1
|
Williams JMG, Baer R, Batchelor M, Crane RS, Cullen C, De Wilde K, Fennell MJV, Kantor L, Kirby J, Ma SH, Medlicott E, Gerber B, Johnson M, Ong EL, Peacock JW, Penman D, Phee A, Radley L, Watkin M, Taylor L. What Next After MBSR/MBCT? An Open Trial of an 8-Week Follow-on Program Exploring Mindfulness of Feeling Tone (vedanā). Mindfulness (N Y) 2022; 13:1931-1944. [PMID: 35818377 PMCID: PMC9261229 DOI: 10.1007/s12671-022-01929-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/09/2022]
Abstract
Objectives
The effectiveness of mindfulness-based programs (MBPs) has been established in many randomized controlled trials. However, effect sizes are often modest, and there remains ample scope to improve their effectiveness. One approach to this challenge is to offer a “follow-on” course to people who have completed an MBP and are interested in further skill development. We developed and tested a new 8-week course for this purpose based on awareness of feeling tone (vedanā), an understudied aspect of mindfulness in many current MBPs, incorporating new developments in neuroscience and trauma sensitivity. We examined its effectiveness and the frequency and severity of unpleasant experience and harm. Methods In an open trial, 83 participants, 78 of whom had previously taken part in an MBP (majority MBSR or MBCT), completed the program in nine groups. Participants completed questionnaires before and after and gave qualitative written feedback at completion. Results Participants reported significantly reduced depression (d = 0.56), stress (d = 0.36), and anxiety (d = 0.53) and increased well-being (d = 0.54) and mindfulness (d = 0.65) with 38% meeting criteria for reliable change on anxiety and depression. As expected, about three-quarters of participants reported some unpleasant experiences associated with mindfulness practice during the course, but none reported harm. Five participants showed “reliable deterioration” (an increase) in either depression or anxiety, but four of these five also gave anonymous qualitative feedback describing benefits of the course. Conclusions Findings support the added value of a follow-on course based on the exploration of feeling tone for participants who have a range of previous mindfulness experience. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-022-01929-0.
Collapse
|
2
|
Ondrejková N, Halamová J, Strnádelová B. Effect of the intervention mindfulness based compassionate living on the - level of self - criticism and self – compassion. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00799-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
3
|
Goren G, Schwartz D, Friger M, Banai H, Sergienko R, Regev S, Abu-Kaf H, Greenberg D, Nemirovsky A, Ilan K, Lerner L, Monsonego A, Dotan I, Yanai H, Eliakim R, Ben Horin S, Slonim-Nevo V, Odes S, Sarid O. Randomized Controlled Trial of Cognitive-Behavioral and Mindfulness-Based Stress Reduction on the Quality of Life of Patients With Crohn Disease. Inflamm Bowel Dis 2022; 28:393-408. [PMID: 33847758 DOI: 10.1093/ibd/izab083] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with Crohn disease have debilitating psychological symptoms, mental fatigue, and poor quality of life. Psychological intervention may improve these symptoms. METHODS We performed a randomized parallel-group physician-blinded trial of cognitive-behavioral and mindfulness-based stress reduction (COBMINDEX) on quality of life and psychological symptoms in adults with mild-moderate Crohn disease. COBMINDEX was taught by social workers in one-on-one video conferences over 3 months; quotidian home practice was mandated. RESULTS Fifty-five COBMINDEX and 61 waitlist control patients completed the study; mean age was 33 years and 65% of participants were women. At 3 months, COBMINDEX patients had significantly reduced disease activity (per Harvey-Bradshaw Index score, C-reactive protein level, and calprotectin level), increased quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ] score increased from baseline 41 to 50; P < 0.001), decreased psychological symptoms (Global Severity Index [GSI], 0.98-0.70; P < 0.001), reduced fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue, 26-33; P < 0.001), and increased mindfulness disposition (Freiburg Mindfulness Inventory, 33-38; P < 0.001). Waitlist patients had a significant but small change in Harvey-Bradshaw Index, SIBDQ, and GSI scores, without improvement in fatigue or mindfulness. There were significant correlations (0.02 > P < 0.002) in COBMINDEX patients between baseline SIBDQ, GSI, Freiburg Mindfulness Inventory, and Functional Assessment of Chronic Illness Therapy-Fatigue scores with a relative change (baseline to 3 months) of the SIBDQ score, but none among waitlist patients. Predictors of relative change of the SIBDQ score in COBMINDEX patients included the GSI score (90% quantile; coefficient 0.52; P < 0.001), somatization (90%; 0.20; P = 0.001), depression (75%; 0.16; P = 0.03), and phobic anxiety (75%; 0.31; P = 0.008). CONCLUSIONS COBMINDEX was effective in increasing patients' quality of life and reducing psychological symptoms and fatigue. Patients with severe baseline psychological symptoms benefited the most from COBMINDEX.
