Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
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 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. 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