Use Of Mindfulness-based Cognitive Therapy Research Articles

Mindfulness-based cognitive therapy for adherence of immunosuppressive treatment in liver transplant recipients: A randomized controlled trial

ObjectiveThe aim of this study was to analyze the effects of mindfulness-based cognitive therapy on the adherence of liver transplant recipients to immunosuppressive therapy with a randomized controlled design. MethodThis randomized controlled trial was performed with 120 liver transplant recipients hospitalized at the liver transplant department of a research and practice hospital (n = 120). While we administered no intervention to the patients in the control group (n = 60), we provided Mindfulness-Based Cognitive Therapy to those in the experimental group (n = 60). We used the Mindful Attention Awareness Scale and the Immunosuppressant Therapy Adherence Scale to collect data. We utilized descriptive statistics, paired-samples t-tests, independent-samples t-tests, one-way analysis of variance, and chi-squared tests to analyze the data. ResultsAfter the intervention, the immunosuppressive therapy adherence levels of the experimental group increased significantly (p < 0.01). On the other hand, the control group had significantly higher adherence to immunosuppressive therapy and significantly higher levels of mindfulness in the pretest phase than it did in the posttest phase (p < 0.01). ConclusionsComplete adherence to immunosuppressive therapy is imperative for the prevention of graft rejection in liver transplant recipients. In our study, the experimental group equipped with enhanced mindfulness had higher adherence to immunosuppressive therapy. Therefore, the use of Mindfulness-Based Cognitive Therapy in the promotion of adherence to immunosuppressive therapy is recommended.

A randomised controlled trial to investigate the clinical effectiveness and cost effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depressed non-responders to Increasing Access to Psychological Therapies (IAPT) high-intensity therapies: study protocol

BackgroundMajor depression represents a pressing challenge for health care. In England, Increasing Access to Psychological Therapies (IAPT) services provide evidence-based psychological therapies in a stepped-care approach to patients with depression. While introduction of these services has successfully increased access to therapy, estimates suggest that about 50% of depressed patients who have come to the end of the IAPT pathway still show significant levels of symptoms. This study will investigate whether Mindfulness-Based Cognitive Therapy (MBCT), a group intervention combining training in mindfulness meditation and elements from cognitive therapy, can have beneficial effects in depressed patients who have not responded to high-intensity therapy in IAPT. It will seek to establish the effectiveness and cost-effectiveness of MBCT as compared to the treatment these patients would usually receive.MethodsIn a 2-arm randomised controlled trial, patients who currently meet the criteria for major depressive disorder and who have not sufficiently responded to at least 12 sessions of IAPT high-intensity therapy will be allocated, at a ratio of 1:1, to receive either MBCT (in addition to treatment as usual [TAU]) or continue with TAU only. Assessments will take place at baseline, 10 weeks and 34 weeks post-randomisation. The primary outcome will be reduction in depression symptomatology 34 weeks post-randomisation as assessed using the Public Health Questionnaire-9 (PHQ-9). Secondary outcomes will include depressive symptomatology at 10 weeks post-randomisation and other clinical outcomes measured at 10-week and 34-week follow-up, along with a series of binarised outcomes to indicate clinically significant and reliable change. Evaluations of cost-effectiveness will be based on assessments of service use costs collected using the Adult Service Use Schedule and health utilities derived from the EQ-5D.DiscussionThis trial will add to the evidence base for the use of MBCT in depressed treatment non-responders. It will constitute the first trial to test MBCT following non-response to psychological therapy, with results providing a direct estimate of efficacy within the IAPT pathway. As such, its results will offer an important basis for decisions regarding the adoption of MBCT for non-responders within IAPT.Trial registrationClinicalTrials.gov NCT05236959. Registered on 11 February 2022. ISRCTN 17755571. Registered on 2 February 2021.

The effectiveness of mindfulness-based cognitive therapy combined with medication therapy in preventing recurrence of major depressive disorder in convalescent patients.

