Impact of an integrated mindfulness and cognitive behavioural treatment for provoked vestibulodynia (IMPROVED): a qualitative study

Abstract

Provoked Vestibulodynia (PVD) is a chronic pain condition involving sharp pain to the vulvar vestibule. Because of compelling outcomes using mindfulness-based approaches in the treatment of chronic pain, we developed and tested a four-session mindfulness and cognitive behavioural therapy tailored to women with PVD (called “IMPROVED”). Here we report on the experiences of 14 women (mean age 39.6 years) following IMPROVED using qualitative analysis. Six major themes emerged that captured women's narrative stories: (1) feelings of normality and community in the group setting, (2) positive psychological outcomes following IMPROVED, (3) impact of relationship – including the beneficial effect of having a supportive partner and the negative impact of having an uncooperative partner, (4) an appreciation for treatment, including gratitude towards group facilitators, (5) barriers impeding ongoing practice of acquired skills following the completion of IMPROVED and (6) self-efficacy, which included a feeling that pain management was much more under women's own control than they previously believed. Although the precise mechanisms of action are unknown and quantitative analysis of outcomes is still pending, these data are the first to report on the benefits of a mindfulness-based approach for improving quality of life and reducing genital pain among women with PVD.