Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders.

J Altern Complement Med

Whole Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT.

Published: September 2019

The aim of this study was to evaluate utilization and outcomes of mindfulness-based cognitive therapy (MBCT) provided to veterans with psychiatric disorders. Retrospective chart review. Veterans Administration Medical Center (VAMC). Ninety-eight veterans with psychiatric illness who were enrolled in an MBCT class between May of 2012 and January of 2016. Subjects were predominately white (95%), male (81%), and >50 years old (74%). The most common psychiatric conditions were any mood disorder (82%) and post-traumatic stress disorder (54%). Eight-week MBCT class. Session attendance and pre- to postintervention changes in numbers of emergency department (ED) visits and psychiatric hospitalizations. The average number of sessions attended was 4.87 of 8 and only 16% were present for all sessions. Veteran demographic variables did not predict the number of MBCT sessions attended. However, both greater numbers of pre-MBCT ED visits ( = 0.004) and psychiatric admissions ( = 0.031) were associated with attending fewer sessions. Among patients who experienced at least one pre- or post-treatment psychiatric admission in the 2 years pre- or postintervention ( = 26, 27%), there was a significant reduction in psychiatric admissions from pre to post ( = 0.002). There was no significant change in ED visits ( = 0.535). MBCT may be challenging to implement for veterans with psychiatric illness in, at least some, outpatient VAMC settings due to a high attrition rate. Possible mediation approaches include development of methods to screen for high dropout risk and/or development of shorter mindfulness-based interventions (MBIs) and/or coupling MBIs with pleasurable activities. The finding of a significant decrease in psychiatric hospitalizations from pre- to post-MBCT suggests that prospective studies are warranted utilizing MBCT for veterans at high risk for psychiatric hospitalization.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748402PMC
http://dx.doi.org/10.1089/acm.2018.0511DOI Listing

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