Collapse
Affiliation(s)
- Ganit Goren
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Doron Schwartz
- Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Friger
- Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Hagar Banai
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ruslan Sergienko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shirley Regev
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Heba Abu-Kaf
- Department of Gastroenterology and Hepatology, Soroka Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dan Greenberg
- Department of Health Systems Management, School of Public Health, Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Anna Nemirovsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Karny Ilan
- The Shraga Segal Department of Microbiology and Immunology, Faculty of Health Sciences, The National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Livnat Lerner
- The Shraga Segal Department of Microbiology and Immunology, Faculty of Health Sciences, The National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alon Monsonego
- The Shraga Segal Department of Microbiology and Immunology, Faculty of Health Sciences, The National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Iris Dotan
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Henit Yanai
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rami Eliakim
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel
| | - Shomron Ben Horin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel
| | - Vered Slonim-Nevo
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shmuel Odes
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Orly Sarid
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| |
Collapse
|
4
|
Williams K, Hartley S, Anderson IM, Birtwell K, Dowson M, Elliott R, Taylor P. An ongoing process of reconnection: A qualitative exploration of mindfulness-based cognitive therapy for adults in remission from depression. Psychol Psychother 2022; 95:173-190. [PMID: 34272797 DOI: 10.1111/papt.12357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/27/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Mindfulness-based cognitive therapy (MBCT) is an 8-week relapse-prevention intervention designed for people who have experienced multiple episodes of depression and remain vulnerable to relapse. Previous qualitative explorations of the effects of MBCT for people in remission from depression have suggested a number of themes regarding changes arising from participating in MBCT ranging from awareness, agency, perspective, group processes, self-related change, and new ways of understanding depression. We aimed to qualitatively explore how participants in remission from depression experienced MBCT both post-MBCT and during a follow-up period. METHODS In a preference-choice trial design, 35 participants took part in qualitative interviews and assessments post-MBCT and at three time points during a 12-month follow-up. Data were analysed using reflexive thematic analysis. RESULTS Two overarching themes were developed as follows: (1) 'reconnection with experience, self, and others' and (2) 'acknowledging an ongoing process of change'. In theme one, sub-themes captured participants' experiences of increasing levels of awareness of their experience (e.g., thoughts, emotions, sensations, and present moment) from which they described changes in their relationship with experience describing increases in control, choice, acceptance, and calm. Participants described shifts towards reconnection with aspects of the self and relationships with others. In theme two, sub-themes reflected participants' conflict between avoidance and engagement in mindfulness practices, and the recognition of the gradual change following MBCT and long-term investment needed in mindfulness practices. CONCLUSIONS Our findings have clinical implications in terms of facilitating MBCT and point to important themes around recognizing the ongoing process of reconnection with experiences, self, and others. PRACTITIONER POINTS Participants with histories of depression may have experienced disconnection and isolation from internal experiences (e.g., thoughts and emotions), self, and others; MBCT encourages a deliberate shift towards reconnection with these experiences. Practitioners could encourage more psychoeducation and discussions around depression during MBCT to encourage reflections on the process of reconnection. Practitioners should maintain an awareness of the ongoing, gradual processes of change and potential for conflict experienced during MBCT Practitioners could provide a stronger emphasis on building awareness of body sensations during MBCT, with suggestions provided in the discussion section.
