Depression

Mindfulness Training Improves Major Depression after One but Not Two Years

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Mindfulness Training Improves Major Depression after One but Not Two Years

 

By John M. de Castro, Ph.D.

 

“Depression is not only the most common mental illness, it’s also one of the most tenacious. Up to 80 percent of people who experience a major depressive episode may relapse. Drugs may lose their effectiveness over time, if they work at all. But a growing body of research is pointing to an intervention that appears to help prevent relapse by altering thought patterns without side effects: mindfulness-based cognitive therapy, or MBCT.” – Stacy Lu

 

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 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. Most studies, however, only follow the patients for 6 months to a year following therapy. Hence, there is a need to examine the effectiveness of MBCT for the prevention of major depressive disorder relapse over longer post-intervention periods.

 

In today’s Research News article “Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month Follow-Up of Mindfulness-Based Cognitive Therapy Versus an Active Control.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112178/), Shallcross and colleagues recruited adults who had experienced at least 3 previous bouts of depression and randomly assigned them to receive either an 8-week group program of Mindfulness-Based Cognitive Therapy (MBCT) or an health education active control condition. They were measured for relapse reoccurrence, practice amounts, depression, life satisfaction, and antidepressant medication use at 6, 12, and 26 months after the intervention.

 

They found in comparison to baseline and the active control condition that both groups had significant decreases in depressive symptoms and increases in life satisfaction but the patients who received Mindfulness-Based Cognitive Therapy (MBCT) had significantly greater reductions in depressive symptoms over the 12 months following the intervention. But at 26 months after the intervention there were no significant differences between the groups. In addition, over the 26-month post-intervention period there were no significant differences between the groups in relapse rates or life satisfaction.

 

Importantly, at the end of the 26 months both groups were still below baseline in both depressive symptoms and well above baseline in life satisfaction. So, both interventions appeared to significantly improve the depression. This suggests that at 2-years after the intervention it wasn’t the content but the fact of intervention that was significant. This further suggests that powerful placebo effects, demand characteristics, experimenter bias effects, etc. may be responsible for the long-term improvements. Hence it would appear that the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression is limited to a 1-year postintervention period. This further suggests that refresher sessions may be needed to maintain effectiveness.

 

So, mindfulness training improves major depression after one but not two years.

 

“MBCT and CT attempt to reduce the risk of relapse by promoting different skill sets. CT promotes challenging dysfunctional thinking and increasing physical activity level. MBCT promotes nonjudgmental monitoring of moment-by-moment experience, and decentering from thoughts or seeing thoughts as transient mental phenomena and not necessarily valid.” – American Mindfulness Research Association

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Shallcross, A. J., Willroth, E. C., Fisher, A., Dimidjian, S., Gross, J. J., Visvanathan, P. D., & Mauss, I. B. (2018). Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month Follow-Up of Mindfulness-Based Cognitive Therapy Versus an Active Control. Behavior therapy, 49(5), 836–849. doi:10.1016/j.beth.2018.02.001

 

Highlights

  • Study tested effects MBCT vs. active control condition (ACC) beyond 12-month trial
  • No emergent effects of MBCT vs. ACC were found over 26-month follow-up
  • Symptom reduction that initially favored MBCT was not sustained past 12 months
  • MBCT is not more effective than ACC for depression outcomes over 26-month follow-up
  • No evidence for effect moderation was found for any outcome

Abstract

We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n=46) or ACC (n=46). Outcomes were assessed at baseline, post-intervention, and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26 month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio (HR) = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from post-intervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b=-4.12, p<=.008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112178/

Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

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Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga classes specifically created for cancer patients offer more than a traditional support group. Yoga creates a sense of belonging, reduces feelings of stress and improves quality of life.” – Sara Szeglowski

 

“Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets” (Cancer Support Community). It typically occurs in older adults and is fairly rare (1-2 cases/100,000 per year) and has a very high survival rate. It produces a variety of psychological and physical symptoms including fatigue, anxiety, pain, depression, and sleep disturbance, reduced physical, social, and cognitive functioning resulting. This produces a marked reduced in the patient’s quality of life.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health including fatigue, anxiety, depression, pain, and sleep disturbance, and improves physical, social, and cognitive functioning as well as quality of life in cancer patients. Yoga practice also improves the physical and mental health of cancer patients. The vast majority of the yoga practice, however, requires a trained instructor. It also requires that the participants be available to attend multiple sessions at particular scheduled times that may be difficult for myeloproliferative neoplasm patients to attend and may or may not be compatible with their schedules and at locations that may not be convenient.

 

As an alternative, online yoga trainings 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 online programs in relieving the psychological and physical symptoms of myeloproliferative neoplasm patients and improving their quality of life.

 

In today’s Research News article “Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556039/), Huberty and colleagues recruited adult myeloproliferative neoplasm patients and randomly assigned them to either receive online yoga training or to a wait-list control condition. Yoga training occurred via streamed videos for a total of 60 minutes training per week for 12 weeks. The individual training videos increased in duration from 5 minutes to 30 minutes over the 12 weeks. The participants were measured for adverse events and yoga participation by self-report and by clicking on the video links and over the training period. Before and after training they were measured for total symptoms, fatigue, pain intensity, anxiety, depression, sleep disturbance, sexual function, and quality of life. In, addition, blood was drawn and assayed for inflammatory cytokines.

