widespread communities and individuals at their convenience. This greatly magnifies the potential societal benefits of mindfulness training; improving health and well-being.

 

So, mindfulness training is effective when learned over the internet.

 

“One of the benefits of living in a digital age is that we can pretty much access whatever we want. That is certainly true of meditation. Every major meditation center or university has an online component, offering you virtual courses, guided meditations, information on retreats and workshops. “ – Mindful

 

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

Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes? Mindfulness, 7(5), 1011–1023. http://doi.org/10.1007/s12671-016-0548-2

 

Abstract

New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: ‘mindfulness’ and ‘technology’. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress (n = 5), depression (n = 6) and anxiety (n = 4) were reported along with mindfulness (n = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects (p < .05). The highest reported effect sizes were large (stress d = 1.57, depression d = .95, both ps > .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that combine the latest technological advances with the knowledge and skills of experienced meditation teachers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010616/