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Learn Mindfulness On-Line to Reduce Stress Effects

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Learn Mindfulness On-Line to Reduce Stress Effects

 

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 the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness-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.

 

The vast majority of the mindfulness training techniques, adopted so far, 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 “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/

Jayewardene and colleagues review and perform a meta-analysis of the published research literature investigating the effectiveness of preventive mindfulness interventions delivered exclusively online for reducing stress responses in normal adults. They identified 8 randomized controlled trials with 75% having waitlist control groups and interventions lasting from 2 to 12 weeks. All but one study employed interventions that were modifications of the Mindfulness Based Stress Reduction (MBSR) program for completely online implementation. MBSR is composed of meditation, body scan and yoga training.

 

They found that overall the published literature reported significant improvements in mindfulness of small effect size and significant reductions in perceived stress of moderate size. They reported that there was no evidence suggesting publication bias as being responsible for the reported effects. So, the literature supports the assertion that mindfulness training online is effective in reducing perceived stress and increasing mindfulness.

 

These are exciting findings. It is well established that mindfulness training is effective for reducing the physical and psychological reactions to stress and that Mindfulness Based Stress Reduction (MBSR) programs are effective. What is new in this review is establishing that these benefits can be produced with training occurring exclusively online. 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.

 

So, learn mindfulness on-line to reduce stress effects.

 

“A live, in-person Mindfulness-Based Stress Reduction (MBSR) class is still the best way to learn mindfulness, because it is more likely that you will complete the course, due to the live interaction and group support. But doing an in-person course is not always possible, for financial and logistical reasons. The online course uses precisely the same course curriculum and resources that are used in the local in-person course, and if you follow the suggestions and practices for each of the eight weeks of the course, the learning can be just as deep and profound.” – Dave Potter

 

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 Twitter @MindfulResearch

 

Study Summary

Jayewardene, 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 overestimation. Number of eligible RCTs was low with inadequate data reporting in some 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/

ACT On-line to Reduce Chronic Pain

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By John M. de Castro, Ph.D.

 

“What kind of therapy is beneficial?  What are the specific components of therapy most applicable to people with chronic pain?  I can tell you that mindfulness, CBT, and ACT based interventions are definitely part of the equation, i.e., they are always helpful.  In fact, mindfulness practice is often a necessary component of healing.” – Howard Schubiner, MD

 

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. For many, however, pain is a constant in their lives. Chronic pain affects a wide swath of humanity.  At least 100 million adult Americans have common chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. Fortunately, there are alternative treatments. Mindfulness and yoga practices have been shown to improve pain. A therapeutic technique that includes mindfulness training called Acceptance and Commitment Therapy (ACT) has been shown to be effective in treating a number of physical and psychological disorders and has been shown to successfully improve acceptance of chronic pain, pain intensity, satisfaction with life, and physical functioning in patients with chronic pain.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, it teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. At its core, ACT is targeted at increasing psychological flexibility, which is an ability to modify behavior based upon conscious and open contact with thoughts, feelings, and sensory experiences, and in a manner that reflects the individual’s values and goals.

 

An impediment to widespread adoption of various psychotherapy techniques, including ACT, is that they require a trained professional therapist and attendance at scheduled therapy sessions. This can make the treatments expensive and inconvenient. The internet holds great promise to deliver therapy inexpensively and conveniently to large numbers of people spread across wide geographic areas. Mindfulness training has been successfully conducted over the internet with positive benefit. ACT has been successfully has been delivered on-line reducing depression. So, on-line ACT training appears to be a viable method for treatment.

 

In today’s Research News article “Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1369590659731523/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786566/

Trompetter and colleagues investigate the effectiveness of ACT, delivered on-line, to treat chronic pain and what variable might predict the kinds of patients who are most likely to have positive responses to ACT. They recruited patients suffering from chronic pain and randomly assigned them to either receive 12-weeks of on-line ACT treatment or Expressive Writing Treatment or to a waitlist control group. They measured pain and pain interference in daily life before and after treatment and 3 months after the conclusion of treatment. Before treatment they also measured demographic variables, pain intensity, pain disability, psychological distress, and mental health.

