The Effectiveness of a Training Program for Healthcare Professionals to Enhance Competence of Mindfulness-Based Cognitive Therapy for Depression
DOI:
https://doi.org/10.60099/jtnmc.v38i03.264204Keywords:
depressive disorder, mindfulness-based cognitive therapy, healthcare professionals, competenceAbstract
Introduction Mindfulness-based cognitive therapy (MBCT) for depression, combined with medication therapy using antidepressants, assists in reducing depressive symptoms and preventing the recurrence of depression. Therapists play a crucial role in this process, requiring the competency to facilitate therapeutic activities effectively.
Objectives The aims of this study were to compare the knowledge of depression and MBCT, levels of mindfulness, and ruminative thought among healthcare professionals before and after participating in a training program.
Design A quasi-experimental with one-group, pretest and posttest design
Methodology A sample of 20 healthcare professionals from the psychiatric hospital, the provincial hospital, a district health promoting hospital, and the nursing college in Ubon Ratchathani province, was purposively selected according to the inclusion criteria. The sample size was determined based on the guiding principles of a pilot study. Research instruments included: 1) Demographic questionnaire, 2) Knowledge Test, 3) Ruminative Response Scale, 4) Philadelphia Mindfulness Scale (Thai version), and 5) A 4-day training program comprising 5 learning modules. During the training, participants’ reflections and emotions after learning activities were taken. The program revealed a content validity index of .83. Data were analyzed using descriptive statistics and Paired t-test.
Results The sample consisted entirely of females, with the mean age of 38 years (SD = 6.93) and mean work experience of 16 years (SD = 7.24). The majority were professional nurses (80%). Before participating in the program, the sample had mean knowledge about depression and MBCT of 10.30 (SD = 2.00), mean ruminative thought of 37.00 (SD = 10.35), and mean mindfulness level of 60.70 (SD = 12.11). After the program, their knowledge (M = 11.90, SD = 2.83) was significantly higher, compared to before the program (t = -3.559, p = .002). The ruminative thought after the program (M = 35.00, SD = 9.06) had no significant difference from before the program (t = 0.848, p = .407). Similarly, the mindfulness level after the program (M = 64.65, SD = 6.06), had no significant difference from before the program (t = -1.588, p = .129).
Recommendation Healthcare professionals who completed training in MBCT attain a greater knowledge and are prepared with the competence to consistently and continuously apply mindfulness techniques in therapy. They can integrate these skills into their ongoing practice, subsequently offering therapy to patients with depression.
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References
World Health Organization. Depressive disorder (depression) [Internet]. [cited 2023 Mar 29]. Available from: https://www.who.int/news-room/fact-sheets/detail/depression.
Bueno-Notivol J, Gracia-García P, Olaya B, Lasheras I, López-Antón R, Santabárbara J. Prevalence of depression during the Covid-19 outbreak: A metaanalysis of community-based studies. Int J Clin Health Psychol 2021;21(1):100196. doi: 10. 1016/j.ijchp.2020.07.007. Epub 2020 Aug 31. PMID: 32904715; PMCID: PMC7458054.
Kessing LV, Hansen MG, Andersen PK, Angst J. The predictive effect of episodes on the risk of recurrence in depressive and bipolar disorders - a life-long perspective. Act Psychiatr Scand 2004;109(5): 339-44. doi: 10.1046/j.1600-0447.2003.002 66.x. PMID: 15049770.
Prasrimahabhodi Psychiatric Hospital. Annual report. Ubon Ratchathani: Prasrimahabhodi Psychiatric Hospital; 2018. (in Thai)
Hollon SD, DeRubeis RJ, Shelton RC, Amsterdam JD, Salomon RM, O’Reardon JP, et al. Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Arch Gen Psychiatry 2005;62(4):417-22. doi: 10.1001/archpsyc. 62.4.417. PMID: 15809409.
Choompubut P, Kenbubpha K, Sukhawaha S, Leejongpermpoon J, Saima-in H. The findings from need analysis and problems management of major depressive disorders in prasrimahabhodi psychiatric hospital. Ubon Ratchathani: Prasrimahabhodi Psychiatric Hospital 2021. (in Thai)
Chen H, He Q, Wang M, Wang X, Pu C, Li S, et al. Effectiveness of CBT and its modifications for prevention of relapse/recurrence in depression: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2022;319:469-81. doi: 10. 1016/j.jad.2022.09.027. Epub 2022 Sep 23. PMID: 36162683.
van der Velden AM, Kuyken W, Wattar U, Crane C, Pallesen KJ, Dahlgaard J, et al. A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clin Psychol Rev 2015;37:26-39. doi: 10.1016/j.cpr.2015.02.001. PubMed PMID: 257 48559.
Segal ZV, Williams JM, Teasdale JD. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press; 2002.
Segal ZV, Williams JM, Teasdale JD. Mindfulness-based cognitive therapy for depression. 2nd ed. New York: Guilford Press; 2013.
Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte; 1990.
