Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial
ObjectivesThis study investigated the effectiveness of a group-based 8-week intervention, Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), to decrease psychological distress and increase wellbeing in a heterogeneous population in primary health care. MiCBT focuses on the importance of inte...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.815170/full |
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| author | Sarah E. B. Francis Frances Shawyer Bruno Cayoun Joanne Enticott Joanne Enticott Graham N. Meadows Graham N. Meadows Graham N. Meadows |
| author_facet | Sarah E. B. Francis Frances Shawyer Bruno Cayoun Joanne Enticott Joanne Enticott Graham N. Meadows Graham N. Meadows Graham N. Meadows |
| author_sort | Sarah E. B. Francis |
| collection | DOAJ |
| description | ObjectivesThis study investigated the effectiveness of a group-based 8-week intervention, Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), to decrease psychological distress and increase wellbeing in a heterogeneous population in primary health care. MiCBT focuses on the importance of interoception and its interaction with cognition in emotional experience. These interactions are represented in the co-emergence model of reinforcement, in which non-reactivity (equanimity) to interoceptive signals facilitates adaptive behavior.MethodsParticipants (n = 125, aged 20–72) were randomized to two groups (MiCBT), and treatment-as-usual (TAU). Outcomes were assessed at pre-, mid-, and post-intervention and at 6-month follow-up. The primary outcome was psychological distress, measured by the Depression, Anxiety and Stress Scale (DASS-21). Secondary outcome measures were the Kessler Psychological Distress Scale-10 (K10), Satisfaction with Life Scale (SWLS), and Flourishing Scale (FS). Mediator or process measures of interoceptive awareness, metacognitive awareness (decentering), equanimity, and social functioning were included to investigate putative mediators.ResultsThe MiCBT intervention significantly reduced DASS-21 scores at mid and post-treatment and the gains were maintained at 6-month follow-up (p < 0.0001, d = 0.38). Flourishing scores also showed significant improvement post-treatment and at 6-month follow-up (d = 0.24, p < 0.0001). All measures selected showed a similar pattern of positive change, with the exception of the SWLS, which failed to reach significance. Mediation analysis suggested equanimity to be the most influential mediator of the primary outcome.ConclusionsThe results support the effectiveness of MiCBT in creating rapid and sustainable reduction of psychological distress and improvement in flourishing in a primary mental health care setting with heterogenous groups. These promising results support the scaled-up implementation of this intervention.Clinical Trial RegistrationThis trial is registered with the Australian and New Zealand Clinical Trial Registry: https://www.anzctr.org.au/ACTRN12617000061336. |
| first_indexed | 2024-12-12T06:07:11Z |
| format | Article |
| id | doaj.art-9731e62934404f6398f31265602911ae |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-12T06:07:11Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-9731e62934404f6398f31265602911ae2022-12-22T00:35:16ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-05-011310.3389/fpsyt.2022.815170815170Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled TrialSarah E. B. Francis0Frances Shawyer1Bruno Cayoun2Joanne Enticott3Joanne Enticott4Graham N. Meadows5Graham N. Meadows6Graham N. Meadows7Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, AustraliaSouthern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, AustraliaMindfulness-Integrated Cognitive Behavior Therapy Institute, Hobart, TAS, AustraliaSouthern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, AustraliaMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, AustraliaSouthern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, AustraliaMental Health Program, Monash Health, Melbourne, VIC, AustraliaMelbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, AustraliaObjectivesThis study investigated the effectiveness of a group-based 8-week intervention, Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), to decrease psychological distress and increase wellbeing in a heterogeneous population in primary health care. MiCBT focuses on the importance of interoception and its interaction with cognition in emotional experience. These interactions are represented in the co-emergence model of reinforcement, in which non-reactivity (equanimity) to interoceptive signals facilitates adaptive behavior.MethodsParticipants (n = 125, aged 20–72) were randomized to two groups (MiCBT), and treatment-as-usual (TAU). Outcomes were assessed at pre-, mid-, and post-intervention and at 6-month follow-up. The primary outcome was psychological distress, measured by the Depression, Anxiety and Stress Scale (DASS-21). Secondary outcome measures were the Kessler Psychological Distress Scale-10 (K10), Satisfaction with Life Scale (SWLS), and Flourishing Scale (FS). Mediator or process measures of interoceptive awareness, metacognitive awareness (decentering), equanimity, and social functioning were included to investigate putative mediators.ResultsThe MiCBT intervention significantly reduced DASS-21 scores at mid and post-treatment and the gains were maintained at 6-month follow-up (p < 0.0001, d = 0.38). Flourishing scores also showed significant improvement post-treatment and at 6-month follow-up (d = 0.24, p < 0.0001). All measures selected showed a similar pattern of positive change, with the exception of the SWLS, which failed to reach significance. Mediation analysis suggested equanimity to be the most influential mediator of the primary outcome.ConclusionsThe results support the effectiveness of MiCBT in creating rapid and sustainable reduction of psychological distress and improvement in flourishing in a primary mental health care setting with heterogenous groups. These promising results support the scaled-up implementation of this intervention.Clinical Trial RegistrationThis trial is registered with the Australian and New Zealand Clinical Trial Registry: https://www.anzctr.org.au/ACTRN12617000061336.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.815170/fullmindfulnessequanimitytransdiagnostic treatmentinteroceptionMindfulness-integrated Cognitive Behavior Therapy (MiCBT) |
| spellingShingle | Sarah E. B. Francis Frances Shawyer Bruno Cayoun Joanne Enticott Joanne Enticott Graham N. Meadows Graham N. Meadows Graham N. Meadows Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial Frontiers in Psychiatry mindfulness equanimity transdiagnostic treatment interoception Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) |
| title | Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial |
| title_full | Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial |
| title_fullStr | Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial |
| title_full_unstemmed | Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial |
| title_short | Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial |
| title_sort | group mindfulness integrated cognitive behavior therapy micbt reduces depression and anxiety and improves flourishing in a transdiagnostic primary care sample compared to treatment as usual a randomized controlled trial |
| topic | mindfulness equanimity transdiagnostic treatment interoception Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.815170/full |
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