Mindfulness-based Therapy Program Research Articles

(020) Implementing a Virtual Mindfulness-based Group Therapy to Improve Male Sexual Dysfunction

Abstract Introduction Erectile dysfunction (ED) is almost always multi-factorial. Simultaneous performance anxiety and psychogenic inhibition can impair erectile function even when underlying organic aetiologies are present. Sex therapy should be considered first-line treatment for ED. Mindfulness is a technique to focus on being aware of what you're sensing and feeling in the moment, without interpretation or judgment. Mindfulness-based therapy programs have been successful at improving female sexual dysfunction and prostate cancer survivors quality of life (QOL). Objective To design and evaluate the feasibility of a virtual, mindfulness-based group therapy (vMBGT) program for patients experiencing mild-to-moderate ED. We secondarily assess relationship satisfaction, QOL, and changes in erectile function after intervention. Methods A mixed-methods approach was taken for this feasibility pilot study. A total of 18 participants (mean age: 42; range 22-69 years) with ED were recruited to participate in a 4-week virtual mindfulness-based group therapy program. Three groups were led by trained facilitators on a weekly basis via Webex platform and ran 1.5-2 hours in length, followed by daily home-practice and sex education between sessions. Participants completed questionnaires (International Index of Erectile Functioning, Erection hardness scale, Relationship Assessment Scale, Five Facets of Mindfulness Questionnaire) as a baseline and 3 months after treatment. Qualitative exit interviews and program feedback was requested from all participants. Results The dropout rate for this study was 11%. Two of the eighteen men missed 2 of the 4 sessions; one participant dropped out and one had unanticipated work commitments. There was a statistically significant improvement in the mean IIEF scores from baseline 41 to 49 after vMBGT intervention (p < 0.05). There was a clinically significant improvement in SHIM score by 4 points. There was an improvement in EHS at 3 months compared to baseline (p=0.08) Overall, feedback was positive, and all participants responded that they would recommend this program to others. Some participants felt that the material could be lengthened to 6 weeks and/or that an in-person setting would have been more interactive, whereas others appreciate the convenience and comfort of the virtual platform. Conclusions This is the first published vMGBT program for patients experiencing mild to moderate ED. This program is feasible, the content was well received, and patients had improvement in their erectile function and QOL. Our pilot study has provoked a change to the treatments we can offer patients with ED and we have modified the program based on feedback. Further studies are needed to compare this to medical management and other psychotherapy interventions. Disclosure No

Sustained improvement with mindfulness-based therapy for psychogenic nonepileptic seizures

BackgroundWe previously reported on the efficacy of a manualized 12-session mindfulness-based therapy (MBT) for psychogenic nonepileptic seizures (PNES). Completion of MBT provided improvements in weekly PNES frequency and self-rated intensity. ObjectivesIn this study, we aimed to determine sustainability of improvement of seizure-related measures at 3- to 6-month follow-up after treatment completion. We also examined changes at treatment end and at follow-up on therapeutic targets of the MBT program. MethodsPatients with documented PNES were recruited from 2014 to 2018. Baseline measures were collected at time of diagnosis (T0) and at first follow-up post-diagnosis (T1). Outcomes are reported at MBT treatment completion (T3) and 3- to 6-month follow-up (T4). The Wilcoxon signed-rank test was used for pair-wise comparisons of PNES frequency; linear mixed models were used for other outcomes. ResultsFourteen of the 26 MBT completers (54%) attended follow-up (median 147.5 days between T3 and T4). PNES frequency, intensity, and number of days/week with PNES remained reduced at T4 (p < 0.01 for all; median frequency reduction 1.3/week from T1). Illness perception and feeling understood remained improved at T4 (p < 0.001 for both) as did worry about PNES (p < 0.05). Illness attribution (physical, mental or both) changed from T0 to T3 (p < 0.01), but not to T4. Psychological flexibility did not change over time. ConclusionPreviously reported improvements in seizure-related measures with MBT at treatment conclusion were maintained at 3- to 6-month follow-up. There were sustained improvements in some underlying processes (illness perception, feeling understood, and symptom worry) over the course of treatment and at follow-up. Long-term benefits of MBT need to be established with randomized controlled trials.