Improve the Mental Health on Intensive Care Nurses with Mindfulness

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 burnoutincreasing 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/

 

Promote Well-Being in Adolescents with Spirituality

Promote Well-Being in Adolescents with Spirituality

 

By John M. de Castro, Ph.D.

 

“Call it faith. Call it spirituality. Call it zealotry. Our consciousness creates the reality that reflects it. If we feel apart, other, afraid, and deadened, we will live in a world that reflects and perpetuates these energies.” – Kelly Brogan

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. ”Spirituality has been promulgated as a solution to the challenges of life both in a transcendent sense and in a practical sense. The transcendent claims are untestable with the scientific method. But the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health.

 

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.

 

It makes sense, then, to investigate the influence of spirituality on the ability of youths to navigate this difficult time and develop positive qualities and better mental health. In today’s Research News article “A Longitudinal Study of Spirituality, Character Strengths, Subjective Well-Being, and Prosociality in Middle School Adolescents.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00377/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_925884_69_Psycho_20190305_arts_A ), Kor and colleagues recruited adolescents aged 13 to 17 years and had them complete scales at baseline and 3 and 14 months later measuring character strength, optimism, spirituality, religiosity, transcendence, devotion, positive and negative emotions, life satisfaction, and prosociality.

 

They found that spirituality in adolescents was composed of spirituality, religiosity, transcendence, and devotion and was relatively stable over the 14-month measurement period. They found that the higher the levels of spirituality, the greater the levels of character strength, life satisfaction, positive emotions, and prosocial behaviors over all three measurement time points.

 

These findings are interesting but correlational. So, conclusions regarding causation cannot be reached. But the findings suggest that, surprisingly, spirituality does not fluctuate greatly over time in adolescents. They also suggest that spirituality is associated with a relatively satisfying and happy life that is engaged positively with other people. Hence, spirituality would appear to be a positive factor that is helpful to youths in maintaining well-being over the turbulent time of adolescence.

 

So, promote well-being in adolescents with spirituality.

 

“Both religion and spirituality can have a positive impact on mental health. In some ways, they provide the same impact. For example: Both religion and spirituality can help a person tolerate stress by generating peace, purpose and forgiveness.” – Laura Greenstein

 

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

 

Kor A, Pirutinsky S, Mikulincer M, Shoshani A and Miller L (2019) A Longitudinal Study of Spirituality, Character Strengths, Subjective Well-Being, and Prosociality in Middle School Adolescents. Front. Psychol. 10:377. doi: 10.3389/fpsyg.2019.00377

 

Using data from 1,352 middle-school Israeli adolescents, the current study examines the interface of spirituality and character strengths and its longitudinal contribution to subjective well-being and prosociality. Participants were approached three times over a 14-months period and completed measures of character strengths, spirituality, subjective well-being (positive emotions, life satisfaction), and prosociality. Findings revealed a fourth-factor structure of character strengths that included the typical tripartite classification of intrapersonal, interpersonal, and intellectual strengths together with spirituality emerging as a statistically autonomous factor. Spirituality was stable over time and contributed to higher subjective well-being and prosociality both cross-sectionally and longitudinally. Discussion focuses on spirituality as a fundamental character strength and an important aspect of positive development.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00377/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_925884_69_Psycho_20190305_arts_A

 

Improve Balanced Time Perspective with Mindfulness

Improve Balanced Time Perspective with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is how we think about the future that determines whether the outcome is beneficial. You can think about what you want and how to make it happen, or you can think about what you don’t want and worry about how to prevent it from happening. The first way increases your chances of bringing positive emotions and experiences into your life, while the second causes you to experience negative emotions about things that may never happen; further, it decreases the amount of time and energy you have for creating positive experiences.” – Jannice Vilhauer

 

Mindfulness stresses present moment awareness, minimizing focus on past memories and

future planning. But, to effectively navigate the environment it is necessary to remember past experiences and project future consequences of behavior. So, there is a need to be balanced such that the amount of attention focused on the past, present, and future is balanced. This has been termed as balanced time perspective. It is possible that mindfulness helps balance time perspective or that it might even overly emphasize the present moment to the detriment of balance. The relationship of mindfulness to this balanced time perspective has not been previously investigated.

 

In today’s Research News article “Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395405/), Ge and colleagues recruited college students and measured them for mindfulness, self-compassion, subjective well-being, balanced time perspective, and time perspective including subscales measuring past negative, past positive, present fatalistic, present hedonistic, and future.

