Anxiety

Improve Psychological Well-Being of Recovered Cardiorespiratory Patients with Mindfulness

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Improve Psychological Well-Being of Recovered Cardiorespiratory Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation can be a useful part of cardiovascular risk reduction. I do recommend it, along with diet and exercise. It can also help decrease the sense of stress and anxiety.” – Deepak Bhatt

 

Patients who experience cardiorespiratory failure have now a high likelihood of survival if they are treated promptly in an intensive care unit. Unfortunately, after physical recovery and discharge the patients often experience negative physical and psychological consequences. These include physical symptoms and psychological issues such as depression, anxiety, and post-traumatic stress symptoms, stress, fear and foreboding, emotional disability, and social disruption. Treatments are needed to help alleviate these troubling residual symptoms.

 

Mindfulness practices have been shown to improve depression, anxiety, and post-traumatic stress disorder (PTSD), stress, fear and foreboding, emotional disability, and social function. It would seem reasonable then to project that mindfulness practice may be beneficial for the psychological well-being of patients who have recovered from cardiorespiratory failure. But such patients generally find it difficult or impossible to come to a clinic for treatment. As an alternative, mindfulness training can be delivered remotely with smartphone apps. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations for treatment. But the question arises as to the effectiveness of these programs.

 

In today’s Research News article “Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460929/ ), Cox and colleagues recruited patients who had been released from the intensive care unit following cardiorespiratory failure and were at home. They were randomly assigned to receive a 4-session mindfulness training either by phone or smartphone app, or receive a web-based education program. They completed online measures of acceptability, feasibility, and usability and also were measured before and 3 months after the intervention for anxiety, depression, symptom severity, post-traumatic stress, physical distress, quality of life, coping skills, stress, and mindfulness.

 

The program was found to be acceptable, feasible, and usable as 83% of the patients completed the study with no significant differences between conditions. They found that in comparison to baseline and the education group, both mindfulness training groups had significant improvements in physical symptoms, posttraumatic stress symptoms, depression and anxiety. They also found that the greater the use of the mobile app the greater the improvement in depression.

 

The results of the study are encouraging and show that mindfulness training delivered either by telephone or a smartphone app is acceptable, feasible, and usable and is effective for the treatment of patients who were recovering from cardiorespiratory failure improving their physical and mental health. This is important as these patients are suffering and, like many others, have difficulty coming to a particular location at a particular time to receive therapist delivered mindfulness training. So, smartphone and phone-based programs are a valuable solution.

 

So, improve psychological well-being of recovered cardiorespiratory patients with mindfulness.

 

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – John Denninger

 

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

 

Cox, C. E., Hough, C. L., Jones, D. M., Ungar, A., Reagan, W., Key, M. D., … Porter, L. S. (2019). Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial. Thorax, 74(1), 33–42. doi:10.1136/thoraxjnl-2017-211264

 

Abstract

Background:

Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs.

Methods:

Pilot randomized clinical trial with 3-month follow up conducted at two academic medical centers. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomized after discharge home to one of three month-long interventions: a self-directed mobile app-based mindfulness program; a therapist-led telephone-based mindfulness program; or a web-based critical illness education program.

Results:

Among 80 patients allocated to mobile mindfulness (n= 31), telephone mindfulness (n=31), or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomization 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 [standard deviation 3.8]), and usability (mean Systems Usability Score 89.1 [SD 11.5]). For secondary outcomes, mean values (and 95% confidence intervals) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (−4.8 [−6.6, −2.9]), telephone (−3.9 [−5.6, −2.2]), education (−3.0 [−5.3, 0.8]); the Generalized Anxiety Disorder scale (mobile −2.1 [−3.7, −0.5], telephone −1.6 [−3.0, −0.1], education −0.6 [−2.5, 1.3]), the Post-Traumatic Stress Scale (mobile −2.6 [−6.3, 1.2], telephone −2.2 [−5.6, 1.2], education −3.5 [−8.0, 1.0]), and the Patient Health Questionnaire physical symptom scale (mobile −5.3 [−7.0, −3.7], telephone −3.7 [−5.2, 2.2], education −4.8 [−6.8, 2.7]).

