scholarly journals Cost‐utility of individual internet‐based and face‐to‐face Mindfulness‐Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients

2019 ◽  
Vol 29 (2) ◽  
pp. 294-303 ◽  
Author(s):  
Félix Compen ◽  
Eddy Adang ◽  
Else Bisseling ◽  
Marije Lee ◽  
Anne Speckens
Keyword(s):  
Psychological Distress ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Cost Utility ◽  
Treatment As Usual ◽  
Face To Face

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 Predictors and Effects of Usage of an Online Mindfulness Intervention for Distressed Cancer Patients: Usability Study

10.2196/17526 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e17526
Author(s):  
Linda Cillessen ◽  
Monique OM van de Ven ◽  
Félix R Compen ◽  
Else M Bisseling ◽  
Marije L van der Lee ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Cancer Recurrence ◽  
Well Being ◽  
Fear Of Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Future Research ◽  
Linear Regression Models ◽  
Treatment As Usual

Background One in three cancer patients experience high psychological distress. Mindfulness-based interventions are effective in reducing psychological distress in this patient group. However, these interventions lack availability and flexibility, which may compromise participation in the intervention for cancer patients experiencing late symptoms like fatigue or pain. Therefore, mindfulness-based interventions are increasingly offered via the internet. However, little is known about the usage of these online mindfulness-based interventions. Objective The aim of this study was to (1) predict uptake of and adherence to online mindfulness-based cognitive therapy (eMBCT) using baseline patient characteristics (demographic, cancer-related, personality, and psychological variables) and (2) examine the relations between adherence and treatment outcomes in eMBCT for cancer patients. Methods A total of 125 cancer patients were assigned to eMBCT in a parent randomized controlled trial comparing MBCT and eMBCT with treatment as usual in distressed cancer patients. Various usage measures of eMBCT were automatically tracked within the online program. Based on activity of use, participants were classified as nonusers, minimal users, low users, and intended users. Questionnaires were used to assess baseline characteristics (preintervention) and outcomes (pre- and postintervention). To answer the research questions, data were analyzed with t tests, χ2 tests, and linear regression models. Results Based on weekly activity, participants were classified as nonusers (n=17, 13.6%), who completed no exercises in MBCT; minimal users (n=31, 24.8%), who completed at least one exercise of one to three sessions; low users (n=12, 9.6%), who completed at least one exercise of four to seven sessions; and intended users (n=65, 52.0%), who completed at least one exercise of eight to nine sessions. Nonusers had more fear of cancer recurrence at baseline than users (uptake), and intended users were more conscientious than minimal and low users (adherence). Intended users reported a larger reduction in psychological distress and more improvement of positive mental health (ie, emotional, psychological, and social well-being) after the intervention than other participants. Conclusions This study showed that adherence was related to improved patient outcomes. Patients with strong fear of recurrence or low levels of conscientiousness should receive extra attention, as they are less likely to respectively start or complete eMBCT. Future research may focus on the development of flexible and adaptive eMBCT programs to fit individual needs.

scholarly journals Tele-delivered mindfulness-based cognitive therapy in chronic obstructive pulmonary disease: A mixed-methods feasibility study

2018 ◽  
Vol 25 (8) ◽  
pp. 468-475 ◽  
Author(s):  
Ingeborg Farver-Vestergaard ◽  
Maja O’Connor ◽  
Nina C Smith ◽  
Anders Løkke ◽  
Elisabeth Bendstrup ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Psychological Distress ◽  
Health Status ◽  
Cognitive Therapy ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Physical Health Status ◽  
Obstructive Pulmonary Disease ◽  
Face To Face ◽  
Home Based

Introduction Mindfulness-based cognitive therapy has been shown to reduce psychological distress in chronic obstructive pulmonary disease, but uptake and attendance rates of hospital-based, face-to-face mindfulness-based cognitive therapy are low. The present mixed-methods study evaluates the clinical feasibility of home-based, tele-delivered mindfulness-based cognitive therapy in chronic obstructive pulmonary disease. Methods Eight patients with chronic obstructive pulmonary disease (mean age: 72.6 years; 50% female) received a standardised eight-week mindfulness-based cognitive therapy programme delivered via home-based video-conferences in groups of four. Feasibility in relation to (a) clinical change, (b) attendance and (c) instructor-patient working alliance were evaluated with questionnaires and semi-structured interviews. Results Statistically non-significant reductions in psychological distress (Cohen’s d = 0.504; p = 0.399) and physical health status impairment ( d = 0.743; p = 0.156) were observed from pre- to post-intervention. Participant narratives about clinical outcomes focused on changes in how to relate to unpleasant sensations, i.e. through attentional flexibility, taking a pause and acceptance. The average attendance rate was 7.5 (standard deviation = 0.8) out of eight sessions and no participants dropped out. The tele-based format appeared to accommodate participants’ planning difficulties and promoted their ability and wish to participate. Although participant narratives suggested the tele-based format to be a barrier to developing a trusting and safe therapeutic environment, working alliance questionnaire scores were comparable to those found for face-to-face mindfulness-based cognitive therapy. Discussion The preliminary results indicate that tele-delivered mindfulness-based cognitive therapy is a clinically feasible intervention in chronic obstructive pulmonary disease. Future large-scale, randomised controlled trials testing its efficacy on the outcomes of psychological distress and physical health status should include analyses of potential mediators and moderators of the effect as well as and careful monitoring of attendance and adverse events.

