Acceptability, Practicality and Preliminary Indications of Efficacy of a Blended Individual Mindfulness Intervention for Patients with Persistent Depression

Abstract Objectives Mindfulness training has been shown to be helpful in the treatment of depression. However, standard mindfulness-based interventions (MBIs) are still not widely available and sustaining a mindfulness practice can be difficult for patients with current depression. Alternative delivery formats may serve to address these problems. This study tested the acceptability, practicality and preliminary efficacy of a blended individual mindfulness-based intervention that supports patients in their practice individually and beyond the duration of standard mindfulness-based interventions.

Method: Thirty-nine patients with persistent depression were entered into the study and supported to practice with either standard length practices (30 min once a day) or shorter, more frequent practices (15 min twice a day) over 12 weeks with minimal therapist support (6 sessions of 30 min duration). Symptoms were assessed at the beginning, and after each third of the intervention. Engagement in practice was monitored throughout and qualitative interviews were conducted post-intervention. Data from 24 service users who waited for depression treatment were collected for benchmarking purposes.

Results: Of those randomised, 24 (62%) completed the intervention. Completers engaged in an average of 89% of formal practices and showed reductions in symptoms of high effect size, η p 2 = 0.66, 90% CI [0.54, 0.73], with 75% of completers moving to symptoms levels below the clinical threshold. Thematic analysis of feedback from completers indicated high acceptability but highlighted the need for longer therapist sessions.

Conclusions: Blended individual mindfulness-based interventions have promise for supporting depressed patients to engage in mindfulness practice and reduce symptoms while aligning well with current trends in service delivery. However, adjustments to the current intervention in line with patient suggestions, including more time for individual therapist sessions to bring them closer to the standard length of psychotherapy sessions, are needed to reduce drop-out and underlying practicality problems. Preregistration This study was pre-registered on ClinicalTrials.gov (ClinicalTrials.gov ID: NCT04576741).