Effectively Treat Substance Use Disorder with Mindfulness

Effectively Treat Substance Use Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise.” – James Davis

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “A Narrative Review of Third-Wave Cognitive-Behavioral Therapies in Addiction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080172/ ) Balandeh and colleagues review and summarize the published research studies of the effectiveness of mindfulness-based therapies for the treatment of addictions.

 

They report that the published research demonstrates that the mindfulness-based therapies of Mindfulness-Based Relapse Prevention (MBRP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Mindfulness-Based Stress Reduction (MBSR), and Mindfulness-Based Cognitive Therapy (MBCT) are all effective for the treatment of addictions. These therapies vary greatly in emphasis and techniques. The major common thread is mindfulness training. This would suggest that it’s developing mindfulness per se that is effective in treating addictions.

 

They report that on a number of explanations for the effectiveness of mindfulness-based therapies for the treatment of addictions. These include the ability of mindfulness training to change the individual’s responses to the usual triggers for drug use, changing the brain’s response to cravings, and sensing cravings as just another physical sensation. Regardless of the mechanism or mechanisms, it is clear that mindfulness training is effective for the treatment of substance use disorder.

 

So, effectively treat substance use disorder with mindfulness.

 

One reason addiction is so hard to beat is that it’s a pattern of conditioned responses. The part of your brain responsible for higher reasoning essentially gets cut out of the decision-making process and you react reflexively to stimuli associated with drugs and alcohol. Practicing mindfulness gradually undoes this conditioning.” – Renewal Lodge

 

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

 

Balandeh, E., Omidi, A., & Ghaderi, A. (2021). A Narrative Review of Third-Wave Cognitive-Behavioral Therapies in Addiction. Addiction & health, 13(1), 52–65. https://doi.org/10.22122/ahj.v13i1.298

 

Abstract

Substance use disorder (SUD) is a prevalent health issue with serious social and personal consequences. SUDs are linked to numerous physical health problems. In the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-V), the essential characteristic of a SUD is a collection of cognitive, behavioral, and psychological manifestations indicative of the subject’s unbaiting substance use despite experiencing significant problems due to continued use. Several alternative interventions have been indicated. Among them, mindfulness-based therapies are receiving growing attention. This article reviews evidence for the use of third-wave cognitive-behavioral therapies (CBTs) in addiction treatment. We have reviewed the literature published from 1990 to 2019. Further research is required to better understand the types of mindfulness-based interventions that work best for specific types of addiction, patients, and situations. Current findings increasingly support third-wave CBTs as a promising complementary therapy for the treatment and prevention of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080172/

 

Improve the Psychological Well-Being of University Students with Mindfulness

Improve the Psychological Well-Being of University Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness apps offer modest but clear benefits to users in terms of improved mental health. They present a promising supplement to traditional mental health services.” – Oskari Lahtinen

 

There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance. Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. Indeed, these practices have been found to improve psychological health in college students.

 

In today’s Research News article “The Mental Health and Wellbeing of University Students: Acceptability, Effectiveness, and Mechanisms of a Mindfulness-Based Course.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199969/ ) Medlicott and colleagues recruited university students who attended an 8-week mindfulness training. The program was based upon Mindfulness-Based Cognitive Therapy (MBCT) and was delivered in 8 weekly 90 minute sessions along with daily home practice. The participants were measured before and after the program and 6 weeks later for expected benefits from the program, wellbeing, mental health, mindfulness, self-compassion, resilience, and academic goals.

 

They found that following the course there were significant improvement in wellbeing. mental health, mindfulness, self-compassion, resilience, and orientation toward their academic goals that were maintained 6 weeks later. The effects were greater for participants who had mental health problems at the beginning of the program. In addition, the greater the amount of home practice, the greater the improvements observed. The amount of change in mindfulness and self-compassion produced by the course was related to the amount of improvement in wellbeing and mental health while the amount of change in resilience was related to the improvements in wellbeing.

 

It has to be recognized that the study did not contain a control, comparison, condition, so it is open to numerous alternative, confounding, explanations. But previous controlled research has demonstrated that mindfulness training produces improvements in wellbeing, mental health, mindfulness, self-compassion, and resilience. So, it is likely that the present findings are the result of the effects of the mindfulness training program rather than some alternative explanation.

