Mindfulness Training for Psychotherapeutic Care

NCT ID: NCT04680559

Last Updated: 2020-12-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

204 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-29

Study Completion Date

2020-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

It has been shown that mindfulness-based interventions (MBI) applied to psychotherapists improve their empathy and increase the therapeutic alliance. It is expected that these improvements may beneficially affect the results of psychotherapy. However, new studies are needed to examine whether an MBI can have an effect on the healthy evolution of these professionals' patients.

The objective of this project is to analyze the influence of a mindfulness and compassion based intervention (MCBI) applied to psychotherapists, on the empathy perceived by their patients, the therapeutic alliance and their symptomatology.

This study is a randomized clinical trial of an intervention based on MBSR and adapted to the population of psychotherapists, including in the last two sessions the practice of compassion, called Mindfulness and Compassion Based Intervention (MCBI). The subjects (n = 63) were randomly assigned to MCBI (n = 33) or to a Waiting List group in which they fill in a self-record of their own feelings, thoughts, etc. in therapy for 8 weeks (n = 30). Participants in the MCBI intervention condition were asked to meet weekly during a two-hour session for two months. Pre / post-intervention and five-month evaluations were performed as a follow-up.

Mindfulness measures (FFMQ) will be taken for the evaluation of psychotherapists, Self-compassion (SCS-SF), negative symptomatology (DASS-21), empathy (EUS-T, TECA), personal therapist style (EPT-C) and mindfulness instructional style (MIQ).

For the evaluation of patients, measures of mindfulness (FFMQ), self-compassion (SCS-SF) will be taken - to try to control without these skills they can be vicariously modified without being directly trained-, subjective well-being (PHI), psychological well-being (BSI), therapeutic alliance (WATOCI, ENAT) and perceived empathy (EUS-P).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The practice of psychotherapy involves the formation and development of a series of skills by the professional. These skills encourage the establishment of a quality therapeutic link, which helps to improve the effectiveness of therapy sessions. In this sense, current research indicates that the link established between the psychotherapist and his patients has a high effect on the evolution and results of psychotherapy. This improvement is to a greater extent attributed to the establishment of the link than to the specific techniques that are applied in therapy.

Among the variables that favor the link, the empathy of the psychotherapist has been widely studied, and has proven to be highly related to the benefits of psychological interventions.

Therefore, the development of healthy empathy is one of the most important variables on which the benefits of psychotherapy are based. It facilitates a true understanding of the vital situations of the patients and is essential in establishing the therapeutic link.

The influence of the latter on the results of psychological interventions has meant that empathy training is one of the basic objectives to follow in the training of clinical and health psychologists, increasing research on effective strategies for this, among which mindfulness and compassion based interventions (MCBI) stand out.

In recent years, the MCBI have established themselves as a very useful intervention in the healthcare field, and several authors suggest the advantages of their application in psychotherapists, pointing out their beneficial influence on the therapeutic relationship and the psychotherapeutic process.

The MCBI are structured interventions in which a series of attitudes and mental states associated with mindfulness and compassion are trained through different meditation techniques. You also learn to generalize these states in the way we relate to the experiences we live. Based on this, the MCBI can be an especially useful strategy to train a series of skills that beneficially influence the therapeutic link and the results of psychotherapy. In relation to the above, it has been seen that MCBI have a beneficial effect on the levels of self-reported empathy of clinical and health psychologists. In addition, an interesting association has been observed between the levels of mindfulness and self-reported empathy in psychotherapists, and between these variables and the therapeutic alliance established with their patients. An association has also been found between the results of the therapeutic alliance measures between therapists and patients after a Mindfulness-based Intervention (MBI). Finally, it has been seen that the application of an MCBI in psychotherapists indirectly influences the evolution of their patients, helping to reduce their symptoms and increase their levels of well-being.

These results imply important support for the advantages of including the MCBI in the training of clinical and health psychologists, in order to increase their levels of empathy and the effectiveness of their interventions. However, there are many limitations we find in these results.

First, the studies that have analyzed the influence of MCBI on empathy only include a self-reported evaluation of psychotherapists on this variable. In addition, this evaluation does not give us information about whether the MCBI affects the empathy that patients perceive in their therapists, which prevents us from assessing whether these benefits exert a real influence on the therapeutic relationship and the psychotherapeutic process.

On the other hand, studies that have established a relationship between levels of mindfulness and direct results in therapeutic alliance include only mindfulness-based interventions (MBI), not including compassion training in a manner explicit. We are interested in observing whether a MCBI significantly influences the perception of the therapeutic alliance by patients.

