Randomized Controlled Trial of Group-Blended and Individual-Unguided Online Mindfulness-Based Cognitive Therapy to Reduce Psychological Distress in People With Cancer.

A three-armed randomized controlled trial compared two co-created online mindfulness-based cognitive therapy (eMBCT) formats—group-blended and individual-unguided—against care as usual (CAU) for people with cancer. Group-blended eMBCT significantly reduced psychological distress at post-treatment and at 3-month follow-up compared to CAU, while individual-unguided eMBCT showed significant reductions only at follow-up. Both formats also improved secondary outcomes like rumination, mindfulness, decentering, and self-compassion at follow-up. The authors suggest these eMBCT formats may be accessible, potentially low-cost interventions to reduce distress in people with cancer.

Study at a glance

Abstract

Online mindfulness-based cognitive therapy (eMBCT) can reduce psychological distress in people with cancer, but adherence and scalability could be improved. Through co-creation, we developed two eMBCT formats: group-blended and individual-unguided. This trial compared the effects of the two eMBCT to care as usual (CAU) on psychological distress and other mental health outcomes in people with cancer. In this parallel, three-armed randomized controlled trial, people with cancer were randomly allocated to group-blended eMBCT, individual-unguided eMBCT, or CAU. Participants completed baseline, mid-treatment, post-treatment, and 3 months follow-up assessments. The primary outcome analyzed in the intention-to-treat (ITT) population was psychological distress (Hospital Anxiety and Depression Scale) at post-treatment. In total, 186 participants were randomized to group-blended eMBCT (N = 57), individual-unguided eMBCT (N = 75), or CAU (N = 54). Most participants were female (81%) with breast cancer (49%), and treated with curative intent (76%). In ITT analyses, group-blended eMBCT participants reported significantly lower levels of psychological distress at post-treatment (Cohen's d = 0.38) and follow-up (Cohen's d = 0.64) than those receiving CAU, while individual-unguided eMBCT participants only had significantly less psychological distress at follow-up (Cohen's d = 0.48). Additionally, participants in group-blended eMBCT had less rumination and greater mindfulness, decentering, and self-compassion than those in CAU at follow-up. Participants in individual-unguided eMBCT had greater decentering than those in CAU at post-treatment and follow-up, and less rumination and greater mindfulness skills than CAU at follow-up. Compared to CAU, both eMBCT conditions were effective in reducing psychological distress and could be an accessible, and potentially low-cost intervention to reduce distress in people with cancer. Dutch Registry CCMO, NL73117.091.20; clinicaltrials.gov, NCT05336916.