This study aims to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) combined with medication therapy in preventing the recurrence of major depressive disorder (MDD) in convalescent patients. A total of 130 patients with convalescent MDD were enrolled in this prospective study. Sixty-five patients were assigned to the experimental group and received medication therapy combined with MBCT, and 65 patients were assigned to the control group and treated with medication alone. The recurrence rate and related hormonal changes were compared between the two groups. After 1 year of MBCT intervention, eight patients experienced recurrence in the experimental group, a recurrence rate of 12.31%, and 19 patients experienced recurrence in the control group, a recurrence rate of 29.23%. The Hamilton Depression Rating Scale (HAM-D) and the World Health Organization Quality of Life Scale (WHOQOL-BREF) scores in both the experimental and the control groups were significantly improved after treatment (P < 0.05). The difference in the HAM-D scores before and after treatment in the experimental group was 16.74 ± 4.54; this was significantly higher than that of the control group (8 ± 3.89, P < 0.0001). The WHOQOL-BREF scores in the experimental group were significantly improved compared with those of the control group (P < 0.0001). The differences in the levels of corticotrophin-releasing hormone (CRH), adrenocorticotropic hormone, and cortisol before and after treatment in the experimental group and the control group were statistically significant (P < 0.05). The difference in CRH before and after treatment in the experimental group was 16.8 ± 7.2, which was higher than that of the control group (2.75 ± 9.27, P < 0.0001). The intervention with MBCT had a significant impact on the recurrence of MDD [β = 1.206, P = 0.039, 95% (confidence interval) CI = 0.0790-1.229]. The difference in the HAM-D scores also had a significant impact on the recurrence of MDD (β = 1.121, P = 0.0014, 95% CI = 0.805-0.976). Compared with medication therapy alone, the use of MBCT combined with medication therapy can effectively prevent the recurrence of MDD in convalescent patients.

A Systematic Review of Studies on the Use of Mindfulness-Based Cognitive Therapy for the Treatment of Anxiety and Depression in Older People

To review the evidence base for mindfulness-based cognitive therapy for the treatment of anxiety and depression in older people. A systematic review was conducted, based on Joanna Briggs Institute methodology. Any study design focusing on qualitative or quantitative data was considered for review. Inclusion criteria were mindfulness-based cognitive therapy; symptoms of anxiety and/or depression; older age; and qualitative and/or quantitative methods. Studies not in English were excluded from the review. Ten studies evaluating the use of mindfulness-based cognitive therapy to treat older participants with anxiety and/or depression were identified as potentially eligible for inclusion. Of these, nine met the eligibility criteria and were of sufficient methodological quality to be included in the review. These nine studies included five mixed method studies, one non-controlled quasi-experimental study, one wait-list controlled quasi-experimental study, a collection of five single case reports and a randomized controlled trial. To date there is insufficient evidence for the use of mindfulness-based cognitive therapy to treat anxiety and depression in older adults. Existing preliminary studies report positive results but have multiple methodological weaknesses that limit their utility in informing clinical practice. Further rigorous research is warranted, to establish an evidence base for mindfulness-based cognitive therapy in older people with anxiety and/or depression.

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group.

BackgroundMindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.ObjectivesTherefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.MethodsA clinical trial was conducted in 2017 - 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis.ResultsStatistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.ConclusionsMBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

