MBCT

Mindfulness-Based Cognitive Therapy (MBCT) Plus Loving-Kindness Mediation is highly Effective in Depressed Patients

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Mindfulness-Based Cognitive Therapy (MBCT) Plus Loving-Kindness Mediation is highly Effective in Depressed Patients

 

By John M. de Castro, Ph.D.

 

“MBCT can provide a viable relapse prevention intervention for people with a history of recurrent depression.” – Catherine Crane

 

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

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT has been found to be effective in treating depression.

 

Loving Kindness Meditation (LKM) is designed to develop kindness and compassion to oneself and others. The individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being. Although LKM has been practiced for centuries, it has received very little scientific research attention. But it may be effective in counteracting the effects of stress and self-criticism. It is not known how effective the combination of Mindfulness-Based Cognitive Therapy (MBCT) and Loving Kindness Meditation might be in treating depression.

 

In today’s Research News article “A study on the effects of mindfulness-based cognitive therapy and loving-kindness mediation on depression, rumination, mindfulness level and quality of life in depressed patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205847/ ) Wang and colleagues recruited adult patients with depression and randomly assigned them to receive either regular care or to receive 1 hour once per day for 1 week Loving Kindness Meditation followed by 8 weeks, once per week of Mindfulness-Based Cognitive Therapy (MBCT) also with Loving Kindness Meditation practice. Regular care consisted of “basic knowledge of depression, common drugs, possible adverse drug reactions, and prevention of adverse reactions . . . Face-to-face communication with patients was conducted regularly to understand their thoughts, evaluate the depression degrees of patients, so as to provide psychological support for depressed patients, and care for patients in daily life.” They were measured at baseline and at 2, 4, 6, and 8 weeks for mindfulness, depression, rumination, quality of life, self-acceptance, and sense of stigma.

 

They found that both groups significantly decreased in depression, sense of stigma, and rumination and increased in mindfulness, self-acceptance and quality of life over the 8 weeks. But the intervention group improved significantly more than the control group on all measures.

 

Previous research has shown that mindfulness training produces significant decreases in depression and rumination and increases in self-acceptance and quality of life. What is new here is that they found that the combination of Mindfulness-Based Cognitive Therapy (MBCT) and Loving Kindness Meditation was significantly more effective than the conventional psychological intervention. This is important but must be followed up to see if the improvements in the patients with depression are sustained over longer periods of time.

 

So, Mindfulness-Based Cognitive Therapy (MBCT) plus Loving-Kindness Mediation is highly effective in depressed patients.

 

“MBCT leads to a decrease in depressive symptoms, reduction in depression relapse rate and improvement in terms of mindfulness.” – Zulkiflu ArgunguMusa

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Wang, Y., Fu, C., Liu, Y., Li, D., Wang, C., Sun, R., & Song, Y. (2021). A study on the effects of mindfulness-based cognitive therapy and loving-kindness mediation on depression, rumination, mindfulness level and quality of life in depressed patients. American journal of translational research, 13(5), 4666–4675.

 

Abstract

Objective: To analyze the effects of mindfulness-based cognitive therapy (MBCT) plus loving-kindness mediation (LKM) in depressed patients. Methods: A total of 125 depressed patients diagnosed in the Department of Psychiatry of our hospital were selected as the research subjects and were randomly divided into a control group (n=62) and an observation group (n=63). The control group was treated with conventional psychological intervention, while the observation group was treated with MBCT plus LKM. The therapeutic outcomes were compared between the two groups. Results: At 2, 4, 6 and 8 weeks after intervention, the Hamilton Depression Rating Scale (HAMD) scores and the scores for introspection and deliberation, forced thinking, rumination of symptoms, treatment, ability and social relationships in the observation group were lower than those in the control group, while Five Facet Mindfulness Questionnaire (FFMQ) scores and the scores for psychology, environment, physiology, social relations, self-acceptance, and self-evaluation in the observation group were higher than those in the control group (P < 0.05). Conclusion: MBCT plus LKM can effectively improve depression, rumination, mindfulness level, quality of life, the sense of stigma and degree of self-acceptance in depressed patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205847/

 

Improve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

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Improve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

“MBCT encourages individuals with [Major Depressive Disorder] to become more aware of their internal events (ie, thoughts, feelings, and bodily sensations) and to change the ways in which they relate to these thoughts. For example, individuals are encouraged to view their thoughts as passing events in the mind, rather than treat them as reality. Disengaging from automatic negative cognitive patterns, such as rumination, reduces the future risk of relapse.” – Meagan MacKenzie

 

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

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  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. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. The research has been accumulating. So, it is reasonable to take an overall look at what has been learned.

