Elsevier

Asian Journal of Psychiatry

Volume 39, January 2019, Pages 58-62
Asian Journal of Psychiatry

Effectiveness of mindfulness based cognitive behavior therapy on life satisfaction, and life orientation of adolescents with depression and suicidal ideation

https://doi.org/10.1016/j.ajp.2018.12.001Get rights and content

Highlights

  • The effectiveness of mindfulness-based cognitive behaviour therapy was assessed in the treatment of adolescents with depression and suicidal ideation.

  • Participation in therapy leads to mindfulness practices using various senses and enhance their daily experiences of adolescents.

  • Mindfulness based cognitive behaviour therapy led to changes in suicidal ideation and depression among adolescents.

  • Mindfulness based cognitive behaviour therapy improves life satisfaction, life orientation and family functioning of adolescents.

Abstract

Suicide and depression are among the most alarming phenomena prevalent throughout the world. Various approaches have tried to explain the intricacies in depression and suicide, as a consequence of faulty psychological adjustment of the individual. Several therapeutic approaches have been developed to strengthen one’s coping process, among which cognitive behaviour therapy has shown promising results. Also, mindfulness-based approaches to cognitive behavioural therapy have further accelerated the well-being of such individuals. This study was conducted with an aim to see the effect of mindfulness-based cognitive behaviour therapy on life satisfaction and life orientation in adolescents with depression and suicidal behaviour. A sample of 30 adolescents who scored high on scales of depression and suicidal tendencies were administered pre-test measures on life satisfaction and life orientation. After that they were exposed to an eight weeks programme on mindfulness-based cognitive behaviour therapy, followed by a post-assessment on the same measures. The analysis of pre and post test revealed a significant enhancement in life satisfaction, life orientation, and family functioning as well as a reduction in depressive symptoms and suicidal ideation. It is concluded that mindfulness-based cognitive behaviour therapy serves as an effective medium to enhance the psychological functioning of depressive and suicidal adolescents.

Introduction

It is estimated that about one-third of all people have suicidal ideation at some time during their lifetime. The prevalence of adolescent depression and suicidal ideation in the general population is quite substantial, and it has been associated with impairment in psychosocial functioning at school, with friends and family, often with potentially dangerous long-term consequences (Bansal et al., 2009; Rao et al., 2010). There are many types of treatment for depressed, high on suicidal risk adolescents including psychodynamic/psychoanalytic psychotherapy, cognitive behavioural therapy, family therapy, group therapy, and pharmacotherapy. Many of these treatments are widely used in clinical practice despite the fact that they lack sufficient evidence for their efficacy with adolescents (Klomek et al., 2007). Studies have also shown that the majority of adolescents treated with psychotherapeutic interventions still had impairment in the key areas of their lives (Emslie et al., 2003). Thus, research has consistently suggested the need for implementation of programmes that enhance health and emotional well- being, and foster the use of adaptive coping skills to reduce the use of nonproductive coping skills. Mindfulness-based therapies are emerging to be an effective alternative for serving these issues. Various studies also have shown their effectiveness regarding the outcomes reflecting increased self-awareness and self-reflection, as well as increased emotional and social functioning (Brown and Ryan, 2003; Schoeberlein and Koffer, 2005; Singh et al., 2007; Burke, 2009; Semple et al., 2010).

Quality of life can be defined as an individual‘s perception of his/her position in life in the context of the culture and value systems in which they live and about their goals, expectations, standards, and concerns (WHOQOL Group, 1998). Quality of life is a multifaceted concept involving a variety of factors. Campbell et al. (1976) identified various factors that can influence the degree of satisfaction in life including marriage, family life, health, neighborhood, friendship, housework, work or lack of it, life in the country of habitation, the standard of living, level of education etc. The WHO definition of quality of life also incorporates aspects of physical health, psychological state, level of independence, social relationships, personal belief, and an individual’s relationship to salient features of a person‘s environment. Although there is no definitive consensus on the concept of quality of life, all the proposed models significantly stress the subjective dimension of it, that is, the way an individual perceives his or her life to be (Berlim and Fleck, 2007).

