Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Research Trends

Perceptions of Adjunctive Mindfulness-Based Cognitive Therapy to Prevent Suicidal Behavior Among High Suicide-Risk Outpatient Participants

Published Online:May 31, 2018https://doi.org/10.1027/0227-5910/a000519

Abstract

Abstract.Background: Few investigations of patient perceptions of suicide prevention interventions exist, limiting our understanding of the processes and components of treatment that may be engaging and effective for high suicide-risk patients. Aims: Building on promising quantitative data that showed that adjunct mindfulness-based cognitive therapy to prevent suicidal behavior (MBCT-S) reduced suicidal thinking and depression among high suicide-risk patients, we subjected MBCT-S to qualitative inspection by patient participants. Method: Data were provided by 15 patients who completed MBCT-S during a focus group and/or via a survey. Qualitative data were coded using thematic analysis. Themes were summarized using descriptive analysis. Results: Most patients viewed the intervention as acceptable and feasible. Patients attributed MBCT-S treatment engagement and clinical improvement to improved emotion regulation. A minority of patients indicated that factors related to the group treatment modality were helpful. A small percentage of patients found that aspects of the treatment increased emotional distress and triggered suicidal thinking. These experiences, however, were described as fleeting and were not linked to suicidal behavior. Limitations: The sample size was small. Conclusion: Information gathered from this study may assist in refining MBCT-S and treatments to prevent suicidal behavior among high suicide-risk patients generally.

References

  • Allen, M., Bromley, A., Kuyken, W., & Sonnenberg, S. J. (2009). Participants' experiences of mindfulness-based cognitive therapy: "It changed me in just about every way possible". Behavioural and Cognitive Psychotherapy, 37, 413–430. First citation in articleCrossref Medline, Google Scholar

  • Beck, A., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47, 343–352. First citation in articleCrossref Medline, Google Scholar

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. 10.1191/1478088706qp063oa First citation in articleCrossref, Google Scholar

  • Britton, W. B., Lepp, N. E., Niles, H. F., Rocha, T., Fisher, N. E., & Gold, J. S. (2014). A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children. Journal of School Psychology, 52(3), 263–278. 10.1016/j.jsp.2014.03.002 First citation in articleCrossref Medline, Google Scholar

  • Bruffaerts, R., Demyttenaere, K., Hwang, I., Chiu, W.-T., Sampson, N., Kessler, R. C., … Nock, M. K. (2011). Treatment of suicidal people around the world. The British Journal of Psychiatry, 199(1), 64–70. 10.1192/bjp.bp.110.084129 First citation in articleCrossref Medline, Google Scholar

  • Cairns, V., & Murray, C. (2015). How do the features of mindfulness-based cognitive therapy contribute to positive therapeutic change? A meta-synthesis of qualitative studies. Behavioural and Cognitive Psychotherapy, 43(3), 342–359. 10.1017/S1352465813000945 First citation in articleCrossref Medline, Google Scholar

  • Chadwick, P., Kaur, H., Swelam, M., Ross, S., & Ellett, L. (2011). Experience of mindfulness in people with bipolar disorder: A qualitative study. Psychotherapy Research, 21(3), 277–285. 10.1080/10503307.2011.565487 First citation in articleCrossref Medline, Google Scholar

  • Cheng, Q., Li, H., Silenzio, V., & Caine, E. D. (2014). Suicide contagion: A systematic review of definitions and research utility. PloS One, 9(9), e108724. 10.1371/journal.pone.0108724 First citation in articleCrossref Medline, Google Scholar

  • Chesin, M. S., Benjamin-Phillips, C. A., Keilp, J., Fertuck, E. A., Brodsky, B. S., & Stanley, B. (2016). Improvements in executive attention, rumination, cognitive reactivity, and mindfulness among high-suicide risk patients participating in adjunct mindfulness-based cognitive therapy: Preliminary findings. Journal of Alternative and Complementary Medicine, 22(8), 642–649. 10.1089/acm.2015.0351 First citation in articleCrossref Medline, Google Scholar

