Adherence in an Optimized Program of Mindfulness Based Stress Reduction

Abstract

Objective: Mindfulness Based Stress Reduction (MBSR) programs have been successful in treating stress across various populations, however, little is known about how to best promote adherence to MBSR program teachings. The purpose of this dissertation study was to examine adherence to MBSR practice and the feasibility of a 12-session adherence enhancement intervention in the context of an MBSR and support group program. Measures included MBSR practice time, commitment and confidence for regular MBSR practice, and stress levels. Common themes of MBSR practice experiences that may have influenced adherence to the MBSR program teachings were also explored. Design and Method: An exploratory, single-group, longitudinal research design was used with a sample of 11 women. An adherence intervention package that included self-monitoring logs, telephonic coaching, and financial incentives were implemented over an 11-week period as subjects participated in an 8-session MBSR course supplemented with 4 support group sessions (i.e., 12 sessions total over 11 weeks). In addition, a series of qualitative, semi-structured interviews were administered at weekly intervals. Findings: On average, participants with complete baseline and follow-up measures had a statistically significant 9 point (49%) increase from baseline in their MBSR practice scores from a self-report survey. In addition, logged MBSR practice time increased by a non-significant 35 minutes per day between baseline and completion. Although commitment and confidence levels remained stable during the study, results from correlation analyses indicated that higher MBSR practice survey scores were significantly associated with lower stress levels. Qualitative interviews indicated that lack of routine, lack of time, and limited personal space were the most common barriers to regular MBSR practice. Participants reported experiencing major emotional growth in regard to confronting and accepting their present stressors. Conclusions: The intervention package was feasible and acceptable to study participants, as indicated by the high degree of exposure to its components. There was also evidence indicting accelerating frequency of MBSR practice over time. However, improvements in commitment and confidence for regular MBSR practice, and stress levels were negligible. Future research should replicate the study intervention in a larger sample with more rigorous statistical controls.