Conclusions:

Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability, and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led program. A larger trial is warranted to formally test the efficacy of this approach.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460929/

 

Improve Depression, Anxiety, and Stress Symptoms and Lower Rumination with Mindfulness

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Improve Depression, Anxiety, and Stress Symptoms and Lower Rumination with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based practices have proved to be helpful in promoting mental well-being, especially by reducing the symptoms of depression and anxiety in various populations.” – Han Ding

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. There is a vast array of techniques for the development of mindfulness that include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices.

 

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. Another therapeutic technique is Compassion Focused Therapy (CFT). “It seeks to help individuals develop compassion for self and others . . . and includes cultivating mindfulness and body awareness. . . . MBCT puts the primary focus on cultivating mindfulness whereas CFT puts it on cultivating compassion toward self and others.”

 

In today’s Research News article “Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients With Depression, Anxiety, and Stress.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01099/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_999212_69_Psycho_20190528_arts_A), Frostadottir and colleagues recruited patients at a 4-week inpatient rehab clinic who were suffering from mild to moderate depression, anxiety, or stress symptoms. They were assigned to receive twice a week 2 hour sessions for 4 weeks of either Mindfulness-Based Cognitive Therapy (MBCT), Compassion Focused Therapy (CFT), or a wait-list control condition. They were measured before and after treatment and one month later for mindfulness, self-compassion, rumination, anxiety, depression, and stress.

 

They found that in comparison to baseline and the wait-list control group, the groups that received either Mindfulness-Based Cognitive Therapy (MBCT) or Compassion Focused Therapy (CFT) demonstrated significantly lower levels of rumination, anxiety, depression, and stress and significantly higher levels of mindfulness and self-compassion. These improvements were still present and significant at the 1-month follow-up. Those participants who were high in rumination had significantly higher posttreatment mindfulness for the MBCT group while CFT produced higher mindfulness regardless of rumination.

 

Since there wasn’t an active control group placebo effects and experimenter bias are possible alternative explanations for the changes. Other research however has routinely demonstrated that mindfulness training produces lower levels of anxiety, depression, stress symptoms, and rumination and higher levels of self-compassion and mindfulness. Hence, it is likely that the benefits seen in the present study were due to the interventions and not to artifact.

 

The results suggest that both Mindfulness-Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) are beneficial for the mental health of patients with mild to moderate depression, anxiety, or stress symptoms. Since, both therapies train mindfulness and both successfully increased mindfulness, it would appear that mindfulness training in general is beneficial to patients with mild to moderate mental health issues. So, the present study adds to the large literature demonstrating the benefits of mindfulness for psychological health.

 

So, improve depression, anxiety, and stress symptoms and lower rumination with mindfulness.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Frostadottir AD and Dorjee D (2019) Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients With Depression, Anxiety, and Stress. Front. Psychol. 10:1099. doi: 10.3389/fpsyg.2019.01099

 

Objectives: Over the past decade there has been an increasing interest in exploring self-compassion as a related and complementary construct to mindfulness. Increases in self-compassion may predict clinical outcomes after MBCT and cultivation of compassion toward self and others is central to CFT. This pilot study compared the impact of MBCT applying implicit self-compassion instructions and CFT employing explicit self-compassion instructions on symptom change, mindfulness, self-compassion, and rumination.

Method: This non-randomized wait-list controlled study (N = 58) with two intervention arms (MBCT N = 20, CFT N = 18, Control N = 20) assessed the outcomes of clients with depression, anxiety, and stress symptoms from before to after the interventions and at one month follow up (MBCT N = 17, CFT N = 13, Control N = 13).

Results: Both treatments resulted in significant increases in mindfulness and self-compassion and decreases in rumination, depression, anxiety, and stress. Furthermore, MBCT enhanced mindfulness for people who were initially high in rumination, whereas CFT enhanced mindfulness across the board.

Conclusion: The findings suggest that both MBCT and CFT, and hence implicit or explicit self-compassion instructions, produce similar clinical outcomes with CFT enhancing mindfulness regardless of client’s rumination level.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01099/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_999212_69_Psycho_20190528_arts_A

 

Reduce Anxiety with Acceptance and Commitment Therapy

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Reduce Anxiety with Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

“Self-compassionate people tend to have lower levels of social anxiety—perhaps because self-compassion includes mindfulness, which soothes the stress associated with anxiety.” – Jill Suttie

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) and also Cognitive Behavioral Therapy (CBT) have been shown to be effective in treating Social Anxiety Disorder (SAD).