 

In today’s Research News article “Mindfulness-based cognitive therapy in patients with depression: current perspectives.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018485/ ) MacKenzie and colleagues review and summarize the published research on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression.

 

They report that the published research studies demonstrate that Mindfulness-Based Cognitive Therapy (MBCT) produces significant decreases in current depression in patients with major depressive disorder and also significantly reduces the reoccurrence of depression in patients in remission. the research also found that MBCT produces these improvements in depression by increasing mindfulness, positive emotions and self-compassion and reducing rumination, negative emotions, and cognitive and emotional reactivity.

 

Hence, the published research has built a compelling case that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for depression and its reoccurrence. It does so by altering a number of intermediaries that directly effect depression. MBCT should be recommended as a front-line treatment.

 

So, improve depression with Mindfulness-Based Cognitive Therapy (MBCT).

 

“meta-analyses have demonstrated the efficacy of MBCT for reducing depression symptoms in patients with current depression . . . MBCT has been shown to perform as well as other comparable evidence-based treatments.” – Alice Tickell

 

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

 

MacKenzie, M. B., Abbott, K. A., & Kocovski, N. L. (2018). Mindfulness-based cognitive therapy in patients with depression: current perspectives. Neuropsychiatric disease and treatment, 14, 1599–1605. https://doi.org/10.2147/NDT.S160761

 

Abstract

Mindfulness-based cognitive therapy (MBCT) was developed to prevent relapse in individuals with depressive disorders. This widely used intervention has garnered considerable attention and a comprehensive review of current trends is warranted. As such, this review provides an overview of efficacy, mechanisms of action, and concludes with a discussion of dissemination. Results provided strong support for the efficacy of MBCT despite some methodological shortcomings in the reviewed literature. With respect to mechanisms of action, specific elements, such as mindfulness, repetitive negative thinking, self-compassion and affect, and cognitive reactivity have emerged as important mechanisms of change. Finally, despite a lack of widespread MBCT availability outside urban areas, research has shown that self-help variations are promising. Combined with findings that teacher competence may not be a significant predictor of treatment outcome, there are important implications for dissemination. Taken together, this review shows that while MBCT is an effective treatment for depression, continued research in the areas of efficacy, mechanisms of action, and dissemination are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018485/

 

Mindfulness is a Cost-Effective Treatment to Prevent Depression Relapse

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Mindfulness is a Cost-Effective Treatment to Prevent Depression Relapse

 

By John M. de Castro, Ph.D.

 

“MBCT significantly reduces the rates of depressive relapse or recurrence compared with usual care or placebo, corresponding to a relative risk reduction of 34%.” – Willem Kuyken

 

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

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be effective for the treatment of major depression. But there is little understanding of the cost-effectiveness of MBCT relative to drug treatment. So, it is important to take a serious look at the costs of implementing MBCT and its effectiveness in comparison to the costs and effectiveness of antidepressant pharmacotherapy.

 

In today’s Research News article “Cost-Utility Analysis of Mindfulness-Based Cognitive Therapy Versus Antidepressant Pharmacotherapy for Prevention of Depressive Relapse in a Canadian Context. Canadian journal of psychiatry” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492890/ )  Pahlevan and colleagues reviewed published research studies comparing the cost-effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) versus antidepressant pharmacotherapy for the prevention of relapse in patients with Major Depressive Disorder who had had at least 2 past episodes of major depression.

 

They report that the published research found that over a 2-year period Mindfulness-Based Cognitive Therapy (MBCT) costs $2,224.67 less than antidepressant pharmacotherapy and produces greater gains in quality of life. This greater cost effectiveness of MBCT disappeared when adherence rates were considered. Hence, the greater cost effectiveness of MBCT was due to its ability to motivate greater compliance with the treatment.