 

They found that 79% of the patients in the yoga group completed participation averaging 42 minutes per week and there were no adverse events reported. Self-reports of yoga participation were over-reported by on average 10 minutes as assessed by actual clicks on the yoga video links. They found that in comparison to baseline and the wait-list group, the yoga group reported a moderate decrease in depression and small decreases in anxiety, pain intensity, sleep disturbance, and in TNF-α blood levels.

 

This was a pilot feasibility study and did not have a sufficient number of participants to detect small effects. It also lacked an active control, such as aerobic exercise. Nevertheless, the trial suggests that teaching yoga online is feasible and can successfully improve the psychological health of myeloproliferative neoplasm patients and reduce inflammation. This is potentially important as yoga treatment can be successfully employed remotely, inexpensively, and conveniently and can reduce the suffering of myeloproliferative neoplasm patients. A large randomized clinical trial with an active control condition is justified by these encouraging results.

 

So, improve the symptoms of myeloproliferative neoplasm patients with online yoga.

 

“Some people with cancer say it helps calm their mind so that they can cope better with their cancer and its treatment. Others say it helps to reduce symptoms and side effects such as pain, tiredness, sleep problems and depression.” – Cancer Research UK

 

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

 

Huberty, J., Eckert, R., Dueck, A., Kosiorek, H., Larkey, L., Gowin, K., & Mesa, R. (2019). Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC complementary and alternative medicine, 19(1), 121. doi:10.1186/s12906-019-2530-8

 

Abstract

Background

Myeloproliferative neoplasm (MPN) patients suffer from significant symptoms, inflammation and reduced quality of life. Yoga improves these outcomes in other cancers, but this hasn’t been demonstrated in MPNs. The purpose of this study was to: (1) explore the limited efficacy (does the program show promise of success) of a 12-week online yoga intervention among MPN patients on symptom burden and quality of life and (2) determine feasibility (practicality: to what extent a measure can be carried out) of remotely collecting inflammatory biomarkers.

Methods

Patients were recruited nationally and randomized to online yoga (60 min/week of yoga) or wait-list control (asked to maintain normal activity). Weekly yoga minutes were collected with Clicky (online web analytics tool) and self-report. Those in online yoga completed a blood draw at baseline and week 12 to assess inflammation (interleukin-6, tumor necrosis factor-alpha [TNF-α]). All participants completed questionnaires assessing depression, anxiety, fatigue, pain, sleep disturbance, sexual function, total symptom burden, global health, and quality of life at baseline, week seven, 12, and 16. Change from baseline at each time point was computed by group and effect sizes were calculated. Pre-post intervention change in inflammation for the yoga group was compared by t-test.

Results

Sixty-two MPN patients enrolled and 48 completed the intervention (online yoga = 27; control group = 21). Yoga participation averaged 40.8 min/week via Clicky and 56.1 min/week via self-report. Small/moderate effect sizes were generated from the yoga intervention for sleep disturbance (d = − 0.26 to − 0.61), pain intensity (d = − 0.34 to − 0.51), anxiety (d = − 0.27 to − 0.37), and depression (d = − 0.53 to − 0.78). A total of 92.6 and 70.4% of online yoga participants completed the blood draw at baseline and week 12, respectively, and there was a decrease in TNF-α from baseline to week 12 (− 1.3 ± 1.5 pg/ml).

Conclusions

Online yoga demonstrated small effects on sleep, pain, and anxiety as well as a moderate effect on depression. Remote blood draw procedures are feasible and the effect size of the intervention on TNF-α was large. Future fully powered randomized controlled trials are needed to test for efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556039/

 

Improve Chronic Obstructive Pulmonary Disease (COPD) Symptoms with Qigong

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Improve Chronic Obstructive Pulmonary Disease (COPD) Symptoms with Qigong

 

By John M. de Castro, Ph.D.

 

“Along with traditional medical treatments, pulmonary exercise has been utilized to increase endurance during physical activity and decrease breathlessness.  Reports using TaiQi and Qigong have shown better functional capacity and pulmonary function in patients with COPD.” – Ryan Killarney

 

Chronic Obstructive Pulmonary Diseases (COPD) are progressive lung diseases that obstruct airflow. The two main types of COPD are chronic bronchitis and emphysema. COPD is very serious being the third leading cause of death in the United States, over 140,000 deaths per year and the number of people dying from COPD is growing. More than 11 million people have been diagnosed with COPD, but an estimated 24 million may have the disease without even knowing it. COPD causes serious long-term disability and early death. Symptoms develop slowly. Over time, COPD can interfere with the performance of routine tasks and is thus a major cause of disability in the United States. COPD is not contagious. Most of the time, treatment can ease symptoms and slow progression.

 

There is no cure for Chronic Obstructive Pulmonary Diseases (COPD). Treatments include lifestyle changes, medicine, bronchodilators, steroids, pulmonary rehabilitation, oxygen therapy, and surgery. They all attempt to relieve symptoms, slow the progress of the disease, improve exercise tolerance, prevent and treat complications, and improve overall health. Mindful Movement practices such Tai Chi and qigong are ancient Chinese practices involving mindfulness and gentle movements. They are easy to learn, safe, and gentle. So, it may be appropriate for patients with COPD who lack the ability to engage in strenuous exercises to engage in these gentle practices.