 

They found that mindfulness was positively related to balanced time perspective directly with the higher the levels of mindfulness the better the balance in time perspective. They also observed that mindfulness was positively related to balanced time perspective indirectly through self-compassion and subjective well-being such that high levels of mindfulness was associated with higher levels of self-compassion and subjective well-being which, in turn, were associated with higher balanced time perspective.

 

These results are interesting and for the first time demonstrate a positive relationship of mindfulness to balanced time perspective. Since a balanced time perspective may be seen as an adaptive mix of past, present, and future perspectives, it is possible that this is one of the reasons that mindfulness has such positive effects on mental health and well-being. So, mindfulness may be beneficial not just by increasing present moment awareness but also by producing appropriate allocation of attention to the past or the future where appropriate. It remains for future research to examine these possibilities.

 

So, improve balanced time perspective with mindfulness.

 

“while a mindfulness exercise that shifts attention to internal events extends one’s experience of time, a mindfulness exercise that shifts attention to an external event could potentially make time feel like it’s passing more quickly.” – Emily Nauman

 

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

 

Ge, J., Wu, J., Li, K., & Zheng, Y. (2019). Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students. Frontiers in Psychology, 10, 367. doi:10.3389/fpsyg.2019.00367

 

Abstract

Balanced time perspective is associated with optimal social functioning and provides psychological benefits in times of stress. Previous studies have found that mindfulness is positively associated with balanced time perspective and might promote it. However, the mechanism through which mindfulness affects balanced time perspective remains unexplored. The purpose of the present study was to investigate the mediating role of self-compassion and subjective well-being in the relationship between mindfulness and balanced time perspective. A total of 754 Chinese college students, aged 17–27 years, completed the Chinese versions of the Five-Facet Mindfulness Questionnaire, Self-Compassion Scale, Subjective Well-Being Scale, and Zimbardo Time Perspective Inventory. There were significant positive correlations between mindfulness, self-compassion, subjective well-being, and balanced time perspective. Structural equation modeling indicated that in addition to the direct influence of mindfulness on balanced time perspective, self-compassion and subjective well-being played a partial mediating role. On the basis of these findings, we conclude that mindfulness has an important positive influence on balanced time perspective, and highlights the crucial role of the self-compassion in cultivating a balanced time perspective. Limitations of the present study are also discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395405/

 

Mindfulness Practice Quality not Quantity Predicts Psychological Improvement

Mindfulness Practice Quality not Quantity Predicts Psychological Improvement

 

By John M. de Castro, Ph.D.

 

Ultimately, engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.” – Jennifer Wolkin

 

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. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. With impacts so great it is important to know how to  measure and optimize the development of mindfulness.

 

There is a vast array of techniques for the development of mindfulness. They include a variety of forms of meditationyogamindful movementscontemplative prayer, and combinations of practices. Some are recommended to be practiced for years while others are employed for only a few weeks. Regardless of the technique, they all appear to develop and increase mindfulness. One particularly effective mindfulness training program is Mindfulness-Based Stress Reduction (MBSR). The MBSR program consists of 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients are also encouraged to perform daily practice. It is unclear, however, exactly whether it is the quantity or the quality of practice that is essential to producing maximum benefits.

 

In today’s Research News article “The secret ingredient in mindfulness interventions? A case for practice quality over quantity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333205/ ), Goldberg and colleagues recruited adults for a “Quit Smoking Trial” and had them participate in an 8 week, once a week for 1.5 hours, mindfulness training program based upon the Mindfulness-Based Stress Reduction (MBSR) program but targeting smoking cessation. They also practiced at home for 30 minutes per day. In addition, for the first 4 weeks they also received nicotine patches. They were measured before and after the program and 5 months later for smoking, mindfulness, psychological functioning, emotion regulation, negative emotions, and quality of life. At each of the 8 practice sessions the participants also reported on the amount of time they practiced during the week and quality of these practices. The measure of practice quality was “composed of two dimensions: perseverance (e.g., “During practice, I attempted to return to my present-moment experience, whether unpleasant, pleasant, or neutral”) and receptivity (e.g., “During practice I was actively avoiding or ‘pushing away’ certain experiences”).”

