Improve the Psychological Symptoms of Lupus with Mindfulness

Improve the Psychological Symptoms of Lupus with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Before I got lupus, I had no idea what an anxiety attack felt like, let alone how to work to stave one off. I’d always used meditation for personal focus and professional clarity. Meditation and mindfulness are how I have accomplished a lot of goals over the years but I never thought they would help me with anxiety.” – Kellie McRae

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S..

 

The symptoms of Lupus can look like a number of other diseases so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is possible that mindfulness training could improve Lupus and its symptoms.

 

In today’s Research News article “The Effectiveness of Mindfulness-based Cognitive Therapy on Psychological Symptoms and Quality of Life in Systemic Lupus Erythematosus Patients: 
A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632694/ ), Solati and colleagues investigated the effectiveness of mindfulness training as a treatment for Lupus. They recruited Lupus patients and randomly assigned them to receive either treatment as usual or an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). MBCT occurred in weekly 2-hour sessions and the patients were encouraged to practice at home. The control group in addition to usual medical care were provided advice on exercise, diet, and rest. They were measured before and after treatment and 6 months later for depression, anxiety, social function, somatization, and mental and physical quality of life.

 

They found that following MBCT there was a large, significant reduction in psychological symptoms including depression, anxiety, social function, somatization and a significant improvement in the patient’s psychological quality of life. The changes were clinically significant with large effect sizes. Importantly, these improvements remained significant at the 6-month follow-up.

 

Mindfulness-Based Cognitive Therapy (MBCT) is directed at assessing and altering negative thought patterns and judgements and developing mindfulness skills. Participants learn to become aware of their body sensation, thoughts, and emotions without judgement. MBCT was developed specifically to treat depression but has been found to be effective for a variety of psychological conditions. The present results demonstrate that it is also effective for the psychological symptoms of Lupus.

 

Lupus is a difficult painful condition that creates major stress and disruption of the patients’ lives. This, in turn, produces mental health challenges and marked decreases in the quality of life. The disease is difficult enough by itself. But, the psychological issues produced act to increase the suffering. Mindfulness training has been shown to reduce the psychological and physiological responses to stress, and stress has the effect of eliciting and amplifying Lupus symptoms. So, reducing response to stress can markedly improve the symptoms. The present study suggests that developing non-judgmental awareness of how and what they are feeling and what they are thinking in the present moment has tremendous beneficial effects, reducing the mental suffering and improving their quality of life.

 

So, improve the psychological symptoms of lupus with mindfulness.

 

“Meditation’s goal is to relax the mind and body, engage feelings about pain or other challenges, release tension and tap into a positive outlook – despite a chronic illness like Lupus. Focusing on negativity, especially on feelings of loss of health and well-being, only exacerbates pain.  Meditation helps bring things into present-moment awareness, to see where we are, and assess things in that moment.” – Jasmine Ly

 

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

 

Solati, K., Mousavi, M., Kheiri, S., & Hasanpour-Dehkordi, A. (2017). The Effectiveness of Mindfulness-based Cognitive Therapy on Psychological Symptoms and Quality of Life in Systemic Lupus Erythematosus Patients: 
A Randomized Controlled Trial. Oman Medical Journal, 32(5), 378–385. http://doi.org/10.5001/omj.2017.73

 

Abstract

Objectives

This study was conducted to determine the efficacy of mindfulness-based cognitive therapy (MBCT) on psychological symptoms and quality of life (QoL) in patients with systemic lupus erythematosus (SLE).

Methods

We conducted a randomized single-blind clinical trial in patients with SLE referred from the Imam Ali Clinic in Shahrekord, southwest Iran. The patients (46 in total in two groups of 23 each) were randomly assigned into the experimental and control groups. Both groups underwent routine medical care, and the experimental group underwent eight group sessions of MBCT in addition to routine care. The patient,s QoL was assessed using the General Health Questionnaire-28 and 36-Item Short Form Health Survey before, after, and six months after intervention (follow-up).

Results

A significant difference was seen in psychological symptoms and QoL between MBCT and control groups immediately after the intervention and at follow-up (p ≤ 0.050). However, the difference was not significant for the physical components of QoL (p ≥ 0.050).

Conclusions

MBCT contributed to decreased psychological symptoms and improved QoL in patients with SLE with a stable effect on psychological symptoms and psychological components of QoL, but an unstable effect on physical components.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632694/

Reduce Postpartum Depression with Mindfulness

Reduce Postpartum Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Interventions that bring a deeper sense of self-knowing and well-being to mothers allow them, in turn, to model this behavior for their children. We can’t possibly have the foresight to see how it ripples out from there, but we can be sure that it does.” – Heather Grimes

 

The birth of a child is most often a joyous occasion. But, often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Postpartum depression is treated much like depression in general with medications, psychotherapy, and support groups. But these methods often don’t work or have troublesome side effects. So, alternative treatments are needed. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to study the effects of mindfulness training as a treatment for postpartum depression.