Collapse
Affiliation(s)
- Kate Williams
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Prestwich, UK.,Neuroscience and Psychiatry Unit, University of Manchester, UK
| | - Samantha Hartley
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK.,Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Ian M Anderson
- Neuroscience and Psychiatry Unit, University of Manchester, UK
| | - Kelly Birtwell
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
| | - Merryn Dowson
- Neuroscience and Psychiatry Unit, University of Manchester, UK
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, University of Manchester, UK
| | - Peter Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK
| |
Collapse
|
5
|
Changed dynamic symptom networks after a self-compassion training in patients with somatic symptom disorder: A multiple single-case pilot project. J Psychosom Res 2022; 154:110724. [PMID: 35078078 DOI: 10.1016/j.jpsychores.2022.110724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Pre-to-post mean group differences of intermittently assessed generic outcome variables may not capture all relevant treatment-related changes in individual patients with somatic symptom disorder (SSD). Aim of this multiple single-case observational pilot project was to find out whether the Experience Sampling Method (ESM) and dynamic symptom networks may offer new opportunities in evaluating treatment outcomes for individual patients with SSD. METHODS Patients with SSD (N = 6 in study 1, N = 7 in study 2) received a self-compassion training in a tertiary care mental health expert center. Using a single-case pre-post treatment observational design, intensive longitudinal data were collected with ESM. A brief questionnaire was presented via the patient's smartphone three times per day for 16 weeks before, during and after the training in study 1, and for 5 weeks before and 5 weeks after the training in study 2. Eleven questions comprised somatic symptoms, functional disability, stress, self-compassion, and acceptance of affect; three personalized questions comprised self-chosen affects and an additional symptom. RESULTS Sufficient observations for means and network comparison were obtained for 11 and 10 patients, respectively. After the training, self-compassion was significantly increased in 10 patients, functional disability, stress and affect improved in 6 patients, and (although not a treatment goal) somatic symptoms decreased in 6 patients. Dynamic symptom networks significantly changed in 5 patients. CONCLUSION Patient-specific changes in means and dynamic symptom networks were observed after self-compassion training. In future clinical trials, single-case ESM may offer new opportunities to evaluate treatment outcomes in patients with SSD.
Collapse
|
6
|
Age Inclusive Compassion-Focused Therapy: a Pilot Group Evaluation. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00132-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThis study aimed to evaluate and provide recommendations to improve the effectiveness of an age inclusive compassion-focused therapy (CFT) group in secondary mental health services for participants experiencing a range of mental health difficulties. Of particular interest was the acceptability and impact of having a wide range of ages in such a group. The study employed a mixed method design. Validated self-report questionnaires were administered before and after the group intervention, and qualitative semi-structured interviews were conducted with six group participants. There was a significant increase in ratings on the Self-Compassion Scale (SCS) and Mindful Attention Awareness Scale (MAAS), a significant decrease in the depression subscale within the Depression and Anxiety Stress Scale (DASS) and a significant reduction in the risk subscale of the Clinical Outcome in Routine Evaluation (CORE). No significant differences were found on the overall scores and other subscales of the CORE and the DASS. Thematic analysis of the qualitative data identified four main themes: “Connection with others”, “Experience of a diverse age range”, “Group as a secure space” and “New strategies and tools”. This study provides preliminary evidence that an age inclusive CFT group is well received and has a beneficial impact for participants, with particular positivity gained through compassionately connecting with others. The range of ages was appreciated and appeared to have therapeutic benefits, although awareness of differing age-related needs is important. Limitations, recommendations for improvement and future research are discussed.
Collapse
|
7
|
Chio FHN, Mak WWS, Yu BCL. Meta-analytic review on the differential effects of self-compassion components on well-being and psychological distress: The moderating role of dialecticism on self-compassion. Clin Psychol Rev 2021; 85:101986. [PMID: 33667941 DOI: 10.1016/j.cpr.2021.101986] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/18/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022]
Abstract
Although self-compassion has been extensively studied in the recent decades, the representation of self-compassion as a unitary measure or the presence of self-warmth (i.e., presence of the positive components: self-kindness, common humanity, and mindfulness) and self-coldness (i.e., presence of the negative components: self-judgment, isolation, and mindfulness) remains controversial. Moreover, the differential effects of the six components of self-compassion on mental well-being and psychological distress have not been systematically investigated. To synthesize the differential effects of the six components of self-compassion and to examine how people in different cultures may associate the positive and negative components of self-compassion differentially, the present meta-analysis synthesized 183 effect sizes across 27 cultures. Results showed that the negative components of self-compassion (rs = 0.44 to 0.45) showed greater effect sizes with psychological distress than the positive counterparts (rs = -0.17 to -0.29) whereas the positive components of SCS (rs = 0.29 to.39) showed greater effect sizes with mental well-being than the negative counterparts (rs = -0.29 to -0.36), with the exception of common humanity and isolation (r = 0.29 and - 0.36). Cultural orientation of dialecticism moderated the association between the positive and the negative components of self-compassion, with dialectical cultures showing lower associations between the two opposing components. Findings have implications on the design and implementation of self-compassion interventions cross-culturally.