Finally, in Grepmair's study in which the benefits of applying an MCBI in psychotherapists on the evolution of their patients have been observed, the mediating variables that could explain these results were not evaluated. The objective of this project is to identify the mechanisms of action of the MCBI and its effect on the different variables that could be influencing the results of psychotherapy, such as the empathy of the psychotherapist and the therapeutic alliance established with their patients.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Mindfulness, Compassion Empathy, Working Alliance, Patients' Symptomatology, Psychotherapeutic Process Psychotherapist

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

MCBI Group

Training in mindfulness and compassion (MCBI) is facilitated in eight weekly sessions of 2 hours. With a didactic format, through theory, class discussions, and guided meditation practices.

Group Type EXPERIMENTAL

MCBI

Intervention Type BEHAVIORAL

The topics covered in the sessions are: Week 1: Introduction to mindfulness and attention to breathing. Week 2. Open awareness of bodily sensations. Week 3: Work with thoughts, introductory theory and practice in attention to sounds. Week 4: Working with thoughts, advanced theory and practice in mental landscape. Week 5: Introductory theory and practice in labeling emotions. Session 6: Advanced theory in working with emotions and practice in difficult emotions. Week 7: Introductory theory on self-compassion and compassion. Practice in self-compassion. Week 8: Practice in compassion and active compassion (acts of kindness and shared humanity).

Active-Wait List Group

Completion of a record during these 8 weeks. Active work of introspection about one's own sensations, thoughts, distractions, judgments, etc. in therapy sessions. Registered after each session.

Group Type ACTIVE_COMPARATOR

Active Comparator

Intervention Type BEHAVIORAL

Free observation of the psychotherapist's own feelings, thoughts, distractions, biases and behavior in general for 8 weeks. Observations of these variables are recorded during psychotherapy sessions with patients participating in the research.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

MCBI

The topics covered in the sessions are: Week 1: Introduction to mindfulness and attention to breathing. Week 2. Open awareness of bodily sensations. Week 3: Work with thoughts, introductory theory and practice in attention to sounds. Week 4: Working with thoughts, advanced theory and practice in mental landscape. Week 5: Introductory theory and practice in labeling emotions. Session 6: Advanced theory in working with emotions and practice in difficult emotions. Week 7: Introductory theory on self-compassion and compassion. Practice in self-compassion. Week 8: Practice in compassion and active compassion (acts of kindness and shared humanity).

Intervention Type BEHAVIORAL

Active Comparator

Free observation of the psychotherapist's own feelings, thoughts, distractions, biases and behavior in general for 8 weeks. Observations of these variables are recorded during psychotherapy sessions with patients participating in the research.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Have a psychology degree.
* Be able to read and write using the Spanish language.
* Be doing therapy with at least one patient.

Eligible participants were contacted through the main psychotherapeutic schools and university centers to invite them to an explanatory meeting of the study.


* Be between 18 and 75 years old.
* Be able to read and write using the Spanish language.

Eligible participants were contacted by their personal psychotherapist, either by a phone call or regular therapy appointment to invite them to participate in the study.

Exclusion Criteria

* Have extensive experience in mindfulness practice
* Use mindfulness in therapy with your patients.
* Do not engage in clinical psychology or psychotherapy

* Serious active mental disorders (schizophrenia, bipolar disorder, psychotic disorders) • Disorders due to active substance use (if consumed in the last year)
* Cognitive impairment
* Take more than 2 and a half years in therapy with the same therapist
Minimum Eligible Age

25 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Valencia

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Ausias Cebolla

Full professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Elena Garrote Caparrós, Student

Role: PRINCIPAL_INVESTIGATOR

Universitat de València

Miguel Bellosta Batalla, Dr.

Role: STUDY_DIRECTOR

Universitat de València

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Universitat de València

Valencia, , Spain

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Spain

References

Explore related publications, articles, or registry entries linked to this study.

Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006 Mar;13(1):27-45. doi: 10.1177/1073191105283504.

Reference Type BACKGROUND
PMID: 16443717 (View on PubMed)

Andrade-González, N. (2009). El papel del terapeuta en la alianza terapéutica. Trabajo presentado en la UNED, Guadalajara, España.

Reference Type BACKGROUND

Barrett-Lennard, G. T. (1978). The Relationship Inventory: Later developments and adaptations. JSAS: Catalog of Selected Documents in Psychology, 8(68), 1-55

Reference Type BACKGROUND

Brito, G. (2014). Rethinking mindfulness in the therapeutic relationship. Mindfulness, 5(4), 351-359.

