Feasibility, acceptability, and fidelity of remote-delivered abbreviated mindfulness-based cognitive therapy interventions for patients with migraine and depressive symptoms.
Elizabeth K. Seng, Jacob D Hill, Annie Kate Reeder, Pallavi Visvanathan, Rebecca E Wells, Richard B Lipton, Mia T. Minen, Amanda J Shallcross
Headache: The Journal of Head and Face Pain April 1, 2025 DOI: 10.1111/head.14857 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label single-arm clinical trial Peer reviewed |
|---|---|
| Sample size | 16 |
| Population | People with migraine and comorbid elevated depressive symptoms recruited from a large urban health system |
| Duration | 8-week intervention, with assessments at baseline, mid-treatment, and post-treatment |
| Topics | Meditation |
| Keywords | Depressive symptoms Migraine |
| Key findings | Remotely delivered abbreviated mindfulness-based cognitive therapy was feasible and acceptable for people with migraine and depressive symptoms, and was associated with significant reductions in headache-related disability and depressive symptomatology. |
Abstract
This study was an open-label single-arm clinical trial evaluating the fidelity, feasibility, acceptability, and clinical signal of abbreviated mindfulness-based cognitive therapy (MBCT-brief) delivered either via telephone (MBCT-T) or by video conferencing (MBCT-V) for people with migraine and comorbid depressive symptoms. Migraine is commonly comorbid with elevated depressive symptoms. MBCT reduces depressive symptoms and shows promise to reduce migraine-related disability. An abbreviated and remotely delivered version of MBCT could increase access to care. People with migraine and elevated depressive symptoms were recruited from a large urban health system. Participants were assigned in blocks of eight to receive an evidence-based MBCT-brief treatment, including eight weekly group classes and home practice delivered via telephone (MBCT-T) or video (MBCT-V); MBCT-T was randomly selected for the first block. Sessions were recorded and coded for treatment fidelity. Feasibility was assessed via session attendance (primary), homework completion, recruitment rate, and survey completion rate. Acceptability was assessed via the eight-item Client Satisfaction Questionnaire (CSQ-8; primary), the Credibility/Expectancy Questionnaire (CEQ), the System Usability Scale (SUS), and items assessing survey acceptability. Participants completed the Headache Disability Inventory (HDI) and Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS-SR16) at baseline, mid-treatment, and post-treatment. Feasibility and acceptability rates were compared to a priori benchmarks. Participants (n = 16) were all female with a mean (standard deviation [SD]) age of 45 (13) years, the majority of whom identified as White (13/16, 81%) and non-Hispanic (14/16, 88%). The intervention met the a priori criteria set for therapist fidelity to treatment protocol (mean [SD] MBCT-Treatment Acceptability and Competence Scale Adherence score 2.9 [0.2]), feasibility (mean [SD] session attendance was 7.9/8 [0.3]), and acceptability (mean [SD] CSQ-8 score 28.8 [3.3]) for the entire sample and for each treatment arm. The usability of the remote-delivery system was high across study participants (mean [SD] SUS score 84.8 [11.0]). Survey procedures were broadly deemed acceptable, with at least 80% participants either endorsing "Agree" or "Strongly Agree" across all items. Using Wilcoxon tests, we observed significant reductions in both the HDI (pre-treatment median [interquartile range] score 63 [40, 70] vs. post-treatment 36 [26, 54], p = 0.004) and the QIDS-SR16 (pre-treatment median [interquartile range] score 8 [5, 13] vs. post-treatment 4 [3, 6], p = 0.003). We found that remotely delivered MBCT-brief for migraine and depressive symptoms was feasible and acceptable to patients in both the telephone and video modalities. Intervention was associated with significant post-treatment reductions in headache-related disability and depressive symptomatology, findings that must be interpreted cautiously in the absence of a control group.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 2
- Treatment for Migraine and Mood (TEAM-M) study: Protocol for a three-arm multi-site randomized controlled feasibility trial comparing an abbreviated version of mindfulness-based cognitive therapy delivered via telephone or videoconferencing to enhanced usual care (Preprint) February 16, 2026
- Evaluating an Abbreviated Version of Mindfulness-Based Cognitive Therapy Delivered via Telephone or Videoconferencing Compared to Enhanced Usual Care—Treatment for Migraine and Mood (TEAM-M) Study: Protocol for a Three-Arm Multisite Randomized Controlled Feasibility Trial JMIR Research Protocols June 12, 2026
Cites 15
- Mechanisms of mindfulness Journal of Clinical Psychology December 29, 2005
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- Mindfulness-Based Stress Reduction for Health Care Professionals: Results From a Randomized Trial. International Journal of Stress Management May 1, 2005
- 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 residual depressive symptoms and relapse prophylaxis Current Opinion in Psychiatry December 11, 2015
and 10 more in the library