Effectiveness of Mindfulness-Based Stress Reduction in a Self-Selecting and Self-Paying Community Setting

Lise Juul,Christine Parsons,Lone Overby Fjorback,Jacob Piet,Karen Johanne Pallesen

doi:10.1007/s12671-017-0873-0

Lise Juul, Christine Parsons + Show 3 more

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https://doi.org/10.1007/s12671-017-0873-0

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Journal: Mindfulness	Publication Date: Dec 19, 2017
Citations: 9	License type: open-access

Affiliation: Aarhus University

Abstract

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.

Highlights

Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al 2006; Horri et al 2010; Kelly and Ismail 2015; Pallesen et al 2016; Rosengren et al 2004; Stansfeld et al 2002)
For the Symptom Check List (SCL)-5, the pre-score was 2.1 ± 0.6 in the total study population (Table 2) and 2.5 ± 0.6 in the subgroup with Perceived Stress Scale (PSS) ≥ 18 at baseline (Table 3), which were statistically significantly reduced after Mindfulness-Based Stress Reduction (MBSR) to be 1.8 ± 0.5 and 2.1 ± 0.5, respectively
This study evaluated the effects of attending a self-paid MBSR course in a community setting, delivered by MBSR teachers trained to international standards in Denmark

Summary

Introduction

Long-term stress is an increasing public health problem and is associated with impaired psychological and physical functioning (Chandola et al 2006; Horri et al 2010; Kelly and Ismail 2015; Pallesen et al 2016; Rosengren et al 2004; Stansfeld et al 2002). During long-term on-going stress, in contrast, the stress response causes wear and tear on the body, as restitution is put on hold (Mc Ewen and Norton Lasley 2002; Pallesen et al 2016). Another consequence of long-term stress can be physiological changes that have wideranging harmful effects on bodily functions. Only recently identified, is decreased physiological sensitivity to cortisol, which occurs as this stress hormone is present in the blood stream for extended periods of time (Cohen et al 2012).

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