MiCBT Research (Selected Studies)

MiCBT Research (Selected Studies)

Research and Publications on Mindfulness-integrated CBT.

Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions

Tuesday, March 21, 2017
1 Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
2 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
3 Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India


Background: Cognitive behavior therapy (CBT) involving exposure and response prevention is the gold standard psychotherapeutic intervention for obsessive-compulsive disorder (OCD). However, applying traditional CBT techniques to treat patients with predominant obsessions (POs) without covert compulsions is fraught with problems because of inaccessibility of mental compulsions. In this context, we examined the efficacy of mindfulness-integrated CBT (MICBT) in patients with POs without prominent overt compulsions.

Materials and Methods: Twenty-seven patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD were recruited from the specialty OCD clinic and the behavior therapy services of a tertiary care psychiatric hospital over 14 months. Patients had few or no overt compulsions and were free of medication or on a stable medication regimen for at least 2 months prior to baseline assessment. All patients received 12–16 sessions of MICBT on an outpatient basis. An independent rater (psychiatrist) administered the Yale–Brown Obsessive-Compulsive Scale (YBOCS) and the Clinical Global Impression Scale at baseline, mid- and post-treatment, and at 3-month follow-up.

Results: Of the 27 patients, 18 (67%) achieved remission (55% reduction in the YBOCS severity score) at 3-month follow-up. The average mean percentage reduction of obsessive severity at postintervention and 3-month follow-up was 56 (standard deviation [SD] = 23) and 63 (SD = 21), respectively.

Conclusions: Our study demonstrates that MICBT is efficacious in treating patients with POs without prominent overt compulsions. The results of this open-label study are encouraging and suggest that a larger randomized controlled trial examining the effects of MICBT may now be warranted.

Keywords: Cognitive behavior therapy, mindfulness-integrated cognitive behavior therapy, mindfulness meditation, obsessions, obsessive-compulsive disorder

Kumar A, Sharma MP, Narayanaswamy JC, Kandavel T, Janardhan Reddy Y C. Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions. Indian J Psychiatry [serial online] 2016 [cited 2017 Mar 21];58:366-71. Available from: http://www.indianjpsychiatry.org/text.asp?2016/58/4/366/196723

The Effects of Mindfulness Practice on Child and Parent Anxiety: A Multiple Baseline Case Series

Saturday, November 05, 2016

A report submitted in partial fulfilment of the requirements for the degree of Master of Clinical Psychology at the University of Technology Sydney, October 2016.

Lauren Winney
Principle Supervisor: Alice Shires (1, 2)
Co-Supervisor: Bruno Cayoun (2)

1 Graduate School of Health, University of Technology, Sydney, NSW Australia
2 MiCBT Institute, 277 Macquarie Street, Hobart, TAS, Australia


Anxiety is a common, normative experience for both children and adults. However, elevated anxiety in childhood is predictive of adult anxiety disorders, which can have a considerable impact at both the individual and societal level. There is substantial evidence that mindfulness interventions can alleviate adult anxiety, however less is known about mindfulness effects with children. Furthermore, many existing mindfulness interventions neglect the family system, despite its central role in children’s development and wellbeing. This study therefore investigated the effects of a parent-child mindfulness meditation program on child anxiety, with additional investigations into parental anxiety. An A-B-A multiple baseline case series design was used to achieve this aim. Three mother-child dyads participated in the study, and all children initially met DSMIV criteria for two or more anxiety disorders. Two of the three dyads completed the 8-week program, which was based on Mindfulness integrated Cognitive Behaviour Therapy (MiCBT). The program provided training in mindfulness of breath and body sensations, and required children to undertake daily mindfulness practice. Results showed that the two retained children no longer met criteria for any anxiety disorder at post-treatment and follow-up. Both children experienced clinically significant and/or reliable reductions in anxiety symptoms and life interference, however only one child achieved improvements in self-reported mindfulness. One mother experienced a reliable reduction in anxiety symptoms, however neither mother demonstrated improvements in self-reported mindfulness. These findings provide some support for mindfulness as a means of alleviating child and maternal anxiety, and have implications for interventions, theory, and future research.

The Effect of Mindfulness-integrated CBT on Depression and Anxiety among Pregnant Women: a Randomized Clinical Trial

Thursday, September 01, 2016

Reza Yazdanimehr(1), Abdollah Omidi(1), Zohreh Sadat(2), Hossein Akbari(3)

1 Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
2 Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
3 Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran


Introduction: Pregnancy can be associated with different psychological problems such as depression and anxiety. These problems are often neglected and left untreated. This study aimed to examine the effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women. 

Methods: A convenient sample of 80 pregnant women were selected. Participants were randomly allocated to either the experimental or the control groups. Participants in the experimental group received mindfulness-integrated cognitive behavior therapy while women in the control group only received routine prenatal care services. A demographic questionnaire, the Edinburgh Postnatal Depression Scale, and the Beck Anxiety Inventory were used for data collection. Descriptive statistics measures such as frequency, mean, and standard deviation as well as the repeated-measures analysis of variance test were used for data analysis. 