 

They found that after treatment there was a significant relationship between practice time and the change in practice quality and the psychological functioning of the individuals with small to moderate effect sizes. In particular, the greater the amount of time spent practicing and also the greater the change in the quality of practice, the greater the improvement in psychological function in the participants. At the 5-month follow-up, however, only the change in quality of practice was associated with improved psychological function. Neither the amount of time spent practicing or the quality of practice was associated with smoking cessation at the end of treatment or 5 months later.

 

These results are interesting and suggest the importance of quality of practice in influencing the effectiveness of mindfulness practice on the psychological function of the individual. The quality measure components of perseverance and receptivity reflect exactly what is taught in mindfulness training where the meditator is asked to return to mindfulness whenever they detect mind wandering and to simply let things be as they are without attempts to change or control them. How well these skills are mastered, as evidenced by their change over the 8 weeks of training appears to be very important for maintaining the benefits.

 

This is an unusual study as most research on mindfulness training do not measure either amount or quality of the trained practice, while only a few, monitor the amount of time spent practicing. The current study underlines the importance of measuring quality. It appears to be important for assessing benefits but also may be used to examine practice methods that maximize the quality and quantity of practice and their importance for their benefits.

 

“Mindfulness is an important part of mental wellbeing; it can help us take stock of the fast-paced world around us and understand our emotions and feelings better. Practising mindfulness regularly can help reduce stress and improve mood; it can also help people to become more emotionally alert, to listen more attentively, communicate more clearly, and can increase self-awareness and the awareness of others.” – Fit for Work

 

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., Del Re, A. C., Hoyt, W. T., & Davis, J. M. (2014). The secret ingredient in mindfulness interventions? A case for practice quality over quantity. Journal of counseling psychology, 61(3), 491-7.

 

Abstract

As mindfulness-based interventions become increasingly widespread, interest has grown in better understanding which features of these treatments produce beneficial effects. The present study examined the relative contribution of mindfulness practice time and practice quality in predicting psychological functioning (negative affect, emotion regulation, quality of life, mindfulness). Data were drawn from a randomized clinical trial of mindfulness training for smokers and assessed outcomes at posttreatment (n = 43) and 5-month follow-up (n = 38). The intervention included instruction in mindfulness techniques targeted to smoking cessation and relapse prevention and was composed of 10 group meetings over 8 weeks. Data from 8 treatment groups were used. Mindfulness practice quality was measured weekly over the course of treatment, and multilevel modeling was used to estimate trajectories of change in practice quality. The measure of practice quality was shown to be valid and reliable, with change in practice quality predicting change in psychological functioning at both posttreatment (β= .31, 95% CI =[0.04, 0.56], p = .022) and follow-up (β= .45 [0.16, 0.73], p = .002), even when controlling for practice time. Practice time predicted outcomes at posttreatment (β= .31 [0.05, 0.57], p = .019) but not at follow-up (β= .16 [[H11002]0.14, 0.47], p = .293). Neither practice time nor change in practice quality predicted smoking abstinence at 1 month or 6 months postquit. Results support the importance of practice quality as a relevant aspect of mindfulness interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333205/

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

Improve Psychological Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

Mobile phones are often scorned as devices of distraction, but paradoxically, they may serve as a good platform to practice being in the moment and being mindful given their wide use,” – Jayde Flett

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress and resilience in the face of stress. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these Apps in inducing mindfulness and improving psychological health.

 

In today’s Research News article “). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329416/ ), Walsh and colleagues recruited undergraduate students and randomly assigned them to practice with one of two smartphone apps, “Wildflowers” Mindfulness Training or “2048” Cognitive Training, for 10 minutes per day for three weeks. “2048” is described as “fun and relaxing puzzle game”. “Wildflowers” involves a variety of meditation trainings. “Ratings of current mood, stress level, and heart rate were recorded within each app before and after each training session.” Also, before and after the 3 weeks of training with the Apps the participants completed online measures of perceived stress, personality, well-being, psychological inflexibility, experiential avoidance, mindfulness, interoceptive awareness, spirituality, meaning in life, attentional control, interoceptive attention, and positive and negative mood.

 

They found that in comparison to the before session mood and the cognitive training group, after the session the participants who engaged in mindfulness training had significantly improved mood and reduced perceived stress. Hence, on the short term, engagement with the mindfulness app improved the emotional state of the participants.

 

They also found that both groups significantly improved over the 3 weeks of training on awareness and self-acceptance. The mindfulness training group, however, had significantly greater improvement in self-acceptance. In addition, the mindfulness training group had a significant improvement in attentional control, specifically increased ability to deal with conflicts for attention. This may be particularly helpful for the academic ability of college students. Hence on the longer term, engaging with the mindfulness app results in improved attentional ability and self-acceptance.