 

These results are important as when multiple effective treatments are available, the cost of treatment becomes important. The analysis suggests that Mindfulness-Based Cognitive Therapy (MBCT) not only costs less to deliver but also produces greater benefits. It is interesting that this advantage over antidepressant pharmacotherapy was due to improved compliance and not the superiority of the treatment. But a treatment is only as good as the patient’s adherence to its requirements and MBCT  produces greater adherence.

 

So, mindfulness is a cost-effective treatment to prevent depression relapse.

 

“The rationale behind the MBCT program is based on an empirically supported, theoretical framework suggesting that patients with recurrent depression become more vulnerable to developing depression as cognitive reactivity increases.” – Marloes J Huijbers

 

 

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

 

Pahlevan, T., Ung, C., & Segal, Z. (2020). Cost-Utility Analysis of Mindfulness-Based Cognitive Therapy Versus Antidepressant Pharmacotherapy for Prevention of Depressive Relapse in a Canadian Context: Analyse coût-utilité de la thérapie cognitive basée sur la pleine conscience contre la pharmacothérapie antidépressive pour prévenir la rechute de la dépression en contexte canadien. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 65(8), 568–576. https://doi.org/10.1177/0706743720904613

 

Abstract

Objective:

Patients suffering from major depressive disorder (MDD) experience impaired functioning and reduced quality of life, including an elevated risk of episode return. MDD is associated with high societal burden due to increased healthcare utilization, productivity losses, and suicide-related costs, making the long-term management of this illness a priority. The purpose of this study is to evaluate the cost-effectiveness of mindfulness-based cognitive therapy (MBCT), a first-line preventative psychological treatment, compared to maintenance antidepressant medication (ADM), the current standard of care.

Method:

A cost–utility analysis was conducted over a 24-month time horizon to model differences between MBCT and ADM in cost and quality-adjusted life years (QALY). The analysis was conducted using a decision tree analytic model. Intervention efficacy, utility, and costing data estimates were derived from published sources and expert consultation.

Results:

MBCT was found to be cost-effective compared to maintenance ADM over a 24-month time horizon. Antidepressant pharmacotherapy resulted in 1.10 QALY and $17,255.37 per patient on average, whereas MBCT resulted in 1.18 QALY and $15,030.70 per patient on average. This resulted in a cost difference of $2,224.67 and a QALY difference of 0.08, in favor of MBCT. Multiple sensitivity analyses supported these findings.

Conclusions:

From both a societal and health system perspective, utilizing MBCT as a first-line relapse prevention treatment is potentially cost-effective in a Canadian setting. Future economic evaluations should consider combined treatment (e.g., ADM and psychotherapy) as a comparator and longer time horizons as the literature advances.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492890/

 

Improve Anxiety and Depression with an Abbreviated Mindfulness-Based Cognitive Therapy

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Improve Anxiety and Depression with an Abbreviated Mindfulness-Based Cognitive Therapy

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Anxiety disorders are the most common mental illness, affecting 40 million adults in the U.S., or 18% of the population. Depression affects over 6% of the population. And anxiety and depression often co-occur. Anxiety and depression are generally treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety and depression. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been shown to be very effective. MBCT, however, is an 8-week program delivered in relatively small groups. It is not clear if a briefer program to larger groups might also be effective.

 

In today’s Research News article “A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057287/ )  Burgess and colleagues recruited adult patients with an anxiety or mood disorders and provided them with 5 weekly 2-hour group based session of Mindfulness-Based Cognitive Therapy (MBCT) with daily home practice. The group size was larger than the typical MBCT program (i.e., 16–20 participants rather than 12 participants) and meditation practice was reduced to 10-15 minutes compared to the traditional 40 minutes. They were measured before and after training for anxiety, depression, self-compassion, perceived stress, mental well-being, and disability.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there was significant reductions in anxiety, depression, worry, and acute distress, and significant increases in self-compassion and mental well-being. There were large clinically significant changes such that 50% of the patients had remissions of depression and 20% had remissions of anxiety.

 

It should be noted that there was no control condition in the present study. But previous controlled studies have routinely demonstrated that Mindfulness-Based Cognitive Therapy (MBCT) produces significant improvements in anxiety, depression, worry, distress, self-compassion, and mental well-being. So, the present results are unlikely to be due to confounding factors. The present study demonstrates that the significant benefits of MBCT can be produced with an abbreviated program delivered to a large group. This reduces the amount of time clinicians have to devote to the program, thereby reducing cost. It would also be likely that the abbreviated program would improve adherence to the program requirements and reduce drop-outs. This allows more patients at lower cost to have their suffering reduced.

