Cognitive Behavioral Therapy (CBT) and medication are regarded as initially-line therapies for anxiousness issues. However, only about 60% of patients respond properly to these therapies. With anxiousness issues on the rise, the want for options for patients who do not respond to initially-line therapies or who have residual symptoms is crucial.
A current clinical trial explored mindfulness-primarily based CBT (MBCT) as an efficient solution for patients with therapy-refractory anxiousness issues. The researchers published their findings in the Journal of Anxiety Disorders. The pragmatic randomized controlled trial compared MBCT to normal psychological relapse prevention therapy for therapy-refractory anxiousness disorder (CBT-RP).
The researchers recruited 171 adults aged 18 and more than in between 2013 and 2018. They performed the study at PsyQ, a major mental well being center in the Netherlands. Participants had received at least 1 initially-line psychological therapy for a diagnosed anxiousness disorder and continued to practical experience symptoms.
Both the MBCT and CBT-RP groups received weekly 2-hour group sessions for 8 weeks. Groups integrated 4 to 8 persons. Both groups had to total homework: either 1 hour day-to-day of mindfulness practice and workouts or 1 hour day-to-day of homework associated to their relapse prevention strategy. Symptoms had been measured ahead of, throughout, and just after therapy, as properly as throughout a 6-month adhere to-up.
“When compared with the CBT-RP group, at post-treatment, the MBCT group showed a significantly larger decrease in self-reported anxiety and avoidance, while changes in depression severity and quality of life were comparable,” the authors reported.
“MBCT may also be effective in patients who responded insufficiently to evidence-based CBT as a first-line treatment provided for at least 20 sessions.” The researchers also identified the MBCT group showed higher improvement in emotional regulation compared with the CBT-RP group.
The researchers admit a handful of study limitations. Treatment-refractory anxiousness disorder is poorly defined in literature as it applies to psychological therapy. Also, patients knew throughout pretreatment which group they would be in, which may perhaps have triggered attrition bias. Small sample size and the use of “advanced beginner” level therapist may perhaps have also impacted the benefits.
However, the study benefits indicate guarantee for mindfulness-primarily based CBT in these patients. “Regular booster sessions may be needed to maintain or enlarge short-term treatment effects,” the researchers conclude. “Future research in larger samples assessing long-term effects and using intensive longitudinal designs to identify possible working mechanisms is called for.”
Spinhoven P, Hoogerwerf E, van Giezen A, Greeven A. Mindfulness-based cognitive group therapy for treatment-refractory anxiety disorder: A pragmatic randomized controlled trial. J Anxiety Disord. 202290:102599. doi:10.1016/j.janxdis.2022.102599