 

This research is well structured as the control, comparison, condition involved an equivalent amount of practice, time commitment, and expectation of benefit. So, the findings can be viewed as solid. The study, however, lacks a follow-up to determine if the effects are lasting or fleeting. The results though demonstrate that engaging in mindfulness practices with a smartphone produces short-term benefits for the individual’s emotional and psychological state and attentional ability. These are substantial benefits for a 10 minute per day investment of time. The low cost, scalability, flexibility, and convenience of training using a smartphone make it an important advance in mindfulness training.

 

So, improve psychological well-being with a smartphone mindfulness app.

 

Mindfulness does not mean avoiding digital media, nor does it mean making one’s own mindfulness dependent on it – so let’s be more mindful when it comes to mindfulness!” – Annika Heinemeyer

 

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

 

Walsh, K. M., Saab, B. J., & Farb, N. A. (2019). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study. JMIR mental health, 6(1), e10844. doi:10.2196/10844

 

Abstract

Background

Mindfulness training (MT) includes a variety of contemplative practices aimed at promoting intentional awareness of experience, coupled with attitudes of nonjudgment and curiosity. Following the success of 8-week, manualized group interventions, MT has been implemented in a variety of modalities, including smartphone apps that seek to replicate the success of group interventions. However, although smartphone apps are scalable and accessible to a wider swath of population, their benefits remain largely untested.

Objective

This study aimed to investigate a newly developed MT app called Wildflowers, which was codeveloped with the laboratory for use in mindfulness research. It was hypothesized that 3 weeks of MT through this app would improve subjective well-being, attentional control, and interoceptive integration, albeit with weaker effects than those published in the 8 week, manualized group intervention literature.

Methods

Undergraduate students completed 3 weeks of MT with Wildflowers (n=45) or 3 weeks of cognitive training with a game called 2048 (n=41). State training effects were assessed through pre- and postsession ratings of current mood, stress level, and heart rate. Trait training effects were assessed through pre- and postintervention questionnaires canvassing subjective well-being and behavioral task measures of attentional control and interoceptive integration. State and trait training data were analyzed in a multilevel model using emergent latent factors (acceptance, awareness, and openness) to summarize the trait questionnaire battery.

Results

Analyses revealed both state and trait effects specific to MT; participants engaging in MT demonstrated improved mood (r=.14) and a reduction of stress (r=−.13) immediately after each training session compared with before the training session and decreased postsession stress over 3 weeks (r=−.08). In addition, MT relative to cognitive training resulted in greater improvements in attentional control (r=−.24). Interestingly, both groups demonstrated increased subjective ratings of awareness (r=.28) and acceptance (r=.23) from pre- to postintervention, with greater changes in acceptance for the MT group trending (r=.21).

Conclusions

MT, using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. Although further investigation is warranted, there is evidence that with continued usage, MT via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329416/

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

 

Improve Psychological Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

Mindfulness mediation apps can be useful for some people, but for others, when unwell, using these apps or even engaging in mediation its self can be quite difficult,” – Kym Jenkins

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress and resilience in the face of stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these Apps in inducing mindfulness and improving psychological health.

 

In today’s Research News article “The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312207/ ), Champion and colleagues recruited over the internet healthy adults who were not mindfulness practitioners and randomly assigned them to either a wait-list control condition or to receive mindfulness training via a smartphone app (Headspace). They practiced once a day for 10 minutes for 30 days. “The program is intended to introduce the key principles behind mindfulness, and how one can apply mindfulness to their daily life, using technique such as breath awareness, body scanning, and noting. . . The audio content is supplemented with educational videos and animations.” The participants completed questionnaires over the internet measuring general health, satisfaction with life, perceived stress, resilience, and engagement and experience with the app.

 

They found in comparison to baseline and to the wait-list controls that the participants who used the app had significant improvements in satisfaction with life, perceived stress, and resilience. The increases in psychological health were greatest between baseline and day 10 of practice but continued to increase over the next 20 days. This suggests that the benefits are available relatively rapidly but continued practice produces greater benefits. It remains to be determined whether these effects are enduring or are only present in the immediate aftermath of training.

