Mindfulness based cognitive therapy: effectiveness and mechanisms of action in people with visible skin conditions

Abstract

Background: Social anxiety is commonly reported by people living with visible skin conditions. Mindfulness based cognitive therapy aims to cultivate a non-judgmental attitude towards experiences so that individuals can recognise and dis-engage from negative patterns of thinking which maintain social distress. This study examined the effectiveness of group MBCT in reducing social anxiety in people with visible skin conditions. Method: Using a multiple baseline single case design, participants (N=11) were randomly allocated to a 2,3 or 4-week baseline. Following baseline, participants completed an 8-week group MBCT intervention, and four-week follow-up. Idiographic measures of social anxiety were administered daily; mindfulness and social anxiety were measured weekly; and anxiety, depression, and skin-specific quality of life, were measured pre-intervention, post-intervention and follow-up. Visual analysis and TAU U were used to examine change in daily social anxiety. The Reliable Change Index was used to examine pre-post changes in distress. Follow-up interviews, analysed using thematic analysis, examined experiences of MBCT. Findings: Seven participants completed the intervention and demonstrated clinically significant reductions in social anxiety (TAU = - 0.54, p = <. 001) and reliable and/or clinically significant change in at least one other measure of distress. Increased ‘Non-judgement’ and ‘non-reactivity’ to inner experiences were associated with reductions in social anxiety, particularly the ability to reduce habitual processing of negative self-appraisals. Discussion. Findings suggest that learning flexible ways of attending to negative self-beliefs through MBCT can be beneficial. Further research of MBCT in people living with a range of health conditions is warranted.