scholarly journals Therapeutic alliance—not therapist competence or group cohesion—contributes to reduction of psychological distress in group‐based mindfulness‐based cognitive therapy for cancer patients

2019 ◽  
Vol 26 (3) ◽  
pp. 309-318 ◽  
Author(s):  
Else M. Bisseling ◽  
Melanie P.J. Schellekens ◽  
Philip Spinhoven ◽  
Félix R. Compen ◽  
Anne E.M. Speckens ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Therapeutic Alliance ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Group Cohesion ◽  
Therapist Competence

scholarly journals Development of the therapeutic alliance and its association with treatment outcome in internet-based Mindfulness-Based Cognitive Therapy (eMBCT) compared to group-based MBCT (MBCT) for distressed cancer patients (Preprint)

2019 ◽  
Author(s):  
Else Bisseling ◽  
Linda Cillessen ◽  
Philip Spinhoven ◽  
Melanie Schellekens ◽  
Félix Compen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Psychological Distress ◽  
Therapeutic Alliance ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Psychological Treatment ◽  
Well Being ◽  
Post Treatment ◽  
Treatment Dropout ◽  
Mental Well Being

BACKGROUND Mindfulness-Based Cognitive Therapy (MBCT) is an evidence-based group-based psychological treatment in oncology, resulting in reduction of depressive and anxiety symptoms. Internet-based Mindfulness-based Cognitive Therapy (eMBCT) has been found to be an effective alternative for MBCT. The therapeutic alliance, i.e. the bond between therapist and patient, is known to have a significant impact on psychological treatment outcomes, including MBCT. A primary concern in the practice of eMBCT is whether a good therapeutic alliance can develop. Although evidence for the beneficial effect of therapist-assistance on treatment outcome in internet-based interventions (IBIs) is accumulating, it is still unclear whether the therapeutic alliance is related to outcome in IBIs. OBJECTIVE The objectives of the present study were: (1) to explore whether early therapeutic alliance predicts treatment dropout in (e)MBCT; (2) to compare the development of the therapeutic alliance during eMBCT and MBCT; and (3) to examine whether early therapeutic alliance is a predictor of the reduction of psychological distress and the increase of mental well-being at post-treatment in both conditions. METHODS The present study was part of a multicentre randomized controlled trial (RCT; n=245) on the effectiveness of (e)MBCT for distressed cancer patients. The therapeutic alliance was measured at the start of week 2 (i.e. early therapeutic alliance), week 5 and week 9. Outcome measures were psychological distress, measured with the Hospital Anxiety and Depression Scale (HADS) and mental-wellbeing, measured with the Mental Health Coninuum-short form (MHC-SF). RESULTS The strength of early therapeutic alliance did not predict treatment dropout in (e)MBCT (B=-0.39, p=.21). Therapeutic alliance increased over time in both conditions (F=16.46,Wilks’ λ=.732, p<.001). This increase did not differ between eMBCT and MBCT (F=0.114, p=.74). Therapeutic alliance at week 2 predicted a reduction of psychological distress (B=-.126, t=-2.656, p=.01) and an increase of in mental well-being (B=.234, t=2.651, p=.01) at post-treatment. The relationship with reduction of psychological distress differed between treatments: a weaker early therapeutic alliance predicted higher psychological distress at post-treatment in MBCT but not in eMBCT(B=.217, t=2.261, p=.03). CONCLUSIONS A therapeutic alliance can develop in both eMBCT and MBCT. Findings revealed that the strength of early alliance did not predict treatment dropout. Furthermore, the level of therapeutic alliance predicted reduced psychological distress and increased mental well-being at post-treatment in both conditions. Interestingly, the strength of therapeutic alliance is appeared to be more related to treatment outcome in group-based MBCT than in eMBCT. CLINICALTRIAL NCT02138513 https://clinicaltrials.gov/ct2/show/NCT02138513

scholarly journals Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators (Preprint)

2017 ◽  
Author(s):  
Félix R Compen ◽  
Else M Bisseling ◽  
Melanie PJ Schellekens ◽  
Ellen TM Jansen ◽  
Marije L van der Lee ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Qualitative Content Analysis ◽  
Patient Characteristics ◽  
Barriers And Facilitators ◽  
Number Of Patients ◽  
Facilitators And Barriers ◽  
The Individual ◽  
Living With Cancer

BACKGROUND The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT. OBJECTIVE This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists. METHODS Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT. RESULTS Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics. CONCLUSIONS The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found.

scholarly journals Role of Mindfulness‐Based Cognitive Therapy in Alleviating Psychological Distress among Cancer Patients

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Fatemeh Abdollahi ◽  
Prof. Mahmood S. Khan
Keyword(s):  
Psychological Distress ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Psychological Problem ◽  
Complex Problem ◽  
Research Literature ◽  
Behavioral Approach ◽  
World Health ◽  
Health Organization

The purpose of this research was to examine the research literature on role of Mindfulness-Based Cognitive Therapy in alleviating psychological distress among cancer patients. World Health Organization and medical experts have expressed alarm about constantly the growing problem of cancer patients in the world. The researcher emphasize that the diagnosis of cancer not only has obvious physical ramifications for the patient, but also the trauma of a diagnosis produces psychological problem such as somewhat hardly manageable distress as well, and in the face of psychological stressors that negatively impact the patient’s overall quality of life. The present study examined the results of various studies, for identifying the potential efficacy of MBCT as it could be applied to patients with cancer which presents psychological distress. Research on Mindfulness-Based Cognitive Therapy has supported the safety and effectiveness of this approach might be used with distress associated problems among cancer patients also other studies obtained results signified the effectiveness of this therapy while dealing with cancer patients showed significant impact in alleviating different type of problems associated with this disease. It suggests need for a comprehensive solution that combines medical, psychological, social and behavioral approach to this complex problem in initiating the distress of cancer patients.

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