Mindfulness - Evidence Based Support

How the Mindfulness-Based Skess Reduction Program May be Able to Help Some of Your Patients (data compiled by Jim Carmody of UMass Medical School)

trainingcan be powerfuladjuncts Publishedresearchhas repeatedlyshownthat meditationand relaxation the medicaltreatmentof manydisorders.The StressReductionProgramincorporates to the conventional programs andtakesthe healingprocessan andmeditation criticalelementsof all theserelaxation importantstepfurther. A centralfeatureof the programis the teachingof a gentleyet effectivemethodthat (momentof mindfulness levelof inquiryintothe application the patientto developa profound encourages in everydaylife. Patients copingstrategies non-judgmental awareness) andmindfulness-based to-moment, to supporttheirhealth, in the programaretaughtto becomeawareof, anddevelop,theirownresources withbetterhealthacrossthe lifespan. thusbecomingmorestresshardy,a qualitythatis associated medicine for Programhasbeenon the cuttingedgeof mindibody and integrative The StressReduction and integrativemedicineat its best. Over 13,000patients twentytwo yearsand representsparticipatory completed the eight-week courseand 1,400physicians havesuccessfully withall mannerof diagnoses .PU:ijiishdd patientsto thTS-p-fogram. outCbmesresultin$Trom eVal0ations of the merJiCal haveret'erreci patientparticipation in the numberof medicalsymptomsanda 40%reduction haveshowna 35%reduction 1982,1985,1986, 1992,1998,Milleret al in psychological symptoms(stableoverfouryears)(Kabat-Zinn 1995,etc.).

Numberof Medical Symptoms

Psychological Distress (GSr/SCL-e0-R)

(MScL)

Pre

Post

2A02

Pre

Wff Post

2002

so theseoutcomedataapply by theirreferraldiagnosis, Patientscomingto the programare notseparated thathavebeenreferred. acrossall the diagnostic categories

Stressand Patient Presentation hasestimatedthat up to twothirdsof all officevisitsto family The AmericanAcademyof FamilyPhysicians symptoms.Recentresearchhas indicatedthat up to 60%of all HMOvisitsare doctorsare for stress-related disorder- the "worriedwell"(Sobel1995)- andthatmanyof these madeby peoplewithno diagnosable presenting symptomsare relatedto the patient'spsychosocialfunctioning - suchthingsas depression, 1989).At leastonethirdof chestpain ovenrvork etc.(Kroenke& Mangelsdorff anxiety,socialisolation, patientswithnormalor nearnormalcoronaryarterieshavebeenfoundto be suffering frompanic cardiology disorder(Kushner1989). these in addressing the malaisethatoftenunderlies Mindfulness traininghas beenshowneffective presentations (Kabat-Zinn 1982,1985,1986,1992,Miller1995,etc.),andfurtherevidenceof thiscanbe meditation training(Kabat-Zinn,'1987b, seenin studiesshowingreducedneedfor clinicalservicesfollowing 1994). Hellman1990,Caudill199'la,1991b,Tate1994,Orme-Johnson (continued on back)

PatientsWho Can Benefit From Taking the StressReduction Program (data compiled by UMass Medical School) Stress ReductionProgramand learnedhow to use Since its inceptionin 1979, more than 13,000 people have completedour eight-weekMindfulness-Based their innate resourcesand abilitiesto respond more effectivelyto stress, pain, and illness. The centralfocus of the SR Program is intensivetraining in mindfulnessmediationand its integrationinto the challenges/adventures of everydaylife.

regimenshas been The additionof meditation trainingto standardcardiacrehabilitation shownto reducemortality(41%decreaseduringthe first two yearsfollowing,and 460/o reductionin recurrencerates)morbidity,psychological distress,and some biologicalrisk factors(plasmalipids,weight,bloodpressure,bloodglucose)(Linden1996,Zammara practicealonehas beenshownto reduceexercise-induced myocardial 1996).Meditation ischemia in patientswithcoronaryarterydisease(Zammara1996,Ornish1983). to the Meditation traininghas beenshownto reducebloodpressurein amountscomparable and otherlifestylemodifications suchas weight changesthat are producedby medication loss, sodiumrestriction, and increasedaerobicexercise(Schneider1995, Linden& 1994,Alexander 1994). Chambers StressReduction A randomized trial with canceroutoatients showedMindfulness-Based (MBSR)was effectivein significantlydecreasingmood disturbance(65%), including of stress depression, anxiety,angerand confusion, and also in decreasing the symptoms such as cardiopulmonary and gastrointestinal symptoms(Speca2000). Thesechanges weresustained at six rnonthfollowup (Carlson2001). Survivalratesof bothmelanomaand rnetastaticbreest cancer patlentshave L'eensignificantlylnnprorred by refaxationand lessenedin meditation distresswas training(Fawzy1993,Speigal1989)and psychological womenwithearlybreastcancer(Bridge1988).Anticipatory nauseaand vomitingdue to (Green1991). chemotherapy is alsoinhibited Mindfulness meditationhas been shownto reduceboth the experienceof pain and its inhibitionof patients'everydayactivities. Further,mood disturbanceand psychological (includinganxietyand depression)are also reduced.Pain-related drug symptomatology wasdecreased andactivitylevelsandselfesteemincreased.Thiswas in marked utilization group,whichshowedno changeon these contrastto a traditionalpaincliniccomparison (Kabat-Zinn at four-year dimensions 1982,85). Thesegainswere nearlyall maintained follow-up(Kabat-Zinn 1987). in physical Mindfulness trainingresulted in clinically significant improvements condition and (Kaplan 1994,Weissbecker 2OO2). bothpsychologicaland socialspheres 1993,Goldenberg type Meditation trainingsignificantly loweredglucoselevelsin patientswithpoorlycontrolled (McGrady I diabetes 1991). Meditation traininghas beenshownto be effectivein improvingthis condition (Blanchard 1992). Mindfulness reducesymptomsof anxiety,psychological traininghasbeenshownto clinically (Kabat-Zinn at 3distressandsecondary depression 1992).Thesechangesweremaintained yearfollow-up (Miller1995). well-being,functional Relaxationtraininghas been shownto improvethe psychological statusand frequencyof attacksof asthmapatientsas well as adherenceto treatment (Devine1996). lt has also been shownto have a beneficialeffecton dyspneaand psychotogicaiWell-beihgafronS-eduifilWrth-ob-slructrve Ttum-onarydis:ase (Devine & Pearcy,in press). published Recently research hasshownthatmindfulness meditation increases skinclearing (Kabatratesfour-fold whenusedin conjunction withphototherapy and photochemotherapy Zinn1998). 1987). Meditation hasbeenshownto decrease headache activity(Anastasio The skills derivedfrom mindfulness trainingand cognitivetherapyhave been shown reducingthe recurrence of majordepressive episodesin patients ive in significantly (Teasdale 2000). whohavebeentreatedfor depression improvement Trainingin mindfulness of movement resultedin MS patientsreporting over (Mills2000). broadrangeof symptoms, including balance qualityof life. (functional MBSRhasbeenshownto significantly improvehealth-related physical psychological (Reibel2001) well-being, reduced symptoms, distress) ,