 

So, improve anxiety and depression with an abbreviated Mindfulness-Based Cognitive Therapy.

 

“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com

 

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

 

Emilee E. Burgess, Steven Selchen, Benjamin D. Diplock, Neil A. Rector. A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression. Int J Cogn Ther. 2021 Apr 20 : 1–19. doi: 10.1007/s41811-021-00105-x

 

Abstract

Mindfulness-based interventions (MBIs) have emerged as clinically effective interventions for anxiety and depression although there are significant barriers to their access in the general population. The present study examined the effectiveness of a 5-week abbreviated mindfulness-based cognitive therapy (MBCT) intervention for a physician-referred, treatment-seeking, community sample (N = 54) with mood and/or anxiety symptom burden. Treatment effects demonstrated significant reductions in mood and anxiety symptom severity and significant increases in general well-being. Observed effect sizes were generally large, with high response and remission rates. The present study offers preliminary support that an abbreviated MBCT protocol can offer large treatment effects for decreasing mood and anxiety symptoms and could potentially offer an effective population-level strategy to improve cost-effectiveness and access to care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057287/

 

Improve Anxiety Disorders in Children and Adolescents with Mindfulness

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Improve Anxiety Disorders in Children and Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The more present you are in life, the more you realize you make better decisions, manage your emotions, and are fully engaged in life.” – Stephanie Gutzmer

 

A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety often co-occurs with depression or is a precursor to bipolar disorder. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. In addition, drugs can be problematic for the developing brain. So, there is a need to develop alternative treatments particularly for children and adolescents. Mindfulness practices have been shown to be quite effective in relieving anxiety.

 

Mindfulness-Based Cognitive Therapy (MBCT) involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to reduce anxiety. It has been proposed that intervening early may tend to mitigate or prevent future disorders So, it makes sense to examine the ability of MBCT to treat anxiety disorders in children and adolescents.

 

In today’s Research News article “Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307795/ ) Cotton and colleagues recruited youths aged 9-18 years diagnosed with anxiety disorder and who had at least one parent diagnosed with bipolar disorder. They were assigned in an age balanced way to either a wait-list control condition or to receive 12 weekly, 75-minute Mindfulness-Based Cognitive Therapy for Children (MBCT-C) group sessions. They were measured before and after training and weekly for anxiety, clinician-rated anxiety and anxiety-related functional impairment, emotion regulation, mindfulness, and clinician-rated illness severity.

 

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy for Children (MBCT-C) there was a significant reduction in clinician-rated illness severity. They also found that during the 12 weeks of treatment, the MBCT-C group had significant reductions in anxiety. In addition, the greater the increase in mindfulness the greater the reduction in anxiety and the greater the increase in emotion regulation.

 

These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) may be effective in reducing anxiety and illness severity in children and adolescents with anxiety disorders at-risk for bipolar disorder. In some ways these results are not surprising in that MBCT has been shown to reduce anxiety in adults and mindfulness has been found to be associated with reduced anxiety and improved emotion regulation. But MBCT might be considered as too sophisticated for children and adolescents. So, it is significant that it can be successfully applied to children and adolescents. It can relieve their anxiety and decrease the intensity of their disorder.

 

So, improve anxiety disorders in children and adolescents with mindfulness.

 

“Being mindful means paying attention to the present moment, exactly as it is. It is really hard to be anxious if you are completely focused on the present moment – what you are sensing and doing RIGHT NOW … and NOW … and NOW.” – Anxiety Canada

 

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

 

Cotton, S., Kraemer, K. M., Sears, R. W., Strawn, J. R., Wasson, R. S., McCune, N., Welge, J., Blom, T. J., Durling, M., & Delbello, M. P. (2020). Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial. Early intervention in psychiatry, 14(2), 211–219. https://doi.org/10.1111/eip.12848

 

Abstract

Aim.

Previous studies suggest that Mindfulness-Based Cognitive Therapy for Children (MBCT-C) is feasible and may improve anxiety and emotion regulation in youth with anxiety disorders at-risk for bipolar disorder. However, controlled studies are warranted to replicate and extend these findings.

