Low-Intensity Guided Help Through Mindfulness (LIGHTMIND): Study protocol for a randomised controlled trial comparing supported Mindfulness-Based Cognitive Therapy self-help to supported Cognitive Behavioural Therapy self-help for adults experiencing depression
Clara Strauss, Amy Arbon, Michael Barkham, Sarah Byford, Rebecca S. Crane, Richard De Visser, Margaret Heslin, Anna-Marie Jones, Fergal Jones, Laura Lea, Glenys Parry, Claire Rosten, Kate Cavanagh
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial protocol |
|---|---|
| Sample size | 410 |
| Population | Adults experiencing mild to moderate depression recruited from IAPT services in England |
| Interventions | Mindfulness-based cognitive therapy self-help (MBCT-SH) cognitive behavioural therapy self-help (CBT-SH) |
| Duration | 16-week workbook completion period with six support sessions; follow-up duration not stated |
| Topics | Depression Meditation |
| Key findings | The protocol proposes testing whether supported mindfulness-based cognitive therapy self-help is more effective than supported cognitive behavioural therapy self-help for mild to moderate depression in IAPT services, with an exploratory non-inferiority analysis if the primary hypothesis is not supported. The authors argue that MBCT's different focus, approach and practice may improve outcomes and treatment completion. |
Abstract
Abstract Background Depression has serious personal, family and economic consequences. It is estimated that it will cost £12.15 billion to the economy each year in England by 2026. Improving Access to Psychological Therapies (IAPT) is the National Health Service talking therapies service in England for adults experiencing anxiety or depression. Over 1 million people are referred to IAPT every year, over half experiencing depression. Where symptoms of depression are mild/moderate, people are typically offered Cognitive Behavioural Therapy (CBT) self-help supported by a psychological wellbeing practitioner (PWP). The problem is that over half of people who complete treatment for depression in IAPT remain depressed despite receiving National Institute of Health and Care Excellent (NICE) recommended treatment. Furthermore, less than half of IAPT service users complete treatment. This study seeks to investigate the effectiveness of an alternative to CBT self-help. Mindfulness-based cognitive therapy differs from CBT in focus, approach and practice and may be more effective with a higher number of treatment completions. Methods/Design This is a definitive randomised controlled trial comparing supported mindfulness-based cognitive therapy self-help (MBCT-SH) with supported cognitive behavioural therapy self-help (CBT-SH) for adults experiencing mild/moderate depression being treated in IAPT services. Four hundred and ten participants experiencing mild/moderate depression will be recruited from IAPT services and randomised to receive either an MBCT-based self-help workbook or a CBT-based self-help workbook. Participants will be asked to complete their workbook within 16 weeks, with six support sessions with a PWP. The primary outcome is depression symptom severity upon treatment completion. Secondary outcomes are treatment completion rates and measures of generalized anxiety, wellbeing, functioning and mindfulness. An exploratory non-inferiority analysis will be conducted in the event the primary hypothesis is not supported. A semi-structured interview with participants will guide understanding of change processes. Discussion If the findings from this randomised controlled trial demonstrate that MBCT-SH is more effective than CBT-SH for adults experiencing depression, this will provide evidence for policy makers and lead to changes to clinical practice in IAPT services, leading to greater choice of self-help treatment options and better outcomes for service users. If the exploratory non-inferiority analysis is conducted and this indicates non-inferiority of MBCT-SH in comparison to CBT-SH this will also be of interest to policy makers when seeking to increase service user choice of self-help treatment options for depression.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cites 4
- Web-Based Intervention in Mindfulness Meditation for Reducing Residual Depressive Symptoms and Relapse Prophylaxis: A Qualitative Study Journal of Medical Internet Research March 24, 2014
- Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLoS One June 15, 2016
- How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review April 1, 2015
- Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology December 1, 2008