Reference Type BACKGROUND

Bruce N, Shapiro SL, Constantino MJ, Manber R. Psychotherapist mindfulness and the psychotherapy process. Psychotherapy (Chic). 2010 Mar;47(1):83-97. doi: 10.1037/a0018842.

Reference Type BACKGROUND
PMID: 22402003 (View on PubMed)

Corbella, S., & Botella, L. (2004). Psychometric properties of the Spanish version of the Working Alliance Theory of Change Inventory (WATOCI). Psicothema, 16(4), 702-705.

Reference Type BACKGROUND

Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychol Med. 1983 Aug;13(3):595-605.

Reference Type BACKGROUND
PMID: 6622612 (View on PubMed)

Díaz-Oropeza, I. F., & Peña-Leyva, L. A. (2016). Validation of the Spanish version of the Therapeutic Alliance Negotiation Scale. Estudios de Psicología, 37(2-3), 604-632.

Reference Type BACKGROUND

Doran JM, Safran JD, Waizmann V, Bolger K, Muran JC. The alliance negotiation scale: psychometric construction and preliminary reliability and validity analysis. Psychother Res. 2012;22(6):710-9. doi: 10.1080/10503307.2012.709326. Epub 2012 Aug 6.

Reference Type BACKGROUND
PMID: 22861685 (View on PubMed)

Duncan, B. L., & Miller, S. D. (1999). Working Alliance Theory of Change Inventory (WATOCI). The Institute for the Study of Therapeutic Change (ISTC)

Reference Type BACKGROUND

Fernández-Álvarez, H., García, F., LoBianco, J., & Corbella, S. (2003). Assessment questionnaire on the personal style of the therapist PST-Q. Clinical Psychology & Psychotherapy, 10(2), 116-125.

Reference Type BACKGROUND

Garcia-Campayo J, Navarro-Gil M, Andres E, Montero-Marin J, Lopez-Artal L, Demarzo MM. Validation of the Spanish versions of the long (26 items) and short (12 items) forms of the Self-Compassion Scale (SCS). Health Qual Life Outcomes. 2014 Jan 10;12:4. doi: 10.1186/1477-7525-12-4.

Reference Type BACKGROUND
PMID: 24410742 (View on PubMed)

Hervas G, Vazquez C. Construction and validation of a measure of integrative well-being in seven languages: the Pemberton Happiness Index. Health Qual Life Outcomes. 2013 Apr 22;11:66. doi: 10.1186/1477-7525-11-66.

Reference Type BACKGROUND
PMID: 23607679 (View on PubMed)

Katz BA, Lustig N, Assis Y, Yovel I. Measuring regulation in the here and now: The development and validation of the State Emotion Regulation Inventory (SERI). Psychol Assess. 2017 Oct;29(10):1235-1248. doi: 10.1037/pas0000420. Epub 2016 Dec 12.

Reference Type BACKGROUND
PMID: 27936820 (View on PubMed)

Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness-based stress reduction for healthy individuals: A meta-analysis. J Psychosom Res. 2015 Jun;78(6):519-28. doi: 10.1016/j.jpsychores.2015.03.009. Epub 2015 Mar 20.

Reference Type BACKGROUND
PMID: 25818837 (View on PubMed)

Evans, C., Mellor-Clark, J., Margison, F., Barkham, M., Audin, K., Connell, J., & McGrath, G. (2000). CORE: Clinical Outcomes in Routine Evaluation. Journal of Mental Health, 9(3), 247-255.

Reference Type BACKGROUND

Kiken LG, Garland EL, Bluth K, Palsson OS, Gaylord SA. From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Pers Individ Dif. 2015 Jul 1;81:41-46. doi: 10.1016/j.paid.2014.12.044.

Reference Type BACKGROUND
PMID: 25914434 (View on PubMed)

Leonard, H. D., Campbell, K., & Gonzalez, V. M. (2018). The relationships among clinician self-report of empathy, mindfulness, and therapeutic alliance. Mindfulness, 9(6), 1837-1844.

Reference Type BACKGROUND

López-Pérez, B., Fernández-Pinto, I., & Abad, F. J. (2008). TECA. Test de Empatía Cognitiva y Afectiva. Madrid: Tea Ediciones, S.A.