 

These results suggest that participating in a mindfulness training program produces significant benefits for the psychological health and wellbeing of university students. The fact their orientation to academic goals was also improved suggests that the program may also improve their academic performance. Indeed, it would be expected that improvement in the students wellbeing and mental health would improve the likelihood of academic success.

 

So, improve the psychological well-being of university students with mindfulness.

 

In college, it’s easy to compile all of the problems we’re facing and place it in to one big feeling of paranoia or stress. Headspace helps sort that out and filter what I should be worried about.” – Ryan Coughlin

 

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

 

Medlicott, E., Phillips, A., Crane, C., Hinze, V., Taylor, L., Tickell, A., Montero-Marin, J., & Kuyken, W. (2021). The Mental Health and Wellbeing of University Students: Acceptability, Effectiveness, and Mechanisms of a Mindfulness-Based Course. International journal of environmental research and public health, 18(11), 6023. https://doi.org/10.3390/ijerph18116023

 

Abstract

Mental health problems are relatively common during university and adversely affect academic outcomes. Evidence suggests that mindfulness can support the mental health and wellbeing of university students. We explored the acceptability and effectiveness of an 8-week instructor-led mindfulness-based course (“Mindfulness: Finding Peace in a Frantic World”; Williams and Penman, 2011) on improving wellbeing and mental health (self-reported distress), orientation and motivation towards academic goals, and the mechanisms driving these changes. Eighty-six undergraduate and post-graduate students (>18 years) participated. Students engaged well with the course, with 36 (48.0%) completing the whole programme, 52 (69.3%) attending 7 out of 8 sessions, and 71 (94.7%) completing at least half. Significant improvements in wellbeing and mental health were found post-intervention and at 6-week follow-up. Improvements in wellbeing were mediated by mindfulness, self-compassion, and resilience. Improvements in mental health were mediated by improvements in mindfulness and resilience but not self-compassion. Significant improvements in students’ orientation to their academic goal, measured by “commitment” to, “likelihood” of achieving, and feeling more equipped with the “skills and resources” needed, were found at post-intervention and at 6-week follow-up. Whilst exploratory, the results suggest that this mindfulness intervention is acceptable and effective for university students and can support academic study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199969/

 

Improve Brain Processing in Mood Dysregulated Adolescents with Mindfulness

Improve Brain Processing in Mood Dysregulated Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based interventions—practices that promote non-judgmental attention to the present—can help individuals respond with acceptance to challenging circumstances or emotions and is a promising approach to treatment of mood lability.” – D. M. Hafemann

 

Adolescence is a time of mental, physical, social, and emotional growth. But it 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. This can lead to emotional and behavioral problems. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents

 

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. The brains of adolescents are different from fully mature adult brains. They are dynamically growing and changing. It is unclear how mindfulness affects their maturing brains particularly in adolescents who have mood dysregulations.

 

In today’s Research News article “Network-level functional topological changes after mindfulness-based cognitive therapy in mood dysregulated adolescents at familial risk for bipolar disorder: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080341/ ) Qin and colleagues recruited adolescents (13-17 years of age) who were mood dysregulated and who had at least one biological parent with bipolar disorder. They were provided a once a week for 75 minutes for 12-weeks program of Mindfulness-Based Cognitive Therapy (MBCT) adapted for children along with home practice. They were measured before and after training for emotion regulation, depressive and manic symptoms, overall global functioning, and clinical ratings. They also had their brains scanned with functional Magnetic Resonance Imaging (fMRI).

 

In comparison to baseline they found that after Mindfulness-Based Cognitive Therapy (MBCT) there were surprisingly no significant changes in emotion regulation, depressive and manic symptoms, overall global functioning, and clinical ratings. But there were significant increases in network efficiency and decreases in path length in the cingulo-opercular network and frontal parietal network and increases in the connectivity of brain structures within the cingulo-opercular network and the default mode network. In addition, the shorter the path length within the cingulo-opercular network the higher the level of emotion regulation.