Results: After the study intervention, the mean scores of anxiety and depression in the experimental group were significantly lower than the control group. 

Conclusion: Mindfulness-integrated cognitive behavior therapy can significantly alleviate pregnant women’s depression and anxiety. So implementation of this method alongside with other prenatal care services is recommended.

Full paper may be downloaded here: Yazdanimehr R, Omidi A, Sadat Z, Akbari H. The effect of mindfulness-integrated cognitive behavior therapy on depression and anxiety among pregnant women: a randomized clinical trial. J Caring Sci 2016; 5 (3): 195-203. doi:10.15171/jcs.2016.021.  

Unlearning chronic pain with equanimity: Immediate and lasting pain reduction following a self-implemented mindfulness-based interoceptive exposure task

Tuesday, June 07, 2016

Presented at the 2nd International Mindfulness Conference in Rome, May 2016

Submitted for publication

Bruno Cayoun (1), Akeesha Simmons (2) and Alice Shires (1,2,3)
1 Mindfulness-integrated CBT Institute, 277 Macquarie Street, Hobart, TAS, Australia
2 Graduate School of Health, University of Technology Sydney, Sydney, NSW Australia
3 School of Psychology, University of Sydney, NSW 2006, Australia


Introduction: Recent neurological research shows that about 80% of people who transit from acute to chronic pain produce neuroplasticity linking pain pathways to learning areas of the brain, showing evidence that chronic pain is largely learned. This pilot study investigated the efficacy of a short self-guided mindfulness-based interoceptive exposure task (MIET) in extinguishing learned aversive responses to pain sensations. The MIET has been used routinely in Mindfulness-integrated Cognitive Behaviour Therapy for over a decade to decrease emotional distress and regulate emotions more generally, but its effects on chronic pain have never been empirically demonstrated.

Method: Fifteen (8 males, 7 females) diagnosed chronic pain patients, aged 26 to 73 (M = 47.33), individually underwent two 30-second exposures to pain sensations (pre-treatment) and were asked to self-implement this method aided by printed instructions each time their pain reached high intensity, for the following two weeks (post-treatment). Following post-treatment interview, participants were asked to continue practising the method on their own for another two months (follow-up).

Results:The results show large reductions in pain-related anxiety from pre- to post-treatment (p=.001; d=0.96) and further reduction at 2-month follow-up (p=.03; d=0.42), and large decrease in pain severity from pre- to post-treatment (p=.01; d=0.86), which was maintained at 2-month follow-up. Averaged dynamic data also show large reductions in pain intensity after each 30-second exposure (p<.001; d=1.37). Large reduction in emotional distress (depression, anxiety and stress) was also observed from pre-treatment to 2-month follow-up (p<.001; d=0.81). Participants rated the task as highly acceptable and some reduced their use of analgesic medication.

Discussion: These early results show the possible benefits of this method as a costless adjunct to traditional treatments of chronic pain and has the potential to change unhelpful habits and moderate the mechanism of brain reorganisation in pain chronification.

Grist to the Mill: A Qualitative Investigation of Mindfulness-Integrated Cognitive Behaviour Therapy for Experienced Health Professionals

Tuesday, March 15, 2016

Darby, M1. and Beavan, V2. (2016), Grist to the Mill: A Qualitative Investigation of Mindfulness-Integrated Cognitive Behaviour Therapy for Experienced Health Professionals. Australian Psychologist. doi: 10.1111/ap.12215 

1Progress Psychology 
2Department of Psychological Sciences, Australian College of Applied Psychology


Objective: Mindfulness-integrated cognitive behaviour therapy (MiCBT) is a transdiagnostic psychological intervention for the alleviation of chronic mental health conditions. Although health workers utilise the approach in Australasia, Europe, and North America, the modality has been overlooked in the literature. Furthermore, few qualitative studies have investigated mindfulness training for experienced healthcare professionals. This study addresses these gaps and is the first investigation of an Australian sample in this field of study. 

Method: The design comprises a two-stage qualitative analysis of the recorded experiences of six health professionals during introductory MiCBT training in Australia, using course workbooks and semi-structured interviews conducted at between 3 and 21 months’ follow-up. 

Results: Results show a high level of agreement with the extant literature on other mindfulness-based approaches. Themes involve harnessing of personal challenges during training to one's advantage, gaining equanimity through exposure, and personal benefits linked to home practice. However, notable themes from the literature relating to group cohesion and professional self-care are absent. Novel findings include the reported ability of participants to regard personal difficulties as opportunities, rather than threats, to practice; and differences in how mindfulness training is implemented professionally by psychologists and social workers working with dissimilar client groups. 

Conclusions: Results suggest that specifics of the training delivery, occupation of professionals, and level of client functioning could all play a part in determining perceived outcomes of mindfulness training for participants. The findings will be of interest to anyone who designs, implements, or participates in mindfulness-based training programmes.