 

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

 

In today’s Research News article “The effectiveness of acceptance and commitment group therapy on social anxiety in female dormitory residents in Isfahan university of medical sciences.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432841/), Toghiani and colleagues recruited female college students and randomly assigned them to receive 5-week, one 2-hour session per week, group Acceptance and Commitment Therapy (ACT) or to a no-treatment control group. Before the intervention and 2 months later the students were measured for social anxiety, performance anxiety and psychological flexibility.

 

They found that in comparison to baseline and the no-treatment control group, the students who received ACT had significantly reduced social anxiety, social avoidance, performance anxiety, and performance avoidance. These results must be interpreted cautiously as there was not an active control condition leaving open the possibility of placebo effects and experimenter bias effects. Nevertheless, the study suggests that ACT is an effective therapy to reduce anxiety in female college students with lasting effects.

 

So, reduce anxiety with Acceptance and Commitment Therapy.

 

“the art of mindfulness meditation practice. If you are suffering with the symptoms of social anxiety disorder (SAD), regular practice will eventually improve your self-concept and ability to handle negative emotions. You will also learn how to better respond to troubling thoughts and treat yourself with more compassion.” – Arlin Cuncic

 

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

 

Toghiani, Z., Ghasemi, F., & Samouei, R. (2019). The effectiveness of acceptance and commitment group therapy on social anxiety in female dormitory residents in Isfahan university of medical sciences. Journal of education and health promotion, 8, 41. doi:10.4103/jehp.jehp_111_18

 

Abstract

AIM AND BACKGROUND:

Social anxiety can interfere with performance and academic success in students. One of the third-generation treatments for social anxiety is acceptance and commitment therapy. Therefore, the current study aims to determine the effectiveness of acceptance and commitment group therapy on social anxiety of female dormitory residents of Isfahan University of Medical Sciences.

METHODS:

This was a semiempirical study with pre- and posttest conducted on 71 female students living in the dormitory of Isfahan University of Medical Sciences. The study was carried out in five training sessions using the Liebowitz Social Anxiety Scale and second version of acceptance and commitment scale whose validity and reliability were confirmed. Data were analyzed using Student’s t-test.

RESULTS:

The findings showed that acceptance and commitment group therapy has affected the social anxiety in female dormitory residents of Isfahan University of Medical Sciences (P < 0.0001).

CONCLUTIONS:

The findings of this study can be used by student deputies of universities, consultation centers, as well as counselors and psychologists to improve the conditions for students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432841/

 

Improve Sensory Discrimination with Alternate-Nostril Yoga Breathing

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Improve Sensory Discrimination with Alternate-Nostril Yoga Breathing

 

By John M. de Castro, Ph.D.

 

“alternate nostril breathing, has a long history in Ayurvedic medicine and yoga, where it’s thought to harmonize the two hemispheres of the brain, resulting in a balanced in physical, mental and emotional well-being.” – Paula Watkins

 

Yoga practice is becoming increasingly popular in the west, for good reason. It has documented benefits for the individual’s psychological and physical health and well-being. It has also been shown to have cognitive benefits, improving memory. Yoga, however, consists of a number of components including, poses, breathing exercises, meditation, concentration, and philosophy/ethics.  So, it is difficult to determine which facet or combination of facets of yoga are responsible for which benefit. Hence, it is important to begin to test each component in isolation to determine its effects.

 

Alternate nostril yoga breathing is a regulated breathing alternating between the left and right nostril that is commonly practiced in yoga. Breathing through each nostril is thought to affect its respective hemisphere in the brain producing differential effects. Recently, it has been shown to reduce blood pressure and increase vigilance and reduce perceived stress.

 

In today’s Research News article “Changes in Shape and Size Discrimination and State Anxiety After Alternate-Nostril Yoga Breathing and Breath Awareness in One Session Each.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6496972/), Telles and colleagues recruited healthy adult males with at least 3 months of yogic breathing practice. They each completed 3 sessions, alternate nostril breathing, breath awareness, and quiet sitting in counterbalanced orders. Each session consisted of three 5-minute practice periods separated by one minute. Before and after each session the participants competed measures of state and trait anxiety and completed a shape and size discrimination task involving inserting “50 coins and squares of different sizes and thickness into 5 slits of a wooden box, where each slit has been especially designed to allow a square or coin of a specific size and thickness to pass through it.”

 

They found that after the alternate nostril breathing session but not breath awareness or quiet sitting sessions there were significantly fewer error on the shape and size discrimination task. On the other hand, after the breath awareness or quiet sitting sessions but not the alternate nostril breathing session there were significantly lower levels of anxiety.