 

In today’s Research News article “The effectiveness of mindfulness training on reducing the symptoms of postpartum depression.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/, Sheydaei and colleagues recruited new mothers who exhibited symptoms of depression and randomly assigned them to receive either treatment as usual or an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) to investigate and alter aberrant thought patterns underlying depression. MBCT was administered for 2 hours, once a week, for 8 weeks. The women were measured for depression before and after treatment.

 

They found that after treatment the control group showed no change in depression while, on the other hand, the women who received the MBCT program had a significant, 25%, reduction in depression. The conclusions from this study need to be tempered with the fact that the control condition did not have an active treatment. So, placebo effects, demand characteristics, experimenter bias, etc. could be alternative explanations. But, it has been well established that mindfulness training in general and MBCT in particular are effective in treating depression. So, it is likely that MBCT effectively reduced the depression in these women with newborn children. Hence, MBCT appears to be a safe and effective treatment for postpartum depression. Mindfulness training might be employed not only to treat postpartum depression but also as a preventative measure.

 

So, reduce postpartum depression with mindfulness.

 

“mothers in the mindfulness group seemed to have had a better psychological experience of labor compared to the control group. They reported feeling greater “self-efficacy” during childbirth (the sense that they were able to handle it rather than feeling afraid), and lower symptoms of depression after the workshop and several weeks after childbirth.” – Jenn Knudsen

 

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

 

Sheydaei, H., Ghasemzadeh, A., Lashkari, A., & Kajani, P. G. (2017). The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electronic Physician, 9(7), 4753–4758. http://doi.org/10.19082/4753

 

Abstract

Background and Aim

Postpartum depression is one of the prevalent disorders among new mothers. The present research aimed to examine the effectiveness of mindfulness training on reducing the symptoms of postpartum depression.

Method

The present quasi-experimental research was conducted on 410 new mothers in Shahid Chamran Hospital, Tehran in 2014. Using the Beck Depression Inventory (BDI), Structured Clinical Interview and Psychological Clinical Diagnosis, 67 mothers were selected and then randomly divided into experimental and control groups, each of which with 32 applicants. Afterwards, the experimental group received mindfulness training for 8 sessions, each lasting for two hours while the control group received no training. The data were analyzed through descriptive statistics and Analysis of Covariance (ANCOVA) in SPSS, version 20.

Results

Results showed that based on Beck Inventory, the scores for the experimental group in post-test were significant (p<0.001), compared to those for the control group. Also, it was revealed that pre- and posttest mean scores for postpartum depression in the control group were 25.81 and 25.12 respectively while the scores for the experimental group were 24.75 and 18.5 respectively. Since the posttest mean score in the experimental group was lower than that in the pretest, it can be said that the treatment, i.e., mindfulness training, was effective in reducing depression symptoms in mothers.

Conclusion

Findings proved that mindfulness training was effective in reducing the symptoms of postpartum depression in new mothers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/

Treat Obesity with Mindfulness

Treat Obesity with Mindfulness

 

By John M. de Castro, Ph.D.

 

“ mindfulness breeds resilience—a quality necessary for one to stick with your diet or exercise regimen. And given how much of our unhealthy eating is essentially mindless—such as stuffing our faces while we watch television—it’s easy to see how simply paying attention could have a significant impact on our diets.” – Tom Jacobs

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (BMI > 25). Although the incidence rates have appeared to stabilize, the fact that over a third of the population is considered obese is very troubling. This is because of the health consequences of obesity. Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.

 

Obviously, there is a need for effective treatments to prevent or treat obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesityalter eating behavior and improve health in obesity. This suggests that mindfulness training may be an effective treatment for overeating and obesity alone or in combination with other therapies.

 

In today’s Research News article “Effectiveness of mindfulness training and dietary regime on weight loss in obese people.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319254/, Asadollahi and colleagues recruited obese (BMI>30) individuals and randomly assigned them to one of four conditions; No-treatment, dietary regimen, Mindfulness-Based Cognitive Therapy (MBCT), or MBCT plus dietary regimen. MBCT was administered in 2-hour sessions once a week for 8 weeks and consists of mindfulness training and Cognitive Behavior Therapy (CBT) that is targeted at investigating and altering the individuals aberrant thought process. Participants were measured for psychopathology and anyone with significant pathology was eliminated from the study. The participants were also measured before and after the interventions and 2 months later for body weight and height.

 

They found that mindfulness training alone or a dietary regimen alone produced significant weight losses that persisted 2 months after the end of formal training. When mindfulness training was combined with a dietary regiment the weight loss was significantly greater at the end of training and 2 months later. So, Mindfulness-Based Cognitive Therapy (MBCT) is effective in reducing weight in obese participants and its effectiveness is amplified by combining it with a dietary regimen. So, mindfulness training can help to reduceobesity alone or in combination with dieting.

 

It is unclear how MBCT produces these positive effects on obesity, but it is known that MBCT can increase mindful eating and that eating food mindfully can results in lower overall intake and weight loss. MBCT is also known to reduce the psychological and physical responses to stress and stress is known to promote eating. So, it is reasonable to conclude that MBCT produces its effects on the body weight of the obese by increasing mindful eating and reducing stress.

