Integrating Metta Into CBT: How Loving Kindness and Compassion Meditation Can Enhance CBT for Treating Anxiety and Depression

The Impact of Loving-Kindness Meditation on Compassion Fatigue of Nurses Working in the Neonatal Intensive Care Unit: A Randomized Clinical Trial Study

Compassion fatigue is a common complication in nurses, which can lead to burnout, job dissatisfaction, and a decline in the quality of patient care. This study aimed to investigate the impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit (NICU). This cluster-blinded randomized clinical trial study was conducted on 66 NICU nurses in 2 educational hospitals selected. The intervention group received a 1-month online program for daily training and practice of loving-kindness meditation. The control group received miscellaneous files on mental health during the COVID-19 pandemic period. The Nursing Compassion Fatigue Inventory (NCFI) was filled out by the 2 groups, before and after the intervention. The results showed that the mean scores of the NCFI in the intervention group decreased significantly compared with before the intervention (P = .002). In comparison with the control group, there was a significant difference between the mean scores of the 2 groups after the intervention (P = .034). Among nurses working in NICU, loving-kindness meditation significantly reduces compassion fatigue after 1 month. These findings support the use of this intervention for nurses.

Mindfulness and Nondual Well-Being – What is the Evidence that We Can Stay Happy?

Research into subjective well-being (SWB) focuses on conducive life conditions, healthy cognitive-affective processes and adaptive behaviours, however, in this model, well-being fluctuates based on changing mental and physical phenomena. This inquiry explores the possibility that we can have a nondual experience of well-being that is unaffected by such movements and investigates if the literature supports this. The assertion in traditional mindfulness that the sense of self is constructed and responsible for such fluctuations is explored, along with what evidence there is that mindfulness practices deliver relevant cognitive and behavioural correlates associated with such a way of being. Proposed preconditions include (a) nondual awareness or the perception of no-self; (b) increased positive affect, decreased negative affect, and increased self-lessness; (c) increased capacity to maintain (or protect) well-being including heightened emotional self-regulation and resilience to aversive stimuli. Research findings provide some evidence that the sense of self can be both constructed and deconstructed, and that mindfulness training may target psychological dimensions that could contribute to an experience of well-being that transcends the impact of life conditions. Recommendations are made for a collaborative relationship between SWB research and mindfulness to expand the inquiry into possible causes and conditions of ‘nondual well-being’.

Metta-Based Therapy for Chronic Depression: a Wait List Control Trial

Objectives

Current treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression.

Methods

Forty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation.

Results

Mixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up.

Conclusions

The results provide preliminary support for the effectiveness of MBT in treating chronic depression.

Trial Registration

ISRCTN, ISRCTN97264476.

Treating a Cluster of Internalizing Disorders With the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Case Study

Psychotherapy outcome research rarely focuses on the ideographic application of treatment manuals, though some modules might prove markedly more important for a client than others. Clients in need of psychoeducation, emotion regulation skills, and changes in maladaptive patterns of thinking might balk at portions of the Unified Protocol for the Treatment of Emotional Disorders that seem irrelevant to their concerns. The current case study focused on emotion dysregulation and perfectionism given their role in anxiety, depression, obsessions, and compulsions. The Overall Anxiety Severity and Impairment Scale (OASIS), Overall Depression Severity and Impairment Scale (ODSIS), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) confirmed qualitative reports and therapist observations of improvement. Additional sessions focused on fostering self-compassion and processing the termination of a romantic relationship rather than completing every section of the manual. This case demonstrates that flexible adaptation of a transdiagnostic treatment manual, in conjunction with a strong working alliance and other non-specifics of therapy, can produce beneficial outcomes even when other modules are not applied. These results might support ideographic application of select modules from treatment manuals and support a symptoms approach to psychotherapy.