Trial shows that MBCT reduces psychological distress in cancer patients

A cancer diagnosis is usually devastating for a patient and for their close family.  We can see that receiving such news is traumatic – leaving patients anxious about death and the impact upon loved ones; or fearful of the treatment or of being unable to control their emotions.  Yet the subsequent treatment phases can also be stressful, debilitating and challenging as patients may face the longer-term impact of surgery on their function and self-image…  and even the end of treatment – the “all clear” – can cause problems as families celebrate but the patients themselves are not feeling so positive as they try to process and adjust to the impact of their experience and the way in which they  have changed… and of course the anxiety of wondering if there will be a reoccurance. (See a previous blog post on this subject ).

Yet Mindfulness Based Cognitive Therapy can really help cancer patients to reduce distress.

This week I have been looking at a Dutch study on 245 patients using Mindfulness Based Cognitive Therapy  (MBCT) to reduce anxiety. Each of the cancer patients taking part in the study was categorised as experiencing “psychological distress” — I.e. demonstrating a score ≥ 11 on the Hospital Anxiety and Depression Scale (HADS).  See here.

The study compared patients treated with the usual psychological support  with those receiving an eight week course in either “therapist lead” MBCT or self-help (internet based) eMBCT.

The results demonstrated that both face-to-face and internet-based self-help mindfulness based cognitive therapy significantly reduced psychological distress in patients with cancer – reducing fear of cancer recurrence and improving mental health–related quality of life.

The result showed:

  • “Usual treatment” produced a change in mean HADS score from 17.04 at baseline to 16.37 at post-intervention
  • “Face to face MBCT” achieved a change from 18.81 to 13.25
  • and the “eMBCT group” achieved a change from 17.24 to 11.87 – almost eliminating  “psychotically distress” as defined

So, both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and more positive mental health compared with usual treatment.

The investigators concluded, “Compared with treatment as usual, MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.”

This research is exciting for us at Carina Sciences as we are currently working on a project to help cancer patients and their carers by providing a blend of information, advice and psychological support from diagnosis through treatment and beyond.  I will keep you posted.

Mindfulness for the Education Sector

A friend drew my attention to two new research reports from the charity “Education Support Partnership” on the wellbeing staff in universities.  A qualitative study found that academics are often isolated and anxious, in a system they feel is driven by financial targets – what one called a “treadmill of justification”.  A second survey, by YouGov for the charity, found that 55% of higher education professionals describe themselves as stressed and nearly four in 10 had considered leaving the sector in the past two years as a result of health pressures.

A piece in the Guardian quoted Dennis Guiney, an educational psychologist and co-author of the research:

“Lack of collegiality was a big concern for the academics we spoke to. Rather than focusing solely on money, they felt university managers should be building this. Academics need to feel valued. Praise is important.” His research found that academics felt under much more pressure to deliver within the competitive new market in higher education, and this meant a sense of loss of control over their job. The report quotes one academic saying: “You have to do all you can to keep student numbers high. Otherwise, next year one of your colleagues might lose their job.” [See here ]

It seems that the “target driven approach” to education is causing stress for staff at all levels of the education system.  From my own experience it seems that most working in education are continuously suspicious that all DOFE initiatives are specifically designed to case more stress and anxiety.  They may or may not do so… but it is undeniable that there is an ingrained belief that teachers are stressed and the high-ups don’t care.

Yet before we get too despondent, there is hope.  I can highlight two reports summarising the positive impact of mindfulness interventions on staff in education:

First, a  2014 Report by K Weare  of University of Exeter  summarised the evidence (from 13 studies published in peer reviewed journals ) on the impact of mindfulness on the wellbeing and performance of school staff:

  • reductions in stress, burnout and anxiety, including a reduction in days off work and feelings of task and time pressure,
  • improved ability to manage thoughts and behaviour, an increase in coping skills, motivation, planning and problem solving, and taking more time to relax.
  • better mental health including less distress, negative emotion, depression and anxiety.
  • greater wellbeing, including life satisfaction, self-confidence, self-efficacy, self-compassion and sense of personal growth.
  • increased kindness and compassion to others, including greater empathy, tolerance, forgiveness and patience, and less anger and hostility.
  • better physical health, including lower blood pressure, declines in cortisol (a stress hormone) and fewer reported physical health problems. 
  • increased cognitive performance, including the ability to pay attention and focus, make decisions and respond flexibly to challenges.
  • enhanced job performance, including better classroom management and organisation, greater ability to prioritise, to see the whole picture, to be more self-motivated and autonomous, to show greater attunement to students’ needs, and achieve more supportive relationships with them.

  Second, a 2019 paper from Bristol University demonstrated that mindfulness-based interventions contribute to the overall educator wellbeing and this may increase students’ sense of connectedness to teachers without themselves undergoing any intervention:

  • lower levels of perceived stress
  • reduced sleep difficulty
  • higher levels of mindfulness
  • increased self-compassion
  • better emotion
  • Improved students’ sense of connectedness to teachers.

So mindfulness really can help to address the stress and anxiety of education workers.  Of course there are many research papers that show how mindfulness can help people in many professions to be less stressed and less prone to anxiety and depression – but surely these results will convince colleges and schools to introduce such initiatives asap.  They make fiscal sense, educational sense and fulfill the moral obligation to their stressed-out staff.