Effectiveness of Nature- and Animal Assisted Mindfulness for Relapse Prevention in Depressed Patients With a History of Childhood Maltreatment
Elisabeth Schramm, Christoph Breuninger, Rainer Wohlfarth, Moritz Elsaesser, Hannah Piosczyk, Thomas Fangmeier
Frontiers in Psychiatry July 14, 2022 DOI: 10.3389/fpsyt.2022.899318 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 67 |
| Population | Unstable or partially remitted depressed patients with a history of early life trauma |
| Interventions | Nature- and animal-assisted mindfulness program Treatment-as-usual |
| Duration | 8-week intervention, 12-month follow-up |
| Topics | Meditation |
| Keywords | Mindfulness based intervention Nature based Animal assisted Psychotherapy Depression prevention Randomized controlled trial |
| Key findings | A nature- and animal-assisted mindfulness program combined with treatment-as-usual significantly reduced depression relapse rates and weeks depressed over 12 months compared to treatment-as-usual alone. |
Abstract
BackgroundFor relapse prevention in depression, conventional mindfulness programs such as the mindfulness-based cognitive therapy proved to be useful. However, early life trauma is a risk factor for having adverse experiences during meditation. Thus, for this patient group mindfulness skills are often difficult to learn and may be facilitated by using animals and a nature setting.MethodsThe aim of the study was to evaluate the preventative efficacy of a nature- and animal assisted mindfulness program (NAM) over the course of 1 year in unstable or partially remitted depressed patients with a history of early life trauma. NAM included 8 group sessions of 150 min each over 8 weeks plus one booster session. Sixty-seven participants were randomized to either NAM combined with treatment-as-usual (TAU; guideline oriented treatment) or TAU alone. The primary outcome was depression diagnosis over the course of 12 months after end of treatment. Secondary outcomes included clinician- and self-rated depressive symptoms, quality of life, mindfulness skills, and rumination post, and 12 months after the intervention. In addition, we evaluated the participants' satisfaction with the program.ResultsAnalyses revealed significant differences in relapse rates and number of weeks depressed throughout the course in favor of NAM. Furthermore, global quality of life improved significantly more in the NAM group. There was no significant difference for other secondary outcomes. Satisfaction with the program was high with a low drop-out rate of 6%. The vast majority of the participants felt safe practicing mindfulness in nature and found sheep for assistance helpful and motivating.ConclusionsA nature- and animal assisted mindfulness program proved to be feasible, highly acceptable, and more effective than standard treatment in preventing relapses in recurrently depressed patients with childhood maltreatment. Nature and animals can facilitate the engagement in the treatment process for individuals with a history of early trauma. However, further evidence in multicenter trials is necessary.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 13
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists PLoS One May 24, 2017
- The mindfulness‐based cognitive therapy adherence scale: inter‐rater reliability, adherence to protocol and treatment distinctiveness Clinical Psychology & Psychotherapy March 1, 2002
- Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial. Journal of Consulting and Clinical Psychology December 3, 2013
and 8 more in the library