 

So, treat obesity with mindfulness.

 

“Mindful eating is eating with purpose, eating on purpose, eating with awareness, eating without distraction, when eating only eating, not watching television or playing computer games or having any other distractions, not eating at our desks.” – Carolyn Dunn

 

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

 

Asadollahi, T., Khakpour, S., Ahmadi, F., Seyedeh, L., Tahami, Matoo, S., & Bermas, H. (2015). Effectiveness of mindfulness training and dietary regime on weight loss in obese people . Journal of Medicine and Life, 8(Spec Iss 4), 114–124.

 

Abstract

The present research was aimed to investigate the effectiveness of mindfulness training and dietary regime on weight loss in obese people. The research was quasi-experimental with posttest-pretest that used control group. The population consisted of all the individuals who attended two clinics of nutrition advice and diet therapy in Karaj. 60 individuals, whose BMI was more than 30, were selected by using the random sampling method. Moreover, they were evaluated by using the SCL-90 test in order to neglect them in case there existed any other significant disorder. Next, they were selected based on age, sex, and education. After explaining the individuals the ongoing research and collecting the informed consent written by them, the samples were placed in four groups (15 in each group). The groups that received mindfulness training attended the nutrition center for eight to 120-minute sessions. In addition, since all the participants referred to the center were motivated to lose weight, individuals who were placed in the control group and those who received mindfulness training were asked not to follow any specific diet for two months. Moreover, the in depth relaxation CD was prepared for those who asked, in order to train themselves at home. Descriptive statistical methods were employed in order to analyze the data and ANACOVA and variance analysis with frequent measurement were used. The research findings indicated that mindfulness training was accompanied by diet, which resulted in weight loss in obese patients. In addition, the findings of the two-month follow-up indicated lasting results.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319254/

Improve Teachers’ Coping with Stress and Emotion Regulation with Mindfulness

Improve Teachers’ Coping with Stress and Emotion Regulation with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For me, it’s important to be very familiar with the subject matter before I teach it. . . It’s the same with meditation. Before I began consciously bringing mindfulness into the classroom, I needed to feel like I knew what I was doing and had benefited from it.” – Elizabeth McAvoy

 

Teaching is a stressful profession causing many to burn out and leave the profession. A recent survey found that roughly half a million U.S. teachers move or leave the profession each year. That’s a turnover rate of about 20 percent compared to 9 percent in 2009. Indeed, anywhere from 40 and 50 percent of teachers will leave the classroom within their first five years, with over nine percent leaving before the end of their first year.

 

The high stress of the occupation shows up in higher rates of anxiety disorders, but particularly in physical ailments, with higher rates of laryngitis, conjunctivitis, lower urinary tract infections, bronchitis, eczema/dermatitis and varicose veins in female teachers. There is a pressing need to retain good teachers. So, it has become very important to identify means to help relieve the stress and lower burnout rates.

 

Mindfulness has been shown repeatedly to decrease physiological and psychological responses to stress. Mindfulness has also been shown to help improve performance and relieve stress in students. In addition, mindfulness has been shown to decrease burnout in a variety of professions. So, it would seem reasonable to suspect that mindfulness training would help teachers to reduce stress, the consequent physical symptoms, and burnout.

 

In today’s Research News article “Teaching Mindfulness to Teachers: a Systematic Review and Narrative Synthesis.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605579/, Emerson and colleagues review the published research literature on the effects of mindfulness training on teachers of students from 5 to 18 years of age. They identified 12 published research studies employing Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT) and variations on these programs.

 

They found that the research strongly suggests that mindfulness training significantly improves the ability of the teachers to cope with and regulate their emotions and suggests that it also significantly reduces the teachers’ physical and psychological responses to stress. Less clear cut was mindfulness effectiveness for reducing anxiety and depression and increasing self-efficacy, compassion, and self-compassion.

 

These are interesting and important findings that suggest that mindfulness training equips teachers to withstand the stresses of their profession and help them to keep control of their emotions. These may go a long way to preventing professional burnout. In addition, by reducing stress and improving emotion regulation mindfulness training should allow them to be better teachers. It is clear, however, that further research is needed to clarify any other benefits of mindfulness training.

 

So, improve teachers’ coping with stress and emotion regulation with mindfulness.

