Relationships between amount of post-intervention mindfulness practice and follow-up outcome variables in an acceptance-based behavior therapy for Generalized Anxiety Disorder: The importance of informal practice

Abstract

Because most behavioral treatments are time-limited, skills and practices that foster long-term maintenance of gains made during treatment are of critical importance. While some studies have found mindfulness practice to be associated with improvements in outcome variables over the course of treatment (Vettese et al., 2009), very little is known about the effects of continued mindfulness practice following treatment termination. The current study examined the relationships between separate single item measurements of three types of mindfulness practices (formal, informal, and mindfulness of breath in daily life) and longer-term outcomes in worry, clinician-rated anxiety severity, and quality of life following treatment with an acceptance-based behavior therapy (ABBT) for Generalized Anxiety Disorder (GAD) in two separate treatment studies. Results from Study 1 showed that at 9-month follow-up, amount of informal mindfulness practice was significantly related to continued beneficial outcomes for worry, clinician-rated anxiety severity, and quality of life. Similarly, in Study 2, at 6-month follow-up informal mindfulness practice was significantly related to continued beneficial outcomes for anxiety severity and worry, and at 12-month follow-up informal mindfulness practice was significantly related to continued beneficial outcomes for quality of life and worry, and mindfulness of breath was significantly related to quality of life. When results from the final time point in both studies were combined, informal practice was significant related to all three outcome variables, and mindfulness of breath was significantly related to worry and quality of life. Formal practice was not significantly related to outcomes in either study, or in the combined sample. These findings support the further study of informal mindfulness practices as important tools for continued beneficial clinical outcomes following treatment for people with a principal diagnosis of GAD.

Adherence to Practice of Mindfulness in Novice Meditators: Practices Chosen, Amount of Time Practiced, and Long-Term Effects Following a Mindfulness-Based Intervention

“…In a study investigating the effect of MBSR on sleep disturbances in women with breast cancer, only the amount of informal practice correlated with sleep efficacy (Shapiro et al 2003). The same results were found in a generalized anxiety disorder sample at 6- and 9-month follow-ups (Morgan et al 2014), and on a smoking cessation clinical trial in which only the amount of informal practice moderated the correlation between craving and smoking, being negatively correlated with the number of cigarettes per day (Elwafi et al 2013). …”

A pilot randomized controlled trial of mindfulness-based stress reduction for caregivers of family members with dementia

“…Second, and mutually inclusive with this, the short-term (pre-post-intervention) psychosocial benefits of MBSR on perceived stress and mood may have been due to the daily practice of mindfulness prescribed in MBSR – practice that may have been curtailed or abandoned after course completion, resulting in null differences on these outcomes at the follow-up point. Recent research indicates that ongoing practice of mindfulness is related to mental health outcomes up to a year following course completion (Morgan et al, 2014). It is also possible that the study did not assess specific psychosocial or neurobiological outcomes that would have shown treatment condition differences.…”

Measuring the effects of self-awareness: Construction of the Self-Awareness Outcomes Questionnaire

“…A second and related conceptualization of self-awareness, namely mindfulness, has come under extensive scrutiny recently, with research generally indicating a positive relationship between mindfulness and well-being (Brown & Ryan, 2003) and mindfulness practice associated with long-term positive impacts on quality of life (Morgan, Graham, Hayes-Skelton, Orsillo, & Roemer, 2014). Mindfulness can be defined as attention to and awareness of the present moment which does not seek to react to or classify experience (Brown & Ryan, 2003).…”