 

They found that ACT produced a significant reduction in pain interference in daily life and that this effect was moderated by the psychological well-being of the participants. That is, that participants with high levels of psychological well-being had much greater benefit from ACT than those at lower levels. There were no other significant predictors of benefit. These results suggest that ACT conducted on-line can be effective in reducing the interference from pain in the conduct of the daily lives of chronic pain patients. This is important as on-line presentation can greatly increase the scalability, affordability, and convenience of treatment for the huge numbers of chronic pain patients. The results further indicate that on-line ACT should be used primarily for patients who have moderate to high levels of psychological well-being at the beginning.

 

So, ACT on-line to reduce chronic pain.

 

“Overall, it appears that the cognitive-behavioral approach has a positive effect when combined with active treatments such as medications, physical therapy, and medical treatments for chronic pain clients in treating pain, thoughts about pain, and pain behavior problems.” –  Carrie L. Winterowd

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Trompetter, H. R., Bohlmeijer, E. T., Lamers, S. M. A., & Schreurs, K. M. G. (2016). Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective. Frontiers in Psychology, 7, 353. http://doi.org/10.3389/fpsyg.2016.00353

 

Abstract

The web-based delivery of psychosocial interventions is a promising treatment modality for people suffering from chronic pain, and other forms of physical and mental illness. Despite the promising findings of first studies, patients may vary in the benefits they draw from self-managing a full-blown web-based psychosocial treatment. We lack knowledge on moderators and predictors of change during web-based interventions that explain for whom web-based interventions are especially (in)effective. In this study, we primarily explored for which chronic pain patients web-based Acceptance and Commitment Therapy (ACT) was (in)effective during a large three-armed randomized controlled trial. Besides standard demographic, physical and psychosocial factors we focused on positive mental health. Data from 238 heterogeneously diagnosed chronic pain sufferers from the general Dutch population following either web-based ACT (n = 82), or one of two control conditions [web-based Expressive Writing (EW; n = 79) and Waiting List (WL; n = 77)] were analysed. ACT and EW both consisted of nine modules and lasted nine to 12 weeks. Exploratory linear regression analyses were performed using the PROCESS macro in SPSS. Pain interference at 3-month follow-up was predicted from baseline moderator (characteristics that influence the outcome of specific treatments in comparison to other treatments) and predictor (characteristics that influence outcome regardless of treatment) variables. The results showed that none of the demographic or physical characteristics moderated ACT treatment changes compared to both control conditions. The only significant moderator of change compared to both EW and WL was baseline psychological wellbeing, and pain intensity was a moderator of change compared to EW. Furthermore, higher pain interference, depression and anxiety, and also lower levels of emotional well-being predicted higher pain interference in daily life 6 months later. These results suggest that web-based self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based) ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786566/

 

Get Mindful On-Line and Get Feeling Better

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By John M. de Castro, Ph.D.

 

“mindfulness exercises delivered in face-to-face settings or remotely via the Internet seem to yield similar changes in symptoms. The remote delivery does not seem to lessen the efficacy of mindfulness interventions.”– Johanna Boettcher

 

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.

 

The vast majority of the mindfulness training techniques, adopted so far, 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 results, 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:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1362554723768450/?type=3&theater

or see summary below or view the full text of the study at:

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

Fish and colleagues review the published research literature on the effectiveness of technology-based mindfulness training programs that did not include an active facilitator’s participation. They found 10 studies published, 9 of which were web-based programs. They found that, in general, the mindfulness programs produced increases in mindfulness and reductions in perceived stress, depression, anxiety, and rumination and these effects were maintained at follow-ups occurring as much as 6-months later. Unfortunately, compliance was relatively low and drop-out rates were relatively high.

 

These are encouraging findings and suggest that mindfulness can be effectively trained with web-based materials and that this can produce psychologically beneficial results. But, there were no direct comparisons to traditional programs. So, it cannot be determined if the web-based programs are as effective as traditional programs. In addition, there methods need to be developed to help maintain compliance and decrease dropping out of web-based programs. Regardless, the benefits are substantial and the results are sufficiently positive to encourage further research.