There have been previous studies which have illustrated the efficacy of Mindfulness-based Cognitive behaviour Therapy in the prevention of relapse in depression, like the work of Teasdale et al. (2000, 2002); Teasdale et al., 2000. However, most of the studies focused on the application of Mindfulness-based Cognitive behaviour Therapy on the adult population. Although mindfulness-based approaches have been shown to have a robust set of interventions to offer that can be offered in the child and adolescent area, the research is insufficient, especially in the Indian context. It also has been noted that in case of investigations conducted in child and adolescent settings, most of the times mindfulness has been taken as the one part of a wider treatment approach, making it difficult to ascertain the relative contribution of mindfulness (Thompson and Gauntlett-Gilbert, 2008). Also, there is a dearth of empirical data to support the actual impact and effects of Mindfulness-based Cognitive behaviour Therapy on measures that make this integrated treatment efficacious. It is known that some mechanisms that may explain how mindfulness skills lead to symptom reduction and behaviour change include acceptance, exposure, and reduction of experiential avoidance; cognitive change concerning non-judgmental observation and cognitive flexibility; relaxation; and self-management or development of coping skills. Insufficient work has been done to examine the effects of mindfulness skills on these mechanisms of awareness, acceptance, and cognitive flexibility. In India, research on mindfulness-based cognitive behaviour therapy is in its initial stages with limited work looking into these mechanisms. It was found essential to investigate the impact of Mindfulness-based Cognitive behaviour Therapy on these mechanisms in a clinical sample for which the treatment is intended. In this context, the present study examines the effects of Mindfulness-based Cognitive behaviour Therapy on mindfulness skills and quality of life in adolescents with suicidal behaviour.

Section snippets

Participants

The present research was conducted on participants from the state capital (Gangtok) of Sikkim (a state in the North-eastern part of India with an alarmingly high rate of suicide amongst youth population). Participants were recruited from five schools having a school counselor/counseling centre. A total of 175 adolescents, who were frequent visitors of their school center/counselor, were contacted and administered the Beck’s Depression Inventory and the Modified Scale for Suicidal Ideation. Out

Analysis of socio demographic data

The mean age of the respondents was 14 years ranging from 12 to 17 years. 50% respondents were male and 50% respondents were female. Out of 30 students, 53% belonged to 12th standard, followed by 23% from 10th standard, 13% from 11th class, 6.7% from the 8th class, and 3.3% students from 9th class.

Table 1 shows the comparison between pre and post scores on various measures used in this study. The paired “t” test was used to see the significant differences between the pre and post assessment,

Discussion

A growing body of research suggests that mindfulness-based psychosocial interventions are effective for a broad range of mental and physical health disorders in adult populations (e.g., Baer, 2003; Brown et al., 2007; Hoge et al., 2013; McCay et al., 2016). Little is known about the effects of such interventions for adolescents. Most systematic reviews and meta-analyses indicate the effectiveness of mindfulness -based interventions, like Gotlink et al. (2015), revealed the effectiveness of

Summary and conclusion

To summarize, this study aimed at observing the effectiveness of mindfulness based cognitive behaviour therapy and at exploring the potential usefulness of mindfulness techniques for treatment of adolescents diagnosed of with depression and suicidal ideation. Adolescent participants in therapy readily engaged in exploring mindfulness using various senses to enhance their daily experiences. Changes over the suicidal ideation and depression measures in post assessments also indicate the

Financial disclosure

We, the authors of the Manuscript entitled “Effectiveness of Mindfulness Based Cognitive Behavior Therapy on Life Satisfaction, Life Orientation and Family Functioning of Adolescents with Depression and Suicidal Behavior” declare that the research work reported in this manuscript was undertaken with our own finance and we did not received any financial help from any individual/agency.

Acknowledgment

We gratefully acknowledge the help provided by Dr. Pankaj Bharti, Assistant Professor, Entrepreneur Development Institute of India, Ahmadabad for reviewing this manuscript and providing valuable comments to improve it. We also gratefully acknowledge the help of two anonymous reviewers for their valuable review and useful comments.

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