Collapse
Affiliation(s)
- Floria H N Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
| | - Ben C L Yu
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| |
Collapse
|
8
|
Finlay‐jones AL. The relevance of self‐compassion as an intervention target in mood and anxiety disorders: A narrative review based on an emotion regulation framework. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12131] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Amy Louise Finlay‐jones
- School of Psychology and Speech Pathology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia,
| |
Collapse
|
9
|
Craig C, Hiskey S, Spector A. Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations. Expert Rev Neurother 2020; 20:385-400. [PMID: 32196399 DOI: 10.1080/14737175.2020.1746184] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Compassion focused therapy (CFT) is an increasingly popular therapeutic modality. Its holistic and integrative approach to universal human suffering means that it is well placed as a transdiagnostic therapy. Research into its effectiveness and acceptability has increased over the previous 10 years as the therapy has evolved, and to help consider its status as an evidence-based therapy research concerning its treatment outcomes needs evaluating.Areas covered: This paper reviews research investigating the effectiveness of CFT in clinical populations.Expert opinion: CFT shows promise for a range of mental health problems, especially when delivered in a group format over at least 12 hours. This is important for funding bodies and commissioning groups to consider as they allocate healthcare resources in light of current evidence-based practice. CFT is demonstrably well accepted by clients and clinicians and there is now a clear need for an updated, universally deployed, standard manual to direct future research. This will be critical in enabling widespread implementation and further adoption into mainstream clinical practice, will address the lack of standardization in the current research, and pave the way for further randomized control trials aimed at reducing existing methodological limitations.
Collapse
Affiliation(s)
- Catriona Craig
- Buckinghamshire Older People's Psychology Services, The Whiteleaf Centre, Aylesbury, Buckinghamshire, UK, Oxford Health NHS Foundation Trust
| | - Syd Hiskey
- Department of Clinical Psychology, The Oaks Hospital, Colchester, Essex, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology University College London, London, UK
| |
Collapse
|
10
|
Lv J, Liu Q, Zeng X, Oei TPS, Liu Y, Xu K, Sun W, Hou H, Liu J. The effect of four Immeasurables meditations on depressive symptoms: A systematic review and meta-analysis. Clin Psychol Rev 2020; 76:101814. [PMID: 31945711 DOI: 10.1016/j.cpr.2020.101814] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/09/2019] [Accepted: 01/03/2020] [Indexed: 01/26/2023]
Abstract
The Four Immeasurables Meditations (FIM) intervention have been shown as a promising intervention for reducing depressive symptoms. The current study is a systematic review of FIM intervention effects on depressive symptoms. Among 192 empirical research articles on FIM published before May 2019, 40 independent trials from 35 records measured depressive symptoms. The meta-analysis included 21 randomized controlled trials (RCT; n = 1468) and 16 uncontrolled trials (n = 376). The results supported overall effectiveness of FIM on depressive symptoms (d = 0.38 for RCT and d = 0.87 for uncontrolled trials). Moderator analysis indicated the effects differed across protocols, and effects were smaller in RCT using active control groups. No significant differences were observed for participant type, measures, intervention length, or intervention components. Individual studies found no direct association between meditation practice time and effects, and mindfulness and self-compassion were widely supported as mechanisms of change. Current evidence supports FIM as an effective intervention for reducing depressive symptoms, but additional studies with more rigorous designs using active control groups are needed. Further investigation should be encouraged regarding specific protocols and participants, the contribution of meditation practice, and other mechanisms such as positive emotions.
Collapse
Affiliation(s)
- Jing Lv
- Faculty of Education, East China Normal University, Shanghai, PR China
| | - Qiuling Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, PR China
| | - Xianglong Zeng
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, PR China.
| | - Tian P S Oei
- School of Psychology, The University of Queensland, Australia
| | - Yidan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, PR China
| | - Kexin Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, PR China
| | - Wenxiang Sun
- Faculty of Education, Beijing Normal University, PR China
| | - Hanchao Hou
- Centre for Positive Psychology, Melbourne Graduate School of Education, The University of Melbourne, Australia
| | - Jing Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
11
|
Compassion and Loving-Kindness Meditation: An Overview and Prospects for the Application in Clinical Samples. Harv Rev Psychiatry 2019; 26:201-215. [PMID: 29975338 DOI: 10.1097/hrp.0000000000000192] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This article presents a brief overview of the empirical evidence of well-established mindfulness interventions and an in-depth review of less-established compassion-based interventions (CBIs) and loving-kindness meditation (LKM). Definitions, cognitive and physiological mechanisms, and methods of assessment are discussed. METHOD A literature review using the databases Google Scholar, PsycINFO, and PubMed was conducted. RESULTS Whereas the efficacy of mindfulness-based stress reduction and mindfulness-based cognitive therapy has been documented in many trials, only seven randomized, controlled trials have been completed on CBIs and LKM. In these trials, CBIs were effective in treating psychotic disorders, affective disorders with psychotic features, major depressive disorder, eating disorders, and patients with suicide attempts in the past year; LKM was effective in treating chronic pain; and a combination of both was effective for borderline personality disorder. A larger number of nonrandomized studies indicate that CBIs and LKM may be effective in treating a wide range of clinical conditions, including depression, anxiety disorders, chronic pain, and posttraumatic stress disorder. CONCLUSIONS Further studies are needed to confirm the promising effects of CBIs and LKM. Preliminary evidence suggests that both approaches might be beneficial across various clinical populations. Future studies need to clarify whether these approaches might be options as stand-alone treatments or as adjuncts or augmentation of evidence-based methods in psychotherapy.