 

“Teachers who received mindfulness training “showed reduced psychological distress and time urgency . . . And then improvements in mindfulness and emotion regulation. Translation: These teachers were better able to cope with classroom challenges and manage their feelings, which made it easier for them to manage their students’ big feelings. And that helps students learn.” – Patricia Jennings,

 

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

 

Emerson, L.-M., Leyland, A., Hudson, K., Rowse, G., Hanley, P., & Hugh-Jones, S. (2017). Teaching Mindfulness to Teachers: a Systematic Review and Narrative Synthesis. Mindfulness, 8(5), 1136–1149. http://doi.org/10.1007/s12671-017-0691-4

 

Abstract

School teachers report high levels of stress which impact on their engagement with pupils and effectiveness as a teacher. Early intervention or prevention approaches may support teachers to develop positive coping and reduce the experience and impact of stress. This article reviews research on one such approach: mindfulness-based interventions (MBIs) for school teachers. A systematic review and narrative synthesis were conducted for quantitative and qualitative studies that report the effects of MBIs for teachers of children aged 5–18 years on symptoms of stress and emotion regulation and self-efficacy. Twelve independent publications were identified meeting the inclusion criteria and these gave a total of 13 samples. Quality appraisal of the identified articles was carried out. The effect sizes and proportion of significant findings are reported for relevant outcomes. The quality of the literature varied, with main strengths in reporting study details, and weaknesses including sample size considerations. A range of MBIs were employed across the literature, ranging in contact hours and aims. MBIs showed strongest promise for intermediary effects on teacher emotion regulation. The results of the review are discussed in the context of a model of teacher stress. Teacher social and emotional competence has implications for pupil wellbeing through teacher–pupil relationships and effective management of the classroom. The implications for practice and research are considered.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605579/

Improve Bipolar Disorder with Mindfulness

Improve Bipolar Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness looks like a potentially effective way of managing bipolar disorder, especially the depressive pole, which may be the most difficult to treat with medication alone. Mindfulness exercises and meditations are useful for people with bipolar disorder (manic depression) because mindfulness decreases the relapse rate for depression, reduces stress and anxiety, which contribute significantly to the onset of both mania and depression and may worsen the course of the illness, and improves a person’s ability to manage thoughts and feelings and increases awareness of the way the person tends to internalize external stimuli.” Shamash Alidina

 

Bipolar Disorder, also known as Manic Depressive Disorder, is a mood disorder characterized by alternating states of extreme depression, relative normalcy, and extreme euphoria (mania). The symptoms of depression and mania are so severe that the individual is debilitated and unable to conduct their normal daily lives. The depression is so severe that suicide occurs in about 1% of cases of Bipolar Disorder. It is thought to result from imbalances in the monoamine neurotransmitter systems in the nervous system and appears to be highly linked to the genes. There are great individual differences in Bipolar Disorder. The extreme mood swings can last for a few days to months and can occur only once or reoccur frequently.

 

Bipolar Disorder affects about 1% of the population throughout the world at any time. But about 3% to 10% of the population may experience it sometime during their lives. It is usually treated with drugs. But, these medications are not always effective and can have difficult side effects. Hence, there is a great need for alternative treatments. Mindfulness practices and treatments have been shown to be effective for major mental disorders, including depression and anxiety disorders and to improve the regulation of emotions. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed for the treatment of depression and has been shown to be very effective. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. So, MBCT may be a safe and effective treatment for Bipolar Disorder.

 

In today’s Research News article “Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590538/, Bojic and Becerra reviewed and summarized the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of Bipolar Disorder. They identified 13 published research studies.

 

They report that the published research finds that MBCT in conjunction with drug treatments produces significant improvements in most of the symptoms of Bipolar Disorder. MBCT  was found to produce significant improvements in mood, including decreased mania, anxiety, and depression. In addition, there were significant increases in the patients’ ability to regulate their emotions and their ability to think clearly (cognitive abilities). The studies report that MBCT remains effective one year after the conclusion of treatment.

 

Thus the current state of the research suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a safe, effective, and lasting treatment for Bipolar Disorder when used in addition to the standard drug treatments. These are important and exciting findings. They suggest that MBCT can help to relieve the suffering and improve the patients ability to conduct their lives.

 

So, improve bipolar disorder with mindfulness.

 

“The extreme highs and lows of bipolar disorder can be difficult to cope with, and difficult for those around you. The disorder causes anxiety at one end and depression at the other. Meditation is an easy and natural method for relaxing and reducing stress in anyone, and particularly in people with bipolar disorder.” – Anthony Watt

 

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

 

Bojic, S., & Becerra, R. (2017). Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature. Europe’s Journal of Psychology, 13(3), 573–598. http://doi.org/10.5964/ejop.v13i3.1138

 

Abstract

Despite the increasing number of studies examining the effects of mindfulness interventions on symptoms associated with Bipolar Disorder (BD), the effectiveness of this type of interventions remains unclear. The aim of the present systematic review was to (i) critically review all available evidence on Mindfulness Based Cognitive Therapy (MBCT) as a form of intervention for BD; (ii) discuss clinical implications of MBCT in treating patients with BD; and (iii) provide a direction for future research. The review presents findings from 13 studies (N = 429) that fulfilled the following selection criteria: (i) included BD patients; (ii) presented results separately for BD patients and control groups (where a control group was available); (iii) implemented MBCT intervention; (iv) were published in English; (v) were published in a peer reviewed journal; and (vi) reported results for adult participants. Although derived from a relatively small number of studies, results from the present review suggest that MBCT is a promising treatment in BD in conjunction with pharmacotherapy. MBCT in BD is associated with improvements in cognitive functioning and emotional regulation, reduction in symptoms of anxiety depression and mania symptoms (when participants had residual manic symptoms prior to MBCT). These, treatment gains were maintained at 12 month follow up when mindfulness was practiced for at least 3 days per week or booster sessions were included. Additionally, the present review outlined some limitations of the current literature on MBCT interventions in BD, including small study sample sizes, lack of active control groups and idiosyncratic modifications to the MBCT intervention across studies. Suggestions for future research included focusing on factors underlying treatment adherence and understanding possible adverse effects of MBCT, which could be of crucial clinical importance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590538/

