Restoration Skills Training in a Natural Setting Compared to Conventional Mindfulness Training: Sustained Advantages at a 6-Month Follow-Up

Abstract

Restoration skills training (ReST) is a mindfulness-based course in which participants draw support from a natural practice setting while they learn to meditate. Well-established conventional mindfulness training (CMT) can improve psychological functioning but many perceive it as demanding and fail to sustain practice habits. Applying non-inferiority logic, previous research indicated that ReST overcomes compliance problems without compromising the benefits gained over 5 weeks' training. This article applies similar logic in a 6-month follow-up. Of 97 contacted ReST and CMT course completers, 68 responded and 29 were included with multiple imputation data. The online survey included questions about their psychological functioning in three domains (dispositional mindfulness, cognitive lapses, and perceived stress) and the forms and frequencies with which they had continued to practice mindfulness after the course. Former ReST participants continued, on average, to show higher dispositional mindfulness and fewer cognitive lapses compared to pre-course ratings. Improved psychological functioning in one or more domains was demonstrated by 35%, as determined by a reliable change index. Again, analyses detected no indications of any substantive disadvantages compared to the more demanding, established CMT approach. Compared to the CMT group, more ReST participants had also continued to practice at least occasionally (92 vs. 67%). Continued practice was linked to sustained improvements for ReST but not clearly so for CMT. ReST participants thus continued to use the skills and sustained the improvements in psychological functioning that they had gained in the course, further supporting the utility of ReST as a health intervention.

Keywords: acceptability; compliance; follow-up; health; meditation; mindfulness; nature; restoration.

Figure 1

Participant flow through the recruitment, interventions, and evaluations in the four data collection rounds of the study, where participants in rounds 2–4 were contacted for the 6-month follow-up. * denotes approximations necessitated by incompleteness of the records from early stages of the recruitment for data collection round 2.

Figure 2

Average levels (estimated marginal means) and 95% CIs of change observed in the 6-month follow-up compared to the initial assessments before the course started, for mean item ratings of dispositional mindfulness (Five Facet Mindfulness Questionnaire; possible range 1–5), cognitive lapses (Cognitive Failures Questionnaire; possible range 0–4), and perceived stress (Perceived Stress Scale; possible range 0–4). Pretest scores obtained before the course on the respective measures were entered as covariates. The figure reflects the observed data obtained from 37 ReST participants and 31 CMT participants (estimates based on the multiple imputation datasets with N = 97 were very similar).