  • Chesin, M., Sonmez, C., Benjamin-Phillips, C., Beeler, B., Brodsky, B., & Stanley, B. (2015). Preliminary effectiveness of adjunct mindfulness-based cognitive therapy to prevent suicidal behavior in outpatients who are at elevated suicide risk. Mindfulness, 1–11. 10.1007/s12671-015-0405-8 First citation in articleCrossref, Google Scholar

  • Chesin, M. S., Stanley, B., Haigh, E. A. P., Chaudhury, S. R., Pontoski, K., Knox, K. L., & Brown, G. K. (2016). Staff views of an emergency department intervention using safety planning and structured follow-up with suicidal veterans. Archives of Suicide Research, 21, 1–11. 10.1080/13811118.2016.1164642 First citation in articleCrossref Medline, Google Scholar

  • Crane, C., & Williams, J. M. G. (2010). Factors associated with attrition from mindfulness-based cognitive therapy in patients with a history of suicidal depression. Mindfulness, 1, 10–20. 10.1007/s12671-010-0003-8 First citation in articleCrossref Medline, Google Scholar

  • Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychological Bulletin, 135(3), 495–510. 10.1037/a0015616 First citation in articleCrossref Medline, Google Scholar

  • Finucane, A., & Mercer, S. W. (2006). An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry, 6(1), 14. 10.1186/1471-244X-6-14 First citation in articleCrossref Medline, Google Scholar

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition. New York, NY: Biometrics Research Department, New York State Psychiatric Institute. First citation in articleGoogle Scholar

  • Forkmann, T., Wichers, M., Geschwind, N., Peeters, F., van Os, J., Mainz, V., & Collip, D. (2014). Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: Results from a randomised controlled trial in patients with residual depressive symptoms. Comprehensive Psychiatry, 55(8), 1883–1890. 10.1016/j.comppsych.2014.08.043 First citation in articleCrossref Medline, Google Scholar

  • Haw, C., Hawton, K., Niedzwiedz, C., & Platt, S. (2013). Suicide clusters: A review of risk factors and mechanisms. Suicide and Life-Threatening Behavior, 43(1), 97–108. 10.1111/j.1943-278X.2012.00130.x First citation in articleCrossref Medline, Google Scholar

  • Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183. 10.1037/a0018555 First citation in articleCrossref Medline, Google Scholar

  • Kenny, M. A., & Williams, J. M. G. (2007). Treatment-resistant depressed patients show a good response to mindfulness-based cognitive therapy. Behaviour Research and Therapy, 45(3), 617–625. 10.1016/j.brat.2006.04.008 First citation in articleCrossref Medline, Google Scholar

  • Kline, A., Chesin, M., Latorre, M., Miller, R., St. Hill, L., Shcherbakov, A., … Interian, A. (2016). Rationale and study design of a trial of mindfulness-based cognitive therapy for preventing suicidal behavior (MBCT-S) in military veterans. Contemporary Clinical Trials, 50, 245–252. 10.1016/j.cct.2016.08.015 First citation in articleCrossref Medline, Google Scholar

  • Le, T., & Gobert, J. (2013). Translating and implementing a mindfulness-based youth suicide prevention intervention in a Native American community. Journal of Child and Family Studies, 1–12. 10.1007/s10826-013-9809-z First citation in articleCrossref, Google Scholar

  • Lilja, J. L., Broberg, M., Norlander, T., & Broberg, A. G. (2015). Mindfulness-based cognitive therapy: Primary care patients' experiences of outcomes in everyday life and relapse prevention. Psychology (Savannah, Ga.), 6(4), 464. 10.4236/psych.2015.64044 First citation in articleCrossref, Google Scholar

  • Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40. 10.1037/0022-006x.72.1.31 First citation in articleCrossref Medline, Google Scholar