 

These results need to be interpreted with caution as there was no control comparison condition and so there are potential confounding variables that could account for the results. But the psychological results are very disappointing. Mindfulness-Based Cognitive Therapy (MBCT) has been routinely found to improve emotions and emotion regulation in previous research. But it did not in the present study. It is possible that unlike with adults, MBCT is simply ineffective in improving the psychological health of mood dysregulated adolescents.

 

On the other hand, the functional Magnetic Resonance Imaging (fMRI) findings were interesting. The cingulo-opercular network and frontal parietal network are both involved in top-down cognitive control. The observed increases in network efficiency within these networks after Mindfulness-Based Cognitive Therapy (MBCT) suggests that MBCT improves the ability of mood dysregulated adolescents to control their thinking. This is exactly what MBCT is designed to do. Unfortunately, the researchers did not measure cognitive ability in this study, so there is no confirmatory behavioral results. The increased emotion regulation associated with decreases in path length in the cingulo-opercular network, though, suggests that the changes in the youths’ brains may be associated with improved ability to control their emotions. This may suggest an a lessened chance of developing major mental illness in the future.

 

So, Improve Brain Processing in Mood Dysregulated Adolescents with Mindfulness.

 

With low level of mindfulness, adolescents might be lack of emotion clarity, self-control and acceptance, which in turn might lead to their poor realization of emotion and easy immersion into dysfunctional emotional reactions such as impulse and aggressive behavior toward others or blame to themselves.” – Ying Ma

 

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

 

Qin, K., Lei, D., Yang, J., Li, W., Tallman, M. J., Duran, L., Blom, T. J., Bruns, K. M., Cotton, S., Sweeney, J. A., Gong, Q., & DelBello, M. P. (2021). Network-level functional topological changes after mindfulness-based cognitive therapy in mood dysregulated adolescents at familial risk for bipolar disorder: a pilot study. BMC psychiatry, 21(1), 213. https://doi.org/10.1186/s12888-021-03211-4

 

Abstract

Background

Given that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), Mindfulness-Based Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option. However, little is known about the brain mechanisms of beneficial outcomes from this intervention. Herein, we aimed to investigate the network-level neurofunctional effects of MBCT-C in mood dysregulated adolescents.

Methods

Ten mood dysregulated adolescents at familial risk for BD underwent a 12-week MBCT-C intervention. Resting-state functional magnetic resonance imaging (fMRI) was performed prior to and following MBCT-C. Topological metrics of three intrinsic functional networks (default mode network (DMN), fronto-parietal network (FPN) and cingulo-opercular network (CON)) were investigated respectively using graph theory analysis.

Results

Following MBCT-C, mood dysregulated adolescents showed increased global efficiency and decreased characteristic path length within both CON and FPN. Enhanced functional connectivity strength of frontal and limbic areas were identified within the DMN and CON. Moreover, change in characteristic path length within the CON was suggested to be significantly related to change in the Emotion Regulation Checklist score.

Conclusions

12-week MBCT-C treatment in mood dysregulated adolescents at familial risk for BD yield network-level neurofunctional effects within the FPN and CON, suggesting enhanced functional integration of the dual-network. Decreased characteristic path length of the CON may be associated with the improvement of emotion regulation following mindfulness training. However, current findings derived from small sample size should be interpreted with caution. Future randomized controlled trials including larger samples are critical to validate our findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080341/

 

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

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

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

Improve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. The research has been accumulating. So, it is reasonable to take an overall look at what has been learned.

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Mindfulness is a Cost-Effective Treatment to Prevent Depression Relapse

Mindfulness is a Cost-Effective Treatment to Prevent Depression Relapse

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Objective:

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

Method:

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

Results:

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

Conclusions:

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

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

 

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

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

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve Anxiety Disorders in Children and Adolescents with Mindfulness

Improve Anxiety Disorders in Children and Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

Aim.

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

Methods.

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

Results.

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

Conclusions.

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

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

 

Improve Hypertension with Mindfulness Training

Improve Hypertension with Mindfulness Training

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

So, improve hypertension with mindfulness training.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

Reduce Stress and Improve Healthcare Worker Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Background/Objective

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

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