Collapse
|
12
|
Krieger T, Reber F, von Glutz B, Urech A, Moser CT, Schulz A, Berger T. An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial. Behav Ther 2019; 50:430-445. [PMID: 30824257 DOI: 10.1016/j.beth.2018.08.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 01/07/2023]
Abstract
Increased levels of self-criticism and a lack of self-compassion have been associated with the development and maintenance of a range of psychological disorders. In the current study, we tested the efficacy of an online version of a compassion-focused intervention, mindfulness-based compassionate living (MBCL), with guidance on request. A total of 122 self-referred participants with increased levels of self-criticism were randomly assigned to care as usual (CAU) or the intervention group (CAU + online intervention). Primary endpoints were self-reported depressive, anxiety and distress symptoms (DASS-21) and self-compassion (SCS) at 8 weeks. Secondary endpoints were self-criticism, mindfulness, satisfaction with life, fear of self-compassion, self-esteem, and existential shame. At posttreatment, the intervention group showed significant changes with medium to large effect sizes compared to the control group regarding primary outcomes (Cohen's d: 0.79 [DASS] and -1.21 [SCS]) and secondary outcomes (Cohen's ds: between 0.40 and 0.94 in favor of the intervention group). The effects in the intervention group were maintained at 6-months postrandomization. Adherence measures (number of completed modules, self-reported number of completed exercises per week) predicted postintervention scores for self-compassion but not for depressive, anxiety, and distress symptoms in the intervention group. The current study shows the efficacy of an online intervention with a transdiagnostic intervention target on a broad range of measures, including depressive and anxiety symptoms and self-compassion.
Collapse
|
13
|
Schuling R, Huijbers M, Jansen H, Metzemaekers R, Den Brink EV, Koster F, Van Ravesteijn H, Speckens A. The Co-creation and Feasibility of a Compassion Training as a Follow-up to Mindfulness-Based Cognitive Therapy in Patients with Recurrent Depression. Mindfulness (N Y) 2017; 9:412-422. [PMID: 29599848 PMCID: PMC5866843 DOI: 10.1007/s12671-017-0783-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to assess the feasibility, acceptability and preliminary effectiveness of Mindfulness - Based Compassionate Living (MBCL) as a follow-up intervention to Mindfulness Based Cognitive Therapy in adults with recurrent depression. We conducted an uncontrolled study in 17 patients with recurrent depression, in two successive groups. The first group contained novices to compassion training (N = 14); in the second group, ten of these participated again, in addition to three new participants (N = 13). The overall group contained 15 females and 2 males, aged between 37 and 71. The MBCL program was qualitatively evaluated using post-intervention focus group interviews in both groups. In addition, self-report questionnaires assessing depressive symptoms, worry and both self-compassion and mindfulness skills were administered before and after MBCL. No patients dropped out of the intervention. Average attendance was 7.52 (SD 0.73) out of eight sessions. Helpful elements were theory on the emotion regulation systems, practicing self-compassion explicitly and embodiment of a compassionate attitude by the teachers. Unhelpful elements were the lack of a clear structure, lack of time to practice compassion for self and the occurrence of the so-called back draft effect. We adapted the program in accordance with the feedback of the participants. Preliminary results showed a reduction in depressive symptoms in the second group, but not in the first group, and an increase in self-compassion in both groups. Worry and overall mindfulness did not change. MBCL appears to be feasible and acceptable for patients suffering from recurrent depressive symptoms who previously participated in MBCT. Selection bias may have been a factor as only experienced and motivated participants were used; this, however, suited our intention to co-create MBCL in close collaboration with knowledgeable users. Examination of the effectiveness of MBCL in a sufficiently powered randomised controlled trial is needed.
Collapse
Affiliation(s)
- Rhoda Schuling
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Marloes Huijbers
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Hetty Jansen
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Renée Metzemaekers
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | | | - Frits Koster
- Centre for Integral Psychiatry, Hereweg 80, 9725 AG Groningen, The Netherlands
| | - Hiske Van Ravesteijn
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| | - Anne Speckens
- Radboudumc Centre for Mindfulness, P.O. Box 9101, (huispost 966), 6500 HB Nijmegen, The Netherlands
| |
Collapse
|