Psychological therapies for preventing seasonal affective disorder.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions. To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second-generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person-centred outcomes among adults with a history of SAD. We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non-randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second-generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy. Two review authors screened abstracts and full-text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence. We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and abstract review and assessed 126 articles at full-text review for eligibility. We included one controlled study enrolling 46 participants. We rated this RCT at high risk for performance and detection bias due to a lack of blinding.The included RCT compared preventive use of mindfulness-based cognitive therapy (MBCT) with treatment as usual (TAU) in participants with a history of SAD. MBCT was administered in spring in eight weekly individual 45- to 60-minute sessions. In the TAU group participants did not receive any preventive treatment but were invited to start light therapy as first depressive symptoms occurred. Both groups were assessed weekly for occurrence of a new depressive episode measured with the Inventory of Depressive Syptomatology-Self-Report (IDS-SR, range 0-90) from September 2011 to mid-April 2012. The incidence of a new depressive episode in the upcoming winter was similar in both groups. In the MBCT group 65% of 23 participants developed depression (IDS-SR ≥ 20), compared to 74% of 23 people in the TAU group (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.30; 46 participants; very low quality-evidence).For participants with depressive episodes, severity of depression was comparable between groups. Participants in the MBCT group had a mean score of 26.5 (SD 7.0) on the IDS-SR, and TAU participants a mean score of 25.3 (SD 6.3) (mean difference (MD) 1.20, 95% CI -3.44 to 5.84; 32 participants; very low quality-evidence).The overall discontinuation rate was similar too, with 17% discontinuing in the MBCT group and 13% in the TAU group (RR 1.33, 95% CI 0.34 to 5.30; 46 participants; very low quality-evidence).Reasons for downgrading the quality of evidence included high risk of bias of the included study and imprecision.Investigators provided no information on adverse events. We could not find any studies that compared psychological therapy with other interventions of interest such as second-generation antidepressants, light therapy, melatonin or agomelatine. The evidence on psychological therapies to prevent the onset of a new depressive episode in people with a history of SAD is inconclusive. We identified only one study including 46 participants focusing on one type of psychological therapy. Methodological limitations and the small sample size preclude us from drawing a conclusion on benefits and harms of MBCT as a preventive intervention for SAD. Given that there is no comparative evidence for psychological therapy versus other preventive options, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences and other preventive interventions that are supported by evidence.

Mindfulness-based Cognitive Therapy and Persistent Pain in Women Treated for Primary Breast Cancer: Exploring Possible Statistical Mediators: Results From a Randomized Controlled Trial.

The aim of this study was to investigate possible statistical mediators in a randomized controlled trial of mindfulness-based cognitive therapy (MBCT) on pain intensity in women treated for primary breast cancer. The sample consisted of 129 women treated for breast cancer, presenting with persistent pain, who were randomly assigned to MBCT or a wait-list control. We previously reported a statistically significant and robust effect of MBCT on pain intensity (11-point numeric rating scale), which was included as the primary outcome. The proposed mediators were mindfulness (the Five Facet Mindfulness Questionnaire), self-compassion (the Short-Form Self-Compassion Scale), and pain catastrophizing (the Pain Catastrophizing Scale). Measurement points included baseline (T1), postintervention (T2), and 3- (T3) and 6-month (T4) follow-ups. All indirect effects of the mediators were tested in separate Multilevel Models, using the product-of-coefficients approach with bias-corrected confidence intervals (95% BSCI). The statistically significant mediators were then included in a multiple mediator model. Statistically significant indirect effects were found for mindfulness nonreactivity (B=-0.17, BSCI [-0.32 to -0.04]) and pain catastrophizing (B=-0.76, BSCI [-1.25 to -0.47]). No statistically significant indirect effect was found for self-compassion (B=-0.09, BSCI [-0.30 to 0.04]). In a multiple mediator model, including mindfulness nonreactivity and pain catastrophizing, only pain catastrophizing remained statistically significant (B=-0.72, BSCI [-1.19 to -0.33]), explaining 78% of the effect. The results of the present study may have clinical implications. An increased focus on the proposed mediators may optimize the clinical use of MBCT for persistent pain in women treated for breast cancer.

