Skip to main content

Advertisement

SpringerLink
Log in

Feasibility and Acceptability of a Mindfulness-Based Group Intervention for Adolescents with Inflammatory Bowel Disease

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

The aim of the study is to explore the feasibility and initial outcomes of a mindfulness-based group intervention (MBI) for adolescents with inflammatory bowel disease (IBD). A mixed-methods uncontrolled study using an adapted 8-week group MBI for adolescents with IBD was conducted at a pediatric tertiary hospital. Primary outcomes focused on feasibility. Secondary outcomes focused on preliminary efficacy via quality of life, mindfulness, and symptoms of anxiety and depression. Of a total of 44 adolescents invited to participate, 16 adolescents completed the study. Group attendance and home meditation practice was satisfactory. There were significant differences in emotional functioning relative to IBD following MBI-A participation. Qualitative analysis rendered two themes: (1) personal interpretation and application of mindfulness and (2) the benefits of IBD-specific peer support. Several key adaptations are needed to increase feasibility of group MBIs prior to randomized controlled trials. Findings can be generalized to inform group-based therapies for adolescents with IBD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Ahola Kohut, S., Stinson, J., Davies-Chalmers, C., Ruskin, D., & van Wyk, M. (2017). Mindfulness-based interventions in clinical samples of adolescents with chronic ilness: A systematic review. Journal of Alternative and Complementary Medicine,23(8), 581–589. https://doi.org/10.1089/acm.2016.0316.

    Article  PubMed  Google Scholar 

  • Ahola Kohut, S., Walker, K., Ruskin, D., Walters, T. D., Church, P. C., & Pignatiello, T. (2018). Feasibility, acceptability, and initial outcomes of iACT: An online group intervention for adolescents with Inflammatory Bowel disease. Toronto: Hospital for Sick Children.

    Google Scholar 

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice,10(2), 125–143.

    Google Scholar 

  • Berrill, J. W., Sadlier, M., Hood, K., & Green, J. T. (2014). Mindfulness-based therapy for inflammatory bowel disease patients with functional abdominal symptoms or high perceived stress levels. Journal of Crohn’s and Colitis,8(9), 945–955. https://doi.org/10.1016/j.crohns.2014.01.018.

    Article  PubMed  Google Scholar 

  • Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology,77(5), 855–866. https://doi.org/10.1037/a0016241.

    Article  PubMed  Google Scholar 

  • Bursch, B., Tsao, J. C. I., Meldrum, M., & Zeltzer, L. K. (2006). Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions). Pain,125(1–2), 35–42. https://doi.org/10.1016/j.pain.2006.04.026.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chadi, N., Kaufman, M., Weisbaum, E., Malboeuf-Hurtubise, C., Kohut, S. A., Viner, C., & Vo, D. X. (2017). In-Person versus eHealth mindfulness-based intervention for adolescents with chronic illness: Protocol for a randomized controlled trial. JMIR Research Protocols,6(11), e241. https://doi.org/10.2196/resprot.7700.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chadi, N., McMahon, A., Vadnais, M., Malboeuf-Hurtubise, C., Djemli, A., Dobkin, P. L., & Haley, N. (2016). Mindfulness-based intervention for female adolescents with chronic pain: A pilot randomized trial. Journal of the Canadian Academy of Child and Adolescent Psychiatry,25(3), 159–168.

    PubMed  PubMed Central  Google Scholar 

  • Cotton, S., Humenay Roberts, Y., Tsevat, J., Britto, M. T., Succop, P., McGrady, M. E., & Yi, M. S. (2010). Mind-body complementary alternative medicine use and quality of life in adolescents with Inflammatory Bowel disease. Inflammatory Bowel Diseases,16(3), 501–506. https://doi.org/10.1002/ibd.21045.

    Article  PubMed  Google Scholar 

  • Cotton, S., Luberto, C. M., Sears, R. W., Strawn, J. R., Stahl, L., Wasson, R. S.,… Delbello, M. P. (2016). Mindfulness-based cognitive therapy for youth with anxiety disorders at risk for bipolar disorder: A pilot trial. Early Interv Psychiatry, 10(5), 426–434. https://doi.org/10.1111/eip.12216.

    Article  PubMed  Google Scholar 

  • Dewalt, D. A., Thissen, D., Stucky, B. D., Langer, M. M., Morgan Dewitt, E., Irwin, D. E.,… Varni, J. W. (2013). PROMIS Pediatric peer relationships scale: Development of a peer relationships item bank as part of social health measurement. Health Psychology, 32(10), 1093–1103. https://doi.org/10.1037/a0032670.

    Article  PubMed  Google Scholar 

  • Dinya, E., Csorba, J., Sorfozo, Z., Steiner, P., Ficsor, B., & Horvath, A. (2009). Profiles of suicidality and clusters of Hungarian adolescent outpatients suffering from suicidal behaviour. Psychopathology,42(5), 299–310.

