The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

Mindfulness-Based Stress Reduction Increases Mental Wellbeing and Emotion Regulation During the First Wave of the COVID-19 Pandemic: A Synchronous Online Intervention Study

“…). An additional possible limitation can be taken from Canby et al (2021), who showed that instructor -and group -related factors play a role in the therapeutic effects of MBIs. Naturally, a group formed at the beginning of a global pandemic may share the common cohesive experience of difficulty that could positively contribute to the program's overall effect.…”

“…Although positive outcomes remained high, despite the worsening of the pandemic, it is not clear whether the gains would be sustained for extended periods without further structured support (e.g., group setting and instructor). An additional possible limitation can be taken from Canby et al (2021) , who showed that instructor – and group – related factors play a role in the therapeutic effects of MBIs. Naturally, a group formed at the beginning of a global pandemic may share the common cohesive experience of difficulty that could positively contribute to the program’s overall effect.…”

Effects of group mindfulness-based cognitive therapy and group cognitive behavioural therapy on symptomatic generalized anxiety disorder: a randomized controlled noninferiority trial

“…One plausible explanation for more improvements after treatment is the request that participants in the MBCT-A group report their mindfulness home practice in a WeChat group on a daily basis, which could have promoted engagement. It is widely accepted that for MBI participants, there is a significant association between the extent of practice and positive intervention outcomes [ 43 ],especially concerning anxiety [ 44 ]. In contrast, in the CBT-A group, weekly homework was handed in to the therapists and discussed in the following session.…”

From Self-Esteem to Selflessness: An Evidence (Gap) Map of Self-Related Processes as Mechanisms of Mindfulness-Based Interventions

“…Finally the social self – or the self in relation to others, or as part of a group – was only briefly discussed in the section on self-transcendence. Given that many forms of self-hood, both conceptual and embodied, can be influenced by both culture and group membership ( Canby et al, 2020 ), the impacts of MBIs through social dimensions of self deserve more attention.…”