Improve Depression with Diabetes with Mindfulness

Improve Depression with Diabetes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“There is reasonable evidence that mindfulness training decreases anxiety and depression in people with medical conditions like diabetes. On the other hand, what little evidence exists seems to suggest that this alone will not result in better self-management in chronic diseases such as diabetes.” – Andrew Keen

 

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

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs fail. It is a combination of two effective treatments; mindfulness training with Cognitive Behavioral Therapy (CBT). There have been very few controlled trials comparing MBCT to CBT. Such trials could be important for identifying which patients respond best to the which treatment.

 

In today’s Research News article “What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491069/, Tavote and colleagues conduct a comparison of the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) for the treatment of depression that commonly occurs with diabetes patients. They recruited adult patients with Type I or Type II diabetes who were also depressed and randomly assigned them to receive either MBCT or CBT. Both treatments involved 8 weekly meetings lasting 45 to 60 minutes. Homework was also assigned. They were measured at baseline for demographic characteristics, clinical psychological symptoms, personality, and diabetes characteristics. They were also measured for depression prior to and following treatment and 9-months later.

 

They found, as have many others, that both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT) produced significant reductions in depression in the diabetic patients that were maintained at the 9-month follow-up. They also found that MBCT was superior to CBT in relieving depression in highly educated patients. The two treatments were not significantly different in effectiveness for patients who differed on disease-related characteristics, or on clinical and personality factors.

 

Hence, the results suggest that MBCT and CBT are equivalently effective for depression except for highly educated diabetics who respond best to MBCT. It is not clear why highly educated depressed diabetics respond better when mindfulness training is added to Cognitive Behavioral Therapy (CBT). This should be further investigated in future research studies.

 

So, improve depression with diabetes with mindfulness

 

“Many people with diabetes find it difficult not to judge themselves based on their blood glucose numbers. If the numbers are not in range, that makes them feel bad, and they stop turning to the meter. Mindfulness works not by eliminating guilt, shame, or depression but by guiding people to work though these emotions and accomplish what they need to do to feel better — either by pushing through a workout, passing up an extra piece of cake, or checking blood sugar even though they’re in a bad mood.” – Kara Harrington

 

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

 

Tovote, K. A., Schroevers, M. J., Snippe, E., Emmelkamp, P. M. G., Links, T. P., Sanderman, R., & Fleer, J. (2017). What works best for whom? Cognitive Behavior Therapy and Mindfulness-Based Cognitive Therapy for depressive symptoms in patients with diabetes. PLoS ONE, 12(6), e0179941. http://doi.org/10.1371/journal.pone.0179941

 

Abstract

Objective

Cognitive Behavior Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT) have shown to be effective interventions for treating depressive symptoms in patients with diabetes. However, little is known about which intervention works best for whom (i.e., moderators of efficacy). The aim of this study was to identify variables that differentially predicted response to either CBT or MBCT (i.e., prescriptive predictors).

Methods

The sample consisted of 91 adult outpatients with type 1 or type 2 diabetes and comorbid depressive symptoms (i.e., BDI-II ≥ 14) who were randomized to either individual 8-week CBT (n = 45) or individual 8-week MBCT (n = 46). Patients were followed for a year and depressive symptoms were measured at pre-treatment, post-treatment, and at 9-months follow-up. The predictive effect of demographics, depression related characteristics, and disease specific characteristics on change in depressive symptoms was assessed by means of hierarchical regression analyses.

Results

Analyses showed that education was the only factor that differentially predicted a decrease in depressive symptoms directly after the interventions. At post-treatment, individuals with higher educational attainment responded better to MBCT, as compared to CBT. Yet, this effect was not apparent at 9-months follow-up.

Conclusions

This study did not identify variables that robustly differentially predicted treatment effectiveness of CBT and MBCT, indicating that both CBT and MBCT are accessible interventions that are effective for treating depressive symptoms in broad populations with diabetes. More research is needed to guide patient-treatment matching in clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491069/

Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness

Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Unlike many tools for ADHD, mindfulness develops the individual’s inner skills. It improves your ability to control your attention by helping to strengthen your ability to self-observe, to train attention, and to develop different relationships to experiences that are stressful. In other words, it teaches you to pay attention to paying attention, and can also make people more aware of their emotional state, so they won’t react impulsively. That’s often a real problem for people with ADHD.” – Carl Sherman

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, including nervousness agitation, anxiety, irritability, sleep and appetite problems, head and stomach aches, nausea, dizziness, and heart palpitations. If that’s not enough they can be addictive and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD,  attentionimpulse controlexecutive functionemotion control, and mood improvement. In addition, unlike drugs, it is a relatively safe intervention that has minimal troublesome side effects. Since mindfulness is so promising as a treatment, it is important to further investigate the role of mindfulness in ADHD and its treatment.