Purpose in Life May Lead to Better Sleep

Purpose in Life May Lead to Better Sleep

Can mindfulness-based interventions improve the quality of life of patients with moderate/severe alopecia areata? A prospective pilot study

Can mindfulness-based interventions improve the quality of life of patients with moderate/severe alopecia areata? A prospective pilot study

Mindfulness‐based cognitive therapy as an augmentation treatment for obsessive–compulsive disorder

Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from significant symptoms. Participation in MBCT was also associated with increases in mindfulness skills including increased ability to be nonjudgmental and nonreactive. By fostering a nonjudgmental stance towards intrusive thoughts, mindfulness may discourage suppression and avoidance of thoughts and this could lead to increased habituation and a decreased reliance on compulsions. The use of MBCT as an augmentation treatment should be further explored to elucidate whether this treatment is beneficial for preventing relapse of OCD and could be compared against further cognitive behavioural therapy to see if offering participants a different and theoretically compelling intervention, such as MBCT, would outperform "more of the same" for individuals with OCD.

Effectiveness of mindfulness based cognitive therapy on the distress tolerance of nurses and job burnout

Background and Purpose: Distress is an important issue with significant effects on nurses and patients in the nursing profession. This study aimed to investigate the effects of mindfulness-based cognitive therapy (MBCT) on the distress tolerance of nurses with job burnout. Methods: This quasi-experimental study was conducted with a pretest-posttest design and a control group. Study population consisted of 202 female nurses employed at Fatemeh Zahra Hospital (heart center) of Sari, Iran in 2015. Collected data were indicative of job burnout in 70 participants. In total, 30 nurses were selected as eligible subjects and equally divided into two groups of intervention and control. Pretest was performed on both groups. Nurses in the intervention group received eight sessions of training (two hours each) twice per week, while the control group had no intervention. Both groups were evaluated after the intervention (posttest). Data were collected using Maslach Burnout Inventory (MBI) and Simons and Gaher's Distress Tolerance Scale (DTS). Data analysis was performed in SPSS version 21 using analysis of covariance. Results: In this study, use of MBCT was observed to positively affect the distress tolerance of nurses with job burnout. Conclusion: According to the results of this study, factors such as prompt decision-making, job difficulty, long working shifts, and stressful environments were significantly involved in the psychological and physical stress of nurses, and MBCT could effectively enhance distress tolerance in the participants.

Mindfulness-Based Cognitive Therapy for Patients With Depression Decreases the Need for Outpatient Visits.

To determine if the use of mindfulness-based cognitive therapy (MBCT) in patients with a history of 2 or more episodes of major depressive disorder and other mood disorders will decrease the need for medication management and other interventions and will also decrease the need for outpatient services and the overall cost of treatment. The study patients completed MBCT group sessions between January 1, 2010, and December 31, 2013. Patients who had 2 or more episodes of major depressive disorder (recurrent MDD) were categorized into a group. The remaining patients with other mood disorders were placed in a comparison group. The mean differences in drug treatments and hospital utilizations between the recurrent MDD and nonrecurrent MDD group were compared. Wald P values and 95% CIs were obtained for both adjusted and unadjusted estimated mean differences. Covariates were adjusted for age at start of MBCT, gender, and race/ethnicity. The final sample consisted of 142 patients (93 recurrent MDD and 49 others). There was no significant difference in the effect of MBCT on medication changes between recurrent MDD patients and nonrecurrent MDD patients. Recurrent MDD patients who participated in MBCT experienced reduction in all calls and visits (P = .0068) and less psychiatric visits (P = .0026) in the year after MBCT when compared with the visits before the intervention. This study evaluated the effectiveness of MBCT in reducing the need for additional psychiatric services. The study evaluated patients who received MBCT over 3 years and demonstrated that MBCT decreased the need for care regardless of medication changes. The results raise the question of whether MBCT allows patients to respond to situations more skillfully or if MBCT itself decreases depressive symptoms. The limitations of this study include a small sample size, patient selection, and its design as a retrospective study. However, this study may have implications as a treatment strategy that may be generalizable to other clinics and patient populations.