 

These effects of mindfulness training are well established. This study adds to the accumulating evidence of the effectiveness of mindfulness training over the internet or with smartphone apps. The present study demonstrates that a widely available commercial smartphone app is also effective. This is important as it suggests that training in mindfulness can be made widely and inexpensively available without the presence of a trained therapist and at the convenience of the participant. This may allow for the benefits of mindfulness practice to spread far and wide to tremendous numbers of people. In this regard the Headspace app has already been downloaded 30 million times.

 

So, improve psychological well-being with a smartphone mindfulness app.

 

“A good number of new meditators begin sitting with the hope that the holistic benefits of meditation will make themselves felt in a matter of days. They expect meditation to act as a quick fix – like swallowing a pain relief tablet. It isn’t a reasonable expectation. Most genuine meditation teachers say that while a fortunate few newbies experience benefits very quickly, for the rest of us, meditation has to be practiced regularly over time before its beneficial effects can be appreciated.” – Mindworks

 

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

 

Champion, L., Economides, M., & Chandler, C. (2018). The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial. PloS one, 13(12), e0209482. doi:10.1371/journal.pone.0209482

 

Abstract

Background

Previous evidence suggests that mindfulness training may improve aspects of psychosocial well-being. Whilst mindfulness is traditionally taught in person, consumers are increasingly turning to mindfulness-based smartphone apps as an alternative delivery medium for training. Despite this growing trend, few studies have explored whether mindfulness delivered via a smartphone app can enhance psychosocial well-being within the general public.

Methods

The present pilot randomised controlled trial compared the impact of engaging with the self-guided mindfulness meditation (MM) app ‘Headspace’ (n = 38) for a period of 10 or 30 days, to a wait-list (WL) control (n = 36), using a cohort of adults from the general population. The Satisfaction with Life Scale, Perceived Stress Scale, and Wagnild Resilience Scale were administered online at baseline and after 10 and 30 days of the intervention.

Results

Twelve participants (MM n = 9, WL n = 3) were lost to follow-up for unknown reasons. Relative to the WL control, the MM app positively impacted self-reported satisfaction with life, stress, and resilience at day 10, with further improvements emerging at day 30 (Cohen’s d = 0.57, 1.42, 0.63 respectively). The rate of improvement was largest at the 10-day assessment point, dropping moderately by day 30. Participants that rated the MM app as easy to engage with experienced the largest self-reported benefits. Moreover, the MM app was able to protect against an unexpected increase in perceived stress that emerged in the control group.

Conclusions

This pilot randomised controlled trial shows that self-reported improvements in psychosocial outcomes can be achieved at low cost through short-term engagement with a mindfulness-based smartphone app, and should be followed up with more substantive studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312207/

 

Change the Brain for Greater Well-Being with Meditation

Change the Brain for Greater Well-Being with Meditation

 

By John M. de Castro, Ph.D.

 

Meditation provides experiences that the mind can achieve no other way, such as inner silence and expanded awareness. And as the mind gains experience, the brain shows physical activity as well—sometimes profound changes.” – Depak Chopra

 

There has accumulated a large amount of research demonstrating that mindfulness has significant benefits for psychological, physical, and spiritual wellbeing. One way that mindfulness practices may produce these benefits is by altering the brain. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

In today’s Research News article “Short‐term Sahaja Yoga meditation training modulates brain structure and spontaneous activity in the executive control network.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346416/pdf/BRB3-9-e01159.pdf ), Dodich and colleagues recruited meditation naïve college students and randomly assigned them to either a wait-list control condition or to receive 1-hour Sahaja yoga meditation practice 4 times per week for 4 weeks. Sahaja yoga meditation is an open monitoring meditation technique designed to produce mental silence. The participants underwent brain scans with functional Magnetic Resonance Imaging (fMRI) before and after the 4 weeks of meditation training.

 

They found that in comparison to baseline and the wait-list controls, the participants who received meditation training and practice had significant increases in the brain grey matter density in the inferior frontal gyrus. They also found that the greater the grey matter density the greater the self-reported well-being by the meditation participants.

 

The inferior frontal gyrus is known to be involved in attention, self-control, and self-awareness. These are exactly the skills trained in meditation practice. This suggests that this relatively short-term practice produces neuroplastic changes in the brain expanding the brain matter in the regions underlying the trained skills and this is associated with improved well-being.

 

So, change the brain for greater well-being with meditation.

