Mindfulness-based Cognitive Therapy: Benefits in Reducing Depression Following a Traumatic Brain Injury.

Context Current therapies for traumatic brain injury (TBI) include pharmacotherapy, psychotherapy, and cognitive rehabilitation. Unfortunately, psychological and emotional issues regularly go untreated in individuals with TBI even after they receive treatment for physical, behavioral, and cognitive issues. Mindfulness-based cognitive therapy (MBCT) may offer new rehabilitation opportunities for individuals with TBI. Objective To demonstrate the efficacy of MBCT in the treatment of clinically diagnosed depression in a TBI population. Design The research team measured depression, pain frequency and intensity, energy levels, health status, and function preintervention and postintervention. Setting The research team conducted the study at the Ottawa Hospital Rehabilitation Centre, Ontario, Canada. Participants The research team recruited 23 participants from two sources: (1) the brain injury program at the hospital and (2) the local head-injury association. Twenty participants completed the study. Intervention The intervention was 8 weeks in length, with a 90-minute MBCT session once a week. The research team based the specific content of the study's intervention on a combination of Kabat-Zinn's manualized mindfulness-based stress reduction program and Segal and colleague's manual for MBCT. Outcome Measures The research team determined statistical significance using paired t-tests for continuous outcomes and the McNemar chi-square test for dichotomous categorical outcomes. They also calculated effect sizes for all depression measures. Results Postintervention, the study found that MBCT significantly reduced (P < .050) depression symptoms on all scales compared to baseline. The study demonstrated medium to large effect sizes for each depression measure. Participants indicated reduced pain intensity (P = .033) and increased energy levels (P = .004). No significant changes occurred in anxiety symptoms, pain frequency, and level of functioning postintervention. Conclusion MBCT was efficacious in reducing depression in the TBI population, providing ample rationale for further research with more robust designs. This study marks an important step toward the development and provision of MBCT on a wider scale to support the rehabilitation efforts of people who have depression symptoms following TBI. (Adv Mind Body Med. 2012;26(1):14-20.).
PMID: 22875545