PSYCH  Vol.5 No.15 , October 2014
Effectiveness of Cognitive Therapy and Mindfulness Tools in Reducing Depression and Anxiety: A Mixed Method Study
ABSTRACT
Depression and anxiety continue to be among the most common mental disorders. This study looked at three tracks of participants diagnosed with a mood disorder. The three tracks were Cognitive Therapy (CT), Mindfulness Training (MT), and Treatment As Usual (TAU). All participants had been trained in CT and then randomly separated into three groups. These three tracks were assessed at 3, 6, and 12 months in terms of their stated level of depression (measured on the Beck Depression Inventory) and anxiety (measured by the Beck Anxiety Inventory). This study was a follow-up to two previous studies (Alexander et al., 2012; Alexander & Tatum, 2013). In the current study, the participants reported the tools and skills they used to manage their mood and anxiety and then the effectiveness of these tools/skills was examined. Two tools were identified by three independent coders as the most frequently used by the participants. Both of these tools related to thought management (“thought records” and “thought distortions”). The two tools were combined into a single category (“thought tools”) and the frequency of their use was examined in relation to reductions in depression and anxiety. The results showed that a high use of these tools was connected to a significant reduction in reported depression. There was also a reduction in reported anxiety, but this effect was not statistically significant. Other tools that were reported (e.g., mood tracking, relaxation) showed no significant effects on depression and anxiety. Future research will now focus not on reported tool use, but rather on manipulating the incidence of tool use and determine the direct causal path between using a thought tool and reductions in negative moods.

Cite this paper
Alexander, V. & Tatum, B. (2014). Effectiveness of Cognitive Therapy and Mindfulness Tools in Reducing Depression and Anxiety: A Mixed Method Study. Psychology, 5, 1702-1713. doi: 10.4236/psych.2014.515178.
References
[1]   Alexander, V., & Tatum, B. C (2013). A Qualitative Analysis of Mindfulness Practice and Cognitive Therapy Tools in Preventing Relapse from Depression. Journal of Education Research and Behavioral Sciences, 2, 98-106.

[2]   Alexander, V., Tatum, B. C., Auth, C., Takos, D., Whittemore, S., & Fidaleo, R. (2012). A Study of Mindfulness Practices and Cognitive Therapy: Effects on Depression and Self-Efficacy. International Journal of Psychology and Counselling, 4, 115-122.
http://dx.doi.org/10.5897/IJPC

[3]   American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders IV-Text Revised. Washington DC: Author.

[4]   Anxiety and Depression Association of America (2014). Facts and Statistics.
www.adaa.org

[5]   Baer. R. A., Smith, G. T., & Allen, K. B. (2004). Assessment of Mindfulness by Self-Report: The Kentucky Inventory of Mindfulness Skills. Assessment, 11, 191-206.
http://dx.doi.org/10.1177/1073191104268029

[6]   Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory (2nd ed.). San Antonio TX: The Psychological Corporation.

[7]   Bockting, C. L. H., Schene, A. H., Koeter, M., Wouters, L., Huyser, J., & Kamphuis, J. H. (2005). Preventing relapse/Reoccurrence in Recurrent Depression with Cognitive Therapy: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 73, 647-657.
http://dx.doi.org/10.1037/0022-006X.73.4.647

[8]   Burns, D. (1999). The Feeling Good Handbook (rev. ed.). New York, NY: Plume.

[9]   Chambers, R., Lo, B. C. Y., & Allen, N. B. (2008). The Impact of Intensive Mindfulness Training on Attentional Control, Cognitive Style, and Affect. Cognitive Therapy and Research, 32, 303-322.

[10]   Chen, S. Y., Jordan, C., & Thompson, S. (2006). The Effect of Cognitive Behavioral Therapy on Depression: The Role of Problem-Solving Appraisal. Research in Social Work Practice, 16, 500-510.
http://dx.doi.org/10.1177/1049731506287302

[11]   Corcoran, K. M., Farb, N., Anderson, A., & Segal, Z. V. (2010). Mindfulness and Emotion Regulation: Outcomes and Possible Mediating Mechanisms. In A. M. Kring, & D. M. Sloan (Eds.), Emotion Regulation and Psychopathology: A Transdiagnostic Approach to Etiology and Treatment (pp. 339-355). New York: Guilford Press.

