Online mindfulness-based cognitive therapy to boost lingering depression

Researchers have found online mindfulness-based cognitive therapy (MBCT) can enhance symptoms of residual depression.

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New research has found that a type of online therapy can be beneficial in improving treatment-resistant depression symptoms.

A team of researchers found that online MBCT can improve a variety of chronic depressive symptoms in people who have received depression treatment previously.

The results published in the JAMA Psychiatry review are important both for improving MBCT’s efficacy and for increasing patient access to treatment.

Mindfulness

Emerging from Asian Buddhist traditions, rituals of mindfulness and meditation concentrate on fostering an active awareness of the present moment. Such activities have played an increasingly important role as a part of the health-care system over the last 20 years.

One influential research area is MBCT, which incorporates the practice of mindfulness with cognitive behavioral therapy (CBT).

MBCT gives people the skills to improve how they control their emotions, helping them to analyze their ideas, feelings or feelings instead of responding to them automatically.

A meta-analysis in the journal Clinical Psychology Review found that in some cases, MBCT was as effective as antidepressant drugs. This therapy also proved effective in reducing the relapse of depression in people who had undergone this multiple times before.

However, while MBCT is effective in preventing depression relapses, considerable numbers of people may still experience lingering depressive symptoms after their treatment is over.

According to the study’s lead author, Prof. Zindel Segal of the University of Toronto Scarborough, Canada, “Treatments work well for many[ living with] depression, but there is still a substantial community that continues to struggle with residual symptoms such as sleep, strength, or concern.”

Prof. Segal suggests that these individuals are at an increased risk of recurrence to more severe depression. “Patients with these residual symptoms face a care vacuum,” he says, “because they are not too depressed to need re-treatment but are given no resources to manage the symptom burden they still carry.”

Access an issue

This treatment gap exists not only because of the relative lack of seriousness of chronic symptoms, but also because access to MBCT is extremely difficult for those who live outside the cities.

Prof. Segal has developed an online version of MBCT called Mindful Mood Balance (MMB) for this reason.

“Enhancing access to this treatment is what drove us to develop MMB. The online version uses the same content as the in-person sessions, except that people can now avoid the barriers of cost, travel, or waiting times, and they can effectively and conveniently get the care they need,” says Prof. Segal.

In 2015, Prof. Segal and his colleagues Dr. Arne Beck, of the Kaiser Permanent Institute for Health Research in Denver, Colorado, and Prof. Sona Dimidjian, of the University of Colorado Boulder, received a grant from the National Institutes of Health (NIH) to establish MMB.

To test the program, they conducted a randomized clinical trial involving 460 participants, all receiving regular depression care (UDC) in Kaiser Permanente Colorado clinics.

They found that those who also completed the MMB had reduced symptoms of anxiety and depression, higher remission rates and improved quality of life compared to those who received just UDC.

β€œAn online version of MBCT, when added with usual care, could be a real game changer because it can be offered to a wider group of patients for little cost.”

– Prof. Zindel Segal

While the findings are positive in terms of the potential of extending MBCT and helping people whose symptoms are not serious enough for them to receive treatment, online programs still have problems that need to be addressed.

Online services, for example, typically have higher dropout rates than face-to-face therapies.

However, Prof. Segal notes that”[ t]he higher dropout rates are somewhat offset by[ the] fact that you can reach many more people with online treatment.”

“But,” he continues, “there’s still room for improvement, and we’ll look at our user metrics and results for ways to make MMB more engaging and sustainable.”

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