Mindfulness approach effective where NHS talking therapies have not worked
A programme of mindfulness-based cognitive therapy has been shown to be beneficial in people with depression who had not benefitted from NHS Talking Therapies.
The effect seen was small-to-moderate but comparable to that shown with antidepressants, the researchers said.
At less than £100 per person it was also a cost-effective alternative to usual treatment, the team noted.
Reporting the findings in The Lancet Psychiatry, they concluded mindfulness-based cognitive therapy (MBCT) was an ‘easily scalable group-based intervention’ that should be implemented in the NHS where talking therapies has not worked.
The trial tested the approach in 234 patients in Devon, London and Sussex in patients with major depressive disorder whose symptoms had not reached remission after 12 NHS talking therapy sessions.
Half the participants had group training in mindfulness meditation to help them respond more adaptively to negative mood and stress, in addition to CBT principles which help change negative thought patterns.
MCBT done over an eight-week period on a videoconferencing platform significantly improved depression symptoms compared to continued treatment as usual.
Study co-author Professor Barney Dunn, a research and clinical psychologist at the University of Exeter, said: ‘We know there’s a gap in services for people with depression who haven’t got better through NHS Talking Therapies.
‘These people often don’t qualify for further specialist mental health care, and so are left with no further options.
‘We’ve shown that offering MBCT to this group can be effective and cost-efficient to deliver, and we hope this will lead to it being implemented widely.
‘We need investment in this and other areas where there are gaps in service, to ultimately save the NHS money.’
Professor Clara Strauss, professor of clinical psychology at the University of Sussex, said: ‘For vulnerable people with depression, MBCT is particularly helpful for a number of reasons.
‘It helps people to recognise negative, self-critical thoughts as thoughts, rather than as facts and so helps to lessen their emotional impact. It helps people to be more accepting of their difficult experiences and to be kinder to themselves.
‘MBCT also helps people to avoid getting stuck in unhelpful, repeated cycles of negative thinking.’
Dr Elena Makovac, senior lecturer in clinical psychology at Brunel University of London, said treatment-resistant or difficult-to-treat depression posed a significant challenge for the NHS system.
But she noted it was not possible to definitively determine whether the observed improvements were specifically due to the MCBT, or if they resulted from the fact that the MCBT group received moretreatment overall compared to the control group.
‘This improvement could potentially have been achieved with an extension of the originally delivered Talking Therapies.
‘While research into additional treatments for difficult-to-treat depression is essential, it is even more important to offer interventions grounded in well-understood mechanisms.
‘This process begins with a crucial first step: answering the question of why some patients do not respond to talking therapies.’
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