[12]   Courbasson, C. M., Nishikawa, Y., & Shapira, L. B. (2011). Mindfulness-Action Based Cognitive Behavioral Therapy for Concurrent Binge Eating Disorder and Substance Use Disorders. Eating Disorders, 19, 17-33.
http://dx.doi.org/10.1080/10640266.2011.533603

[13]   Creswell, J. W. (2014). Research Design: Qualitative, Quantitative and Mixed Methods Approaches (4th ed.). Thousand Oaks, CA: Sage.

[14]   Deyo, M., Wilson, K. A., Ong, J., & Koopman, C. (2009). Mindfulness and Rumination: Does Mindfulness Training Lead to Reductions in the Ruminative Thinking Associated with Depression? Explore, 5, 265-271.
http://dx.doi.org/10.1016/j.explore.2009.06.005

[15]   Farb, N. A. S., Anderson, A. K., Mayberg, H., Bean, J., McKeon, D., & Segal, Z. V. (2010). Minding One’s Emotions: Mindfulness Training Alters the Neural Expression of Sadness. Emotion, 10, 25-33.
http://dx.doi.org/10.1037/a0017151.supp

[16]   Fava, G., Grandi, S., Zielezny, M., Canestari, R., & Morphy, M. A. (1996). Cognitive Behavioral Treatment of Residual Symptoms in Primary Major Depressive Disorder. American Journal of Psychiatry, 151, 1295-1299.

[17]   Grossman, P. (2011). Defining Mindfulness by How Poorly I Think I Pay Attention during Everyday Awareness and Other Intractable Problems in Psychology’s Reinvention of Mindfulness: Comment on Brown et al. 2011. Psychological Assessment, 23, 1034-1040.
http://dx.doi.org/10.1037/a0022713

[18]   Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: Guilford Press.

[19]   Hofman, 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, 169-183.
http://dx.doi.org/10.1037/a0018555

[20]   Jarrett, R. B., Kraft, D., Doyle, J., Foster, B. M., Eaves, G. G., & Silver, P. C. (2001). Preventing Recurrent Depression Using Cognitive Therapy with and without a Continuation Phase: A Randomized Clinical Trial. Archives of General Psychiatry, 58, 381-388.
http://dx.doi.org/10.1001/archpsyc.58.4.381

[21]   Jarrett, R. B., Vittengl, J. R., Clark, L. A., & Thase, M. E. (2011). Skills of Cognitive Therapy (SoCT): A New Measure of Patients’ Comprehension and Use. Psychological Assessment, 23, 578-586.
http://dx.doi.org/10.1037/a0022485

[22]   Judd, L. J. (1997). The Clinical Course of Unipolar Depressive Disorders. Archives of General Psychiatry, 54, 989-991.
http://dx.doi.org/10.1001/archpsyc.1997.01830230015002

[23]   Kabat-Zinn, J. (1994). Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New York: Hyperion.

[24]   Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of Mindfulness on Psychological Health: A Review of Empirical Studies. Clinical Psychological Review, 31, 1041-1056.
http://dx.doi.org/10.1016/j.cpr.2011.04.006

[25]   Kennedy, N., Abbott, R., & Paykel, E. S. (2003). Remission and Reoccurrence of Depression in a Maintenance Era: Long-Term Outcome in a Cambridge Cohort. Psychological Medicine, 33, 827-838.
http://dx.doi.org/10.1017/S003329170300744X

[26]   Khong, B. S. L. (2009). Expanding the Understanding of Mindfulness: Seeing the Tree and the Forest. The Humanist Psychologist, 37, 117-136.
http://dx.doi.org/10.1080/08873260902892006

[27]   Lau, M. A., Bishop, S. R., Segal, Z. V., Buis, T., Anderson, N., Carlson, L., Shapiro, S., & Carmody, J. (2006). The Toronto Mindfulness Scale: Development and Validation. Journal of Clinical Psychology, 62, 1445-1467.
http://dx.doi.org/10.1002/jclp.20326

[28]   Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford.