An Introduction to the Buddhist Underpinnings of Mindfulness-Based Interventions: Buddha-Nature and Intrinsic Goodness

An Introduction to the Buddhist Underpinnings of Mindfulness-Based Interventions: Buddha-Nature and Intrinsic Goodness

Mindfulness-based cognitive therapy for inflammatory bowel disease patients: findings from an exploratory pilot randomised controlled trial.

BackgroundInflammatory bowel disease (IBD) is a chronic gastrointestinal condition with a relapsing disease course. Managing the relapsing nature of the disease causes daily stress for IBD patients; thus, IBD patients report higher rates of depression and anxiety than the general population.Mindfulness-based Cognitive Therapy (MBCT) is an evidence-based psychological program designed to help manage depressive and stress symptoms. There has been no randomized controlled trial (RCT) testing the use of MBCT in IBD patients.The purpose of this pilot study is to test the trial methodology and assess the feasibility of conducting a large RCT testing the effectiveness of MBCT in IBD.MethodsThe IBD patients, who were recruited from gastroenterology outpatient clinics at two Scottish NHS Boards, were randomly allocated to an MBCT intervention group (n = 22) or a wait-list control group (n = 22). The MBCT intervention consisted of 16 hours of structured group training over 8 consecutive weeks plus guided home practice and follow-up sessions. The wait-list group received a leaflet entitled ‘Staying well with IBD’. All participants completed a baseline, post-intervention and 6-month follow up assessment. The key objectives were to assess patient eligibility and recruitment/dropout rate, to calculate initial estimates of parameters to the proposed outcome measures (depression, anxiety, disease activity, dispositional mindfulness and quality of life) and to estimate sample size for a future large RCT.ResultsIn total, 350 patients were assessed for eligibility. Of these, 44 eligible patients consented to participate. The recruitment rate was 15 %, with main reasons for ineligibility indicated as follows: non-response to invitation, active disease symptoms, planned surgery or incompatibility with group schedule. There was a higher than expected dropout rate of 44 %. Initial estimates of parameters to the proposed outcomes at post-intervention and follow-up showed a significant improvement of scores in the MBCT group when compared to the control for depression, trait anxiety and dispositional mindfulness. The sample-size calculation was guided by estimates of clinically important effects in depression scores.ConclusionsThis pilot study suggests that a multicentre randomized clinical trial testing the effectiveness of MBCT for IBD patients is feasible with some changes to the protocol. Improvement in depression, trait anxiety and dispositional mindfulness scores are promising when coupled with patients reporting a perceived improvement of their quality of life.Trial registrationISRCTN27934462. 2 August 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0909-5) contains supplementary material, which is available to authorized users.

The Use of Mindfulness-based Cognitive Therapy for Improving Flow Experience of Nurses in the Psychiatric Hospitals

Introduction The Flow experience in job result in increasing the internal interest to job and it is so enjoyable that causes people do that job for itself. So, designing the effective methods and programs for treatment has important role in increasing this features, especially in nursing staff in the psychiatric units that confront to high stress. Objective and Aim the present study has been done by the purpose of effectiveness of the Mindfulness-Based Cognitive Therapy of the Flow experience in nursing staff at the Psychiatric Hospital in Tehran Iran. Method This study is a semi-experimental with pretest-posttest plan along with control group. 30 nurses in the Psychiatric Hospital with score less than 108 in the questionnaire of the Flow State Scale (FSS) of Jackson and Marsh (1997) were selected randomly and then they were divided in two groups of control and experimental. The period of training was 8 sessions with duration of 2 hours for each session once weekly. One week after completion the sessions of Mindfulness-Based Cognitive Therapy, the above mentioned questionnaire was performed for both two groups. Result The results demonstrated that the Mindfulness-Based Cognitive Therapy meaningfully has been effective on the flow experience, Action-awareness merging, the clear goal, Unambiguous feedback, Concentration on task at hand, sense of control and also it has the most effect on the mini-scale of the Loss of self-consciousness (P Conclusion Mindfulness-Based Cognitive Therapy can be effective in increasing the flow experience of nurses who work in the psychiatric hospitals.

