The Psychology Centre

An investigation into the health benefits of Mindfulness-Based Stress Reduction (MBSR) for a specific range of chronic illnesses

Philippa Thomas, The Psychology Centre
Wendy Tuck, Health Waikato
Jeannette Shennan, Pain Management Service, Waikato Hospital
Dr Helen Conaglen, Senior Research Fellow, Waikato Clinical School
Jill Bell, Physiotherapist in private practice

MBSR Pilot Study Executive Summary

Current evidence indicates that mindfulness-based stress reduction training, or MBSR, is effective in alleviating suffering and improving coping related to many chronic illnesses. We believe this study was the first Aotearoa New Zealand pilot study of MBSR training for people with chronic health problems, for example, chronic pain, diabetes, a history of strokes, hypertension, and cancer.

Recruitment began in May 2005; from 115 enquiries between then and October 2006, 78 people were screened, found to meet study criteria and randomly allocated to MBSR training or waitlist conditions. Twenty-one people did not start training; 57 participants began the programme. Between October 2005 and December 2006, 42 of those participants completed one of four eight-week MBSR training groups (15 dropped out). The impact of MBSR training on the completers' physical and psychological health was monitored, and 40 of them were followed up six months later.

Research challenges included recruitment and conservation of a sample large enough to be statistically significant, and consequent problems for the study design and analysis of results. This was compounded by 11 participants who switched from their originally allocated condition to the other condition; six from MBSR training to the waitlist and five from the waitlist to MBSR training.

Consequently, results from a pure randomised sample, and from a "Clayton's" randomised sample of MBSR training completers vs waitlist, while encouraging, were limited in terms of demonstrating MBSR's effectiveness. However, comparison of all completers' results with normative data, and within-group comparison of their baseline, end of training, and follow-up results, found significant improvements in almost all aspects of their physical and mental health on the study measures (SF-36, DASS, KIMS, Pain NRS and PCS). These changes were maintained at follow-up. While limited corroborative data from participants' general practitioners prevented us from definitively stating that MBSR training improved physical health in the completers as a whole, individual group members with considerable health difficulties reported significant achievements, such as reduced use of major pain medications.

The outcome of this study demonstrates (in line with overseas research) the effectiveness of MBSR training. Future possibilities could include provision of mindfulness-based training to patients of primary and secondary service providers; issues yet to be determined include (most notably) funding.

Continuing the research could be considered, with a stronger study design such as comparing MBSR training with a stress reduction programme based on cognitive behaviour therapy (CBT) principles, to see which approach works best, and for whom. If so, the design could be further enhanced by actively recruiting consultants and/or primary health carers willing to measure participants' physical stress markers, so that the primary objective of demonstrating the relationship between increased mindfulness and better physical (not just psychological) health could be achieved.


For further information, please contact Philippa Thomas at the Centre:

The Psychology Centre
PO Box 5556
Frankton
Hamilton 3242
00 64 7 846 6907
philippa@tpc.org.nz