[29]   Matthew, A. & MacLeod, C. (2005). Cognitive Vulnerability to Emotional Disorders. Annual Review of Clinical Psychology, 1, 167-195.
http://dx.doi.org/10.1146/annurev.clinpsy.1.102803.143916

[30]   Owen, G. P., Walter, K. H., Chard, K. M., & Davis, P. A. (2012) Changes in Mindfulness Skills and Treatment Response among Veterans in Residential PTSD Treatment. Psychological Trauma: Theory, Research, Practice and Policy, 4, 221-228.
http://dx.doi.org/10.1037/a0024251

[31]   Paykel, E. S., Scott, J., Teasdale, J. D., Johnson, A. L., Garland, A., & Moore, R. (1999). Prevention of Residual Depression by Cognitive Therapy: A Controlled Trial. Archives of General Psychiatry, 56, 829-835.
http://dx.doi.org/10.1001/archpsyc.56.9.829

[32]   Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder: Evaluation in a Randomized Controlled Trial. Journal of Consulting Clinical Psychology, 76, 1083-1089.
http://dx.doi.org/10.1037/a0012720

[33]   Salemink, E., van den Hout, M., & Kindt, M. (2010). How Does Cognitive Bias Modification Affect Anxiety? Mediation Analysis and Experimental Data. Behavioral and Cognitive Psychotherapy, 38, 59-66.
http://dx.doi.org/10.1017/S1352465809990543

[34]   Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.

[35]   Strunk, D. R., DeRubeis, R. J., Chiu, A. W., & Alvarez, J. (2007). Patients’Competence in the Performance of Cognitive Therapy Skills: Relation to the Reduction of Relapse Risk Following Treatment for Depression. Journal of Consulting and Clinical Psychology, 75, 523-530.
http://dx.doi.org/10.1037/0022-006X.75.4.523

[36]   Teasdale, J. D., Williams, J. M., Soulsby, J. M., Segal, Z. V., Ridgeway, V. A., & Lau, M. A. (2000). Prevention of Relapse/Recurrence in Major Depression by Mindfulness-Based Cognitive Therapy. Journal of Consulting and Clinical Psychology, 68, 615-623.
http://dx.doi.org/10.1037/0022-006X.68.4.615

[37]   Trapper, K., Shaw, C., Illsey, J., Hill, A. J., Bond, F. W., & Moore, L. (2009). Exploratory Randomized Controlled Trial of a Mindfulness-Based Weight Loss Prevention for Women. Appetite, 52, 396-404.
http://dx.doi.org/10.1016/j.appet.2008.11.012

[38]   Wallin, D. J. (2007). Attachment in Psychotherapy. New York: Guilford Press.

[39]   Wells, A. (2002). GAD, Metacognition and Mindfulness: An Information Processing Analysis. Clinical Psychology: Science & Practice, 9, 95-100.
http://dx.doi.org/10.1093/clipsy/9.1.95

[40]   Wolfsdorf, B. A., & Zlotnick, C. (2001). Affect Management in Group Therapy for Women with Posttaumatic Stress Disorder and Histories of Childhood Sexual Abuse. Journal of Clinical Psychology, 57, 169-181.
http://dx.doi.org/10.1002/1097-4679(200102)57:2<169::AID-JCLP4>3.0.CO;2-0

[41]   World Health Organization (2012). Fact Sheet on Depression.
www.who.int/topics/depression/en

[42]   Wright, J. H., Wright, A. S., Salmon, P., Beck, A. T., Kuykendall, J., Goldsmith, L. J., & Zickel, M. B. (2002). Development and Initial Testing of a Multimedia Program for Computer-Assisted Cognitive Therapy. American Journal of Psychotherapy, 56, 76-86.

 
 
Top