Methods.

In the current study, 24 youth with anxiety disorders who have at least one parent with bipolar disorder participated in a MBCT-C treatment period (n = 24; Mage = 13.6, 75% girls, 79% White) with a subset also participating in a prior psychoeducation waitlist control period (n = 19 Mage = 13.8, 68% girls, 84% White). Participants in both the waitlist and MBCT-C periods completed independently-rated symptom scales at each time point. Participants in the waitlist period received educational materials 12 weeks prior to the beginning of MBCT-C.

Results.

There were significantly greater improvements in overall clinical severity in the MBCT-C period compared to the waitlist period, but not in clinician- and child-rated anxiety, emotion regulation or mindfulness. However, increases in mindfulness were associated with improvements in anxiety and emotion regulation in the MBCT-C period, but not the waitlist period.

Conclusions.

Findings suggest that MBCT-C may be effective for improving overall clinical severity in youth with anxiety disorders who are at-risk for bipolar disorder. However, waitlist controlled designs may inflate effect sizes so interpret with caution. Larger studies utilizing prospective randomized controlled designs are warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307795/

 

Improve Hypertension with Mindfulness Training

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Improve Hypertension with Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Several practices that help calm the mind can also lower blood pressure. All are types of meditation, which use different methods to reach a state sometimes described as “thoughtful awareness” or “restful alertness.” – Harvard Health

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternatives to drugs for reducing blood pressure. Mindfulness practices have been shown to aid in controlling hypertension. There has accumulated a body of research on the ability of Mindfulness practices to affect hypertension. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000213/ ) Conversano and colleagues review, summarize and perform a meta-analysis of the published research studies of the effectiveness of mindfulness training on hypertension. They identified 6 published studies that employed either Mindfulness-Based Stress Reduction (MBSR) (3 studies), Mindfulness-Based Cognitive Therapy (MBCT) (2 studies), and mindfulness meditation (1 study).

 

They report that the published research found that mindfulness training improved hypertension with reductions in both systolic and diastolic blood pressure. They further report that mindfulness training worked best when the number of patients taking antihypertensive drugs were low, with the lower the percentage of participants on antihypertensive drugs, the greater the effect size of mindfulness training on hypertension.

 

These are impressive results that suggest that mindfulness training is a safe and effective treatment for hypertension. The trainings appear to work best in the absence of drugs to control hypertension. It follows that mindfulness training would reduce the physical effects of hypertension and thereby improve the overall health and longevity of the patients.

 

So, improve hypertension with mindfulness training.

 

“The hope is that if we can start mindfulness training early in life, we can promote a trajectory of healthy aging across the rest of people’s lives. That will reduce their chances of getting high blood pressure in the first place.” – Eric Loucks

 

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

 

Conversano C, Orrù G, Pozza A, Miccoli M, Ciacchini R, Marchi L, Gemignani A. Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence. Int J Environ Res Public Health. 2021 Mar 11;18(6):2882. doi: 10.3390/ijerph18062882. PMCID: PMC8000213.

 

Abstract

Background: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several studies have reported positive effects of mindfulness-based stress reduction (MBSR) interventions on physical and psychological well-being in other medical conditions, but no meta-analysis on MBSR programs for hypertension has been conducted. Objectives: The objective of this study was to determine the effectiveness of MBSR programs for hypertension. Methods: A systematic review and meta-analysis of randomized controlled trials examining the effects of MBSR on systolic and diastolic blood pressure (BP), anxiety, depression, and perceived stress in people with hypertension or pre-hypertension was conducted. The PubMed/MEDLINE and PsycINFO databases were searched in November 2020 to identify relevant studies. Results: Six studies were included. The comparison of MBSR versus control conditions on diastolic BP was associated with a statistically significant mean effect size favoring MBSR over control conditions (MD = −2.029; 95% confidence interval (CI): −3.676 to −0.383, p = 0.016, k = 6; 22 effect sizes overall), without evidence of heterogeneity (I2 = 0.000%). The comparison of MBSR versus control conditions on systolic BP was associated with a mean effect size which was statistically significant only at a marginal level (MD = −3.894; 95% CI: −7.736–0.053, p = 0.047, k = 6; 22 effect sizes overall), without evidence of high heterogeneity (I2 = 20.772%). The higher the proportion of participants on antihypertensive medications was, the larger the effects of MBSR were on systolic BP (B = −0.750, z = −2.73, p = 0.003). Conclusions: MBSR seems to be a promising intervention, particularly effective on the reduction of diastolic BP. More well-conducted trials are required.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000213/

 

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

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Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The therapeutic applications of mindfulness are considerable and its impact on clinical practice itself appears to be profound. Indeed, several commentators characterize mindfulness as inciting nothing short of a revolution in the way we conduct our mental lives both within the clinic and without.” – Matias P. Raski

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, improving sleep and reduce stress.