 

It would appear that alternate nostril breathing heightens awareness, increasing vigilance allowing for enhanced sensory discrimination ability while breath awareness and quiet sitting are calming reducing negative emotions. It’s interesting that different approaches to the breath have such large differences in their effects. This suggests that further research into the effects of the individual components of yoga practice may be a fruitful approach to understanding and potentially enhancing the benefits of yoga practice.

 

So, improve sensory discrimination with alternate-nostril yoga breathing.

 

“Alternate Nostril Breathing effectively reduces cortisol (stress) levels, increases mental focus, enhances immunity, and decreases depression and anxiety, with quick and lasting effects.” – Art of Living

 

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

 

Telles, S., Vishwakarma, B., Gupta, R. K., & Balkrishna, A. (2019). Changes in Shape and Size Discrimination and State Anxiety After Alternate-Nostril Yoga Breathing and Breath Awareness in One Session Each. Medical science monitor basic research, 25, 121–127. doi:10.12659/MSMBR.914956

 

Abstract

Background

Yoga breathing techniques like high-frequency yoga breathing (HFYB) and breath awareness (BAW) have been associated with improved performance in the shape and size discrimination task. A PubMed search of the literature revealed that alternate-nostril breathing has been shown to improve performance in attention tasks, but the effect on tactile perception has not been studied. Hence, the present study was designed to assess the immediate effects of alternate-nostril yoga breathing (ANYB) compared to breath awareness on shape and size discrimination and state anxiety.

Material/Methods

Fifty healthy male volunteers ages 20–50 years (group mean ±S.D., 28.4±8.2 years) were recruited. Each participant was assessed in 3 sessions conducted on 3 separate days at the same time of day. The 3 sessions were (i) alternate-nostril yoga breathing (ANYB), (ii) breath awareness (BAW), and (iii) quiet sitting (QS), and the sequence of the sessions was randomly allocated. The shape and size discrimination task and state anxiety were assessed before and after all 3 sessions. Repeated measures analysis of variance (RM-ANOVA) followed by post hoc tests for multiple comparisons, which were Bonferroni-adjusted, were performed to compare data before and after all 3 sessions using SPSS version 18.0.

Results

The errors scores in the shape and size discrimination task showed a significant reduction after the ANYB session (p<0.001). A significant reduction was found in the level of state anxiety after breath awareness (p<0.05) and quiet sitting sessions (p<0.001).

Conclusions

The present results suggest that ANYB: (i) improves performance in a task which requires perceptual sensitivity and focused attention, but (ii) does not reduce state anxiety following this task.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6496972/

 

Improve the Mental Health on Intensive Care Nurses with Mindfulness

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Improve the Mental Health on Intensive Care Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Nurses are particularly vulnerable to stress and burnout, with little time in their schedule to commit to self-care or intensive stress reduction programs” . . . on-the-job mindfulness-based intervention is viable for this nursing population. In addition to reductions in stress and burnout, participants also reported improved job satisfaction and self-compassion.” Mindful USC

 

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. This is particularly acute in intensive care. 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. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout in medical professionals in high stress areas.

 

In today’s Research News article “Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482227/), Lu and colleagues recruited intensive care nurses and had them complete measures of burnout, mindfulness, anxiety, depression, perceived stress, and subjective well-being. The measure of subjective well-being is a composite that includes a high level of satisfaction with life, more positive emotions, and fewer negative emotions.

 

They found that the higher the nurses’ levels of mindfulness the better the nurses’ mental health including lower levels of anxiety, depression, perceived stress, negative emotions and burnout and higher levels of subjective well-being, life satisfaction and positive emotions. They also found that the greater the levels of perceived stress the worse the nurses’ mental health including greater levels of burnout, negative emotions, anxiety, and depression, and lower levels of mindfulness, satisfaction with life, positive emotions, and life satisfaction. In addition, they found that mindfulness moderated the negative effects of perceived stress such that when mindfulness was high, perceived stress had a smaller relationship with emotional exhaustion, depression, anxiety, and negative affect and a larger relationship with positive affect.

