명상도서관
Mechanisms of Mindfulness Meditation, Cognitive Therapy, and Mindfulness-based Cognitive Therapy for Chronic Low Back Pain
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- 자료유형학술지논문
- 저자명Day, Melissa A.,Ward, L. Charles,Thorn, Beverly E.,Burns, John,Ehde, Dawn M.,Barnier, Amanda J.,Mattingley, Jason B.,Jensen, Mark P.
- 학회/출판사/기관명LIPPINCOTT WILLIAMS & WILKINS
- 출판년도2020
- 언어영어
- 학술지명/학위논문주기The Clinical journal of pain
- 발행사항Vol.36No.10[2020]_x000D_
- ISBN/ISSN0749-8047
- 소개/요약Objectives: This study evaluated theoretically derived mechanisms and common therapeutic factors to test their role in accounting for pain-related outcome change during group-delivered cognitive therapy (CT), mindfulness meditation (MM) and mindfulness-based cognitive therapy (MBCT) for chronic low back pain. Methods: A secondary analysis of a pilot randomized controlled trial was used to explore the primary mechanisms of pre- to post-treatment changes in pain control beliefs, mindful observing, and pain catastrophizing, and the secondary common factor mechanisms of therapeutic alliance, group cohesion, and amount of at-home skills practice during treatment. The primary outcome was pain interference; pain intensity was a secondary outcome. Results: Large effect size changes in the three primary mechanisms and the outcome variables were found across the conditions. Across all three treatment conditions, change in pain control beliefs and pain catastrophizing were significantly associated with improved pain interference, but not pain intensity. Therapeutic alliance was significantly associated with pain intensity improvement and change in the therapy-specific mechanisms across the three conditions. Mindful observing, group cohesion, and amount of at-home practice were not significantly associated with changes in the outcomes. Discussion: CT, MM and MBCT for CLBP were all associated with significant changes in the primary mechanisms to a similar degree. Change in perceived pain control and pain catastrophizing emerged as a potential "meta-mechanisms" that might be a shared pathway that contributes to improved pain-related outcomes across treatments. Further, strong working alliance may represent a critical therapeutic process that both promotes and interacts with therapeutic techniques to influence outcome.
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