Understanding the Impact of Meditative Homework on Metacognitive Processes in the Context of Mindfulness Based Cognitive Therapy (MBCT)

NCT00938873 | Completed

• 1 other identifier: 1-Lahtinen
• Study Type: observational
• Target: 7
• Locations: 1 country
• Sites: 1

Brief Summary

Mindfulness based cognitive therapy (MBCT) is a group psycho-educational treatment designed to reduce the risk of recurrent depression by integrating mindfulness based meditation practices with cognitive therapy techniques. MBCT comprises eight weekly two-hour group sessions. Additionally, participants are required to commit to one hour per day of between sessions meditative homework assignments six days per week. Existing quantitative research suggest that MBCT is an effective intervention for preventing depressive relapse in patients with three or more episodes of depression (Teasdale et al.2000, Ma \& Teasdale, 2004). The focus of qualitative research has been on evaluating the acceptability of MBCT for various clinical populations; participants' accounts have been positive indicating MBCT may be a potential therapeutic tool for treating older adults (Graham \& Senthinathan, 2007), psychosis (Abba, Chadwick, \& Stevenson, 2008), Parkinson's disease (Fitzpatrick, Simpson, \& Smith, 2010) as well as acute depression (Mason \& Hargreaves, 2001). The benefits of undertaking meditative mindfulness practice in the context of MBCT have been linked to changes in metacognitive processes. Two distinct multi-level information processing frameworks dealing with how thoughts are processed from a metacognitive perspective have been proposed: The Interacting Cognitive Subsystems (ICS; Teasdale, 1999a, 1999b) and the Self Regulatory Executive Function (S-REF; Wells, 2000) theory. The ICS framework forms a rationale for meditative aspects of the MBCT programme. The S-REF model differs from the ICS theory in its conceptualisation of the object or 'being' mode of metacognitive processing. Regular daily practice of mindfulness meditation has been regarded as among the most essential aspects of mindfulness programmes (Kabat-Zinn, 1990; Mason \& Hargreaves, 2001). Existing studies, with their focus on effectiveness or acceptability of MBCT as an intervention, have thus far excluded an important aspect of the course involving the experience of meditative homework assignments. Therefore, the aim of this study was to explore subjective accounts of the meaning of carrying out meditative homework assignments in the context of a National Health Service (NHS) run MBCT course. The research questions focused on the impact of meditative homework on thought processes as well as an exploration of barriers and facilitating factors from a participant's perspective.Six individual in-depth interviews were conducted with participants all of whom had completed the full MBCT programme. Interpretive phenomenological Analysis (IPA) was used as the methodology for analysing interview transcripts. Data analysis began with a detailed examination of one case until a thorough analysis was completed after which subsequent cases were analysed. Finally a cross case analysis was carried out where individual themes were interrogated for similarities and differences (Smith, et al., 2009). Two master themes were presented: 'The relationship of meditative homework to metacognitive experience' and 'Motivating and discouraging factors for engagement in meditative practice'. Results reveal a transformation in metacognitive processes as a result of undertaking meditative homework. The subjective experience of metacognitive processes is examined in the context of existing psychological theories including the ICS (Teasdale, 1999a, 1999b) as well as the S-REF (Wells, 2000) theory involving metacognitions. A model for perceived facilitating factors and difficulties experienced in carrying out meditative homework is constructed based on the Integrated Theoretical Foundations Model for CBT homework assignment (Kazantzis, et al., 2005). The model explores participants' motivation in three stages of the homework process: firstly during assignment of the meditative homework task, secondly in completing the planned task and finally carrying out review of the task in question. Implications of the present study are discussed in relation to psychological literature, homework assignment and the practise of MBCT.

Conditions

Depression

Keywords

MBCT; identity; depression; recurrent; homework

Outcome Measures

Primary Outcomes (1)

• The project involves one 60-minute interview per participant aiming to evaluate lived experience of having taken part in an MBCT programme. The specific focus is on MBCT programme's possible impact on personal identity, barriers and facilitating factors.

  Interviews are conducted upon completion of MBCT course

Study Arms (1)

Mindfulness Based Cognitive Therapy

The present study will use participants who have experienced more than three episodes of depression as judged by South London and Maudsley NHS Trust. No restrictions are placed in terms of participants' use of antidepressant medication. Participants will be 18 to 65 years old and would have participated in an MBCT course run by South London and Maudsley NHS Trust.

Behavioral: Mindfulness Based Cognitive Therapy (MBCT)

Interventions

Mindfulness Based Cognitive Therapy (MBCT) BEHAVIORAL

Mindfulness based cognitive therapy (MBCT) is a group psycho-educational treatment designed to reduce the risk of recurrent depression by integrating mindfulness based meditation practices with cognitive therapy techniques. MBCT comprises eight weekly two-hour group sessions with an additional one hour daily 6 days a week for meditative homework practice.

Also known as: MBCT

Mindfulness Based Cognitive Therapy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Eight participants will be recruited from South London and Maudsley NHS Trust, which is a national health service site offering Mindfulness Based Cognitive Therapy (MBCT).

You may qualify if:

• Participants will be 18 to 65 years of age and recruited through an NHS Trust offering MBCT.

You may not qualify if:

• These authors suggest that MBCT has no significant effect on reducing the relapse rates of depression in patients with ≤ 2 episodes of depression.
• Therefore the present study will use participants who have experienced more than three episodes of depression as judged by the relevant NHS Trust.
• No restrictions are placed in terms of participants' use of antidepressant medication.
• Potential participants engaging in yoga or Buddhist meditation more than twice a week are excluded as these practices significantly overlap with the MBCT program.

Sponsors & Collaborators

• Lahtinen, Marika: lead
• University of East London: collaborator
• South London and Maudsley NHS Foundation Trust: collaborator

Study Sites (1)

South London & Maudsley NHS Trust

London, London, SE5 8AZ, United Kingdom

Location

Related Links

• Resources for Mindfulness Based Cognitive Therapy (MBCT)

MeSH Terms

Conditions

Depression; Recurrence

Interventions

Mindfulness-Based Cognitive Therapy

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Mindfulness; Cognitive Behavioral Therapy; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Marika Lahtinen

  University of East London

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr

Study Record Dates

• First Submitted: July 13, 2009
• First Posted: July 14, 2009
• Study Start: December 1, 2009
• Primary Completion: April 1, 2010
• Study Completion: April 1, 2011
• Last Updated: February 29, 2012

Record last verified: 2012-02

Locations

GB (1)