RESUMO
Objectives: The effectiveness of mindfulness-based programs (MBPs) has been established in many randomized controlled trials. However, effect sizes are often modest, and there remains ample scope to improve their effectiveness. One approach to this challenge is to offer a "follow-on" course to people who have completed an MBP and are interested in further skill development. We developed and tested a new 8-week course for this purpose based on awareness of feeling tone (vedana), an understudied aspect of mindfulness in many current MBPs, incorporating new developments in neuroscience and trauma sensitivity. We examined its effectiveness and the frequency and severity of unpleasant experience and harm. Methods: In an open trial, 83 participants, 78 of whom had previously taken part in an MBP (majority MBSR or MBCT), completed the program in nine groups. Participants completed questionnaires before and after and gave qualitative written feedback at completion. Results: Participants reported significantly reduced depression (d = 0.56), stress (d = 0.36), and anxiety (d = 0.53) and increased well-being (d = 0.54) and mindfulness (d = 0.65) with 38% meeting criteria for reliable change on anxiety and depression. As expected, about three-quarters of participants reported some unpleasant experiences associated with mindfulness practice during the course, but none reported harm. Five participants showed "reliable deterioration" (an increase) in either depression or anxiety, but four of these five also gave anonymous qualitative feedback describing benefits of the course. Conclusions: Findings support the added value of a follow-on course based on the exploration of feeling tone for participants who have a range of previous mindfulness experience. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-01929-0.
RESUMO
BACKGROUND: Mindfulness-based stress reduction (MBSR) has been found to have significant health benefits in studies conducted in the global North. AIM: This study examined the effects of MBSR on stress, mood states and medical symptoms among urban South Africans to inform future research and clinical directions of MBSR in local settings. SETTING: Participants completed an 8-week MBSR programme based in central Cape Town. METHOD: A retrospective analysis of 276 clinical records was conducted. Mindfulness, stress, negative and positive mood, medical symptoms and psychological symptoms were assessed before and after the intervention using self-report questionnaires. We compared pre and postintervention scores and examined the relationship between changes in mindfulness and changes in stress, mood and medical symptoms. RESULTS: Mindfulness scores were significantly higher after intervention, both on the Kentucky Inventory of Mindfulness Skills (KIMS) and the Mindful Attention Awareness Scale (MAAS). Changes on the KIMS were associated with reductions in stress, negative mood, psychological symptoms and total medical symptoms, and improvement in positive mood. Changes in mindfulness, as measured by the MAAS, were significantly correlated only with reduced total number of medical symptoms. CONCLUSION: This study provides preliminary evidence for the positive health impact of MBSR on urban South Africans, and in turn acceptability and feasibility evidence for MBSR in South Africa and supports the case for larger trials in different local settings.