    Article  PubMed  Google Scholar 

  • Gordon, J. S., Staples, J. K., Blyta, A., Bytyqi, M., & Wilson, A. T. (2008). Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: A randomized controlled trial. Journal of Clinical Psychiatry,69(9), 1469–1476.

    Article  PubMed  Google Scholar 

  • Greco, L. A., Baer, R. A., & Smith, G. T. (2011). Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (CAMM). Psychological Assessment,23(3), 606–614. https://doi.org/10.1037/a0022819.

    Article  PubMed  Google Scholar 

  • Greenley, R. N., Hommel, K. A., Nebel, J., Raboin, T., Li, S. H., Simpson, P., & Mackner, L. (2010). A meta-analytic review of the psychosocial adjustment of youth with inflammatory Bowel disease. Journal of Pediatric Psychology,35(8), 857–869. https://doi.org/10.1093/jpepsy/jsp120.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J.,… Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. Journal of Clinical Psychiatry, 74(8), 786–792. https://doi.org/10.4088/jcp.12m08083.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jastrowski Mano, K. E., Salamon, K. S., Hainsworth, K. R., Anderson Khan, K. J., Ladwig, R. J., Davies, W. H., & Weisman, S. J. (2013). A randomized, controlled pilot study of mindfulness-based stress reduction for pediatric chronic pain. Alternative Therapies in Health and Medicine,19(6), 8–14.

    PubMed  Google Scholar 

  • Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

    Google Scholar 

  • Levenstein, S. (2004). Embracing complexity: What determines quality of life in Inflammatory Bowel Disease? European Journal of Gastroenterology and Hepatology,16(12), 1253–1255.

    Article  PubMed  Google Scholar 

  • Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Andreoli, A., Luzi, C.,… Marcheggiano, A. (2000). Stress and exacerbation in ulcerative colitis: A prospective study of patients enrolled in remission. The American Journal of Gastroenterology, 95(5), 1213–1220. https://doi.org/10.1111/j.1572-0241.2000.02012.x.

    Article  CAS  PubMed  Google Scholar 

  • Malboeuf-Hurtubise, C., Achille, M., Muise, L., Beauregard-Lacroix, R., Vadnais, M., & Lacourse, É. (2016). A mindfulness-based meditation pilot study: Lessons learned on acceptability and feasibility in adolescents with cancer. Journal of Child and Family Studies,25(4), 1168–1177.

    Article  Google Scholar 

  • March, J. S., Parker, J. D. A., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The multidimensional anxiety scale for children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry,36(4), 554–565. https://doi.org/10.1097/00004583-199704000-00019.

    Article  CAS  PubMed  Google Scholar 

  • Neilson, K., Ftanou, M., Monshat, K., Salzberg, M., Bell, S., Kamm, M. A.,… Castle, D. (2016). A controlled study of a group mindfulness intervention for individuals living with inflammatory bowel disease. Inflammatory Bowel Diseases, 22(3), 694–701. https://doi.org/10.1097/mib.0000000000000629.

    Article  PubMed  Google Scholar 

  • Otley, A., Smith, C., Nicholas, D., Munk, M., Avolio, J., Sherman, P. M., & Griffiths, A. M. (2002). The IMPACT questionnaire: A valid measure of health-related quality of life in pediatric inflammatory bowel disease. Journal of Pediatric Gastroenterology and Nutrition,35(4), 557–563.

    Article  PubMed  Google Scholar 

  • Palermo, T. M., Eccleston, C., Lewandowski, A. S., Williams, A. C. D. C., & Morley, S. (2010). Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: An updated meta-analytic review. Pain,148(3), 387–397. https://doi.org/10.1016/j.pain.2009.10.004.

    Article  PubMed  Google Scholar 

  • Rausch, J., Hametz, P., Zuckerbrot, R., Rausch, W., & Soren, K. (2012). Screening for depression in Urban Latino adolescents. Clinical Pediatrics,51(10), 964–971.

    Article  PubMed  Google Scholar 

  • Ruskin, D., Campbell, L., Stinson, J., & Ahola Kohut, S. (2018). Changes in parent psychological flexibility after a one-time mindfulness-based intervention for parents of adolescents with persistent pain conditions. Manuscript in preparation.

  • Ruskin, D. A., Gagnon, M. M., Kohut, S. A., Stinson, J. N., & Walker, K. S. (2017). A Mindfulness program adapted for adolescents with chronic pain: Feasibility, acceptability, and initial outcomes. Clinical Journal of Pain,33(11), 1019–1029. https://doi.org/10.1097/ajp.0000000000000490.

    Article  PubMed  Google Scholar 

  • Ruskin, D., Kohut, S. A., & Stinson, J. (2014). The development of a mindfulness-based stress reduction group for adolescents with chronic pain. Journal of Pain Management,7(4), 301.

    Google Scholar 

  • Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing and Health,23(4), 334–340.