 

“So, what’s the best way to build a better brain? Backed by 1000’s of studies, meditation is the neuroscientific community’s most proven way to upgrade the human brain.” – 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

 

Dodich A, Zollo M, Crespi C, et al. Short‐term Sahaja Yoga meditation training modulates brain structure and spontaneous activity in the executive control network. Brain Behav. 2019;9:e01159. https://doi.org/10.1002/ brb3.1159

 

Abstract Introduction: While cross‐sectional studies have shown neural changes in long‐term meditators, they might be confounded by self‐selection and potential baseline differences between meditators and non meditators. Prospective longitudinal studies of the effects of meditation in naïve subjects are more conclusive with respect to causal inferences, but related evidence is so far limited. Methods: Here, we assessed the effects of a 4‐week Sahaja Yoga meditation training on gray matter density and spontaneous resting‐state brain activity in a group of 12 meditation‐naïve healthy adults. Results: Compared with 30 control subjects, the participants to meditation training showed increased gray matter density and changes in the coherence of intrinsic brain activity in two adjacent regions of the right inferior frontal gyrus encompassing the anterior component of the executive control network. Both these measures correlated with self‐reported well‐being scores in the meditation group. Conclusions: The significant impact of a brief meditation training on brain regions associated with attention, self‐control, and self‐awareness may reflect the engagement of cognitive control skills in searching for a state of mental silence, a distinctive feature of Sahaja Yoga meditation. The manifold implications of these findings involve both managerial and rehabilitative settings concerned with well‐being and emotional state in normal and pathological conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346416/pdf/BRB3-9-e01159.pdf

 

Improve Well-Being and Psychological Flexibility with Mindfulness Practice

Improve Well-Being and Psychological Flexibility with Mindfulness Practice

 

By John M. de Castro, Ph.D.

 

“There are an endless variety of ways to meditate and practice mindfulness. . . specific types of mindfulness-meditation seem to have specific benefits. Fine-tuning which type of mindfulness or meditation someone uses as a prescriptive to treat a specific need will most likely be the next big advance in the public health revolution of mindfulness and meditation.” – Christopher Bergland

 

Mindfulness training has been shown to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. Techniques such as Mindfulness Training, Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) as well as Yoga practice and Tai Chi or Qigong practice have been demonstrated to be effective. This has led to an increasing adoption of these mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Mindfulness practice, however, is a complex involving formal and informal practices, and great differences in the frequency and duration of practice. It is not known which of these facets or which combinations of facets are responsible for the beneficial effects of mindfulness. In addition, learning and implementing mindfulness practices can be difficult with a number of impediments and problems present. Hence there is a need to investigate the characteristics of mindfulness practices and the impediments to and supports for practicing mindfulness and their relationship to the well-being and psychological flexibility of the participants.

 

In today’s Research News article “An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320743/  ), Birtwell and colleagues recruited mindfulness practitioners and had them complete a questionnaire on their mindfulness practice, difficulties encountered with practice, and factors that supported their practice. They also completed scales measuring mental well-being and psychological flexibility.

 

They found 37% of the participants learned mindfulness practice through a formal course while the rest learned on their own through books, the internet, or through therapists. Most practiced several times per week or daily for 10 to 45 minutes. 57% of the participants indicated that falling asleep during practice was an impediment to practice and many indicated that finding time to practice was a problem. In support of their practice they reported that it was helpful to set up particular times for practice, to practice with others in groups, and having an accepting and kind attitude toward themselves, particularly during lapses in practice.

 

Correlating practice factors with mental well being and psychological flexibility they found that the greater the frequency and duration of formal and informal practice the greater the levels of mental well-being and psychological flexibility. But, when all of the practice factors were considered they found that the frequency of informal practice was the only one that significantly predicted improved mental well-being and psychological flexibility.

 

Informal practices involved everyday mindful moments such as being mindful while engaged in everyday activities such as “washing the dishes, eating, driving, brushing teeth, walking the dog, drinking coffee, and watching a wild bird or flower.” Hence, it would appear that integrating mindfulness into everyday life is essential for mindfulness to be associated with good mental well-being and psychological flexibility. In other words, feeling psychologically better and being able to approach psychological issues with acceptance and flexibly is best supported by engaging in daily activities mindfully.

 

It needs to be kept in mind that these findings are correlational and conclusions regarding causation cannot be reached. It is possible that people who are flexible and have mental well-being are those who engage in informal practices or some other factor may be responsible for both. There is a need for future manipulative research to determine causation.

 

So, improve well-being and psychological flexibility with mindfulness practice.