 

So, get mindful on-line and get feeling better.

 

“Internet delivery of mindfulness training may be a viable alternative if an evidence base can be established. It can be self-paced, less costly, and more accessible while additionally allowing for participant anonymity. “ – David Messer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

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.

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

 

ACT for Psychological Flexibility, Mindfulness, and Depression

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By John M. de Castro, Ph.D.

 

“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” – Margarita Tartakovsky

 

Mindfulness training in general has been shown to be effective for treating depression. Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT) and has also been shown to be effective for depression. 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. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

As impressive as the effectiveness of many mindfulness based therapies are for depression, they require the supervision of a trained therapist working either with a single individual or in small groups. With the magnitude of the problem of depression, these therapies can only touch a small fraction of depression suffers. Recently the internet has been used to provide therapy to a wide audience. It allows for therapies to be made available to a much larger number of patients over a much larger geographical area. Indeed, ACT provided over the internet has been shown to be effective for depression. It is not known, however, which psychological processes are affected by ACT that work to relieve depression and what participant characteristics are predictive of responsiveness to ACT for depression.

 

In today’s Research News article “How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1260365230654067/?type=3&theater

or below or view the full text of the study at:

http://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0841-6

Pots and colleagues investigated potential mediators of ACT therapy for depression delivered over the internet. They randomly assigned patients diagnosed with mild to moderate depression to either receive Acceptance and Commitment Therapy (ACT), an expressive writing treatment, or a wait-list control condition. ACT was delivered over the internet in nine modules that could be completed by participants over nine to twelve weeks. The expressive writing condition was delivered similarly over the internet over the same time frame and involved the participants writing about their recent emotional experiences. The wait-list control participants received no treatments until 6-months later. Measures were taken of depression, mindfulness, psychological flexibility, anxiety, positive mental health and demographic variables prior to and after treatment and 6 and 12 months later.

 

They found, as previously reported, that ACT produced significant improvements in depressive symptoms that were maintained 6 and 12 months later. ACT produced a large improvement in psychological flexibility and the mindfulness facet of non-reactivity to internal events that were found to mediate the effect on depression. In other words, ACT reduced depression by improving non-reactivity and psychological flexibility.

 

Pots and colleagues state that “The central therapeutic mechanism in ACT is psychological flexibility, which is the ability to act in accordance with intrinsically motivating values or goals while being in contact with the present moment.” Hence, the results indicate that ACT was successful in producing its desired effect and this increase in the alignment of actions with values is a strong determinant of the reduction in depression. This is thought to be an important aspect of emotion regulation that is so important for allowing emotions to be experienced but not allowing them to produce maladaptive responses. This is also facilitated by not being particularly reactive to these emotions. Hence ACT appears to improve depression by improving the coherence and alignment of beliefs and values with the individual’s actions and emotions.

 

So, improve psychological flexibility, mindfulness, and depression with Acceptance and Commitment Therapy (ACT).

 

“It may be wise to not undertake the entire program while in the midst of an episode of clinical depression. Current evidence suggests that it may be prudent to wait until you have gotten the necessary help in climbing out of the depths and are able to approach this new work of working with your thoughts and feelings, with your mind and spirit unburdened by the crushing weight of acute depression.” – Jon Kabat-Zinn, Mark Williams, John Teasdale, and Zindel Segal

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Pots WT, Trompetter HR, Schreurs KM, Bohlmeijer ET. How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms. BMC Psychiatry. 2016 May 23;16:158. doi: 10.1186/s12888-016-0841-6.

 

Abstract

BACKGROUND: Acceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web-based interventions. This study focuses on the mediators, moderators and predictors of change during a web-based ACT intervention.

