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An Empirical Examination of the Role of Common Factors of Therapy During a Mindfulness-based Cognitive Therapy Intervention for Headache Pain.

Melissa A Day, James Halpin, Beverly E Thorn

Clinical Journal of Pain May 2016 DOI: 10.1097/ajp.0000000000000277 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Secondary analysis of a randomized controlled trial Peer reviewed
Sample size 21
Population Participants who completed Mindfulness-Based Cognitive Therapy for headache pain
Intervention Mindfulness-Based Cognitive Therapy (MBCT)
Topics Meditation
Key findings Patient engagement, therapist adherence and quality, working alliance, and pretreatment expectations and motivation were associated with session attendance, at-home practice, satisfaction, and pain-interference improvement, though the expectation-motivation effect on pain interference was fully mediated by baseline pain intensity. The authors argue common factors play an important role in MBCT outcomes for headache pain.

Abstract

It is often assumed that psychosocial pain treatments work because of specific active components of the intervention. The degree to which common factors may contribute to improved pain outcomes is not well researched. The purpose of this study was to examine patient-related and therapist-related common factors during a Mindfulness-Based Cognitive Therapy (MBCT) for headache pain trial. This study was a secondary analysis of a parallel group, unblinded, randomized controlled trial in which MBCT was compared with a control. A series of linear regression models and 1 bootstrap mediation model were conducted with the sample of participants that completed MBCT (N=21). In-session participant engagement was positively associated with treatment dose indicators of session attendance (P=0.038) and at-home meditation practice (P=0.027). Therapist adherence and quality were both significant predictors of posttreatment client satisfaction (P=0.038 and 0.034, respectively). Therapist appropriateness was not significantly associated with any of the variables of interest (P>0.05). Baseline pain intensity was positively associated with pretreatment expectations and motivations (P=0.049) and working alliance (P=0.048), and working alliance significantly predicted posttreatment patient satisfaction (P<0.001). Higher pretreatment expectations and motivation significantly predicted greater improvement in pretreatment to posttreatment change in pain interference (P=0.016); however, this relation was fully mediated by baseline pain intensity (P<0.05). Common factors play an important role in improving pain outcomes and patient satisfaction during a MBCT for headache pain intervention. Stimulating positive pretreatment expectations and patient motivation, as well as building strong rapport is an important component of treatment success.

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

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