 

In today’s Research News article “Effect of Qigong on self-rating depression and anxiety scale scores of COPD patients: A meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708806/), Wu and colleagues review, summarize, and perform a meta-analysis of the published research findings of the effectiveness of Qigong practice in the treatment of Chronic Obstructive Pulmonary Diseases (COPD). They found 6 published randomized controlled trials including a total of 415 participants.

 

They report that the research studies found that Qigong practice produced significant improvements in lung function and significant reductions in anxiety and depression in the patients with Chronic Obstructive Pulmonary Diseases (COPD). It is not known if the improvement in lung function was responsible for the mood improvements in the patients or if this was an independent effect of  Qigong practice. Since Qigong is usually practiced in groups, the increased socialization may also have been responsible for the improvements in mood.

 

These are interesting and important findings. Qigong practice is a very gentle exercise that only mildly increases respiration and as such it is surprising that there were such marked improvements in lung function. But the results clearly suggest that Qigong practice is an excellent safe and effective treatment for Chronic Obstructive Pulmonary Diseases (COPD) improving the patients physical and psychological well-being.

 

So, improve Chronic Obstructive Pulmonary Disease (COPD) symptoms with Qigong.

 

“The gentle movements of tai chi can improve the lives and boost the exercise endurance of people with chronic obstructive pulmonary disease.” – Matt McMillen

 

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

 

Wu, J. J., Zhang, Y. X., Du, W. S., Jiang, L. D., Jin, R. F., Yu, H. Y., … Han, M. (2019). Effect of Qigong on self-rating depression and anxiety scale scores of COPD patients: A meta-analysis. Medicine, 98(22), e15776. doi:10.1097/MD.0000000000015776

 

Abstract

Objective:

To explore the clinical efficacy and safety of Qigong in reducing the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores of patients with chronic obstructive pulmonary disease (COPD).

Methods:

We searched CNKI, Wan fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE for studies published as of Dec 31, 2018. All randomized controlled trials of Qigong in COPD patients, which met the inclusion criteria were included. The Cochrane bias risk assessment tool was used for literature evaluation. RevMan 5.3 software was used for meta-analysis.

Results:

Six studies (combined n = 415 patients) met the inclusion criteria. Compared with conventional therapy alone, Qigong in combination with conventional therapy significantly improved the following outcome measures: SDS score [mean difference (MD) −3.99, 95% CI (−6.17, −1.82), P < .001, I2 = 69%]; SAS score[MD −4.57, 95% CI (−5.67, −3.48), P < .001, I2 = 15%]; forced expiratory volume in one second/prediction (FEV1% pred) [MD 3.77, 95% CI (0.97,6.58), P < .01, I2 = 0]; forced expiratory volume in one second (FEV1) [MD 0.21, 95% CI (0.13, 0.30), P < .001, I2 = 0%]; forced vital capacity (FVC) [MD 0.28, 95% CI (0.16, 0.40), P < .001, I2 = 0]; 6-minute walk test (6MWT) distance [MD 39.31, 95% CI (18.27, 60.34), P < .001, I2 = 32%]; and St. George’s Respiratory Questionnaire (SGRQ) total score [MD −11.42, 95% CI (−21.80, −1.03), P < .05, I2 = 72%].

Conclusion:

Qigong can improve the SDS and SAS scores of COPD patients, and has auxiliary effects on improving lung function, 6MWT distance, and SGRQ score.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708806/

 

Increase Self-Compassion and Decrease Mind Wandering in Depression with Mindfulness

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Increase Self-Compassion and Decrease Mind Wandering in Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“MBCT program is a group intervention that allows participants to become aware of how conditioned patterns of mind and mood can trigger depression relapse and sustain current symptoms of depression.  Through the practice of mindful awareness, they develop the capacity to mindfully disengage from distressing moods and negative thoughts.” – Center for Mindfulness in Medicine

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. 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.

 

Mindfulness-Based Cognitive Therapy (MBCT) is an alternative treatment to drugs that 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. The exact mechanisms by which MBCT improves depression need exploration.

 

In today’s Research News article “Compassionate Hearts Protect Against Wandering Minds: Self-compassion Moderates the Effect of Mind-Wandering on Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426326/), Greenberg and colleagues recruited depressed adults and randomly assigned them to receive either 8 weekly 2-hour sessions of Mindfulness-Based Cognitive Therapy (MBCT) or to a wait list control condition. MBCT participants were also asked to practice at home. All participants continued to receive their usual treatments. They were measured before and after treatment for depression, self-compassion, and mind wandering.

 

They found that prior to treatment the higher the levels of depression, the higher the levels of mind wandering and the lower the levels of self-compassion and that the higher the levels of self-compassion the lower the levels of mind wandering. They also found that participants who were low in mind wandering were significantly lower in depression, but only for participants who were also low in self-compassion. For those high in self-compassion there was no relationship between mind wandering and depression. Only those participants who were both low in self-compassion and high in mind wandering were depression scores high.

