A Randomized Clinical Trial of a Modified Mindfulness-Based Cognitive Therapy for Children Hospitalized with Cancer

Abstract

Many youth diagnosed with cancer also suffer from anxiety, depression, posttraumatic distress, and attention problems, which can negatively affect their quality of life. Mindfulness-based Cognitive Therapy for Children (MBCT-C) aims to enhance self-management of attention, improve emotional self-regulation, and bolster social-emotional resiliency. A modified MBCT-C intervention was conducted with hospitalized pediatric cancer patients to evaluate its efficacy for reducing internalizing and attention problems. Forty children (ages 11 to 13) diagnosed with cancer were randomly assigned to either a modified MBCT-C group (n = 20) or treatment as usual (TAU) control group (n = 20). To meet the needs of hospitalized participants, the manualized MBCT-C protocol was adapted to consist of 20 sessions, each lasting 45 min. Sessions were conducted 5 times weekly for 4 weeks. Primary outcome measures were the Child Behavior Checklist, Parent Report and its companion instrument, and the Youth Self-Report (YSR). Data were collected at pre-intervention, post-intervention, and at 2 months following the intervention. Repeated measures ANOVAs showed that, as compared with TAU controls, the MBCT-C group achieved significant reductions in internalizing and attention problems, and those gains were maintained at the 2-month follow-up. Reliable Change Index scores showed that the gains made by the MBCT-C group were both clinically significant and stable. By reducing internalizing and attention problems, mindfulness-based interventions may improve the quality of life for children hospitalized with cancer. These promising results warrant further investigation into the efficacy of mindfulness-based interventions to remediate internalizing and attentional problems in youth diagnosed with serious medical illnesses.