The Feasibility, Effectiveness, and Process of Change of Mindfulness-Based Cognitive Therapy for Adults With ADHD: A Mixed-Method Pilot Study

Janssen, Lotte; Vries, Alicia M. de; Hepark, Sevket; Speckens, Anne E. M.

doi:10.1177/1087054717727350

Cited by 18 publications

(16 citation statements)

References 46 publications

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“…Instead, participants report that they found the silent day facilitating, because it helped them to deepen their meditation practice and gain more insight in their behavioral patterns. This finding is in line with the study of Janssen et al (Janssen 2017), that showed that a silent day was found helpful by people with ADHD as well.…”

Section: Main Findingssupporting

confidence: 92%

The feasibility of mindfulness-based cognitive therapy for people with bipolar disorder: a qualitative study

Hanssen

Horst

Boele

et al. 2020

Int J Bipolar Disord

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Background Mindfulness- Based Cognitive Therapy (MBCT) could be a promising psychosocial intervention for people with bipolar disorder (BD). However, little is known about the feasibility of MBCT for people with BD. In this study we explore the facilitators and barriers people with BD experience of an adapted MBCT program. Method This qualitative study is part of a large, multicenter randomized controlled trial on MBCT for BD (trial registration number: NCT03507647). The present study included 16 participants with BD who participated in an 8-week adapted MBCT program. Semi- structured interviews exploring the feasibility, with a particular focus on the bipolar symptoms, were recorded verbatim, transcribed and analyzed. For reasons of triangulation, teachers were interviewed as well. Results Participants reported different barriers and facilitators of MBCT, both generally as well as with regard to their bipolar disorder. Four key themes arose: the training itself, psychosocial factors, personal characteristics and the bipolar disorder. Themes were further divided in subthemes. Conclusion The adapted MBCT program seemed to be feasible for people with BD. Depressive symptoms often acted as a barrier for participating in MBCT, suggesting that participants might need additional support when depressed. Manic symptoms could act both as a barrier and facilitator, suggesting that the occurrence of (hypo)mania does not necessarily have to be an exclusion criterion for participation. Further clinical and research implications are suggested. Trial registration: ClinicalTrials.gov, NCT03507647. Registered 25th of April 2018, https://clinicaltrials.gov/ct2/show/NCT03507647.

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Section: Main Findingssupporting

confidence: 92%

The feasibility of mindfulness-based cognitive therapy for people with bipolar disorder: a qualitative study

Hanssen

Horst

Boele

et al. 2020

Int J Bipolar Disord

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“…The finding that MBCT is especially cost-effective in patients who adhered to the treatment, implies that it is important to search for effective ways to increase the adherence, for instance by sending reminders for training sessions and actively contacting participants in case of no shows. A recent pilot study gave insight in perceived facilitators and barriers during MBCT which can, in some cases, be taken into account, such as offering a proper amount of directiveness by the teacher and stimulating helpful coping strategies (Janssen et al 2017).…”

Section: Limitations and Future Researchmentioning

confidence: 99%

“…Conflict of Interest The research team declares it had no part in developing the original MBCT program. AS, LJ, and SH made small modifications to this program as described in our pilot study (Janssen et al 2017). The team does not gain income from the sale of books on MBCT, nor does it gain income from giving lectures or workshops about it.…”

Section: Compliance With Ethical Standardsmentioning

confidence: 99%

Mindfulness-Based Cognitive Therapy Versus Treatment as Usual in Adults with ADHD: a Trial-Based Economic Evaluation

et al. 2019

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Objectives ADHD has a considerable economic impact. The aim of this study is to conduct a trial-based economic evaluation of mindfulness-based cognitive therapy (MBCT) added to treatment as usual (TAU) versus TAU in adults with ADHD. Methods A Dutch economic evaluation with a time horizon of 9 months was conducted from the societal perspective in the intention-to-treat (ITT) sample. Costs were assessed with a self-report questionnaire. Outcomes were expressed in quality adjusted life years (QALYs) and response rate. Bootstrap simulations were performed to estimate mean costs, QALYs, response rate, incremental cost-effectiveness ratios (ICERs), and associated uncertainty. Additional sensitivity analyses were done with imputed data, without extreme cost outliers, using the per protocol sample, and from a health care perspective. Results In the ITT sample, societal costs were €3572 for MBCT + TAU (n = 47; 95% CI 2416 to 4995) and €3389 for TAU (n = 49; 2327 to 4763). Average QALYs were 0.542 (0.522 to 0.563) per patient for MBCT + TAU and 0.534 (0.511 to 0.556) for TAU. In MBCT + TAU, more patients responded than in TAU (31% versus 6%; M bootstrapped difference 25%, 12 to 40%). ICERs were €21,963 per QALY gained and €389 per responder. At a threshold of €30,000 per QALY, the probability of MBCT being cost-effective was 51%. All sensitivity analyses showed more favorable results for MBCT + TAU. Conclusions In most analyses, MBCT was found to be more costly and effective, particularly in terms of disease-specific outcome, than TAU. If the threshold exceeds €30,000 per QALY and €1000 per responder, MBCT seemed cost-effective in treating adult ADHD. Keywords Adult ADHD. Mindfulness-based cognitive therapy. Cost-effectiveness. Health economy. Quality of life Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with an estimated prevalence of 2.5% at adult age (Simon et al. 2009). Its core symptoms affect academic, professional, and social functioning (Karlsdotter et al. 2016), and have a considerable personal and economic impact. A systematic review of Doshi et al. (2012) showed that in the USA, the estimates of overall annual incremental (excess)

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“…Notably, one recent study (Janssen, de Vries, Hepark, & Speckens, 2017) used mixed quantitative-qualitative methodology to assess feasibility and impact of an adapted mindfulness-based cognitive therapy (MBCT) program for adult ADHD patients. Qualitative interviews explored the barriers and facilitators of the training, as well as the process of change.…”

Section: Adverse Events From Mbi Treatment Studies In Adhd Samplesmentioning

confidence: 99%

“…Reasons ranged from universal barriers, such as a family emergency or illness (Zylowska et al, 2008), to experiences of "too much restlessness" and "exacerbation of depression" (Hepark et al, 2015). "Unmet expectations" was a reason for dropping out in an adult treatment study (Janssen et al, 2017), and one adolescent dropped out for "too severe externalizing and behavioral problems to participate in a group setting in another study" (van der Oord, Bogels, & Peijnenburg, 2012). In Janssen and colleagues (2017), overall noncompleters were significantly older and reported higher levels of executive and general dysfunction, as well as poorer physical and mental health status.…”

Section: Adverse Events From Mbi Treatment Studies In Adhd Samplesmentioning

confidence: 99%

Adverse Events in Mindfulness-Based Interventions for ADHD

2018

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The Feasibility, Effectiveness, and Process of Change of Mindfulness-Based Cognitive Therapy for Adults With ADHD: A Mixed-Method Pilot Study

Abstract: The adapted MBCT program seemed to be feasible for adults with ADHD and preliminary evidence for the effectiveness is shown. An adequately powered Randomized Controlled Trial (RCT) is needed to further examine the effectiveness of MBCT for ADHD.

Cited by 18 publications

References 46 publications

The feasibility of mindfulness-based cognitive therapy for people with bipolar disorder: a qualitative study

The feasibility of mindfulness-based cognitive therapy for people with bipolar disorder: a qualitative study

Mindfulness-Based Cognitive Therapy Versus Treatment as Usual in Adults with ADHD: a Trial-Based Economic Evaluation

Adverse Events in Mindfulness-Based Interventions for ADHD

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