The results suggest that MBCT could work through some of the MBCT model's theoretically predicted mechanisms. However, there is a need for more rigorous designs that can assess greater levels of causal specificity.
While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression.
Twenty-six young participants, 18-25 years, with social phobia (SP) were randomly assigned to eight 2-hour sessions of group mindfulness-based cognitive therapy (MBCT) and twelve 2-hour sessions of group cognitive-behavioral therapy (CBT) in a crossover design with participants receiving treatments in reversed order. Outcome was assessed after treatments, and at 6- and 12-month follow-ups. MBCT achieved moderate-high pre-post effect sizes (d=0.78 on a composite SP measure), not significantly different from, although numerical lower than those of CBT (d=1.15). Participants in both groups further improved in the periods following their first and second treatment until 6-months follow-up (pre-follow-up ds = 1.42 and 1.62). Thus, MBCT might be a useful, low cost treatment for SP, although, probably, less efficacious than CBT.
This case study pilot-tests a novel, cognitive behavioral treatment (CBT) program for social phobic clients in an Anxiety Clinic run by the Department of Psychology of the University of Aarhus, Denmark. The core of the program was an intensive therapy group lasting for 5 consecutive days during one week, from 9:00 am to 2:00 pm each day. The group was composed of 9 clients and 8 student therapists in training, who were present throughout the total 25 hours, and two supervising psychologists, who were present during the first 2 hours of each day. Each client was also assigned to one of the student therapists, seeing the therapist for 2-4 individual sessions before the intensive group-week, and 6 weekly 2-hour group sessions after the intensive group experience. The groups were composed of 4 (or 5) clients and 4 students with the students on their own in charge of the therapy. Individual therapy was also provided when clinically indicated after the end of the group therapy. Treatment was evaluated within an embedded case study design with one group and 9 clients via both qualitative information and quantitative measures that assessed the clients' presenting problems and therapeutic progress over the entire course of therapy and at follow-up. The results show that the intensive group treatment was therapeutically valuable for the clients. Specifically, almost all the clients appreciated the intensive group treatment format, and most achieved fast symptomatic declines over the week. Outcomes of the full treatment program for the whole group were in line with results from studies on psychotherapy for social phobia provided by experienced therapists. The educational value of the program is commented on in the discussion.
We aimed to evaluate the effectiveness of Mindfulness-Based Stress Reduction (MBSR) when implemented in a community setting as a self-referred and self-paid course. Pre-post changes and Cohen’s d effect sizes were calculated for questionnaire measures of mindfulness, perceived stress, and symptoms of anxiety and depression. We compared these effect sizes with those from intervention groups in randomized controlled trials (RCTs), with populations similar to our study sample. These RCTs reported significant effects of MBSR compared to control condition. MBSR was delivered in three different Danish cities by ten different MBSR teachers with various professional backgrounds and MBSR teaching experience. One hundred and thirty-two participants were included in the study: 79% were women, mean age 45 ± 10.4 years, 75% of the participants had more than 15 years of education, 38% had a Perceived Stress Scale (PSS) score≥18, and 27% had a history of mental disorder. Post MBSR, the proportion of participants with a PSS≥18 decreased by 16% points (95%CI −26 to −6), p = 0.0032. Within-group effect sizes for (i) the total study population (ii) the subgroup with PSS≥18 at baseline (iii) intervention group in reference RCTs were as follows: PSS: d = 0.50:1.47:1.00, Symptom Check List 5: d = 0.48:0.81:0.77, Five Facet Mindfulness Questionnaire: d = 0.67:1.09:1.00. Our results showed that MBSR was effective. The effects were largest among the participants reporting highest perceived stress level at baseline. Our participants were mainly women who were middle-aged, with high educational levels, and more perceived stress and a greater history of mental disorder than the general population, and who were able to seek out and pay for an MBSR course. Reaching vulnerable groups with a clear need for stress management will, however, require other implementation strategies.
Background
Standardized mindfulness training courses involve significant at-home assignments of meditation practice. Participants’ self-reported completion of these assignments has been correlated with treatment outcomes, but self-reported data are often incomplete and potentially biased. In addition, mindfulness teachers typically suggest that participants set aside a regular practice time, preferably in the morning, but the extent to which participants do this has not been empirically examined.
Objective
This study aimed to analyze patterns of participant engagement with home practice in a mindfulness-based stress reduction course.
Methods
We used a novel smartphone app to provide 25 participants with access to their daily practice assignments during the 8-week course. We analyzed data collected through our smartphone app to determine usage and listening patterns and performed analyses of the regularity and frequency of participant behavior.
Results
We found that participants listened to a median of 3 of the 6 practice sessions per week, and they did not typically set aside a regular daily practice time. Across weekdays, participants practiced most frequently in the morning, but there was considerable variation in participants’ practice start times. On weekends, the peak practice time was in the evening.
Conclusions
We suggest that it is feasible to integrate a smartphone-monitoring approach into existing mindfulness interventions. High-frequency smartphone monitoring can provide insights into how and when participants complete their homework, information that is important in supporting treatment engagement.
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