 

Compared to baseline and the wait-list controls, participants who received Mindfulness-Based Cognitive Therapy (MBCT) had significantly greater reductions in depression and mind wandering and increases in self-compassion.  They also found that the higher the levels of self-compassion at the beginning of training the larger the improvement in depression produced by MBCT. The improvements in depression were also associated with improvements in mind wandering.

 

The study reveals that self-compassion moderates the relationship of mind wandering with depression such that mind wandering is only associated with depression when self-compassion is low. In other words, when a participant has low levels of compassion for themselves they are vulnerable to the ability of a wandering mind to make depression worse. Mindfulness-Based Cognitive Therapy (MBCT) was shown to improve depression, mind wandering, and self-compassion and the degree of impact of MBCT on depression was dependent on the levels of self-compassion, with high self-compassion associated with greater improvement.

 

So, self-compassion appears to be a critical variable in the relationship of mind wandering with depression and the effectiveness of MBCT on depression. This further suggests that training in self-compassion may be able to help reduce depression and improve the impact of mindfulness-based treatments on depression.

 

So, increase self-compassion and decrease mind wandering in depression with mindfulness.

 

“ When you’re struggling with depression, the last thing you want to do is be self-compassionate. But this is precisely what can help.” – Margarita Tartakovsky

 

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

 

Greenberg, J., Datta, T., Shapero, B. G., Sevinc, G., Mischoulon, D., & Lazar, S. W. (2018). Compassionate Hearts Protect Against Wandering Minds: Self-compassion Moderates the Effect of Mind-Wandering on Depression. Spirituality in clinical practice (Washington, D.C.), 5(3), 155–169. doi:10.1037/scp0000168

 

Abstract

Depression is associated with high levels of mind-wandering and low levels of self-compassion. However, little is known about whether and how these two factors interact with one another to influence depressive symptoms. The current study examined the interaction between mind-wandering, self-compassion and depressive symptoms in a depressed sample and tested the effects of an eight-week Mindfulness Based Cognitive Therapy (MBCT) program on these constructs. At baseline, mind-wandering was associated with higher depressive symptoms only among individuals with low self-compassion. Self-compassion additionally predicted depressive improvement. As expected, MBCT increased self-compassion and reduced mind-wandering compared to a treatment-as-usual control group. Overall, longitudinal changes in self-compassion produced a moderation effect similar to the one at baseline so that increases in mind-wandering were associated with increases in depressive symptoms only among those who decreased in self-compassion. Results provide the first evidence that self-compassion can protect against the deleterious effects of mind-wandering among depressed participants, both at baseline and longitudinally. Findings also suggest that self-compassion is an effective predictor of depressive improvement. Finally, MBCT is effective not only at reducing depressive symptoms, but also at targeting protective and risk factors associated with depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426326/

 

Improve Adolescent Psychological Health with Mindfulness

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Improve Adolescent Psychological Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It may be that mindfulness leads to an increase in self-compassion and a decrease in experiential avoidance. It may be selective attention — if you focus on your breath, you have less bandwidth to ruminate. There are a lot of factors that are operative and we’re just beginning to tease out and deconstruct them. It’s like tasting a soup with 10 spices. Is there one main ingredient or is the flavor a combination of things?” – Stuart Eisendrath

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required.

 

Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training in adults has been shown to reduce anxiety and depression levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health.

 

In today’s Research News article “Effects Of Modified Mindfulness-Based Stress Reduction (MBSR) On The Psychological Health Of Adolescents With Subthreshold Depression: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6758632/), Zhang and colleagues recruited university students (aged 18-22 years) who scored high in depression but were not at clinically diagnosable levels. They were randomly assigned to receive either an 8-week Mindfulness-Based Stress Reduction (MBSR) program or to a no-treatment control condition. They were measured before and after training for depression, mindfulness, and rumination.

 

The MBSR program consists of 8 weekly 1-hour group sessions involving meditation, yoga, body scan, and discussion. The participants are also encouraged to perform daily practice. The program was modified to be better targeted at adolescents. It instructed the adolescents on the application of mindfulness practices to everyday life, including experiencing the pleasant/sad moments in life, walking, sleeping, eating, breathing and exercising to keep the attitude of “mindfulness”.

 

They found that in comparison to baseline and the no-treatment control condition the Mindfulness-Based Stress Reduction (MBSR) program produced large and significant decreases in depression and rumination and increases in mindfulness. Hence, the study demonstrated that a Mindfulness-Based Stress Reduction (MBSR) modified for adolescents is a safe and effective treatment to improve the psychological health of adolescents who had subclinical levels of depression.

 

It should be mentioned that the control condition did not include any activities and thus leaves open the possibilities of confounding by experimenter or participant bias or placebo effects. Also, the lack of a standard MBSR program for comparison to the modified program does not allow for a conclusion that the modifications produced an improved program. Nevertheless the results are encouraging that the modified MBSR program may be useful in relieving the suffering of the large numbers of adolescents with sub-clinical depression.

 

So, improve adolescent psychological health with mindfulness.

