Download Mindfulness Based Cognitive Therapy for Cancer (MBCT Ca

Mindfulness Based Cognitive Therapy for Cancer (MBCT Ca)
CancerHelp
It is well known that having a diagnosis of cancer can be an extremely stressful time for
patient, friends and family, making us more vulnerable to anxiety and depression (1). Many
patients report that the emotional effects of cancer are more difficult to deal with than the
physical or practical effects (2). NICE Guidelines for the supportive and palliative care of
patients (2004), recommend that patients are offered psychological interventions as part of
their care.
One of the emerging influences in psychological health is mindfulness (3).
Mindfulness
Jon Kabat-Zinn defines mindfulness as “the awareness that arises through paying attention,
on purpose, in the moment and non-judgementally” (4). Kabat-Zinn was the originator of
MBSR, an eight week Mindfulness Based Stress Reduction (MBSR) programme,
researched in health care settings since 1979. Practicing mindfulness can help us become
more aware of our patterns of thinking and gain more insight into our moods. It helps to us
to get back in touch with the present and the everyday pleasures of being alive, rather than
getting stuck in going over the past or worrying about the future. It helps us too to bring a
sense of warmth and compassion to the suffering we experience (5).
Anyone can practice mindfulness.
Mindfulness Based Cognitive Therapy – MBCT
Mindfulness Based Cognitive Therapy (MBCT) is an eight week researched healthcare
programme, derived from MBSR that has been scientifically proved to help depression and
anxiety disorders as well as chronic pain (6). It is recommended by NICE guidelines as a
treatment for depression.
Mindfulness Based Cognitive Therapy for Cancer - MBCT Ca
Mindfulness has also been shown as an effective intervention in cancer care, ‘potentially
across the cancer trajectory’ (7) and is highlighted as an approach in the current National
Cancer Survivorship Initiative (8). Mindfulness Based Cognitive Therapy for Cancer is a further
refinement of MBCT (9) and is the programme offered twice a year at Cancer Help, at Vine
House in Preston and Croston House in Garstang
The programme includes
 Guided instruction in mindful meditation.
 Short mindfulness practices.
 Guided gentle physical stretching.
 Group discussion.
 Daily home practice.
 CDs of guided practice and a workbook.
Mindfulness Teacher
The lead mindfulness teacher at CancerHelp teaches in accordance with the UK Network
Good Practice Guidance for Teaching Mindfulness-Based Courses.
She has a Diploma in Mindfulness Based Applications from the Centre of Mindfulness
Research and Practice at Bangor University, and has been made an Associate Teacher for
Bangor University in recognition of her work in mindfulness in cancer care. She co-teaches
mindfulness retreats for oncology health professionals with Trish Bartley, the originator of
MBCT Ca and co- authored a review of mindfulness in cancer care published in PsychoOncology in 2011.
MBCT Ca at Cancer Help
Recruitment and inclusion criteria
Information about MBCT Ca is sent out to possible health referrers, including GPs,
specialist cancer nurses, psycho oncologists and to cancer support groups via electronic
media and leaflets are distributed direct to patients through CancerHelp’s two day centres.
Inclusion criteria are adults affected by a diagnosis of cancer and those with cancer have
generally finished intensive treatment. Patients may also be in palliative care. Each
potential course participant has an individual pre- programme orientation session, to see
whether the course is right for them right now.
Measures
Pre and post quantitative data is gathered using a PHQ9 questionnaire (10), a GAD7
questionnaire (11), a Self-Compassion Scale (12), and a WHO Wellbeing scale (13).
Qualitative statements are collected on a simple MBCT scale survey questionnaire. Results
are consistent with wider research findings of improvement in mood and wellbeing and
increase of self-compassion.
Some participant comments
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I was in an extremely low place before the course. The course has helped me develop
mechanisms of how to deal with things and be in the here and now and made me more aware of
things around me that we all take for granted.
It has helped me cope with things for the better. I no longer have problems with shortness of
breath. I am no longer hard and critical of myself.
I now have a tranquillity in my life I have never had before. I will without doubt maintain the
practices learnt and recommend the course to other people affected by cancer.