 

In today’s Research News article “Mindfulness-Based Cognitive Behavioral Therapy as an Adjunct Treatment of Attention Deficit Hyperactivity Disorder in Young Adults.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526699/, Aadil and colleagues review and summarize the published research literature of the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults. MBCT involves both mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms.

 

They identified 16 published trials and every one of them reported small but significant reductions in symptoms of ADHD. The improvements included significant reductions in ADHD severity, depression and emotional symptoms and increases in mindfulness, attentional ability, and quality of life. These improvements occurred even in patients who did not respond to drug treatment. Hence, MBCT is a safe and effective treatment for Attention Deficit Hyperactivity Disorder (ADHD). These are important and very impressive results. Mindfulness training is clearly a safe and effective treatment that may be used either as a supplement or instead of drug treatment and can help to alleviate the symptoms.

 

So, Improve Attention Deficit Hyperactivity Disorder (ADHD) with Mindfulness.

 

“78% of participants who practiced mindful awareness reported reduction in their ADHD symptoms.” – Lidia Zylowska

 

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

 

Aadil, M., Cosme, R. M., & Chernaik, J. (2017). Mindfulness-Based Cognitive Behavioral Therapy as an Adjunct Treatment of Attention Deficit Hyperactivity Disorder in Young Adults: A Literature Review. Cureus, 9(5), e1269. http://doi.org/10.7759/cureus.1269

 

Abstract

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurological disorder that often continues into adult age. Stimulants medication are the mainstay of treatment, however, in the recent years, there has been a lot of studies conducted to understand the effectiveness and feasibility of mindfulness-based cognitive behavioral therapy for treatment of attention deficit hyperactivity disorder in children and adults. In this article, we have reviewed 17 articles to look for the beneficial effects of such therapy in adults. Overall, we found that there is a clear beneficial effect of such therapies, especially when used in adjunct with stimulant medication and may increase overall compliance. For better understanding, we suggest that large, well-designed studies should be conducted with robust strategies, allowing more comparison studies with the better analytical outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526699/

Improve Psychological Health in Pregnancy with Mindfulness

Improve Psychological Health in Pregnancy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only does cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up—benefits that are well-documented among other groups of people—it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

The perinatal period, from the onset of pregnancy to the end of the infants first year, is a time of intense physiological and psychological change in both the mother and the infant. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Childbirth fear is associated with “low childbirth self-efficacy, greater use of pain medication during labor, more unwanted obstetric interventions in labor, as well as increased risk of postpartum depression.” Hence, it is clear that there is a need for methods to treat childbirth fear, depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy. So, it would make sense to further study the effects of mindfulness training during the perinatal period.

 

In today’s Research News article “A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/, Aslami and colleagues recruited Islamic women in their 16th to 32nd week of pregnancy and based upon pretesting of anxiety and depression selected two groups; a high anxiety and a high depression group. The groups were then randomly divided into a no-treatment control condition, a 12-week Cognitive Behavioral Therapy (CBT) condition or an 8-week Mindfulness-Based Stress Reduction (MBSR) condition. Traditional MBSR consists of training and practice in meditation, yoga, and body scan. The researchers modified the training protocol to include Islamic spiritual teachings. The CBT and MBSR conditions were assigned home practice for 45 minutes per day for 6 days per week. The participants were measured for anxiety and depression before and after treatment.

 

They found that both the Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) conditions produced significant decreases in both anxiety and depression while the no-treatment control group did not. In addition, the MBSR condition produced significantly greater reductions than the CBT condition. In fact, MBSR produced a very large reduction, on average, of 79% in anxiety and 81% in depression while CBT produced, on average, only a 45% reduction in anxiety and a 43% reduction in depression. Hence, although CBT was effective, MBSR produced far greater improvements in the pregnant women’s psychological states.

 

These are excellent results. It has been well established that mindfulness training produces significant reductions in anxiety and depression in a wide variety of people with a variety of conditions. But, this trial compared its effectiveness to another known effective treatment, Cognitive Behavioral Therapy (CBT) and found MBSR to be far superior. I am not aware of any other direct comparisons of the two forms of therapy. It is not known, however, if the inclusion of Islamic spiritual teachings added to MBSR’s effectiveness in this group of Islamic women. Regardless, it is clear the MBSR training is highly effective in reducing anxiety and depression in pregnant women. This should be of great assistance in making for a smooth remainder of the pregnancy and delivery and may well produce better outcomes with the infant.

 

So, improve psychological health in pregnancy with mindfulness.