 

“It is well-documented that mindfulness helps to relieve depression and anxiety in adults.1-4 A small but growing body of research shows that it may also improve adolescent resilience to stress through improved cognitive performance and emotional regulation.” – Malka Main

 

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

 

Zhang, J. Y., Ji, X. Z., Meng, L. N., & Cai, Y. J. (2019). Effects Of Modified Mindfulness-Based Stress Reduction (MBSR) On The Psychological Health Of Adolescents With Subthreshold Depression: A Randomized Controlled Trial. Neuropsychiatric disease and treatment, 15, 2695–2704. doi:10.2147/NDT.S216401

 

Abstract

Background

Sub-threshold depression (SD) has been associated with impairments in adolescent health which increase the rate of major depression. Researchers have shown the effectiveness of mindfulness on mental health, however whether the traditional mindful skills were suitable for youngsters, it was not clear. This study investigated the effects of a tailed Mindfulness-based stress reduction (MBSR) on their psychological state.

Methods

A double-blind, randomized controlled trial was carried out. 56 participants who met the inclusion criteria agreed to be arranged randomly to either the MBSR group (n=28) or the control group (n=28). Participants in MBSR group received a tailored 8-week, one time per week, one hour each time group intervention. The effectiveness of intervention was measured using validated scales, which including BDI-II, MAAS, RRS at three times (T1-before intervention; T2-after intervention; T3-three months after intervention). A repeated-measures analysis of variance model was used to analyze the data.

Results

The results showed significant improvements in MBSR group comparing with control group that depression level decreased after the 8-week intervention and the follow up (F =17.721, p < 0.00). At the same time, RRS score was significantly decreased at T2 and T3(F= 28.277, p < 0.00). The results also showed that MBSR promoted the level of mindfulness and the effect persisted for three months after intervention (F=13.489, p < 0.00).

Conclusion

A tailored MBSR intervention has positive effects on psychology health among SD youngsters, including decrease depression and rumination level, cultivate mindfulness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6758632/

 

Improve Emotion Regulation in Teacher Trainees with Mindfulness

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Improve Emotion Regulation in Teacher Trainees with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful emotion regulation represents the capacity to remain mindfully aware at all times, irrespective of the apparent valence or magnitude of any emotion that is experienced. It does not entail suppression of the emotional experience, nor any specific attempts to reappraise or alter it in any way. Instead, MM involves a systematic retraining of awareness and nonreactivity, leading to defusion from whatever is experienced, and allowing the individual to more consciously choose those thoughts, emotions and sensations they will identify with, rather than habitually reacting to them.” – Richard Chambers

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

Teachers experience burnout at high rates. Roughly a half a million teachers out of a workforce of three million, leave the profession each year and the rate is almost double in poor schools compared to affluent schools. Indeed, nearly half of new teachers leave in their first five years. Burnout frequently results from emotional exhaustion. Hence, methods of improving teacher emotion regulation need to be studied. Intervening during teacher training may be a useful strategy as improving emotion regulation very early before the teaching career begins may prepare the teachers to better deal with the difficulties of their profession.

 

In today’s Research News article “Improving emotion regulation and mood in teacher trainees: Effectiveness of two mindfulness trainings.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749600/), Wimmer and colleagues recruited college students who intended to become school teachers and assigned them to one of four conditions, mindfulness training with yoga, mindfulness training without yoga, awareness training, or no-treatment. The mindfulness training was based upon Mindfulness-Based Stress Reduction (MBSR). The modified MBSR program consisted of 7 weekly 1.5-hour group sessions involving meditation, yoga, body scan, and discussion. The teachers are also encouraged to perform 20 minutes of daily practice. Awareness training occurred on a similar schedule and emphasized reflections on consciousness and awareness. They were measured before and after training for emotion regulation, response style, and positive and negative emotions.

 

They found that in comparison to the no-treatment control and baseline both mindfulness groups had significant increases in reappraisal and decreases in symptom‐focused rumination, distraction, and depressive mood. These effects of mindfulness training were found to be, in part, mediated by the distraction strategy of emotion regulation. There were no significant differences in the effects of mindfulness training with and without yoga on emotion regulation or mood.

 

These results suggest that mindfulness training regardless of whether yoga is included is effective in increasing emotion regulation in college students aspiring to become teachers. It is interesting that distraction was to some extent a mediator of the effects of mindfulness training. This strategy involves dealing with strong emotions by shifting attention to more pleasant aspects of the situation. Mindfulness training, by improving attentional control, may facilitate the ability to shift attention to other distracting areas.

 

It is not known whether these effects of mindfulness training are lasting and may influence the students’ abilities to deal with the stresses of teaching in the future. It would be hoped that mindfulness training may help to prepare prospective teachers to effectively work with the emotions that arise from their profession. This would then improve their resistance to professional burnout. It remains for future research to investigate the longevity of the emotion regulation improvements.

 

So, improve emotion regulation in teacher trainees with mindfulness.