I now feel that I can manage to have a coping strategy for times of trouble and stress
I have slowed down and realised how beautiful the world is
A life changing experience.
The experience of meeting over the period of 8 weeks has enabled me to gradually develop
awareness and practice of mindfulness that enriches each day; helps me achieve more balance,
and reduce the tension of mind and body which often before I would have only noticed when it
was reaching a stressful pitch. I find I have more time, more focus, better memory and enjoy the
'moments'
It has given me a new sense of myself and the world around me. It will stay with me.
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Mindfulness is so simple yet so powerful and affective. I feel I have started on a path of real and
positive change. It is key to developing my inner calm and strength.
really want this course to have shown me that I must keep to the practices to change my way of
thinking
 Has been very enlightening, informative and enjoyable.
 I have learned so many valuable things that have enriched my life. I am changing slowly and
enjoying it and looking forward to a future with my eyes and mind more open.
 It has helped me so much to deal with life. Helped me to calm down and not rush about, and
stop my anxieties.
 This course has given me the knowledge to allow myself space and time and not to react
instantly
 I have become more aware of my thinking in given situations. I value myself more, I know myself
better
 It has helped me put a buffer between thoughts and emotions and automatic reactions
 I appreciate the little and big things in life and value every moment. Feel a lot calmer about
everyday life in general and very happy about getting some kind of control with my OCD.
 It has given me tools for life – really heightened my awareness of how I am and to live life as
much as possible in the present moment which is very important
 I am better at choosing what I want to do for me e.g. the housework can wait, I am going for a
walk
 I have slowed down, I have a more controlled pace where in the past I would have been
overwhelmed
 It is difficult to move from the head into the body – I didn’t know how much I was in my head
 I over react less and feel more tolerant, understanding and appreciative of myself – less selfcritical. I feel as if I have been given permission to look after myself
1. Meeting and being part of a group was beneficial in recognising and appreciating other people’s
struggles and difficulties.
References
1. Lloyd-Williams, M. (2006). Depression, Anxiety and Confusion. In M. Fallon & J. Hanks (Eds.), ABC
of Palliative Care (Second Edition ed., pp. 36-39): Blackwell Publishing
2. Macmillan. Worried Sick –The Emotional Impact of Cancer. MacMillan Cancer Support, 2006.
3. Mindfulness Report. Mental Health Foundation (2010)
4. Kabat-Zinn J. Mindfulness-based interventions in context:past, present, and future. Clin Psychol Sci
Pract2003;10(2):144–156.
5. Dryden W, Still A. Historical aspects of mindfulness and self-acceptance in psychotherapy. J Ration
Emotive Cogn Behav Ther 2006;24(1):3–28.
6. Crane, R. (2009). Mindfulness-based cognitive therapy: Distinctive features. New York, NY, US:
Routledge/Taylor & Francis Group.
7. Shennan, C., Payne, S. and Fenlon, D. (2010). What is the evidence for the use of mindfulness-based
interventions in cancer care? A review. Psycho-Oncology doi: 10.1002/pon.1819
8. National Cancer Survivorship Initiative (NCSI) Living with and Beyond Cancer; Taking Action to
Improve Outcomes. (2013)
9. Bartley, T., (2012) Mindfulness Based Cognitive Therapy for Cancer: Gently Turning Towards.
Oxford:Wiley-Blackwell
10, Cameron IM, Crawford JR, Lawton K, et al; Psychometric comparison of PHQ-9 and HADS for
measuring depression severity in primary care. Br J Gen Pract. 2008 Jan;58(546):32-6. doi:
10.3399/bjgp08X263794.
11, Spitzer RL, Kroenke K, Williams JB, et al; A brief measure for assessing generalized anxiety
disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7.
12. Neff K.D. The development and validation of a scale to measure self-compassion. Self and Identity.
2003;2:223–250.
13. Bech P, Olsen RL, Kjoller M, Rasmussen NK. Measuring well-being rather than the absence of
distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five Well- Being
Scale. Int J Meth Psychiatr Res 2003; 85-91