 

“There could not be a better time to learn mindfulness than during pregnancy and early motherhood. For one thing, this is a time when most people have a strong motivation to become the best person they can be in a relatively short period of time. When you realize the full enormity of the responsibility you have taken on by becoming a mom, the primary source of care for another whole human being, not to mention one that you love more than you thought you could ever love, there is a really high level of motivation to try your best to get yourself into the best mental and emotional shape possible.”Cassandra Vieten

 

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

 

Aslami, E., Alipour, A., Najib, F. S., & Aghayosefi, A. (2017). A Comparative Study of Mindfulness Efficiency Based on Islamic-Spiritual Schemes and Group Cognitive Behavioral Therapy on Reduction of Anxiety and Depression in Pregnant Women . International Journal of Community Based Nursing and Midwifery, 5(2), 144–152.

 

Abstract

Background:

Anxiety and depression during the pregnancy period are among the factors affecting the pregnancy undesirable outcomes and delivery. One way of controlling anxiety and depression is mindfulness and cognitive behavioral therapy. The purpose of this study was to compare the efficiency of mindfulness based on the Islamic-spiritual schemas and group cognitive behavioral therapy on reduction of anxiety and depression in pregnant women.

Methods:

The research design was semi-experimental in the form of pretest-posttest using a control group. Among the pregnant women in the 16th to 32nd weeks of pregnancy who referred to the health center, 30 pregnant women with high anxiety level and 30 pregnant women with high depression participated in the research. Randomly 15 participants with high depression and 15 participants with high anxiety were considered in the intervention group under the treatment of mindfulness based on Islamic-spiritual schemes. In addition, 15 participants with high scores regarding depression and 15 with high scores in anxiety were considered in the other group. The control group consisted of 15 pregnant women with high anxiety and depression. Beck anxiety-depression questionnaire was used in two steps of pre-test and post-test. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant.

Results:

The results of multivariate analysis of variance test and tracking Tukey test showed that there was a significant difference between the mean scores of anxiety and depression in the two groups of mindfulness based on spiritual- Islamic scheme (P<0.001) and the group of cognitive behavioral therapy with each other (P<0.001) and with the control group(P<0.001). The mean of anxiety and depression scores decreased in the intervention group, but it increased in the control group.

Conclusion:

Both therapy methods were effective in reduction of anxiety and depression of pregnant women, but the effect of mindfulness based on spiritual- Islamic schemes was more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385237/

Add Home Practice to Mindfulness Training for Maximum Benefit

Add Home Practice to Mindfulness Training for Maximum Benefit

 

By John M. de Castro, Ph.D.

 

This is the clearest evidence we have that mindfulness-home practice can make a difference. This is a big source of debate because there are many components at play in a MBSR or MBCT course.“ – Christine Parsons

 

Mindfulness practices have been demonstrated to produce significant benefits for the practitioners’ health and well-being. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are specified practices that have proven track records over many years of effectiveness. They are both complex containing discussions, meditation, body scans, and yoga practices. Each is an 8-week program with participants only meeting for instruction once a week. They both rely on the participants practicing the techniques at home daily. There is, however, very little information regarding compliance with the home practice, to what extent do the participants fully comply with the instructions to practice at home, and what effects that may have on the effectiveness of the programs.

 

In today’s Research News article “Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/, Parsons and colleagues review, summarize, and perform a meta-analysis of adherence to home practice requirements during 8 weeks of mindfulness training. They found 49 research articles employing Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) which required home practice.

 

They found that the studies reported that participants performed about 64% of the required home practice. That translated into an average of 29 minutes per day of the required 45 minutes. This level of compliance was found to be true regardless of whether clinical or non-clinical samples were used, or whether the primary outcomes were psychological or physical, or between MBSR or MBCT programs. They also found that there was a small, albeit significant, relationship between the amount of home practice and the magnitude of the benefits from the treatment, such that the greater the amount of home practice, the greater the benefit.

 

Hence, the published research literature suggests that participants in both MBSR and MBCT programs perform on average about 2/3rds of the required home practice and that the better the compliance with the home practice requirement the better the outcomes. This is actually surprising good levels of compliance. Unfortunately, most of the studies used self-reports of home practice and the participants may have felt compelled to report better compliance than what they actually did. Nevertheless, the research suggests that home practice is a beneficial component of the practices. It is possible that this is true because it brings the practice into the everyday environment of the participants, away from the artificiality of the clinic. This may help to more readily transfer what is learned from the clinic to the real world and thereby heighten the impact of the practices.

 

So, add home practice to mindfulness training for maximum benefit.

 

“home practice helps generate meaningful change in dispositional mindfulness, which is purportedly a key mechanism of action in mindfulness-based interventions.” – Dawn Epstein

 

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

 

Parsons, C. E., Crane, C., Parsons, L. J., Fjorback, L. O., & Kuyken, W. (2017). Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants’ mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41. http://doi.org/10.1016/j.brat.2017.05.004

 

Abstract

Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR) emphasize the importance of mindfulness practice at home as an integral part of the program. However, the extent to which participants complete their assigned practice is not yet clear, nor is it clear whether this practice is associated with positive outcomes.