  • Malpass, A., Carel, H., Ridd, M., Shaw, A., Kessler, D., Sharp, D., … Wallond, J. (2012). Transforming the perceptual situation: A meta-ethnography of qualitative work reporting patients' experiences of mindfulness-based approaches. Mindfulness, 3(1), 60–75. 10.1007/s12671-011-0081-2 First citation in articleCrossref, Google Scholar

  • Malterud, K. (2001). Qualitative research: Standards, challenges and guidelines. The Lancet, 358, 483–488. 10.1016/S0140-6736(01)05627-6 First citation in articleCrossref Medline, Google Scholar

  • Mason, O., & Hargreaves, I. (2001). A qualitative study of mindfulness-based cognitive therapy for depression. British Journal of Medical Psychology, 74(2), 197–212. 10.1348/000711201160911 First citation in articleCrossref, Google Scholar

  • Oquendo, M. A., Halberstam, B., & Mann, J. J. (2003). Risk factors for suicidal behavior. Standardized Evaluation in Clinical Practice, 22, 103–129. First citation in articleGoogle Scholar

  • Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis. Clinical Psychology Review, 31(6), 1032–1040. 10.1016/j.cpr.2011.05.002 First citation in articleCrossref Medline, Google Scholar

  • Rudd, M. D., Berman, A. L., Joiner, T. E., Nock, M. K., Silverman, M. M., Mandrusiak, M., … Witte, T. (2006). Warning signs for suicide: Theory, research, and clinical applications. Suicide and Life-Threatening Behavior, 36(3), 255–262. 10.1521/suli.2006.36.3.255 First citation in articleCrossref Medline, Google Scholar

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. G. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford. First citation in articleGoogle Scholar

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York. NY: Guilford. First citation in articleGoogle Scholar

  • Sheehan, D., Lecrubier, Y., Harnett Sheehan, K., Janavs, J., Weiller, E., Keskiner, A., et al. (1997). The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. European Psychiatry, 12, 232–241. 10.1016/S0924-9338(97)83297-X First citation in articleCrossref, Google Scholar

  • Slee, N., Spinhoven, P., Garnefski, N., & Arensman, E. (2008). Emotion regulation as mediator of treatment outcome in therapy for deliberate self-harm. Clinical Psychology & Psychotherapy, 15(4), 205–216. 10.1002/cpp.577 First citation in articleCrossref Medline, Google Scholar

  • Smith, A., Graham, L., & Senthinathan, S. (2007). Mindfulness-based cognitive therapy for recurring depression in older people: A qualitative study. Aging and Mental Health, 11(3), 346–357. 10.1080/13607860601086256 First citation in articleCrossref Medline, Google Scholar

  • Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256–264. 10.1016/j.cbpra.2011.01.001 First citation in articleCrossref, Google Scholar

  • Stanley, B., Chaudhury, S. R., Chesin, M., Pontoski, K., Bush, A. M., Knox, K. L., & Brown, G. K. (2016). An emergency department intervention and follow-up to reduce suicide risk in the VA: Acceptability and effectiveness. Psychiatric Services, 67(6), 680–683. 10.1176/appi.ps.201500082 First citation in articleCrossref Medline, Google Scholar

  • Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623. 10.1037/0022-006x.68.4.615 First citation in articleCrossref Medline, Google Scholar

  • Turecki, G., Ernst, C., Jollant, F., Labonté, B., & Mechawar, N. (2012). The neurodevelopmental origins of suicidal behavior. Trends in Neurosciences, 35(1), 14–23. 10.1016/j.tins.​2011.11.008 First citation in articleCrossref Medline, Google Scholar

  • Wyatt, C., Harper, B., & Weatherhead, S. (2014). The experience of group mindfulness-based interventions for individuals with mental health difficulties: A meta-synthesis. Psychotherapy Research, 24(2), 214–228. 10.1080/10503307.2013.864788 First citation in articleCrossref Medline, Google Scholar