Using Mindfulness-Based Cognitive Therapy in Individual Counseling to Reduce Stress and Increase Mindfulness: An Exploratory Study With Nursing Students

The purpose of this exploratory study was to investigate effectiveness of a modified mindfulness-based cognitive therapy intervention using individual counseling sessions to reduce stress and increase levels of mindfulness among nursing students. An AB single-subject experimental design replicated three times was implemented. Results indicated reduced stress in two out of three participants and increased mindfulness levels in all participants. Implications for college counselors and counselors working with clients in high-stress occupations are provided. Additionally, results show promise for use of mindfulness-based cognitive therapy in individual counseling.Keywords: mindfulness, mindfulness-based cognitive therapy, stress, college counselors, nursing, single-subject experimental designMindfulness-based cognitive therapy (MBCT) has been described as part of a third generation of cognitive therapies (Harrington & Pickles, 2009). Along with dialectical behavioral therapy and others like it, MBCT has integrated construct of mindfulness with standard cognitive-behavioral paradigms. MBCT found its origins in work of Kabat-Zinn's (1990) mindfulness-based stress reduction program. This 8-week group-based program consisted of Buddhist mindfulness mediation practices to help chronic pain sufferers reduce their stress associated with illness. MBCT has incorporated elements of mindfulness-based stress reduction and cognitive- behavioral therapy to help individuals become more aware of thoughts and feelings and put them into context as mental events rather than self-defining constructs (Teasdale et al, 2000).Seeing a need for an intervention to help patients who had repeatedly relapsed into depression, Segal, Williams, and Teasdale (2002) formalized MBCT as a standardized program of therapy. Designed as an 8-week program with specific guidelines for each session, MBCT was originally conceived as a group modality. Clients are placed in classes to learn mindfulness and cognitive-behavioral (Beck, Rush, Shaw, & Emery, 1979) skills needed to regulate emotions and thoughts. MBCT involves training mind to avoid judgmental reactions to events, thoughts, feelings and body sensations and to practice nonjudgmental awareness and acceptance (Ma & Teasdale, 2004). The key component of MBCT is mindfulness.Mindfulness, once an abstract concept in counseling field, is reaching mainstream awareness and gaining more attention in literature (Brown, Marquis, & Guiffrida, 2013). Derived from Zen Buddhism, mindfulness has been described as a commitment to bringing awareness back to moment (Harrington & Pickles, 2009). Brown and Ryan (2003) defined mindfulness as the state of being attentive to and aware of what is taking place in present (p. 822). Despite a growing research base, mindfulness as a testable and operationally defined variable is still being shaped.Bishop et al. (2004) proposed an operational definition of mindfulness as a two-component skill-building approach for responding to emotional and cognitive distress. The first component involves self-regulation of attention. Measurable skills must be obtained to reach a successful level of self-regulation of attention, including sustained attention; switching, or bringing attention back to a focal point; and inhibition of elaborative processing, which involves ability to maintain a state of flexible and nonjudgmental focus and awareness over a period of time. The second component includes developing an orientation to experience. In this, all thoughts, feelings and sensations are acknowledged.Mindfulness training works well in counseling in that it is a simple idea: staying focused on momentary experience (Grabovac, Lau, & Willett, 2011). The core strategy to teach clients is mindfulness meditation. Meditation has many forms but is ultimately practiced skill of quieting mind (Wright, 2007). …

Mindfulness-Based Cognitive Therapy: Primary Care Patients’ Experiences of Outcomes in Everyday Life and Relapse Prevention