 

“our emotions don’t have to take over your life or interfere with your important relationships when you learn how to understand, manage, and respond to your emotions more effectively. Become mindful of your own personal tendencies and emotional triggers. Notice what situations tend to prompt emotional responses in you. When you increase self-knowledge in this way, you are better prepared to competently and confidently employ emotion regulation coping skills no matter what the situation.” – Laura Chang

 

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

 

Wimmer, L., von Stockhausen, L., & Bellingrath, S. (2019). Improving emotion regulation and mood in teacher trainees: Effectiveness of two mindfulness trainings. Brain and behavior, 9(9), e01390. doi:10.1002/brb3.1390

 

Abstract

Background/Objective

The present research investigated potential effects of mindfulness training on emotion regulation and mood of future schoolteachers in a nonrandomized pre–post design, and whether these are influenced by the yoga component of mindfulness‐based stress reduction (MBSR) and/or by homework practice.

Method

N = 169 university students received either mindfulness training (experimental groups), awareness activities (active control group), or no training (passive control group), in the context of university seminars. Allocation to groups was bound by the seminar chosen by participants, and in that sense was self‐selected. Mindfulness was trained in two adapted MBSR courses, one of which including yoga, and the other excluding yoga.

Results

Specific benefits of both mindfulness training groups were observed for emotion regulation in terms of an increase in cognitive reappraisal and a reduction in symptom‐focused rumination as well as depressive mood. No benefits of mindfulness training were observed for reductions in expressive suppression, self‐focused rumination, anxious, and negative mood or an increase in distraction and positive mood respectively. Mindfulness training with and without yoga was mostly equally effective. Outcomes were largely not moderated by practice quantity or quality, but reductions in depressive mood were mediated by gains in reappraisal and distraction.

Conclusions

Mindfulness training can be implemented in the context of university seminars to foster advantageous emotion regulation strategies and lower depressive mood in future schoolteachers. Discontinuing yoga within mindfulness interventions does not seem to reduce training benefits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749600/

 

Improve Psychiatric Problems among Veterans with Mindfulness

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Improve Psychiatric Problems among Veterans with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions show promise in helping soldiers reduce symptoms of PTS and depression as well as experience improvements in various psychosocial domains.” – Adam Clark

 

There are vast numbers of people worldwide who suffer with mental or physical illnesses. Mindfulness practices have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Mindfulness-Based Cognitive Therapy (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 a wide range of psychological issues. Military veterans are highly susceptible to psychiatric illnesses. So, it would make sense to investigate the effectiveness of MBCT for treating the psychiatric problems of military veterans

 

In today’s Research News article “Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748402/), Marchand and colleagues examined the medical records of veterans who had undergone Mindfulness-Based Cognitive Therapy (MBCT) therapy for psychiatric illnesses. MBCT was provided in 8 weeks of once a week 2-hour sessions. Their conditions included psychiatric disorders such as anxiety and depression, substance abuse, and ADHD, and medical disorders such as diabetes, hypertension, and chronic pain.

 

They found that only 67% of the veterans completed the Mindfulness-Based Cognitive Therapy (MBCT)  program. The greater the number of emergency room visits and psychiatric admission prior to the study significantly predicted the likelihood of completion of the MBCT program. This suggests that veterans who have a history of seeking treatment are more likely to complete therapy. Importantly, they found that following the MBCT program there was a significant decrease in psychiatric admission with large effect size.

 

These are interesting findings that suggest that the Mindfulness-Based Cognitive Therapy (MBCT)  program is effective in treating a variety of psychiatric conditions in military veterans. There appears to be a problem, however, with veterans who don’t have a history of seeking treatment completing the therapeutic program. This may signal the need for further study of what can be done to improve participation in this group. It is also possible that prior care with these particular veterans has not been effective and their dropping out of therapy may reflect the lack of success for them with the MBCT program. It is clear nonetheless that when the veterans complete the program it is highly effective in treating their conditions.

 

So, improve psychiatric problems among veterans with mindfulness.

 

“We now have a lot of evidence that mindfulness meditation is helpful for a range of different conditions, including depression, anxiety, substance problems and chronic pain.” – Joseph Wielgosz

 

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

 

Marchand, W. R., Yabko, B., Herrmann, T., Curtis, H., & Lackner, R. (2019). Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders. Journal of alternative and complementary medicine (New York, N.Y.), 25(9), 902–909. doi:10.1089/acm.2018.0511

 

Abstract

Objectives: The aim of this study was to evaluate utilization and outcomes of mindfulness-based cognitive therapy (MBCT) provided to veterans with psychiatric disorders.

Design: Retrospective chart review.

Settings: Veterans Administration Medical Center (VAMC).

Subjects: Ninety-eight veterans with psychiatric illness who were enrolled in an MBCT class between May of 2012 and January of 2016. Subjects were predominately white (95%), male (81%), and >50 years old (74%). The most common psychiatric conditions were any mood disorder (82%) and post-traumatic stress disorder (54%).

Intervention: Eight-week MBCT class.

Outcome measures: Session attendance and pre- to postintervention changes in numbers of emergency department (ED) visits and psychiatric hospitalizations.

Results: The average number of sessions attended was 4.87 of 8 and only 16% were present for all sessions. Veteran demographic variables did not predict the number of MBCT sessions attended. However, both greater numbers of pre-MBCT ED visits (p = 0.004) and psychiatric admissions (p = 0.031) were associated with attending fewer sessions. Among patients who experienced at least one pre- or post-treatment psychiatric admission in the 2 years pre- or postintervention (N = 26, 27%), there was a significant reduction in psychiatric admissions from pre to post (p = 0.002). There was no significant change in ED visits (p = 0.535).