METHODS: Data from 236 adults from the general population with mild to moderate depressive symptoms, randomized to either web-based ACT (n = 82) or one of two control conditions (web-based Expressive Writing (EW; n = 67) and a waiting list (n = 87)), were analysed. Single and multiple mediation analyses, and exploratory linear regression analyses were performed using PROCESS and linear regression analyses, to examine mediators, moderators and predictors on pre- to post- and follow-up treatment change of depressive symptoms.

RESULTS: The treatment effect of ACT versus the waiting list was mediated by psychological flexibility and two mindfulness facets. The treatment effect of ACT versus EW was not significantly mediated. The moderator analyses demonstrated that the effects of web-based ACT did not vary according to baseline patient characteristics when compared to both control groups. However, higher baseline depressive symptoms and positive mental health and lower baseline anxiety were identified as predictors of outcome across all conditions. Similar results are found for follow-up.

CONCLUSIONS: The findings of this study corroborate the evidence that psychological flexibility and mindfulness are distinct process mechanisms that mediate the effects of web-based ACT intervention. The results indicate that there are no restrictions to the allocation of web-based ACT intervention and that web-based ACT can work for different subpopulations.

http://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0841-6

 

Increase Mindfulness with a Brief On-line Training

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By John M. de Castro, Ph.D.

 

“The best way to capture moments is to pay attention. This is how we cultivate mindfulness. Mindfulness means being awake. It means knowing what you are doing.” ~Jon Kabat-Zinn

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. With impacts so great it is important to know how to optimize the development of mindfulness.

 

“Mindfulness is defined as the “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally” (John Kabat-Zinn). This is the goal of mindfulness training. There are, however, a vast array of techniques for the development of mindfulness. They include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices. Some are recommended to be practiced for years while others are employed for only a few weeks. Regardless of the technique, they all appear to develop and increase mindfulness. It is unclear what technique may be best and what components are essential. There does appear, however, to be one central component; the practice of awareness of the present moment.

 

Many mindfulness practices require experienced and/or accredited instructors. This in turn requires traveling to a facility, attending sometimes lengthy classes for many weeks, and involves expense. In today’s busy world many people find that this commitment of time and resources is difficult if not impossible. So, it is important to develop simple, convenient, and efficient means to develop mindfulness. The internet holds great promise. Instruction can be delivered inexpensively and conveniently to large numbers of people spread across wide geographic areas. Mindfulness training has been successfully conducted over the internet with positive benefit. So, on-line mindfulness training appears to be a viable method for developing mindfulness.

 

The issue then becomes how much training is needed. In today’s Research News article “A Moment of Mindfulness: Computer-Mediated Mindfulness Practice Increases State Mindfulness.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1237611539596103/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841572/

Mahmood and colleagues examine if a very brief (5-min) instruction in mindfulness delivered on-line is sufficient to develop at least some improvement in mindfulness. They randomly assigned on-line participants to either a 5-minute body scan meditation condition or a control condition in which the participants were asked to simply sit in silence for 5-minutes. Participants levels of mindfulness were measured before and after the 5-minute training.

 

They found that the mindfulness condition produced significant increases in mindfulness while the control condition did not. Hence, a very brief body scan mindfulness training is capable of increasing mindfulness. It should be noted, however, that the effects were relatively small and there was no testing for how long the effects may last. It remains for future research to determine the amount of on-line practice needed to produce large and lasting increases in mindfulness. But, the fact that a brief mindfulness training can be delivered over the internet and have positive benefits is an encouraging step toward the development of a convenient and inexpensive means to deliver this beneficial training.

 

Regardless, it is clear that mindfulness can be increased with a brief on-line training

 

 

“Mindfulness is simply being aware of what is happening right now without wishing it were different; enjoying the pleasant without holding on when it changes (which it will); being with the unpleasant without fearing it will always be this way (which it won’t).” ~James Baraz

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Mahmood, L., Hopthrow, T., & Randsley de Moura, G. (2016). A Moment of Mindfulness: Computer-Mediated Mindfulness Practice Increases State Mindfulness. PLoS ONE, 11(4), e0153923. http://doi.org/10.1371/journal.pone.0153923

 

