Manual Development and Pilot Randomised Controlled Trial of Mindfulness-based Cognitive Therapy versus Usual Care for Parents with a History of Depression
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Parental depression can adversely affect parenting and children's development. We adapted mindfulness-based cognitive therapy (MBCT) for parents (MBCT-P) with a history of depression and describe its development, feasibility, acceptability and preliminary estimates of efficacy. Manual development involved interviews with 12 parents who participated in MBCT groups or pilot MBCT-P groups. We subsequently randomised 38 parents of children aged between 2 and 6 years to MBCT-P plus usual care (n=19) or usual care (n=19). Parents were interviewed to assess the acceptability of MBCT-P. Preliminary estimates of efficacy in relation to parental depression and children’s behaviour were calculated at 4 and 9 months post-randomisation. Levels of parental stress, mindfulness and self-compassion were measured. Interviews confirmed the acceptability of MBCT-P; 78% attended at least half the sessions. In the pilot RCT, at 9 months, depressive symptoms in the MBCT-P arm were lower than in the usual care arm (adjusted mean difference = -7.0; 95% CI: -12.8 to -1.1; p=0.02) and eleven participants (58%) in the MBCT-P arm remained well compared to six (32%) in the usual care arm (mean difference = 26%; 95% CI: -4% to 57%; p = 0.02). Levels of mindfulness (p=0.01) and self-compassion (p = <0.001) were higher in the MBCT-P arm, with no significant differences in parental stress (p=0.2) or children’s behaviour (p=0.2). Children’s behaviour problems were significantly lower in the MBCT-P arm at 4 months (p=0.03). This study suggests MBCT-P is acceptable and feasible. A definitive trial is needed to test its efficacy and cost effectiveness.
This work was funded by an internal studentship at the Peninsula College of Medicine and Dentistry. Obioha Ukoumunne is supported by the Peninsula Collaboration for Leadership in Applied Health Research and Care (CLAHRC), a collaboration between the University of Exeter, University of Plymouth, and National Health Service South West, funded by the National Institute for Health Research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
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First Online: 25 May 2016