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Mindfulness Cognitive Group Therapy Decreases Anxiety, Avoidance in Treatment-Refractory Patients
Mindfulness-based cognitive group therapy appears promising for the treatment of patients with anxiety disorder who have an insufficient response to first-line cognitive behavioral therapy, according to study results published online ahead of print in the Journal of Anxiety Disorders.
This pragmatic randomized controlled trial compared mindfulness-based cognitive therapy (MBCT) with relapse prevention-cognitive behavioral therapy (CBT-RP) in a group format for 136 outpatients with treatment-refractory anxiety disorder in the Netherlands. All participants showed an insufficient response to at least 20 sessions of first-line psychological treatment for anxiety.
The group interventions consisted of 8 weekly, 2-hour sessions involving between 4 and 8 participants. The MBCT sessions taught skills to help participants become more aware of and relate differently to, their anxious thoughts, feelings, and sensations. Meanwhile, CBT-RP sessions focused on educating participants on symptom deterioration and relapse, developing a personal relapse prevention plan, and identifying strategies to prevent relapse.
Compared with the CBT-RP group, the MBCT group showed a significantly larger decrease in self-reported anxiety, avoidance, emotional regulation difficulties, and worry post-treatment. MBCT participants also demonstrated a significantly larger increase in mindfulness skills.
However, treatment gains with MBCT were slightly diminished at a 6-month follow-up.
“Providing regular booster sessions,” researchers wrote, “may be needed to maintain or enlarge short-term treatment effects.”
Related: Novel Group Exposure Therapy Improves Adolescent Anxiety Over Time
An investigation of candidate-mediating variables to identify potential mechanisms of change for further treatment improvement found the effects of MBCT on anxiety were not mediated by mindfulness, emotional regular, worry, or rumination.
“Future research in larger samples assessing long-term effects and using intensive longitudinal designs to identify possible working mechanisms is called for,” researchers advised.
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