Abstract

Three studies investigated the use of a 5-minute, computer-mediated mindfulness practice in increasing levels of state mindfulness. In Study 1, 54 high school students completed the computer-mediated mindfulness practice in a lab setting and Toronto Mindfulness Scale (TMS) scores were measured before and after the practice. In Study 2 (N = 90) and Study 3 (N = 61), the mindfulness practice was tested with an entirely online sample to test the delivery of the 5-minute mindfulness practice via the internet. In Study 2 and 3, we found a significant increase in TMS scores in the mindful condition, but not in the control condition. These findings highlight the impact of a brief, mindfulness practice for single-session, computer-mediated use to increase mindfulness as a state.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841572/

 

Log-on for Less Anxiety with Mindfulness

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“Needless anxiety and stress cannot burden us if the thoughts don’t enter our mind. And fortunately, we are only capable of focusing on one thing at a time. When you’re aware of only what you’re working on and the sensations of your body, conscious worry is not possible.” – Jordan Bates

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. (Source: National Institute of Mental Health). Generalized Anxiety Disorder (GAD) affects about 3.1% of the U.S. population. GAD involves excessive worry about everyday problems. People with GAD may excessively worry about and anticipate problems with their finances, health, employment, and relationships. They typically have difficulty calming their concerns, even though they realize that their anxiety is more intense than the situation warrants. Physically, GAD sufferers will often show excessive fatigue, irritability, muscle tension or muscle aches, trembling, feeling twitchy, being easily startled, trouble sleeping, sweating, nausea, diarrhea or irritable bowel syndrome, and headaches.

 

Anxiety disorders are not only a torment for the victims but they also place tremendous pressure on the health care system. People with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders. Anxiety disorders are treatable but only about a third of the sufferers get treatment. The most common treatment for GAD is drugs. Anxiolytic drugs are some of the most prescribed drugs in the U.S. Psychotherapy is another common form of treatment with Cognitive Behavioral Therapy particularly effective. Mindfulness practices are known to reduce anxiety (see http://contemplative-studies.org/wp/index.php/2015/11/02/be-open-or-focused-in-meditation-to-reduce-anxiety/,  http://contemplative-studies.org/wp/index.php/2015/07/17/the-mindfulness-cure-for-social-anxiety/, http://contemplative-studies.org/wp/index.php/2015/07/17/stop-worrying/), and appear to do so by altering brain activity (see http://contemplative-studies.org/wp/index.php/2015/08/13/get-the-brain-to-reduce-anxiety-with-meditation/).

 

The problems with these treatments is that drugs can have very troublesome side effects and psychotherapy can be expensive and time consuming. Therapy also demands that there be a qualified professional in the immediate area and the patient has the time and transportation available to attend therapy sessions. So, there is a need for cost-effective, convenient, and safe alternative treatments.

 

One way to lower costs and make therapy available for patients over wide geographical areas is to deliver therapy over the internet. In today’s Research News article “Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1159827387374519/?type=3&theater

Dahlin and colleagues developed a form of mindfulness based Acceptance and Commitment Therapy (ACT) for delivery by a therapist over the internet. They recruited participants with GAD over the internet and assigned them randomly to either receive therapy for 9-weeks or to a waiting list control condition. They found significant improvement in Generalized Anxiety Disorder (GAD) and depression for the therapy group with large to moderate effect sizes. These improvements were still present 34-weeks later.

 

These are exciting results. Anxiety disorders are so prevalent and so infrequently treated that it’s important to demonstrate that a safe and effective therapy can be inexpensively delivered over the internet. This opens the door to widespread access to safe, convenient, effective, and inexpensive treatment. Future trials should employ a more active control condition and open up treatment to a wider array of GAD sufferers.

 

Mindfulness practices have a number of effects that appear to be helpful with anxiety disorders. They have been shown to improve emotion regulation. This allows the individual to experience the anxiety but react to it in a constructive way and thereby preventing an upward spiraling of anxiety as the patient becomes more anxious of becoming more anxious. Mindfulness practices also appear to blunt physiological and psychological reactions to stress. Since, high levels of anxiety are stressful, mindfulness practices may reduce the reactions to this stress, making the anxiety more bearable. Finally, anxiety involves worries about the future. By focusing the individual on the present, mindfulness practices interrupt worries about the future.