 

In interpreting these results, it needs to be recognized that the study was correlational and as such causation cannot be determined. But previous research has already established that mindfulness produces reductions in burnout, anxiety, depression, perceived stress, and negative emotions and produces increases in life satisfaction, positive emotions, and subjective well-being. So, it is reasonable to conclude that the present findings were due to the causal effects of mindfulness. But the present findings add to this knowledge by showing that mindfulness not only directly improves the psychological state of the nurses but also acts to reduce the negative impact of stress.

 

These effects of mindfulness are important as burnout in high stress occupations like nursing is all too common. The results suggest that mindfulness training should be routinely administered to intensive care nurses to improve their well-being and mental health and reduce the likelihood that they will experience burnout.

 

So, improve the mental health on intensive care nurses with mindfulness.

 

Learning mindfulness also helped the ICU personnel to “become aware of what their individual stress response is” and to “practice flexibility in cultivating alternative ways” of dealing with chronic stress.” – Marianna Klatt

 

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

 

Lu, F., Xu, Y., Yu, Y., Peng, L., Wu, T., Wang, T., … Li, M. (2019). Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses. Frontiers in psychiatry, 10, 260. doi:10.3389/fpsyt.2019.00260

 

Abstract

This study aimed to explore the potential moderating effect of mindfulness and its facets on the relationships among perceived stress and mental health outcomes (burnout, depression, anxiety, and subjective well-being) among Chinese intensive care nurses. A total of 500 Chinese intensive care nurses completed self-report measures of mindfulness, burnout syndromes, perceived stress, depression, anxiety, and subjective well-being. Correlation and hierarchical multiple regressions were applied for data analysis. Mindfulness moderated the effects of perceived stress on emotional exhaustion (the core component of burnout syndrome), depression, anxiety, positive affect, and negative affect but not on the other two dimensions of burnout and life satisfaction. Further analyses indicated that the ability to act with awareness was particularly crucial in improving the effects of perceived stress on depression. These results further broaden our understanding of the relationships between perceived stress and burnout, depression, anxiety, and subjective well-being by demonstrating that mindfulness may serve as a protective factor that alleviates or eliminates the negative effects of perceived stress on depression, anxiety, burnout syndrome, and subjective well-being and may instigate further research into targeted mindfulness interventions for Chinese intensive care nurses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482227/

 

Mindfulness Training and Cognitive Therapy Improves Social Anxiety Disorder

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Mindfulness Training and Cognitive Therapy Improves Social Anxiety Disorder

 

By John M. de Castro, Ph.D.

 

“Using mindfulness, we can begin to notice what happens in the body when anxiety is present and develop strategies to empower clients to “signal safety” to their nervous system. Over time, clients feel empowered to slow down their response to triggers, manage their body’s fear response (fight-or-flight) and increase their ability to tolerate discomfort.” – Jeena Chi

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Stress Reduction (MBSR) and also Cognitive Behavioral Therapy (CBT) have been shown to be effective in treating Social Anxiety Disorder (SAD).

 

In today’s Research News article “Emotional clarity and attention to emotions in cognitive behavioral group therapy and mindfulness-based stress reduction for social anxiety disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879018/), Butler and colleagues recruited patients diagnosed with Social Anxiety Disorder (SAD) and a healthy control group and randomly assigned them to receive 12 weekly 2.5 hour sessions of either Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) or to a wait-list control condition. They were measured before and after treatment and 12 months later for emotional clarity, attention to emotions, and social anxiety.

 

They found that at baseline the patients with Social Anxiety Disorder (SAD) had significantly greater social anxiety and lower emotional clarity than the healthy controls. After treatment the patients who had received either MBSR or CBGT had significantly higher levels of emotional clarity than the wait-list controls. The effect remained 12 months later. They also found that the greater the changes in emotional clarity observed after treatment and at the 12-month follow-up, the greater the improvement in Social Anxiety Disorder (SAD). There were no significant effects on attention to emotions.

 

Emotional clarity is an aspect of emotional regulation which involves the ability to identify the emotion that is being experienced. The results suggest that this ability is enhanced by both Cognitive Behavioral Group Therapy (CBGT) and Mindfulness-Based Stress Reduction (MBSR) and that this improvement is related to the treatments ability to improve the symptoms of Social Anxiety Disorder (SAD). This is in line with the repeated finding that mindfulness training improves emotion regulation. The results further refine this understanding by identifying emotional clarity and not attention to emotions as the component of emotional regulation that’s important for improvements in SAD. So, being more sensitive to what is the identity of the emotion being experienced is helpful in dealing with social anxiety, but paying more attention to emotions is not. This further suggests that treatment focusing on emotional clarity may be even more effective in treating SAD.