Conclusions: MBCT may be challenging to implement for veterans with psychiatric illness in, at least some, outpatient VAMC settings due to a high attrition rate. Possible mediation approaches include development of methods to screen for high dropout risk and/or development of shorter mindfulness-based interventions (MBIs) and/or coupling MBIs with pleasurable activities. The finding of a significant decrease in psychiatric hospitalizations from pre- to post-MBCT suggests that prospective studies are warranted utilizing MBCT for veterans at high risk for psychiatric hospitalization.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748402/

 

Better Mental Health During Pregnancy is Associated with Mindfulness

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Better Mental Health During Pregnancy is Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is a seriously beneficial practice during pregnancy, too? Simply tuning in and being aware can be a powerful tool to lessen stress, calm anxiety, and help you feel more connected during those long nine months.” – Carrie Murphy

 

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. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

 

In today’s Research News article “An investigation of dispositional mindfulness and mood during pregnancy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/), Krusche and colleagues recruited pregnant women and had them complete measures of mindfulness, anxiety, depression, perceived stress, pregnancy distress, worries about labor, prenatal distress, pregnancy related discomforts, and pregnancy expectancies.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, worries about labor, pregnancy distress, prenatal distress, first and second trimester discomfort, and frequency and intensity of negative pregnancy experiences, and greater frequency and intensity of positive pregnancy experiences.

 

This study was correlational, so no conclusions can be reached about causation. But the results are striking that mindfulness is associated with better pregnancy related experiences, mood, and mental health. This portends well for the outcome of pregnancy and the health of the child. Future research should attempt to investigate the effects of mindfulness training during pregnancy on the mood, experiences, and mental health of the women.

 

So, better mental health during pregnancy is associated with mindfulness.

 

“cultivating moment-to-moment awareness of thoughts and surroundings seem to help pregnant women keep their stress down and their spirits up. . . it may also lead to healthier newborns with fewer developmental problems down the line.” – Kira Newman

 

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

 

Krusche, A., Crane, C., & Dymond, M. (2019). An investigation of dispositional mindfulness and mood during pregnancy. BMC pregnancy and childbirth, 19(1), 273. doi:10.1186/s12884-019-2416-2

 

Abstract

Background

Mindfulness courses are being offered to numerous groups and while a large body of research has investigated links between dispositional mindfulness and mood, few studies have reported this relationship during pregnancy. The aim of this study was to investigate this relationship in pregnant women to offer insight into whether an intervention which may plausibly increase dispositional mindfulness would be beneficial for this population.

Methods

A cross-sectional analysis was conducted to explore potential relationships between measures of mindfulness and general and pregnancy-specific mood. A sample of pregnant women (n = 363) was recruited using online advertising and community-based recruitment and asked to complete a number of questionnaires online.

Results

Overall, higher levels of mindfulness were associated with improved levels of general and pregnancy-related mood in pregnant women. Controlling for general stress and anxiety, higher scores for mindfulness in (psychologically) healthy women were associated with lower levels of pregnancy-related depression, distress and labour worry but this relationship was not apparent in those with current mental health problems. In participants without children, higher mindfulness levels were related to lower levels of pregnancy-related distress.

Conclusions

These results suggest a promising relationship between dispositional mindfulness and mood though it varies depending on background and current problems. More research is needed, but this paper represents a first step in examining the potential of mindfulness courses for pregnant women. Increasing mindfulness, and therefore completing mindfulness-based courses, is potentially beneficial for improvements in mood during pregnancy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676599/

 

Relieve Depression in Latino Immigrants with Mindfulness Meditation

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Relieve Depression in Latino Immigrants with Mindfulness Meditation

 

By John M. de Castro, Ph.D.

 

“with practice, meditation can help many people control how they react to the stress and anxiety that often leads to depression,” – John Denninger

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant 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. Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs.

 

A particularly vulnerable population is Latino immigrants. They experience many forms of stress while attempting to acculturate to the new culture which frequently produces depression. Mindfulness practices including meditation have been found to be effective in relieving depression and preventing its reoccurrence. There is, however, a lack of studies of the effectiveness of meditation practice on depression in stressed Latino immigrant populations.

 

In today’s Research News article “Mindfulness meditation and improvement in depressive symptoms among Spanish- and English speaking adults: A randomized, controlled, comparative efficacy trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611613/), Lopez-Maya and colleagues recruited adult Latino immigrants who reported high levels of psychological distress and stress. They were randomly assigned to receive 6 weeks of once a week for 2 hours group-based sessions in either mindfulness meditation or health education. The mindfulness meditation program consisted of “mindful sitting meditation, mindful eating, appreciation meditation, friendly or loving-kindness meditation, mindful walking, and mindful movement.” They were measured before and after training for depression, mindfulness, and perceived stress.

 

They found that in comparison to baseline and the health education group, after mindfulness meditation training there was a significant reduction in depression with small to moderate effect size, and large significant increases in mindfulness with large effect size. Hence, the mindfulness meditation program was successful in improving mindfulness and relieving depression in a Latino immigrant population.