 

Regardless of the explanation, it is clear that mindfulness based Acceptance and Commitment Therapy (ACT) is effective for Generalized Anxiety Disorder (GAD) even when delivered over the internet.

 

So log-on for less anxiety with mindfulness.

 

“I confessed to him that I saw breathing exercises as an attempt to distract. He said, “Yes. It’s a tool. Mindfulness is all in the subtleties.” Then he paused and told me, “Instead, when thoughts and feelings come, you simply say to them ‘Hello. I see you. Welcome.’”” – Lucy Roleff


CMCS – Center for Mindfulness and Contemplative Studies

 

Reduce Depression with Cyber-Mindfulness  

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MBCT Depression Internet Beck2

 

“Our emotional reactions depend on the story we tell ourselves, the running commentary in the mind that interprets the data we receive through our senses.” ― Mark Williams,

 

Depression is widespread and debilitating. It is the most common mental illness affecting about 4% of the population worldwide. There are a number of treatments for depression the most common of which is antidepressant medication. But the drugs do not always work and can become ineffective over time. They can also have troublesome side effects. So, there is a need to discover safe and effective alternative treatments.

 

Mindfulness training has been shown to be an effective treatment for depression (see http://contemplative-studies.org/wp/index.php/category/research-news/depression/). Cognitive Behavioral Therapy (CBT) has been shown to be effective for depression by altering the ways people think about and process events that occur in their lives. Mindfulness Based Cognitive Behavioral Therapy (MBCT) adds mindfulness training to CBT. It was designed specifically to treat depression and has been shown to be effective even with people who do not respond to antidepressant medications (see http://contemplative-studies.org/wp/index.php/2015/07/17/dealing-with-major-depression-when-drugs-fail/). MBCT has been so effective that the British Medical Service considers it a treatment of choice for depression.

 

MBCT can be delivered either individually or in groups. But, it requires that a highly trained therapist lead the process and it can be delivered to only a limited number of people at a time. Hence, it is relatively expensive to deliver. Also, it requires the patients to come to a practitioner’s facility on a regular basis over 8 to 12 weeks. This can be inconvenient for many and impossible for others. In addition, depressed individuals lack energy and motivation and many simply can’t find the strength to attend regular sessions. So, there is a need to develop better ways to deliver therapy. The internet provides a mechanism that could potentially overcome many of these drawbacks to face-to-face delivery of MBCT. It’s low cost and widely available and can be accessed when the patient feels up to it.

 

In today’s Research News article “PS2-43: Internet Delivered Mindfulness-based Cognitive Therapy for Reducing Residual Depressive Symptoms: An Open Trial and Quasi-experimental Comparison to Propensity Matched Controls”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1134263793264212/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453426/

Beck and colleagues developed and tested an 8-session MBCT program delivered over the internet to recurrently depressed patients. Compared to treatment as usual for depression internet based MBCT produced a clinically significant decrease in depression with large effect size.

 

These are very exciting results. The cyber MBCT program is highly scalable and can be delivered to large numbers of depression sufferers at low cost. Because it’s delivered over the internet, it is convenient and available to patients who live in areas without access to clinics. The program needs to be compared to face-to-face MBCT. But, these results suggest that its effectiveness is comparable. Further research is definitely called for.

 

So, reduce depression with cyber-mindfulness.

 

“Unhappiness itself is not the problem—it is an inherent and unavoidable part of being alive. Rather, it’s the harshly negative views of ourselves that can be switched on by unhappy moods that entangle us. It is these views that transform passing sadness into persistent unhappiness and depression. Once these harsh, negative views of ourselves are activated, not only do they affect our mind, they also have profound effects on our body—and then the body in turn has profound effects on the mind and emotions.”  ― Mark Williams

 

CMCS – Center for Mindfulness and Contemplative Studies