Huijbers Marloes J, Crane Rebecca S, Kuyken Willem, Heijke Lot, van den Hout Ingrid, Donders A Rogier T, Speckens Anne E M
Department of Psychiatry, Radboud University Nijmegen Medical Centre, Reinier Postlaan 10, 6525 GC Nijmegen, The Netherlands.
Centre for Mindfulness Research and Practice, School of Psychology, Bangor University, Bangor, LL57 2AS UK.
Mindfulness (N Y). 2017;8(4):960-972. doi: 10.1007/s12671-016-0672-z. Epub 2017 Jan 12.
As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission ( = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.
随着基于正念的认知疗法（MBCT）日益成为复发性抑郁症的一种主流治疗方法，对能够教授MBCT的从业者的需求也在不断增加。成为一名合格的正念教师的要求包括个人冥想练习以及至少一年的额外专业培训。本研究首次调查了MBCT教师能力与MBCT治疗结果的几个关键维度之间的关系。处于缓解期的复发性抑郁症患者（ = 241）参与了由15名教师提供的MBCT多中心试验。基于15名教师中每人随机选择的两到四个录像课程，使用基于正念的干预：教学评估标准（MBI:TAC）对教师能力进行评估，由16名经过培训的评估人员进行评估。结果表明，教师能力与依从性（参加的MBCT课程数量）、可能的改变机制（反刍、认知反应性、正念和自我同情）或关键结果（治疗后抑郁症状以及15个月随访期间的抑郁复发/再发）均无显著关联。因此，本研究结果表明，以MBI:TAC衡量的教师能力对复发性抑郁症的MBCT中可能的中介因素和结果变量没有显著影响。可能的解释包括MBCT的标准化实施、MBCT学习过程中对自力更生的高度重视、与参与者相关因素的重要性、评估教师能力的困难、在减轻抑郁症状方面缺乏主要治疗效果以及录像带选择相对较少。需要进一步开展工作以系统地研究这些解释。
