Mindfulness-Based Stress Reduction Interventions for Mood in Older Adults: How Do Qualitative Experiences Inform Clinical Response?

Abstract

Older adulthood presents unique challenges to mental health. We explored how a mindfulness training intervention adapted for older adults addressed these challenges, contributing to a qualitative profile of mindfulness pedagogy for older adults. Mindfulness-based stress reduction (MBSR) was adapted for a geriatric community sample with elevated depressive symptoms. Intervention effects were examined through a combination of scale-based assessment and qualitative interviews. Scales measured depressive symptoms, cognitive function, quality of life, and mindful attitudes. Interviews assessed stressors, goals, perceived obstacles, outcomes, and practice habits. A grounded-theory approach was used to identify responses in each category. Multiple regression analyses were used to identify qualitative responses that best predicted symptom reduction. The program was well-tolerated, positively endorsed, and associated with reduced depressive symptoms. Qualitatively, participants who identified family and mood as their primary stressors benefitted the most from course participation. A focus on present moment awareness was associated with decreased depressive symptoms, whereas a focus on hedonics, i.e., “feeling good,” was associated with poorer treatment outcomes. Participants maintained strong future practice intentions and preferred guided meditations to self-directed practice. The adapted MBSR program was well-tolerated and efficacious in a geriatric community sample. Efficacy may be improved by emphasizing skill development outcomes rather than achievement of positive feeling states, and by prioritizing program referrals for coping with socioemotional rather than environmental stressors. Future research could extend this mixed-methods approach to deepen our understanding of the relationship between participants’ lived experiences and clinical outcomes.