An Evaluation of Cognitive Behaviour Therapy with Mindfulness (CBTm) Classes and Telepsychology Utility in Rural Community Settings

Background: Cognitive behaviour therapy with mindfulness (CBTm) classes are a group-based, psychoeducational, clinical service. Early research has suggested they are a promising low-intensity intervention for reducing psychiatric symptoms such as anxiety and depression (Palay in, Eur J Person Centered Healthcare 62:274, 2018; Thakur in BMC Psychiatry 19:132, 2019). Rural community members may benefit from these classes given the barriers they face in terms of available, accessible, and acceptable psychological treatment (Smalley in J Clin Psychol 66:479–385, 2010). Group-based telepsychology is one potential avenue for increasing access to psychological services in remote rural communities. Methods: This investigation evaluated the effectiveness of four-session weekly group CBTm classes taking place in rural Canada from November 2015 to December 2017, the impact of attendance via telepsychology (group-based videoconferencing at remote health centres closer to their homes) compared to in-person, and factors associated with class dropout. 376 CBTm class participants completed questionnaires during each class, providing a measure of their symptoms over time. Results: Anxious, depressive, and general psychiatric symptoms were reduced over the course of CBTm classes. Telepsychology attendance did not diminish class effectiveness. Predictors of class dropout were difficult to identify, except higher baseline anxiety, which predicted lower dropout rates. Conclusions: Group-based CBTm classes, whether delivered in person or via telepsychology, appear to be an effective avenue for improving mental well-being and service access among rural community members. Although encouraging, results also suggested a need for research on predictors of and reducing antecedents to class dropout in this population.