Mindfulness-based cognitive therapy (MBCT) reduces depression relapse, but about one-third of graduates relapse within a year. Focus groups with MBCT graduates and teachers revealed that the course is highly valued and sometimes life-changing. However, graduates struggle to maintain mindfulness practices and sustain benefits after the course ends, despite using community groups, apps, or retaking the course. One participant described finishing MBCT as feeling like "falling off a cliff." Both graduates and teachers strongly desired additional support, such as a maintenance program, to help sustain long-term benefits and reduce relapse risk.
Older adults with HIV and cognitive impairment who took an 8-week Mindfulness-Based Stress Reduction (MBSR) program showed significant improvement in depression symptoms immediately after the program compared to a waitlist control group, but this benefit was not maintained one month later. The MBSR group also reported improved quality of life from the start of the program to the 16-week follow-up. Cognitive performance, including speed of information processing, working memory, attention, and impulsivity, did not differ between the MBSR and control groups. MBSR may help alleviate depression and improve quality of life in older individuals with HIV-associated neurocognitive disorder, but sustaining these benefits requires further study.
Teaching quality in mindfulness-based stress reduction (MBSR) courses, measured by the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC), shows fair to good inter-rater reliability depending on the number of raters. Using a single rater, reliability was fair (intraclass correlation coefficients 0.33–0.56 across six domains); with three raters, reliability was good (0.6–0.8). Among 152 MBSR students, anxiety, depression, fatigue, sleep, and social role function improved from before the course to two and four months later (improvements of 2.3 to 6.3 points). Higher MBI:TAC ratings predicted greater anxiety reduction: each one-unit increase in composite teaching rating was associated with a 0.31-point greater decrease in anxiety score. No significant relationships were found for other health domains.
A maintenance program called MBCT-D-TiF, designed for graduates of Mindfulness-Based Cognitive Therapy (MBCT) who want structured guidance to sustain their mindfulness practice, was feasible and acceptable in a pilot test. In round one, 14 participants received the program; in round two, 20 were randomized to the program or a waitlist. Attendance was high: all weekly sessions and at least 75% of monthly sessions. Most participants rated weekly sessions (77.1%) and monthly sessions (66.7%) as very or extremely helpful. Qualitative themes included the group's role in social connection, support, and accountability; mental health benefits such as reduced impact of depression and anxiety; and a need for additional support to maintain home practice after weekly sessions ended.