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A maturing mindfulness-based cognitive therapy reflects on two critical issues.

ABSTRACT: Mindfulness-Based Cognitive Therapy (MBCT) is a multimodal intervention that integrates training in mindfulness meditation and the cognitive theory of affective disorder. This hybrid nature may provide an advantage in the prevention field that addresses the critical need for enhancing wellness among people with recurrent mood disorders. Despite the robust evidence base for MBCT, its penetration at the population health level and in routine clinical settings has been limited. Addressing the gap between the science of MBCT and public access requires grappling with two questions: what is the role of home practice of mindfulness skills in realizing the benefits of MBCT? And, what role do digital platforms play in the delivery of mindfulness programs? Addressing these two questions is overdue in the field and the answers generated have the potential to optimize future research and practice on the ways, in which contemplative practices can support agentic self-care.

SUBMITTER: Segal Z

PROVIDER: S-EPMC6661222 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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A maturing mindfulness-based cognitive therapy reflects on two critical issues.

Segal Zindel Z Dimidjian Sona S Vanderkruik Rachel R Levy Joseph J

Current opinion in psychology 20190128

Mindfulness-Based Cognitive Therapy (MBCT) is a multimodal intervention that integrates training in mindfulness meditation and the cognitive theory of affective disorder. This hybrid nature may provide an advantage in the prevention field that addresses the critical need for enhancing wellness among people with recurrent mood disorders. Despite the robust evidence base for MBCT, its penetration at the population health level and in routine clinical settings has been limited. Addressing the gap b ...[more]

PMID: 30798103

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Project description:Healthcare workers experience higher levels of work-related stress and higher rates of sickness absence than workers in other sectors. Psychological approaches have potential in providing healthcare workers with the knowledge and skills to recognise stress and to manage stress effectively. The strongest evidence for effectiveness in reducing stress in the workplace is for stress-management courses based on cognitive behavioural therapy (CBT) principles and mindfulness-based interventions (MBIs). However, research examining effects of these interventions on sickness absence (an objective indicator of stress) and compassion for others (an indicator of patient care) is limited, as is research on brief CBT stress-management courses (which may be more widely accessible) and on MBIs adapted for workplace settings.This protocol is for two randomised controlled trials with participant preference between the two trials and 1:1 allocation to intervention or wait-list within the preferred choice. The first trial is examining a one-day CBT stress-management workshop and the second trial an 8-session Mindfulness-Based Cognitive Therapy for Life (MBCT-L) course, with both trials comparing intervention to wait-list. The primary outcome for both trials is stress post-intervention with secondary outcomes being sickness absence, compassion for others, depression symptoms, anxiety symptoms, wellbeing, work-related burnout, self-compassion, presenteeism, and mindfulness (MBCT-L only). Both trials aim to recruit 234 staff working in the National Health Service in the UK.This trial will examine whether a one-day CBT stress-management workshop and an 8-session MBCT-L course are effective at reducing healthcare staff stress and other mental health outcomes compared to wait-list, and, whether these interventions are effective at reducing sickness absence and presenteeism and at enhancing wellbeing, self-compassion, mindfulness and compassion for others. Findings will help inform approaches offered to reduce healthcare staff stress and other key variables. A note of caution is that individual-level approaches should only be part of the solution to reducing healthcare staff stress within a broader focus on organisational-level interventions and support.ISRCTN Registry, ISRCTN11723441 . Registered on 16 June 2017. Protocol Version 1: 24 April 2017. Trial Sponsor: Sussex Partnership NHS Foundation Trust (ResearchGovernance@sussexpartnership.nhs.uk).

Project description:BACKGROUND:Chronic pain is one of the most prevalent and disabling symptoms associated with multiple sclerosis (MS). Individuals with MS are interested in nonpharmacologic pain management approaches. Cognitive-behavioral therapy (CBT) is efficacious in improving MS-related pain outcomes. Mindfulness-based cognitive therapy (MBCT) is a promising, alternative approach. Little is known about moderators of these treatments' outcomes, however. This article describes the study protocol for the first randomized controlled trial comparing MBCT, CBT, and usual care and examining treatment effect moderators in individuals with chronic pain and MS. METHODS:We will conduct a single-center, randomized, single blind, parallel-group trial comparing MBCT, CBT, and usual care in adults with MS and chronic pain. Both interventions will be delivered via eight group sessions using videoconferencing technology. Primary (average pain intensity) and secondary outcomes (including pain interference, depressive symptoms, fatigue, and sleep) will be assessed pre-treatment, mid-treatment, post-treatment, and at 6-month follow up. Potential treatment moderators will be assessed pre-treatment. We hypothesize that participants randomly assigned to MBCT or CBT will report significantly greater reductions in average pain intensity than participants assigned to usual care at post-treatment (primary study endpoint) and 6-month follow up. We also hypothesize that mindfulness, pain catastrophizing, and behavioral activation pre-treatment will moderate response to both active treatments, but not response to usual care. DISCUSSION:Findings will provide important new information about the efficacy and moderators of two nonpharmacologic pain management approaches delivered using technology to overcome common barriers to treatment access. The knowledge gained may lead to better patient-treatment matching and, ultimately, better pain treatment outcomes in MS. TRIAL REGISTRATION:ClinicalTrials.gov, NCT03782246. Registered on 20 December 2018.

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A maturing mindfulness-based cognitive therapy reflects on two critical issues.

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A maturing mindfulness-based cognitive therapy reflects on two critical issues.

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