Correlates of Treatment Preference in a Randomized Trial Comparing Mindfulness Meditation versus Cognitive-Behavioral Therapy

Purpose: There is growing interest in the clinical application of mindfulness meditation. However, little is known about the extent to which clients prefer mindfulness-based interventions (MBI) over conventional psychological therapies. The present study examined predictors of treatment preference and credibility in individuals with social anxiety disorder (SAD) who participated in a randomized trial of a mindfulness intervention adapted for SAD (MBI-SAD) versus a conventional psychological therapy (cognitive behavior group therapy; CBGT).

Method: The sample included 97 adults who met DSM-5 criteria for SAD. Binary logistic and multiple linear regressions were conducted to examine baseline sociodemographic and clinical predictors of treatment preference for the MBI-SAD and perception of treatment credibility. Analysis of variance was used to compare levels of trait mindfulness across treatment preference groups.

Results: The majority of participants (49%) reported a preference for the MBI-SAD. Ratings of treatment credibility were comparable for the two interventions. Employment status significantly predicted preference for CBGT versus the MBI-SAD, whereas younger age predicted preference for CBGT. Higher household income, a history of psychotherapy, elevated scores on clinician ratings of depression and social anxiety, and lower scores on self-report depression predicted no treatment preference. Higher household income predicted greater perceived credibility of treatment. Trait mindfulness did not differ across the treatment preference groups or predict treatment credibility.

Discussion: Mindfulness meditation appears to be an acceptable and credible treatment for SAD. However, few baseline demographic and clinical characteristics predicted preference for the MBI-SAD. Additional research is needed to explore factors that shape preference and beliefs about mind-body interventions.