Donders Institute for Brain, Cognition and Behaviour
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Thesis defense Felix Compen (Donders series 389)

6 September 2019

Promotor: prof. dr.  . Speckens
Co-promotores: dr. M. van der Lee (Helen Dowling Institute), dr. E. Adang

Group- and individual Internet-based Mindfulness-Based Cognitive Therapy for distressed cancer patients

Estimates indicate that one third of cancer patients suffer from clinically significant levels of psychological distress, which warrants psychological treatments such as cognitive behavioural therapy (CBT) or mindfulness-based interventions (MBIs) such as Mindfulness-based Cognitive Therapy (MBCT).

Mindfulness is defined as: “Paying attention, on purpose, in the present moment and non-judgmentally”. Whilst CBT focuses on identifying and challenging irrational thoughts and behaviour, many of cancer-related thoughts and cognitions are not irrational. Instead of focusing on the contents of thoughts, mindfulness practice teaches participants how they relate to their distress and, as such, enables them to recognize and disengage from habitual modes of reacting to distress.

Unfortunately, treatments such as (group-based) MBCT are not always accessible for cancer patients. Therefore, these interventions are increasingly delivered via Internet. The three-armed randomized controlled trial (RCT) described in this thesis compared MBCT and individual internet-based MBCT (eMBCT) to treatment as usual (TAU) in a sample of 245 mixed-cancer patients who suffered from at least mild psychological distress (Hospital Anxiety and Depression Scale (HADS) ≥ 11). Patients reported significantly less psychological distress in both MBCT interventions compared to TAU with moderate effects. Both interventions significantly improved several secondary outcomes.

Although our qualitative research did indicate that there is much to be improved in the design of eMBCT, these results convincingly demonstrate that Internet-based MBCT renders MBCT much more accessible for cancer patients without compromising intervention efficacy. Both MBCT interventions are (cost-)effective compared to usual care in reducing psychological distress.