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HereSince1628

(36,063 posts)
Sun Nov 30, 2014, 08:43 AM Nov 2014

Lipstick on a pig? Mindfulness "just as effective" as CBT t.a.u.

Anyone around psych clinics knows Mindfulness is a trending treatment phenomenon. Mindfulness approaches are thinly modified from Buddhist practice of "Right-Mindfulness" made popular by Jon Kabat-Zinn. This newly published study done to test the effectiveness of Mindfulness compared to a CBT "treatment as usual", found no difference in effectiveness for depression and anxiety.

Is this really a good thing that justifies Mindfulness over normal CBT? What does it actually mean when different treatments bring the same results? Is CBT just as good as the now fashionable Mindfulness, or is Mindfulness just as good as the once fashionable CBT?

What does it mean to understanding mental disorders that depression and anxiety have no specific treatment but respond basically to the same degree to different treatments? Well, what does it mean besides the economy of Mindfulness being done in a group setting and CBT being done one-on-one?

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http://www.sciencedaily.com/releases/2014/11/141127112755.htm

Mindfulness treatment as effective as CBT for depression, anxiety

<Snip>

A total of 215 patients were included in the study. Before and after treatment, the patients in the mindfulness and regular treatment groups answered questionnaires that estimated the severity of their depression and anxiety. Self-reported symptoms of depression and anxiety decreased in both groups during the 8-week treatment period. There was no statistical difference between the two treatments.

"The study's results indicate that group mindfulness treatment, conducted by certified instructors in primary health care, is as effective a treatment method as individual CBT for treating depression and anxiety," says Jan Sundquist. "This means that group mindfulness treatment should be considered as an alternative to individual psychotherapy, especially at primary health care centres that can't offer everyone individual therapy."

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HereSince1628

(36,063 posts)
3. I'm just as curious about the scoring of the self-reported relief of symptoms...
Sun Nov 30, 2014, 06:45 PM
Nov 2014

A finding of no difference is usually not considered particularly meaningful, unless something significantly cheaper (or more free of downside risk) is just as good as something significantly more expensive (or has more downside risk).

Without accessing the primary publication it's not possible to be be sure that the components that go into the self-reports are actually comparable. For example group therapy by itself results in interpersonal interactions that could be scored as spending more time concerned about others...sometimes that is a performance objective of depression therapy. One-on-one therapy doesn't generate that interaction directly. The differences in experience within the group session might be conflated with outcomes beyond the clinic and from the brief report it's a question that is unaddressed.

But, the investigators reportedly interpret the result as a rationale for replacing one-on-one CBT by a therapist (probably expensive) with group mindfulness sessions run by 'certified instructors' (probably less expensive).

 

TM99

(8,352 posts)
2. Clinicians rarely use Mindfulness techniques in isolation
Sun Nov 30, 2014, 04:01 PM
Nov 2014

when it comes to treatment planning.

I have meditated for over 30 years. I have studied with various Buddhist teachers. I teach mindfulness practices in group settings, and these awareness and meditation practices are wonderful adjuncts to therapy as well as being general anti-stress practices. They are all very basic meditation practices that are prescribed to Buddhist aspirants and are quite devoid of any religious practice, ritual, or thought.

In clinical practice, however, I now use A.C.T. (Acceptance Commitment Therapy) which is the fusion of Mindfulness practices with C.B.T. techniques and protocols.

I am not surprised with the results, but this is a limited study. And as mentioned, how did they standardize on the practices. Mindfulness Based Stress Reduction is the Zinn protocol and is the most popular form of mindfulness meditation practices here in the US. It is regularly taught now in medical schools through out the country. But there are many others including Insight Meditation, Naikan, Vipassana Meditation, and numerous other mindfulness meditation practices taught by Buddhist teachers in the West.

HereSince1628

(36,063 posts)
4. Frankly, I think being taught by Buddhist teachers isn't essential to therapy.
Mon Dec 1, 2014, 05:48 PM
Dec 2014

I don't have a problem with solutions to mental disorders coming from any domain of discovery.

I do think that many therapists who are into Buddhism, aren't able to fully separate the religious components from the basic human components that contribute to well being.

streOne of the repeating problems I've encountered in people promoting derivatives of Buddhist practice, whether in Zinn on stress or Linehan on dialectical behavior therapy, is that they are basically unsuccessful in separating religious components from therapy.

Non-judgemental mindfulness is the theme promoted by Zinn and Linehan, but it never succeeds in differentiating itself from -RIGHT- mindedness. And RIGHT mindedness is nothing if not judgmental.