    Article  CAS  PubMed  Google Scholar 

  • Schoultz, M., Atherton, I., & Watson, A. (2015). Mindfulness-based cognitive therapy for inflammatory bowel disease patients: Findings from an exploratory pilot randomised controlled trial. Trials,16, 379. https://doi.org/10.1186/s13063-015-0909-5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Serpico, M. R., Boyle, B. M., Kemper, K. J., & Kim, S. C. (2016). Complementary and alternatice medicine use in children with inflammatory bowel diseases: A single-centrer survey. Journal of Pediatric Gastroenterology and Nutrition,63(6), 651–657. https://doi.org/10.1097/mpg.0000000000001187.

    Article  CAS  PubMed  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry,39(1), 28–38. https://doi.org/10.1097/00004583-200001000-00014.

    Article  CAS  PubMed  Google Scholar 

  • Simren, M., Axelsson, J., Gillberg, R., Abrahamsson, H., Svedlund, J., & Bjornsson, E. S. (2002). Quality of life inflammatory bowel disease in remission: The impact of IBS-like symptoms and associated psychological factors. American Journal of Gastroenterology,97(2), 389–396. https://doi.org/10.1111/j.1572-0241.2002.05475.x.

    Article  PubMed  Google Scholar 

  • Tan, L., & Martin, G. (2015). Taming the adolescent mind: A randomised controlled trial examining clinical efficacy of an adolescent mindfulness-based group programme. Child and Adolescent Mental Health,20(1), 49–55.

    Article  PubMed  Google Scholar 

  • Turner, D., Griffiths, A. M., Walters, T. D., Seah, T., Markowitz, J., Pfefferkorn, M., & Levine, A. (2010). Appraisal of the pediatric Crohn’s disease activity index on four prospectively collected datasets: Recommended cutoff values and clinimetric properties. American Journal of Gastroenterology,105(9), 2085–2092. https://doi.org/10.1038/ajg.2010.143.

    Article  PubMed  Google Scholar 

  • Turner, D., Otley, A. R., Mack, D., Hyams, J., de Bruijne, J., Uusoue, K., & Griffiths, A. M. (2007). Development, validation, and evaluation of a pediatric ulcerative colitis activity index: A prospective multicenter study. Gastroenterology,133(2), 423–432. https://doi.org/10.1053/j.gastro.2007.05.029.

    Article  PubMed  Google Scholar 

  • Waelde, L. C., Feinstein, A. B., Bhandari, R., Griffin, A., Yoon, I. A., & Golianu, B. (2017). A pilot study on mindfulness meditation for pediatric chronic pain. Children,4(5), 32. https://doi.org/10.3390/children4050032.

    Article  PubMed Central  Google Scholar 

  • Wicksell, R. K., Lekander, M., Sorjonen, K., & Olsson, G. L. (2010). The psychological inflexibility in pain scale (PIPS)—statistical properties and model fit of an instrument to assess change processes in pain related disability. European Journal of Pain,14(7), 771.e771. https://doi.org/10.1016/j.ejpain.2009.11.015.

    Article  Google Scholar 

  • Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools—a systematic review and meta-analysis. Frontiers in Psychology,5, 603. https://doi.org/10.3389/fpsyg.2014.00603.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: A meta-analysis. Mindfulness,6(2), 290–302.

    Article  Google Scholar 

Download references

Acknowledgements

Dr. Ahola Kohut was supported by the Medical Psychiatry Alliance, a collaborative health partnership of the University of Toronto, the Centre for Addiction and Mental Health, the Hospital for Sick Children, Trillium Health Partners, the Ontario Ministry of Health and Long-Term Care, and an anonymous donor. The authors would also like to thank Natalie Weiser for qualitative analysis support.

Funding

This research was generously supported by funds from the Robbie’s Rainbow Accelerator Grant (PI: Ruskin).

Author information

Authors and Affiliations

  1. Department of Psychology, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Sara Ahola Kohut & Danielle Ruskin

  2. Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada

    Sara Ahola Kohut & Jennifer Stinson

  3. Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada

    Sara Ahola Kohut & Ahlexxi Jelen

  4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Sara Ahola Kohut

  5. Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, ON, Canada

    Jennifer Stinson

  6. Department of Psychology, York University, Toronto, ON, Canada

    Danielle Ruskin

Authors
  1. Sara Ahola Kohut
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer Stinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahlexxi Jelen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Danielle Ruskin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sara Ahola Kohut.

Ethics declarations

Conflict of interest

Sara Ahola Kohut, Jennifer Stinson, Ahlexxi Jelen, and Danielle Ruskin declare that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Informed Consent

Informed consent was obtained from all adolescents included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahola Kohut, S., Stinson, J., Jelen, A. et al. Feasibility and Acceptability of a Mindfulness-Based Group Intervention for Adolescents with Inflammatory Bowel Disease. J Clin Psychol Med Settings 27, 68–78 (2020). https://doi.org/10.1007/s10880-019-09622-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-019-09622-6

Keywords

Search

Navigation