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Mindfulness-Based Stress Reduction (MBSR) courses are being taught around the world in various contexts and targeted to various populations. The program has been intentionally designed without a detailed teaching manual so as to allow instructors to respond to what is called for in each teaching moment. It also affords tailoring the program to specific circumstances such as when working with persons suffering from depression or substance abuse. But how does one remain true to core teaching intentions and program components, while undertaking such tailoring? Modifications to the format and content of MBSR have been reported but little is known if these adaptations influence outcomes and processes underlying change compared to the basic curriculum. Here we discuss what we consider to be essential aspects of the program to be carefully considered when adapting it. We describe selected adaptations of MBSR to highlight the types of changes made and report results when data are available. We conclude with suggestions pertaining to how to best remain authentic while being imaginative regarding the administration of MBSR in non-medical settings (e.g., prison) and for special populations (e.g., women with addictions).
Mindfulness-Based Stress Reduction (MBSR) courses are being taught around the world in various contexts and targeted to various populations. The program has been intentionally designed without a detailed teaching manual so as to allow instructors to respond to what is called for in each teaching moment. It also affords tailoring the program to specific circumstances such as when working with persons suffering from depression or substance abuse. But how does one remain true to core teaching intentions and program components, while undertaking such tailoring? Modifications to the format and content of MBSR have been reported but little is known if these adaptations influence outcomes and processes underlying change compared to the basic curriculum. Here we discuss what we consider to be essential aspects of the program to be carefully considered when adapting it. We describe selected adaptations of MBSR to highlight the types of changes made and report results when data are available. We conclude with suggestions pertaining to how to best remain authentic while being imaginative regarding the administration of MBSR in non-medical settings (e.g., prison) and for special populations (e.g., women with addictions).
OBJECTIVE:This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes.
MATERIALS AND METHODS:
RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24).
RESULTS:
Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24).
DISCUSSION:
This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.