Batink T, Peeters F, Geschwind N, van Os J, Wichers M. How does MBCT for depression work? Studying cognitive and affective mediation pathways. PloS one 2013;8(8):e72778. doi: 10.1371/journal. pone .0072778. PubMed PMID 24009704.
Areekit P, Lueboonthavatchai O. The effect of cognitive behavioral therapy and mindfulness on depression in depressive disorder patients. The Journal of Psychiatric Nursing and Mental Health 2012;26(3):71-80. Available from: https://he02.tci-thaijo.org/index.php/JPNMH/article/view/18106 (in Thai)
Rungreangkulkij S, Thongyot S, Kotnara I, Wannatong K. Efficacy of buddhist counseling on decrease depressive symptoms of patients with depressive disorder. Journal of the Psychiatric Association of Thailand 2014; 59(4):381-93. (in Thai)
Kenbubpha K, Pianthong K, Saguanrum K, Sukhawaha S. Effectiveness of mindfulness-based cognitive therapy for depressive disorder in Thailand. the 22nd WPA World Congress of Psychiatry 3-6 August 2022; Bangkok, Thailand.
Weck F., Grikscheit F., Höfling V., Stangier, U. Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions. Behavior Therapy 2014;45(4):541-52. doi: 10. 1016/j.beth.2014.03.003. PubMed PMID: 249 12466.
Fairburn CG, Cooper Z. Therapist competence, therapy quality, and therapist training. Behav Res Ther 2011;49(6-7):373-8. doi: 10.1016/j.brat.2011. 03.005. PubMed PMID: 21492829.
Perepletchikova F, Kazdin AE. Treatment integrity and therapeutic change: Issues and research recommendations. Clin Psychol: Sci Pract 2005;12(4): 365. doi: org/ 10.1093/ clipsy.bpi045
Crane RS, Eames C, Kuyken W, Hastings RP, Williams JMG, Bartley T, et al. Development and validation of the mindfulness-based interventions–teaching assessment criteria (MBI: TAC). Assessment 2013; 20(6):681-8. doi: 10.1177/1073191113490790. PubMed PMID: 23794181.
Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health 2008; 31(2): 180-91. doi: 10.1002/nur.20247. PubMed PMID: 18183564.
Thanoi W, Panitrat R, Phancharoenworakul K, Thompson EA, Nityasuddhi D. The adolescent ruminative response scale (Thai version): Psychometric properties. Journal of Nursing Science 2011;29(2):29-38. Available from: https://he02.tci-thaijo.org/index.php/ns/article/view/2855/2304 (in Thai)
Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. J Pers Soc Psychol 1991;61(1):115-21. doi: 10. 1037/ /0022-3514.61.1.115. PubMed PMID: 1890582.
Cardaciotto L, Herbert JD, Forman EM, Moitra E, Farrow V. The assessment of present-moment awareness and acceptance: The Philadelphia mindfulness scale. Assessment 2008;15(2):204-23. doi: 10.1177/ 1073191107311467. PubMed PMID: 18187399.
Silpakit C, Silpakit O, Wisajun P. The validity of philadelphia mindfulness scale thai version. Journal of Mental Health of Thailand 2011;19(3): 140-7. Available from: https://he01.tci-thaijo.org/index.php/jmht/article/view/968 (in Thai)
Huijbers MJ, Crane RS, Kuyken W, Heijke L, Van den Hout I, Donders ART, et al. Teacher competence in mindfulness-based cognitive therapy for depression and its relation to treatment outcome. Mindfulness 2017;8(4):960-72. doi: 10.1007/s12671-016- 0672-z. PubMed PMID: 28757901.
Hopkins A, Proeve M. Teaching mindfulness-based cognitive therapy to trainee psychologists: Qualitative and quantitative effects. Couns Psychol Q 2013;26(2): 115-30. doi: org/10.1080/09515070.2013 .792998
Segerstrom SC, Tsao JC, Alden LE, Craske MG. Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood.Cogn Ther Res 2000; 24(6):671-688. doi: org/10.1023/ A:1005587 311498
Collard P, Avny N, Boniwell I. Teaching mindfulness based cognitive therapy (MBCT) to students: The effects of MBCT on the levels of mindfulness and subjective well-being. Couns Psychol Q 2008; 21(4): 323-6. doi: org/10.1080/095150708 02602112
Schanche E, Vøllestad J, Visted E, Svendsen JL, Osnes B, Binder PE, et al. The effects of mindfulnessbased cognitive therapy on risk and protective factors of depressive relapse – a randomized wait-list controlled trial. BMC Psychol 2020;8(1):57. doi: 10.1186/s40359-020-00417-1. PubMed PMID: 32503649.
Rocco D, Gennaro A, Filugelli L, Squarcina P, Antonelli E. Key factors in psychotSherapy training: An analysis of trainers’, trainees’ and psychotherapists’ points of view. Res Psychother 2019;22(3):415. doi: 10.4081/ ripppo.2019.415. PubMed PMID: 32913816.
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