 

The fact that mindfulness meditation training reduced depression is not surprising as the efficacy of this training for depression has been well established with a large number of studies. What the current study establishes is that mindfulness meditation training is effective in treating depression in Latino immigrants who are stressed and are experiencing psychological distress. Immigration is difficult and challenging. The present results suggest that mindfulness meditation training is a safe and effective method to help alleviate the psychological effects of these stresses and thereby improve the well-being of the immigrants. Future studies should evaluate the long-term effectiveness of this training for depression.

 

So, relieve depression in latino immigrants with mindfulness meditation.

 

“Depression is rooted in fears about the future and regrets about the past. Focusing on the moment, not the past or the future, is the secret behind meditation’s power.” – Eoc Institute

 

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

 

Lopez-Maya, E., Olmstead, R., & Irwin, M. R. (2019). Mindfulness meditation and improvement in depressive symptoms among Spanish- and English speaking adults: A randomized, controlled, comparative efficacy trial. PloS one, 14(7), e0219425. doi:10.1371/journal.pone.0219425

 

Abstract

Objective

Latino immigrants experience acculturative stress and increased depression risk. Mindfulness meditation improves depressive symptoms, yet the vast majority of research has focused on English speaking populations.

Methods

In this randomized clinical trial with 2 parallel treatment groups, adults with moderate levels of perceived stress (n = 76) were recruited from the Los Angeles community from October 2015 to March 2016, stratified into Spanish- (n = 36) and English speaking (n = 40) language groups, and randomized for 6 weeks of treatment with standardized mindful awareness practices (MAPs) or health education (HE). Main outcome measure was depressive symptoms, measured by the Beck Depression Inventory.

Results

Using an intent-to-treat analysis, the primary outcome, depressive symptoms as indexed by the Beck Depression Inventory, showed greater improvement in MAPs vs. HE, with a between-group post-intervention mean difference of -2.2 (95% CI -4.4 – -0.07) and effect size of 0.28; similar effect sizes were found in the the Spanish- (0.29) and English speaking (0.30) groups. MAPs showed significant improvement relative to HE on secondary outcome of mindfulness with between group difference of 10.7 (95% CI4.5–16.9), but not perceived stress.

Conclusion

The comparable efficacy of Spanish and English formats of mindfulness meditation in improving depressive symptoms suggests that this community based intervention may mitigate depression risk in Latino adults who are experiencing social adversity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611613/

 

Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

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Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Compared with [treatment as usual], MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.” – Felix Compen

 

Receiving a diagnosis of cancer has a huge impact on most people. 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. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. So, it would make sense to study the effectiveness of MBCT and the characteristics of the therapy the psychological distress of cancer patients.

 

In today’s Research News article “Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/ ), Bisseling and colleagues recruited cancer patients who were high in anxiety and depression and randomly assigned them to receive Mindfulness-Based Cognitive Therapy (MBCT) delivered either face-to-face in groups or online or to continue receiving treatment as usual. MBCT was delivered in 8 weekly 2.5 hour sessions along with audio guided home practice. They were measured before and after treatment for psychological distress, group cohesion, therapeutic alliance, and therapist competence.

 

Only the data from patients who had completed therapy were included in the analysis. They found that following treatment there was a significant decrease in anxiety and depression (psychological distress). They also found that the higher the levels of therapeutic alliance the greater the reduction in psychological distress. This was not true for either the group cohesion or the therapist competence.

 

Therapeutic alliance consists of “how closely client and therapist agree on and are mutually engaged in the goals of treatment; how closely client and therapist agree on how to reach the treatment goals; and the degree of mutual trust, acceptance, and confidence between client and therapist.” So, the results suggest that this relationship between patient and therapist is an important factor in the effectiveness of mindfulness treatment to improve the psychological distress of cancer patients. It is not how good the therapist is, but how well they create a mutual agreement regarding the therapy that is important for the effectiveness of the therapy.

 

This agreement may signal a buy-in by the patient to the efficacy of the therapy. This, in turn, can drive a positive expectation for therapeutic success both from the patient and the therapist. It has been demonstrated that the beliefs of the patient and the therapist have powerful effects on the outcome. So, it is possible that the therapeutic alliance is simply a measure of the power of those expectations and, in turn, the effectiveness of the program.

 

“Mindfulness-based cognitive therapy (MBCT) and individual Internet-based MBCT (eMBCT) had comparable efficacy in improving psychological distress among patients with cancer.” – James Nam

 

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

 

Bisseling, E. M., Schellekens, M., Spinhoven, P., Compen, F. R., Speckens, A., & van der Lee, M. L. (2019). Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients. Clinical psychology & psychotherapy, 26(3), 309–318. doi:10.1002/cpp.2352

 

Abstract

Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet‐based versus group‐based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group‐based MBCT out of 120 patients who were randomized to group‐based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.

Key Practitioner Message

  • Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care and has been increasingly applied in oncology to reduce psychological distress.
  • Therapeutic alliance predicts reduction in psychological distress after MBCT for cancer patients, whereas group cohesion and therapist competence did not.
  • Therapist competence did not appear to be a precondition for a good therapeutic alliance and high group cohesion.
  • Contrary to expectation, we found competence to be negatively related to group cohesion.
  • Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT for cancer patients.
  • The current findings should be taken into account in the training of MBCT therapists.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/