The concept of mindfulness has attracted a growing body of research within behavioural medicine over the last decade. Mindfulness-based cognitive therapy (MBCT) has been developed to prevent relapse among people who suffer recurrent depression. Studies show impressive results, with a decrease in the risk of relapse of up to 50%. However, primary care patients’ own experiences and MBCT’s effectiveness as a relapse program and aid to their ability to deal with everyday life remain relatively unexplored. The aim of the study, therefore, was to examine how primary care patients with recurrent depression perceive the usefulness of MBCT in preventing relapse. Nineteen patients who had participated in a MBCT program for recurrent depression within a primary care setting were interviewed 12 months after treatment. Qualitative thematic analysis was used to identify, analyse, and report patterns in the interviews. Analysis suggests two overarching themes, “Strategies for remission” and “Personal development”. This study brings new information about what participants in MBCT classes describe as the most useful interventions for relapse prevention. The formal and informal meditation exercises focused on the body and the breath were described as the most important strategies for remission and the mindfulness practice gave the participants an enhanced self-knowledge that helped them to better deal with everyday stress and interpersonal functioning. The findings also indicate that traditional cognitive behavioural interventions, such as behaviour activation and establishing a maintenance plan, might not be as essential to relapse prevention as formerly thought.

Using MBCT in a Chronic Pain Setting: A Qualitative Analysis of Participants’ Experiences

An estimated 20 % of the global population experiences chronic pain, and comorbidity with emotional disorders such as depression is high. While the use of mindfulness-based cognitive therapy (MBCT) as an intervention for recurrent depression is escalating in both popularity and evidence-based success, MBCT is being increasingly utilised in a range of areas including chronic pain management. The current study was designed to conceptualise chronic pain patients’ perceived benefits of an MBCT programme. Semi-structured interviews were conducted with 17 chronic pain patients who had participated in MBCT group training within a public hospital pain unit between 8 and 50 months previously. The recorded interviews were transcribed and interpreted using thematic analysis to identify key themes in participants’ comments. Four overarching themes were extracted: patients’ belief in the programme, patients’ perception of control, patients’ struggles and patients’ acceptance of the presence of pain. Participants who perceived benefits from the MBCT programme were most motivated to continue mindfulness practice. Identifying patients’ perspectives on their pain and the benefits of ongoing mindfulness practice following participation in an MBCT group intervention provided opportunity to discuss ways to best assist patients in developing and consolidating their practice. Clinical and research implications are discussed.

Mindfulness-based cognitive therapy for depression in adolescents.

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in preventing relapse of depression in adults, but has not previously been applied to adolescents who have residual symptoms of depression following treatment. An 8-week MBCT group was adapted for adolescents, and evaluated using qualitative and quantitative measures. Participants report high levels of satisfaction with the group intervention. Qualitative analysis of semi-structured interviews provides areas for future development of this intervention. Pilot data indicate reductions in depressive symptoms, alongside positive change in mindfulness skills, quality of life and rumination. Preliminary evidence for the use of MBCT with this group of adolescents is provided.

Theoretical Paper How to skin a cat: A case for and against the use of mindfulness-based cognitive therapy in pluralistic therapy

Content and FocusThis paper seeks to answer the following question: ‘How can a pluralistic therapist use a single school approach and remain faithful to their philosophical and collaborative base?’ To do this it explores some of the difficulties associated with integrative/eclectic approaches to therapy. Within this it discusses pluralistic philosophy and suggests that the proverb ‘there is more than one way to skin a cat’ is a helpful way of summarising pluralistic philosophy. From there it discusses Cooper and McLeod’s (2011) Pluralistic Framework for counselling and psychotherapy as an integrative approach and focuses on two distinguishing elements of it; namely that it has its basis in pluralistic philosophy rather than psychological theory and that it is collaborative in nature. The discussion then turns towards mindfulness-based cognitive therapy (MBCT) and the theory and research evidence that underpins it with a view to considering how a single school approach may fit with a pluralist approach. The paper reflects upon two opposing answers to the dilemma that is inherent within the question referred to at the outset of this abstract, suggesting rationale both for and against the use of MBCT from a pluralistic position.ConclusionThe paper concludes by offering the concept of Pragmatic Pluralism as a way for pluralistic therapists to undergird their therapeutic decision making.