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. 2021 Jan 14:11:603394.
doi: 10.3389/fpsyg.2020.603394. eCollection 2020.

The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes

Nicholas K Canby  1   2 , Kristina Eichel  2 , Jared Lindahl  3 , Sathiarith Chau  2 , James Cordova  1 , Willoughby B Britton  2
Affiliations

The Contribution of Common and Specific Therapeutic Factors to Mindfulness-Based Intervention Outcomes

Nicholas K Canby et al. Front Psychol. .

Abstract

While Mindfulness-Based Interventions (MBIs) have been shown to be effective for a range of patient populations and outcomes, a question remains as to the role of common therapeutic factors, as opposed to the specific effects of mindfulness practice, in contributing to patient improvements. This project used a mixed-method design to investigate the contribution of specific (mindfulness practice-related) and common (instructor and group related) therapeutic factors to client improvements within an MBI. Participants with mild-severe depression (N = 104; 73% female, M age = 40.28) participated in an 8-week MBI. Specific therapeutic factors (formal out-of-class meditation minutes and informal mindfulness practice frequency) and social common factors (instructor and group ratings) were entered into multilevel growth curve models to predict changes in depression, anxiety, stress, and mindfulness at six timepoints from baseline to 3-month follow-up. Qualitative interviews with participants provided rich descriptions of how instructor and group related factors played a role in therapeutic trajectories. Findings indicated that instructor ratings predicted changes in depression and stress, group ratings predicted changes in stress and self-reported mindfulness, and formal meditation predicted changes in anxiety and stress, while informal mindfulness practice did not predict client improvements. Social common factors were stronger predictors of improvements in depression, stress, and self-reported mindfulness than specific mindfulness practice-related factors. Qualitative data supported the importance of relationships with instructor and group members, involving bonding, expressing feelings, and instilling hope. Our findings dispel the myth that MBI outcomes are exclusively the result of mindfulness meditation practice, and suggest that social common factors may account for much of the effects of these interventions. Further research on meditation should take into consideration the effects of social context and other common therapeutic factors.

Keywords: MBSR/MBCT; common factors across psychotherapies; group cohesion; meditation; mindfulness; mindfulness-based cognitive therapy; therapeutic alliance.

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Conflict of interest statement

JC is a Sensei in a Zen Buddhist lineage. WB is a MBSR and MBCT teacher and has received financial compensation for this role. WB is nominally affiliated with the Mindfulness Center at Brown University which generates income by offering mindfulness classes to the public. WB is the founder of Cheetah House, a RI non-profit organization that provides information about meditation-related difficulties, individual consultations, and support groups, as well as educational trainings to meditation teachers, clinicians, educators and mindfulness providers. This interest has been disclosed to and is being managed by Brown University, in accordance with its Conflict of Interest and Conflict of Commitment policies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Frequency of teacher and group related social factors mentioned by participants.
See this image and copyright information in PMC

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