For this systematic review and meta-analysis, searches were performed using Scopus and PubMed for studies published through to the end of 2015, reporting on formal home practice of mindfulness by MBSR or MBCT participants.

Across 43 studies (N = 1427), the pooled estimate for participants’ home practice was 64% of the assigned amount, equating to about 30 minutes per day, six days per week [95% CI 60–69%]. There was substantial heterogeneity associated with this estimate. Across 28 studies (N = 898), there was a small but significant association between participants’ self-reported home practice and intervention outcomes (r = 0·26, 95% CI 0·19,–0·34).

MBSR and MBCT participants report completing substantial formal mindfulness practice at home over the eight-week intervention, albeit less than assigned amounts. There is a small but significant association between the extent of formal practice and positive intervention outcomes for a wide range of participants.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501725/

Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

Mindfulness-Based Cognitive Therapy is Effective Regardless of Teacher Competence

 

By John M. de Castro, Ph.D.

 

 “Over the past 15 years, the results of numerous randomized controlled trials have demonstrated that MBCT can be a powerful intervention for people who have experienced clinical depression three or more times. Evidence indicates MBCT may reduce the rate of relapse for individuals with recurrent depression by 50%. MBCT has also been applied to mood and anxiety concerns other than depression, with reported success.” – Good Therapy .org

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat and usually treated with anti-depressive medication. But, of patients treated initially with antidepressant drugs only about a third attained remission of the depression. After repeated and varied treatments including antidepressant drugs, therapy, exercise etc. only about two thirds of patients attained remission. Also, many patients who achieve remission have relapses and recurrences of the depression. In addition, antidepressant drugs often have troubling side effects and can lose effectiveness over time.

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified. Mindfulness training is another alternative treatment for depression. It has been shown to be an effective treatment for depression and is also effective for the prevention of its recurrence. Mindfulness Based Cognitive Therapy (MBCT) was specifically developed to treat depression and can be effective even in the cases where drugs failMBCT is usually delivered by trained certified teachers but is fairly scripted and standardized. So, it is unclear what the importance of the level of teacher training and competence is.

 

In today’s Research News article “Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/, Huijbers and colleagues examine the importance of the competence of the MBCT teacher in the effectiveness of MBCT for depression. They recruited patients who had had at least 3 episodes of depression, were in remission, taking antidepressants, and were engaged in a Mindfulness Based Cognitive Therapy (MBCT) program. MBCT was delivered in of 8 weekly sessions of 2.5 hours.

 

Patients were measured before and after MBCT training and 15 months later for rumination, self-compassion, mindfulness, cognitive reactivity, depressive symptoms, and depression relapse. The MBCT teachers were assessed for competence by two independent professional evaluators who rated a tape recorded MBCT session for “(1) coverage, pacing, and organization of session curriculum; (2) relational skills; (3) embodiment of mindfulness; (4) guiding mindfulness practices; (5) conveying course themes through interactive inquiry and didactic teaching; and (6) holding of group learning environment.” An overall competence rating was calculated as the sum of the 6 component competence scores.

 

They found that following treatment there were significant increases in patient self-compassion and mindfulness and significant decreases in rumination and cognitive reactivity. They also found that teacher competence did not significantly predict the number of sessions that the patients attended, and patient changes in self-compassion, mindfulness, rumination, and cognitive reactivity, or depression severity. In addition, the likelihood of relapse during the 15 month follow-up period was not significantly related to teacher competence. This was true for the overall competence and for each of the 6 competence domains.

 

These results are quite remarkable and suggest that the level of competence and expertise of the instructors in Mindfulness Based Cognitive Therapy (MBCT) does not affect the patient outcomes. These results are contrary to the recent findings that the level of teacher training with Mindfulness-Based Stress Reduction (MBSR) programs is associated with the effectiveness of the program to reduce stress and improve well-being.

 

It’s difficult to reach firm conclusion from the negative results of the present study as the range of teacher competencies was restricted wherein only 2 teachers were characterized as beginner and 2 as advanced. The lack of effect of teacher competence may also be due to the fact that MBCT programs are highly standardized and scripted by the treatment protocol and that patients are supplied with prerecorded materials for home practice. Nevertheless, the results suggest that only modest teacher competence and training is sufficient, with a standardized program, to produce maximal results.

 

So, it appears that Mindfulness-Based Cognitive Therapy is effective regardless of teacher competence.

 

“MBCT teaches people to pay attention to the present moment, rather than worrying about the past or the future, and to let go of the negative thoughts that can tip them over into depression. It also gives people a greater awareness of their own body, helping them to identify the signs of oncoming depression and ward off the episode before it starts.” – BeMindful

 

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

 

Huijbers, M. J., Crane, R. S., Kuyken, W., Heijke, L., van den Hout, I., Donders, A. R. T., & Speckens, A. E. M. (2017). Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome. Mindfulness, 8(4), 960–972. http://doi.org/10.1007/s12671-016-0672-z

 

Abstract

As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506231/