 

In today’s Research News article “Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/ ) Strauss and colleagues recruited healthy adult healthcare workers and randomly assigned them to either a wait-list control condition or to receive 8 weekly 2-hour group sessions of Mindfulness-Based Cognitive Therapy (MBCT) along with 40 minutes of daily practice.  MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT was developed specifically to treat depression. For this study it was modified to be more appropriate for the general population. The participants were measured before and after training for attendance and practice amounts, stress, anxiety, depression, mental well-being, burnout, presenteeism, compassion, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy (MBCT) there were significant increases in mindfulness, mental well-being, and self-compassion, and significant decreases in anxiety, depression, and stress. They also found that the greater the increases in mindfulness and self-compassion produced by MBCT the greater the increase in mental well-being and the decrease in stress.

 

These findings are similar to those found in previous research with different groups that Mindfulness training increases well-being and self-compassion, and decreases anxiety, depression, and stress. Hence, mindfulness training improves the psychological well-being of healthcare workers. This should help protect them against burnout and increase their resilience in the face of high workplace stress.

 

So, reduce stress and improve healthcare worker well-being with mindfulness.

 

“As we become more adept at dwelling in the living presence of our own experience, we begin to connect more deeply with patients, as well as co-workers and family members. Mindfulness practice provides a simple and practical way to recapture the calling of healing.” – Penn Medicine

 

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

 

Strauss, C., Gu, J., Montero-Marin, J., Whittington, A., Chapman, C., & Kuyken, W. (2021). Reducing stress and promoting well-being in healthcare workers using mindfulness-based cognitive therapy for life. International journal of clinical and health psychology : IJCHP, 21(2), 100227. https://doi.org/10.1016/j.ijchp.2021.100227

 

Background/Objective

Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903308/

 

Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

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Relieve Maternal Perinatal Depression with Smartphone-Based Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques.” – Edith Gettes

 

The period of pregnancy is a time of intense physiological and psychological change. 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. 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.

 

In addition, 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.

 

Hence, it is clear that there is a need for methods to treat depression, and anxiety during the perinatal period. 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 and to relieve postpartum depression.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these apps and their ability to relieve depression during the perinatal period.

 

In today’s Research News article “Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/ ) Sun and colleagues recruited pregnant women who were diagnosed with depression and randomly assigned them to receive 8-weeks of either health consultation or mindfulness training. Mindfulness training occurred in 8 weekly sessions delivered on a smartphone app. The training was Mindfulness-Based Cognitive Therapy (MBCT) modified for pregnant women. Health consultation also occurred via smartphone app. They were measured before during, and after training, 10 weeks later, and 6-months after delivery for depression, anxiety symptoms, perceived stress, positive and negative emotions, sleep-related problems, fatigue, memory, and fear of childbirth. There was a 52% completion rate for the trainings.

 

They found that after training the mindfulness group had significantly lower levels of depression and anxiety and significantly higher levels of positive emotions but these were not maintained 6 months after delivery. The mindfulness group also had a significantly higher rate of depression symptom remission. Hence the smartphone-based mindfulness training improved the psychological health of the pregnant women.

 

These findings replicate previous findings that mindfulness training reduces anxiety and depression in non-pregnant individuals and relieves maternal anxiety and depression during pregnancy. The strength of the current study was that these effects were produced by mindfulness training with a smartphone app. This is important as this training is highly scalable at minimal cost and so can be made available to virtually all pregnant women who want it. Hence, it may be able to reduce the psychological misery that occurs in many women during the perinatal period, making pregnancy a happier time for the women and produce better outcoms for the infant.

 

So, relieve maternal perinatal depression with smartphone-based mindfulness training.