Reference Type BACKGROUND

Lovibond, S. H. & Lovibond, P. F. (1993). Manual for the Depression Anxiety Stress Scales (DASS). Psychology Foundation Monograph (Available from The Psychology Foundation, Room 1005 Mathews Building, University of New South Wales, NSW 2052, Australia).

Reference Type BACKGROUND

McCaffrey, S., Reitman, D., & Black, R. (2017). Mindfulness in Parenting Questionnaire (MIPQ): Development and validation of a measure of mindful parenting. Mindfulness, 8(1), 232-246.

Reference Type BACKGROUND

Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother. 2011 May-Jun;18(3):250-5. doi: 10.1002/cpp.702. Epub 2010 Jun 8.

Reference Type BACKGROUND
PMID: 21584907 (View on PubMed)

Ruipérez, M. Á., Ibáñez, M. I., Lorente, E., Moro, M., & Ortet, G. (2001). Psychometric properties of the Spanish version of the BSI: Contributions to the relationship between personality and psychopathology. European Journal of Psychological Assessment, 17(3), 241-250.

Reference Type BACKGROUND

Ryan A, Safran JD, Doran JM, Muran JC. Therapist mindfulness, alliance and treatment outcome. Psychother Res. 2012;22(3):289-97. doi: 10.1080/10503307.2011.650653. Epub 2012 Mar 15.

Reference Type BACKGROUND
PMID: 22417065 (View on PubMed)

Spielberger, C.D., Gorsuch, R.L. and Lushene, R.E. (1970) STAI Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press, Palo Alto.

Reference Type BACKGROUND

Tran US, Cebolla A, Gluck TM, Soler J, Garcia-Campayo J, von Moy T. The serenity of the meditating mind: a cross-cultural psychometric study on a two-factor higher order structure of mindfulness, its effects, and mechanisms related to mental health among experienced meditators. PLoS One. 2014 Oct 16;9(10):e110192. doi: 10.1371/journal.pone.0110192. eCollection 2014.

Reference Type BACKGROUND
PMID: 25330072 (View on PubMed)

Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988 Jun;54(6):1063-70. doi: 10.1037//0022-3514.54.6.1063.

Reference Type BACKGROUND
PMID: 3397865 (View on PubMed)

Bibeau, M., Dionne, F., & Leblanc, J. (2016). Can compassion meditation contribute to the development of psychotherapists' empathy? A review. Mindfulness, 7(1), 255-263.

Reference Type RESULT

Grepmair L, Mitterlehner F, Loew T, Bachler E, Rother W, Nickel M. Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study. Psychother Psychosom. 2007;76(6):332-8. doi: 10.1159/000107560.

Reference Type RESULT
PMID: 17917468 (View on PubMed)

Davis DM, Hayes JA. What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy (Chic). 2011 Jun;48(2):198-208. doi: 10.1037/a0022062.

Reference Type RESULT
PMID: 21639664 (View on PubMed)

Elliott R, Bohart AC, Watson JC, Murphy D. Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy (Chic). 2018 Dec;55(4):399-410. doi: 10.1037/pst0000175.

Reference Type RESULT
PMID: 30335453 (View on PubMed)

Lamothe M, Rondeau E, Malboeuf-Hurtubise C, Duval M, Sultan S. Outcomes of MBSR or MBSR-based interventions in health care providers: A systematic review with a focus on empathy and emotional competencies. Complement Ther Med. 2016 Feb;24:19-28. doi: 10.1016/j.ctim.2015.11.001. Epub 2015 Nov 27.

Reference Type RESULT
PMID: 26860797 (View on PubMed)

Nienhuis JB, Owen J, Valentine JC, Winkeljohn Black S, Halford TC, Parazak SE, Budge S, Hilsenroth M. Therapeutic alliance, empathy, and genuineness in individual adult psychotherapy: A meta-analytic review. Psychother Res. 2018 Jul;28(4):593-605. doi: 10.1080/10503307.2016.1204023. Epub 2016 Jul 7.

Reference Type RESULT
PMID: 27389666 (View on PubMed)

Norcross, J. C., & Lambert, M. J. (Eds.). (2019). Psychotherapy relationships that work: Volume 1: Evidence-based therapist contributions. New York, NY: Oxford University Press.

Reference Type RESULT

Schomaker, S. A. (2014). The impact of mindfulness training on therapeutic alliance, empathy, and lived experience: A mixed methods study with counselor trainees. (Dissertation). Texas A&M: University-Corpus

Reference Type RESULT

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

168021

Identifier Type: -

Identifier Source: org_study_id