 

So, improve social anxiety disorder with mindfulness training or cognitive therapy.

 

“The power of a mindfulness practice, however, may come in the realization that one can live a meaningful life even with social anxiety. Schjerning, who participated in Fleming and Kocovski’s group, says that he still feels nervous in social situations but now feels compassion — not judgment — for himself, and sees that “I can be more the person I want to be.” – Jason Drwal

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Butler, R. M., Boden, M. T., Olino, T. M., Morrison, A. S., Goldin, P. R., Gross, J. J., & Heimberg, R. G. (2018). Emotional clarity and attention to emotions in cognitive behavioral group therapy and mindfulness-based stress reduction for social anxiety disorder. Journal of anxiety disorders, 55, 31–38. doi:10.1016/j.janxdis.2018.03.003

 

Highlights

We examined emotional clarity (EC) and attention to emotion in patients with social anxiety disorder (SAD).

  • Patients demonstrated lower levels of EC than healthy controls.
  • Cognitive-behavioral group therapy increased EC more than a waitlist.
  • Mindfulness-based stress reduction did not increase EC more than a waitlist.
  • Changes in emotional clarity predicted changes in social anxiety.
  • Analyses involving attention to emotions were not significant.

Abstract

We examined (1) differences between controls and patients with social anxiety disorder (SAD) in emotional clarity and attention to emotions; (2) changes in emotional clarity and attention to emotions associated with cognitive-behavioral group therapy (CBGT), mindfulness-based stress reduction (MBSR), or a waitlist (WL) condition; and (3) whether emotional clarity and attention to emotions moderated changes in social anxiety across treatment. Participants were healthy controls (n = 37) and patients with SAD (n=108) who were assigned to CBGT, MBSR, or WL in a randomized controlled trial. At pretreatment, posttreatment, and 12-month follow-up, patients with SAD completed measures of social anxiety, emotional clarity, and attention to emotions. Controls completed measures at baseline only. At pretreatment, patients with SAD had lower levels of emotional clarity than controls. Emotional clarity increased significantly among patients receiving CBGT, and changes were maintained at 12-month follow-up. Emotional clarity at posttreatment did not differ between CBGT and MBSR or between MBSR and WL. Changes in emotional clarity predicted changes in social anxiety, but emotional clarity did not moderate treatment outcome. Analyses of attention to emotions were not significant. Implications for the role of emotional clarity in the treatment of SAD are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879018/

 

Improve Mental Health and Well-Being of College Students with Mindfulness

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Improve Mental Health and Well-Being of College Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Student life can be stressful, but that doesn’t mean students have to let stress take over their lives. By incorporating mindfulness and meditation into daily routines, students can not only relieve the pressure, but also improve their memory, focus and ultimately their grades.” – Todd Braver

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students. So, it would seem important to examine various techniques to relieve the stress and its consequent symptoms in college students.

 

In today’s Research News article “The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491852/), Breedvelt and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mindfulness practices for the mental health and well-being of college students. They identified 23 published studies employing a total of 1373 students.

 

They found that the published research reported that in comparison to baseline and no-treatment or wait-list control conditions mindfulness practices including meditation, mindfulness, and yoga practice produced significant reductions in anxiety, depression, and perceived stress. The effects were still present as much as 24 months later. They did not find any significant differences in the effectiveness of the various practices. These effects were most evident when mindfulness practices were compared to no-treatment or wait-list control conditions. When compared to active controls (drugs, exercise, Cognitive Behavioral Therapy) the effects were much smaller and non-significant.

 

The results suggest that there are many practices including mindfulness, exercise, or other therapies that are effective in improving the mental health of college students. Mindfulness practices are safe and effective treatments but so are other treatments. It would appear that it doesn’t matter so much what treatment is employed, but that some treatment occurs.

 

So, improve mental health and well-being of college students with mindfulness.

 

“a mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.” – J. Galante–

 

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

 

Breedvelt, J., Amanvermez, Y., Harrer, M., Karyotaki, E., Gilbody, S., Bockting, C., … Ebert, D. D. (2019). The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis. Frontiers in Psychiatry, 10, 193. doi:10.3389/fpsyt.2019.00193

 

Abstract

Background: Meditation, yoga, and mindfulness are popular interventions at universities and tertiary education institutes to improve mental health. However, the effects on depression, anxiety, and stress are unclear. This study assessed the effectiveness of meditation, yoga, and mindfulness on symptoms of depression, anxiety, and stress in tertiary education students.

Methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, PsycINFO and identified 11,936 articles. After retrieving 181 papers for full-text screening, 24 randomized controlled trials were included in the qualitative analysis. We conducted a random-effects meta-analysis amongst 23 studies with 1,373 participants.

Results: At post-test, after exclusion of outliers, effect sizes for depression, g = 0.42 (95% CI: 0.16–0.69), anxiety g = 0.46 (95% CI: 0.34–0.59), stress g = 0.42 (95% CI: 0.27–0.57) were moderate. Heterogeneity was low (I2 = 6%). When compared to active control, the effect decreased to g = 0.13 (95% CI: −0.18–0.43). No RCT reported on safety, only two studies reported on academic achievement, most studies had a high risk of bias.

Conclusions: Most studies were of poor quality and results should be interpreted with caution. Overall moderate effects were found which decreased substantially when interventions were compared to active control. It is unclear whether meditation, yoga or mindfulness affect academic achievement or affect have any negative side effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491852/

 

Improve Psychiatric Disorders with Mindfulness

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Improve Psychiatric Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Is mindfulness better than medication or other therapies? No, probably not; But if you are someone who doesn’t believe in taking medication or seeing an individual therapist you might be more inclined to engage in the practice of mindfulness. So, it becomes, ‘OK, we have a modality that people like, it’s appealing and accessible to them, so they’re more motivated to use it.’ [In that case] mindfulness may work better for them.” – Patricia Rockman

 

There are vast numbers of people who suffer with mental illnesses. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxiety, depression, psychoses, addictions, etc..

 

The research is accumulating. Hence it makes sense to step back and summarize what has been learned regarding the effectiveness of mindfulness-based treatments for psychiatric conditions. In today’s Research News article “Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741505/), Goldberg and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness-based treatments for psychiatric conditions. They examined randomized controlled trials that employed mindfulness trainings that included meditation practice and home practice. Any psychiatric disorder, including schizophrenia, addictions, eating disorders, anxiety, smoking and chronic pain, were included with depression the most frequently studied. They identified 142 randomized controlled trials that included a total of 12,005 participants.

 

They found that mindfulness treatments produced significantly greater improvements in psychiatric symptoms than no-treatment control conditions, minimal treatment, non-specific active, and specific active control conditions. They also found that mindfulness treatments produced equivalent improvements in psychiatric symptoms, when compared to evidence-based treatments such as cognitive behavioral therapy (CBT) and drugs. These effects were present immediately after treatment and at follow-up on average 6.43 months after the conclusion of treatment.

 

These results are remarkable. Mindfulness treatments were found to be safe, effective, and lasting for a wide variety of psychiatric disorders and as effective as recognized evidenced based treatments including drug treatments. It is amazing that such a simple and safe treatment could be effective for such a range of disorders, virtually any disorder. How this could be possible is not known, and should be a focus of future research. But focusing on the present moment would appear to an important mechanism for redirecting thinking away from the focus on past and future that appears to produce stress and exacerbate the disorders.

 

So, improve psychiatric disorders with mindfulness.

 

“While mindfulness might seem unconventional, it’s an increasingly accepted method of achieving a healthier mind. Therapists who teach mindfulness techniques to their clients do so to help them cope with mental health challenges and strive for a sense of peace.” – Faith Onimiya

 

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

 

Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2017). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical psychology review, 59, 52–60. doi:10.1016/j.cpr.2017.10.011

 

Abstract

Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d = 0.55), minimal treatment (d = 0.37), non-specific active controls (d = 0.35), and specific active controls (d = 0.23). Mindfulness conditions did not differ from evidence-based treatments (d = −0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d = 0.50), non-specific active controls (d = 0.52), and specific active controls (d = 0.29). Mindfulness conditions did not differ from minimal treatment conditions (d = 0.38) and evidence-based treatments (d = 0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741505/

 

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

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

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

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

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

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

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

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

 

Relieve Anxiety Disorders with Online Acceptance and Commitment Therapy

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Relieve Anxiety Disorders with Online Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

 

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

 

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

 

So, relieve anxiety disorders with online acceptance and commitment therapy

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Background

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

Objective

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

Methods

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

Results

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

Conclusions

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

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