 

“the risk of having moderate depressive symptoms was reduced by nearly 90% in participants receiving the MMT [Mindfulness] intervention.” – Ruta Nonacs

 

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

 

Sun, Y., Li, Y., Wang, J., Chen, Q., Bazzano, A. N., & Cao, F. (2021). Effectiveness of Smartphone-Based Mindfulness Training on Maternal Perinatal Depression: Randomized Controlled Trial. Journal of medical Internet research, 23(1), e23410. https://doi.org/10.2196/23410

 

Abstract

Background

Despite potential for benefit, mindfulness remains an emergent area in perinatal mental health care, and evidence of smartphone-based mindfulness training for perinatal depression is especially limited.

Objective

The objective of this study was to evaluate the effectiveness of a smartphone-based mindfulness training intervention during pregnancy on perinatal depression and other mental health problems with a randomized controlled design.

Methods

Pregnant adult women who were potentially at risk of perinatal depression were recruited from an obstetrics clinic and randomized to a self-guided 8-week smartphone-based mindfulness training during pregnancy group or attention control group. Mental health indicators were surveyed over five time points through the postpartum period by online self-assessment. The assessor who collected the follow-up data was blind to the assignment. The primary outcome was depression as measured by symptoms, and secondary outcomes were anxiety, stress, affect, sleep, fatigue, memory, and fear.

Results

A total of 168 participants were randomly allocated to the mindfulness training (n=84) or attention control (n=84) group. The overall dropout rate was 34.5%, and 52.4% of the participants completed the intervention. Mindfulness training participants reported significant improvement of depression (group × time interaction χ24=16.2, P=.003) and secondary outcomes (χ24=13.1, P=.01 for anxiety; χ24=8.4, P=.04 for positive affect) compared to attention control group participants. Medium between-group effect sizes were found on depression and positive affect at postintervention, and on anxiety in late pregnancy (Cohen d=0.47, –0.49, and 0.46, respectively). Mindfulness training participants reported a decreased risk of positive depressive symptom (Edinburgh Postnatal Depression Scale [EPDS] score>9) compared to attention control participants postintervention (odds ratio [OR] 0.391, 95% CI 0.164-0.930) and significantly higher depression symptom remission with different EPDS reduction scores from preintervention to postintervention (OR 3.471-27.986). Parity did not show a significant moderating effect; however, for nulliparous women, mindfulness training participants had significantly improved depression symptoms compared to nulliparous attention control group participants (group × time interaction χ24=18.1, P=.001).

Conclusions

Smartphone-based mindfulness training is an effective intervention in improving maternal perinatal depression for those who are potentially at risk of perinatal depression in early pregnancy. Nulliparous women are a promising subgroup who may benefit more from mindfulness training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875700/

Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

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Improve Psychological Well-Being in Cancer Survivors with Online Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

“both MBCT and eMBCT interventions reduced fear of cancer recurrence and rumination, and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Félix Compen

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) is a well-established therapy that involves mindfulness training and cognitive therapy to change maladaptive thought processes. MBCT has been found to be effective in reducing the residual psychological issues that are common in cancer survivors.

 

But the vast majority of the mindfulness training techniques require a trained therapist. This results in costs that many parents 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 parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. So, it makes sense to explore the effectiveness of internet-based Mindfulness-Based Cognitive Therapy (iMBCT) in treating the psychological symptoms of cancer survivors.

 

In today’s Research News article “Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/ )  Nissen and colleagues recruited adult breast and prostrate cancer survivors and randomly assigned them to a wait-list control condition or to receive internet-based Mindfulness-Based Cognitive Therapy (iMBCT); consisting of 8 1-week modules. They were measured before and after training and 6 months later for mindfulness, self-compassion, anxiety, depression, and therapy related working reliance.

 

They found that at baseline the higher the levels of self-compassion and the mindfulness facets of describing, non-judging, and acting with awareness, the lower the levels of anxiety and depression. Mindfulness-Based Cognitive Therapy (iMBCT) resulted in significant decreases in anxiety and depression. The amount of decrease in anxiety was related to the baseline depression level with the most depressed participants having the greatest reductions, while the amount of decrease in depression was related to the baseline self-compassion level with the participants with the highest levels of self-compassion having the greatest reductions. Neither mindfulness, therapy related working reliance, nor were related to the improvements.