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 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.

scholarly journals The Modulatory Role of Internet-Supported Mindfulness-Based Cognitive Therapy on Extracellular Vesicles and Psychological Distress in People Who Have Had Cancer: A Protocol for A Two-Armed Randomized Controlled Study

2021 ◽  
Author(s):  
Diana Pereira ◽  
Eunice R. Silva ◽  
Carina Carvalho-Maia ◽  
Sara Monteiro-Reis ◽  
Catarina Lourenço ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cognitive Therapy ◽  
Extracellular Vesicles ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Post Intervention ◽  
Treatment As Usual ◽  
Randomized Controlled ◽  
Booster Sessions ◽  
Health Related

Abstract BackgroundMindfulness-based interventions (MBIs) have been used in oncology contexts as a promising tool with numerous benefits for various health-related and psychosocial outcomes. Despite the increasing popularity of MBIs, few randomized controlled trials (RCTs) have examined their effects upon biological parameters. Specifically, no previous study has examined the effects of MBIs on extracellular vesicles (EVs), which are potentially important markers of health, disease, and stress. Moreover, the lack of RCTs is even more limited within the context of technology-mediated MBIs and long-term effects.MethodsThe current study protocol presents a two-arm, parallel, randomized controlled study investigating the effects of internet-supported mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU). Primary outcomes are psychological distress and EV cargo of distressed participants with previous breast, colorectal, or prostate cancer diagnoses. Secondary outcomes are self-reported psychosocial and health-related measures, and additional biological markers. Outcomes will be assessed at baseline, 4 weeks after baseline (mid-point of the intervention), 8 weeks after baseline (immediately post-intervention), 24 weeks after baseline (after booster sessions), and 52 weeks after baseline. Our goal is to recruit at least 111 participants who have been diagnosed with breast, prostate, or colorectal cancer (cancer stage I to III), are between 18 and 65 years old, and have had primary cancer treatments completed between 3 months and 5 years ago. Half of the participants will be randomized to the TAU group and the other half will participate in an 8-week online MBCT intervention with weekly group sessions via videoconference. The intervention also includes asynchronous homework, an online retreat after the fifth week, and 4 monthly booster sessions after completion of the 8-week program.DiscussionThis study will allow characterizing the effects of internet-based MBCT on psychosocial and biological indicators in the context of cancer. The effects on circulating EVs will also be investigated, as a possible neurobiological pathway underlying mind-body intervention effects. Trial registration: NCT04727593 (date of registration: 27 January 2021; date of record verification: 6 October 2021; https://clinicaltrials.gov/ct2/show/NCT04727593).

Mindfulness-based cognitive therapy for psycho-oncology patients: an exploratory study

2015 ◽  
Vol 32 (3) ◽  
pp. 265-274 ◽  
Author(s):  
T. Kingston ◽  
S. Collier ◽  
D. Hevey ◽  
M. M. McCormick ◽  
C. Besani ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Cancer Patients ◽  
Stress Reduction ◽  
Phase 1 ◽  
Small Pilot Study ◽  
Psychological Variables ◽  
Treatment As Usual ◽  
Self Compassion ◽  
Distress Symptoms ◽  
Anxiety Depression

ObjectivesMindfulness-based cognitive therapy (MBCT) is a group-based intervention similar to mindfulness-based stress reduction, but which includes cognitive therapy techniques. This study investigates its usefulness in the treatment of depressive, anxiety and stress/distress symptoms in cancer patients referred to a psycho-oncology service. It also examines whether effect on depression is mediated by self-compassion.MethodIn phase 1 of this study, 16 cancer patients with mild/moderate psychological distress were randomised to MBCT (n=8) or treatment as usual (TAU;n=8), and assessed pre- and post-treatment. Analysis of variance was performed to examine the effect of treatment on anxiety and depression. In phase 2, the TAU group received the intervention, and results of pre- and post-MBCT assessments were combined with those receiving MBCT in phase 1. Finally, both groups were followed up at 3 months.ResultsIn phase 1, the MBCT group had a significant improvement in mindfulness and a decrease in anxiety. Statistically significant improvements in both depression and anxiety were found at 3 month follow-up. Self-compassion appeared to mediate the effect on anxiety/depression.ConclusionThis small pilot study suggests that MBCT may have a beneficial effect on psychological variables often adversely affected in cancer in a heterogeneous cancer population.

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