 

“Daily meditation is a powerful tool for managing your stress and enhancing your health. But bringing present-moment awareness to all your daily activities is important.” Melissa Young

 

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

 

Birtwell, K., Williams, K., van Marwijk, H., Armitage, C. J., & Sheffield, D. (2018). An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing. Mindfulness, 10(1), 89-99.

 

Abstract

Mindfulness has transdiagnostic applicability, but little is known about how people first begin to practice mindfulness and what sustains practice in the long term. The aim of the present research was to explore the experiences of a large sample of people practicing mindfulness, including difficulties with practice and associations between formal and informal mindfulness practice and wellbeing. In this cross-sectional study, 218 participants who were practicing mindfulness or had practiced in the past completed an online survey about how they first began to practice mindfulness, difficulties and supportive factors for continuing to practice, current wellbeing, and psychological flexibility. Participants had practiced mindfulness from under a year up to 43 years. There was no significant difference in the frequency of formal mindfulness practice between those who had attended a face-to-face taught course and those who had not. Common difficulties included finding time to practice formally and falling asleep during formal practice. Content analysis revealed “practical resources,” “time/routine,” “support from others,” and “attitudes and beliefs,” which were supportive factors for maintaining mindfulness practice. Informal mindfulness practice was related to positive wellbeing and psychological flexibility. Frequency (but not duration) of formal mindfulness practice was associated with positive wellbeing; however, neither frequency nor duration of formal mindfulness practice was significantly associated with psychological flexibility. Mindfulness teachers will be able to use the present findings to further support their students by reminding them of the benefits as well as normalising some of the challenges of mindfulness practice including falling asleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320743/

 

Increase Wellness and Decrease Burnout in Medical Students with Mindfulness

810986

Increase Wellness and Decrease Burnout in Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“training in mindfulness – focusing controlled attention on physical sensations, thoughts, and emotions in the present moment – helps students to acknowledge and process the stresses and strains of their work.” – Cathy Kerr

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. 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 as it 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 burnoutincreasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical School is extremely stressful and many students show distress and express burnout symptoms. Medical school may be an ideal time to intervene.

 

In today’s Research News article “A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040904/ ), Chung and colleagues in an uncontrolled pilot study delivered a mindfulness curriculum to students during their training in emergency medicine. The training was delivered in 4-weekly 60 minute sessions that included meditation practice, readings, journaling, discussion, and developing a personal wellness plan. They completed questionnaires before and after the 4 weeks of training and 6 months later regarding the impact of the training on their behavior and attitudes.

 

They found that in comparison to baseline, after training there were significant improvements in self-reported behaviors and attitudes. The students reported increased confidence in their ability to meditate and be mindful, explain these skills to others, and recommend these practices to others. They also reported that they practiced meditation and mindfulness more often and talked to others about these practices. In addition, they reported that wellness was important to medical students and that they were using their own wellness plan. Importantly, these improvements were still present 6 months after the completion of the training.

 

These are very preliminary results from an uncontrolled pilot study and need to be verified in a randomized controlled trial with objective measures of wellness and resistance to stress. Previous controlled studies, however, have shown that mindfulness training is effective in treating and preventing burnout and reducing the psychological and physiological responses to stress. So, these present results are suggestive that this simple brief curriculum may produce similar benefits.

 

It is important to use a brief training and this one only involved 4 hours of formal instruction. Medical students have a vast amount of important information to learn and master in a limited amount of time. They do not have the luxury of unused time for extensive instruction. So, a brief training that produces positive results that persist could be very valuable to their health and well-being during this stressful time and during a stressful career.

 

So, increase wellness and decrease burnout in medical students with mindfulness.

 

“I have taken my own advice. I am still at it: sitting on the deck, focusing on my breath, watching my thoughts, clearing my mind amid the shrill end-of-summer calls of the cicadas. I think I have noticed an effect — I feel a deeper sense of acceptance in my life, without losing a passion or resolve to change things for the better.” – Manoj Jain

 

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

 

Chung, A. S., Felber, R., Han, E., Mathew, T., Rebillot, K., & Likourezos, A. (2018). A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience. The western journal of emergency medicine, 19(4), 762-766.

 

Abstract

Introduction

Despite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout.

Methods

The curriculum included these components: (1) four, once-weekly, 60-minute classroom sessions; (2) prerequisite reading assignments; (3) individual daily meditation practice and journaling; and (4) the development of a personalized wellness plan with the help of a mentor. The design was based on self-directed learning theory and focused on building relatedness, competence, and autonomy to help cultivate mindfulness.