Again there is the problem of separating the hundreds of things that lead to 'feeling better' from things which actually have demonstrated efficacy in promoting recovery.

 

TM99

(8,352 posts)
5. I am in disagreement with much of what you have wrote.
Mon Dec 1, 2014, 06:31 PM
Dec 2014

I have never encountered a single Buddhist practitioner who is also a therapist (no matter what level of graduate training) that does as you suggest. I would like you to provide some good example to back up the claim.

You do not understand mindfulness. Judgement or non-judgement has zero to do with it. Mindfulness is simply awareness of objects or awareness of thoughts. One can be aware of judgmental thoughts but the mindfulness practice itself is neither judgmental nor non-judgmental.

'Right-mindedness' is an intricate component of any successful and effective method of therapy. Unless one strictly accepts the bio-psychological model that says that all psychological distress is caused only by chemical imbalances and therefore, can only be treated with medication, then yes, clients/patients of all levels of functioning are encouraged to work with their own mind extensively.

The very basis of CBT, a proven method of treatment for various psychological disorders, is not only becoming aware of self-defeating, self-shaming, self-castigating, etc. thoughts but also learning how to change them, to challenge them, and to have them without a strong negative emotional reaction occurring.

To suggest that 'right mindedness' is not an effective aspect of 'good' therapy is untenable to me. It infantilizes the patient and runs the risk of making them wholly dependent upon medications alone, therapists, doctors, etc. outside of themselves for their well-being.

With every disorder or dysfunction, an individual can be empowered and encouraged to act, think, and take control of what they can in their own healing, recovery, etc. To suggest otherwise is as laughable to me as your suggestion that therapists who just happen to be Buddhist are in any way shape or form being judgmental in their applications of mindfulness practices in these new treatment approaches.

Sheldon Cooper

(3,724 posts)
7. Maybe you can have a laugh at this. If you're the alerter, that is.
Mon Dec 1, 2014, 08:49 PM
Dec 2014
AUTOMATED MESSAGE: Results of your Jury Service
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I am in disagreement with much of what you have wrote.
http://www.democraticunderground.com/?com=view_post&forum=1260&pid=838

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Sheldon Cooper

(3,724 posts)
12. Since the alerter didn't add any comments, I have to wonder if it was
Tue Dec 2, 2014, 11:05 AM
Dec 2014

a mistake. But yeah, that was a weird alert.

HereSince1628

(36,063 posts)
8. Go ahead and do any search engine on "non-judgemental mindfulness"
Mon Dec 1, 2014, 08:53 PM
Dec 2014

You'll get a quick dozen or so references.

 

TM99

(8,352 posts)
10. Your point?
Tue Dec 2, 2014, 06:51 AM
Dec 2014

The first step in mindfulness practice is simply 'awareness of'. That can be of thoughts, actions, feelings, etc. Then, yes, as the mind begins to form a response to that object of awareness, yes, the individual is taught to take a non-judgmental stance. From that position, the natural & organic next step is the freedom to choose right action, right thought, right whatever.

So for you to claim that mindfulness based therapies is judgmental then you simply just don't understand nor have any experience with these practices.

mopinko

(71,687 posts)
13. where were the controls?
Sun Mar 22, 2015, 09:33 AM
Mar 2015

what would the data show if they had included, say, 100 people from waiting lists to get in to therapy?

this is a crap study. they may have proven that neither approach is good for anything. without control, you cant know.

mocamine

(1 post)
14. dissociative drug effects or Hallucinogens
Fri Sep 16, 2016, 05:32 AM
Sep 2016

What Are Hallucinogens and Dissociative Drugs effects

The term Dissociation refers to one of the ways which our mind copes in situations with too much stress to handle, particularly following traumatic events. This in general, can be used to describe scenarios or experiences where you may feel disconnected in some way from the entire world around you or from your own self.
Why Do People Take Hallucinogenic or Dissociative Drugs?

Most people go through this surprising phenomenon of our minds as a natural response to trauma which can’t really be manipulated. It can either be a form of reaction to a certain traumatic event which occurred years back or as a result of an ongoing upheaval and physical or emotional abuse. Moreover, bit deviating from the exact point, some people mind tend to get dissociated purposely to calm themselves down on focusing on a certain task or else as a part of a religious ritual. Some of these techniques are even practiced in Yoga and meditation.

Bernardo de La Paz

(50,833 posts)
15. CBT = Cognitive Behavioral Therapy
Fri Sep 16, 2016, 10:45 AM
Sep 2016

CBT = TLA (Three letter acronym), but which one?

Cognitive Behavioral Therapy

Eschew Obfuscation.

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