Mindfulness-Based Cognitive Therapy Delivered in Primary Care: a Naturalistic, Mixed-Methods Study of Participant Characteristics and Experiences

Abstract

Mindfulness-based cognitive therapy (MBCT), an intervention that integrates mindfulness with cognitive-behavioral therapy, is an 8-week program originally developed to prevent relapses in patients with depression. Previous studies have demonstrated the efficacy of MBCT for preventing relapse, but few studies have evaluated MBCT in naturalistic conditions with real-world samples. Therefore, we sought to explore the characteristics and experiences of individuals receiving MBCT in primary care. Mixed-methods approach combining descriptive and qualitative data. Quantitative data were obtained from 269 individuals from different socioeconomic backgrounds who participated in an MBCT program in our healthcare area during the years 2017 and 2018. Qualitative data were obtained from a subsample of participants who agree to participate in semi-structured individual interviews. An interpretative phenomenological analysis (IPA) approach was used to analyze the qualitative data. In the whole sample (n = 269), the most commonly diagnosed disorders were adjustment (41.6%), mood (22.7%), and anxiety (14.1%). Most participants (60%) were taking psychotropic medications (mainly antidepressants). Overall, mindfulness training improved depressive and anxiety symptoms, regardless of the specific diagnosis. A subsample of 14 individuals participated in the qualitative study. Four overarching themes emerged from the IPA analysis in this subsample: (1) effects of mindfulness practice, (2) learning process, (3) group experience, and (4) mindfulness in the healthcare system. The findings of this naturalistic, mixed-methods study suggest that MBCT could be an effective approach to treating the symptoms of common mental disorders in the primary care setting.