Results

Thirty students participated in the curriculum; 20 were included in the final analysis. Each student completed surveys prior to, immediately after, and six months after participation in the curriculum. We found significant changes in the self-reported behaviors and attitudes of the students immediately following participation in the curriculum, which were sustained up to six months later.

Conclusion

Although this was a pilot study, our pilot curriculum had a significantly sustained self-reported behavioral impact on our students. In the future, this intervention could easily be adapted for any four-week rotation during medical school to reduce burnout and increase physician wellness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040904/

Improve Mental Health and Well-Being with Smartphone APP Mindfulness Training

Improve Mental Health and Well-Being with Smartphone APP Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“The seemingly simple act of mindfulness may help reduce the impact of stress, anxiety, depression, and chronic pain. Mindfulness is the act of paying attention to moments of experience with an accepting and friendly attitude so as to observe with all the senses what is happening in each moment. The practice of mindfulness is an effective means of enhancing and maintaining optimal mental health and overall well-being.” – APA

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Mindfulness training programs over the internet and with smartphone apps 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. These online and smartphone app trainings have been shown to be effective. But the question arises as to the relative effectiveness of various online and mobile trainings in inducing mindfulness and improving psychological health.

 

In today’s Research News article “Efficacy and Moderation of Mobile App-Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231823/ ), Mak and colleagues compared the efficacy of 3 smartphone aps that trained for either mindfulness, self-compassion, or cognitive behavioral psychoeducation, to improve mental health and well-being in adults.

 

They recruited adults online and randomly assigned each to one of the three trainings. The participants downloaded the apps for their smartphones. The trainings were delivered in 28 daily sessions. The mindfulness exercises, included body scan, mindful breathing, mindful eating, and mindful walking. Self-Compassion training consisted compassionate body scan, affectionate breathing, loving-kindness meditation for beginners, compassionate walking, soften-allow-soothe, self-compassion break, and self-compassion journaling. Cognitive behavioral psychoeducation included relaxation skills, coping strategies for stress, problem-solving skills, emotional management skills, and cognitive strategies for negative thoughts.

 

The participants completed online measures of mental well-being, psychological distress, mindfulness, self-compassion, discomfort with emotions, ambiguity tolerance, program satisfaction, and utilization before and after training and 3 months later. There were, unfortunately relatively low participation rates with 28% of the recruited participants who downloaded the apps never activated them. Of those that did only 24% completed their program and only 17% completed the follow-up measures. Most of the attrition occurred in the first week.

 

They found that all three trainings produced significant enhancements of mental well-being and mindfulness and significant reductions in psychological distress that persisted at the 3-month follow-up. Self-compassion, and cognitive behavioral psychoeducation trainings, but not mindfulness, resulted in higher self-compassion at the end of training but this was no longer significant at follow-up.

 

This study did not have a control condition for comparison, so the conclusions have to be tempered with the understanding that contaminants such as placebo effects, and time and practice-based contaminants might be responsible for the results. In addition, the high attrition rates may be responsible for the results as those who were not helped by the apps terminated participation leaving only those who were improving left in the sample.

 

On the other hand, other controlled studies have demonstrated the efficacy of mindfulness and self-compassion trainings and cognitive behavioral psychoeducation in improving psychological health and well-being. So, the results from the present study are likely due to the trainings and not contaminants. Hence, these findings are suggestive that the three smartphone apps are able to improve the mental health and well-being of otherwise normal adults. This is important as being able to deliver these trainings over smartphones allows for the distribution of these mental health improving programs economically to widespread audiences.

 

So, improve mental health and well-being with smartphone app mindfulness training.

 

“Fine-tuning which type of mindfulness or meditation someone uses as a prescriptive to treat a specific need will most likely be the next big advance in the public health revolution of mindfulness and meditation. Stay tuned!” – Christopher Bergland

 

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

 

Mak, W. W., Tong, A. C., Yip, S. Y., Lui, W. W., Chio, F. H., Chan, A. T., & Wong, C. C. (2018). Efficacy and Moderation of Mobile App-Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial. JMIR mental health, 5(4), e60. doi:10.2196/mental.8597

 

Abstract

Background

Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health.

Objective

The aim of this study was to examine the efficacy of 3 mobile app–based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation.

Methods

This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators.

Results

Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users’ satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant.

Conclusions

Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231823/