 

These are interesting results that replicate previous findings of mindfulness training producing improvements in depression and anxiety in cancer patients, and that mindfulness training over the internet is effective in improving cancer patients. The primary intent of the research, though, was to examine predictors of patient responsiveness to the therapy. The results here were disappointing as only baseline self-compassion was related to depression improvements and only baseline depression was related to improvements in anxiety. Regardless, it is clear that mindfulness training can be successfully implemented over the internet and it is effective in improving the levels of anxiety and depression in cancer survivors.

 

So, improve psychological well-being in cancer survivors with online Mindfulness-Based Cognitive Therapy (iMBCT).

 

“I love being more mindful. Instead of waiting for the flowers to come out, I go out in the garden and see what is happening now. I am happier. Things still get difficult at times and when they do, I do my practice.” – MBCT Patient

 

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

 

Nissen, E. R., Zachariae, R., O’Connor, M., Kaldo, V., Jørgensen, C. R., Højris, I., Borre, M., & Mehlsen, M. (2021). Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors: Predictors of treatment response. Internet interventions, 23, 100365. https://doi.org/10.1016/j.invent.2021.100365

 

Abstract

Background

The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer.

Methods

Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time.

Results

Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up.

Conclusion

The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843453/

 

Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

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Mindfulness-Based Therapies Benefits are Greatly Affected by Social Factors in Therapy

 

By John M. de Castro, Ph.D.

 

“Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.” – Manuel A. Manotas

 

Psychotherapy is an interpersonal transaction. Its effectiveness in treating the ills of the client is to some extent dependent upon the chemistry between the therapist and the client, termed the therapeutic alliance. Research has demonstrated that there is a positive relationship with moderate effect sizes between treatment outcomes and the depth of the therapeutic alliance.

 

There are also other factors that may be important for successful therapy. The client’s engagement in the process as well as the therapists interpersonal skills may also be important ingredients in producing successful therapeutic outcomes. There are also important social factors present particularly when the therapy is provided in groups. In addition, formal and informal practice effects are involved. There is little known, however, of the role of these components of therapy on the effectiveness of treatment for mental health issues such as depression.

 

In today’s Research News article “The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/ )  Canby and colleagues recruited patients diagnosed with mild to severe depression and randomly assigned them to receive once a week for 8 weeks, 3 hour sessions of either focused meditation, open monitoring meditation or Mindfulness-Based Cognitive Therapy (MBCT) which contains both focused and open monitoring meditation practices. Before and after the 8-weeks of practice and 3 months later they were measured for empathy, therapeutic alliance, formal and informal mindfulness practices, depression, anxiety, stress, mindfulness, and group therapeutic factors in group therapy: instillation of hope, secure emotional expression, awareness of relational impact, and social learning. Finally, they received structured interviews exploring mindfulness practices and impact of treatment.

 

They found that the over treatment and follow-up the groups had significantly increased mindfulness and significantly decreased anxiety, depression and stress. They found that the higher the ratings of the instructors. the ratings of the groups and the amounts of formal meditation practice the greater the changes. In general, the instructor and group factors had stronger relationships to the psychological improvements than the amount of formal meditation and the amount of informal meditation practice had no relationship with the improvements. The analysis of the structured interviews indicated that the participants found the instructor and group factors including bonding, instilling hope, and expressing feelings were important to their improvements.

 

These results are interesting replicate previous findings of mindfulness-based therapies produce improvements in anxiety, depression, and stress. The results suggest that mindfulness-based therapies have complex effects and changes in mindfulness may be less important than the social environment produced by the instructor and the group. These social factors may account for a large proportion of the benefits to the participants. These results are important as they suggest that empathizing the social interactions involved in therapy may improve the impact of the therapy on the patients’ psychological well-being.

 

So, mindfulness-based therapies benefits are greatly affected by social factors in therapy.

 

“Mindfulness’ strength is in helping us to see more clearly, by giving us the room to not be so quickly reactive. And over time the event does not have to jump to emotional distress, like a grasshopper leaping over a stream.” – Barry Boyce

 

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

 

Canby, N. K., Eichel, K., Lindahl, J., Chau, S., Cordova, J., & Britton, W. B. (2021). The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes. Frontiers in psychology, 11, 603394. https://doi.org/10.3389/fpsyg.2020.603394

 

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874060/