Feasibility and acceptability of a single-session, videoconference-delivered group intervention for pain in multiple sclerosis.

OBJECTIVE: Chronic pain is one of the most common and interfering symptoms experienced by people with MS. There is an opportunity to shift the paradigm from interventions delivered after pain has become chronic to early, proactive interventions to alter the impact of MS-related pain. The purpose of this study was to develop and test a remotely delivered single-session group intervention to modify the pain trajectory for individuals with early MS. Research Method/Design: This was a single-center 2-group pilot randomized (1:1) controlled trial comparing a novel videoconference-delivered single-session pain intervention to a waitlist control. Participants were N = 27 adults who were diagnosed with MS in the preceding 36 months and who had moderate or worse pain. The study team developed the intervention to introduce pain coping and commonly used cognitive, behavioral, and acceptance-based approaches for adaptive coping. Participants completed outcome assessments on pain intensity, interference, and coping at pretreatment, posttreatment, and 3-months posttreatment. RESULTS: Among participants in the treatment arm, the majority (54%) indicated satisfaction with treatment and all (100%) indicated continued use of strategies learned in the intervention. The 2 groups did not differ on any of the outcomes at any time point, and large standard deviations were found on most of the measures for both groups at all timepoints. CONCLUSIONS/IMPLICATIONS: This brief, highly accessible intervention targeting pain coping in individuals with early MS is feasible and acceptable. Further research is needed to better understand the effectiveness of the intervention both immediately and in positively impacting future coping in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The body compassion scale: Development and initial validation.

As the newer mindfulness and acceptance-based cognitive behavioral therapies continue to grow, it is important that corresponding valid and reliable assessment tools are developed and evaluated. This article describes the initial development and validation of the body compassion scale. The body compassion scale is a theoretically derived measure designed to bridge the constructs of body image and self-compassion to provide a targeted measure of underlying mindfulness and acceptance-based constructs. Herein, two studies using exploratory and confirmatory factor analysis and examining subsequent relationships among other health-related constructs in college-age samples are presented.

Mindfulness-based cognitive therapy and cognitive behavioral therapy for chronic pain in multiple sclerosis: a randomized controlled trial protocol.

BACKGROUND: Chronic pain is one of the most prevalent and disabling symptoms associated with multiple sclerosis (MS). Individuals with MS are interested in nonpharmacologic pain management approaches. Cognitive-behavioral therapy (CBT) is efficacious in improving MS-related pain outcomes. Mindfulness-based cognitive therapy (MBCT) is a promising, alternative approach. Little is known about moderators of these treatments' outcomes, however. This article describes the study protocol for the first randomized controlled trial comparing MBCT, CBT, and usual care and examining treatment effect moderators in individuals with chronic pain and MS. METHODS: We will conduct a single-center, randomized, single blind, parallel-group trial comparing MBCT, CBT, and usual care in adults with MS and chronic pain. Both interventions will be delivered via eight group sessions using videoconferencing technology. Primary (average pain intensity) and secondary outcomes (including pain interference, depressive symptoms, fatigue, and sleep) will be assessed pre-treatment, mid-treatment, post-treatment, and at 6-month follow up. Potential treatment moderators will be assessed pre-treatment. We hypothesize that participants randomly assigned to MBCT or CBT will report significantly greater reductions in average pain intensity than participants assigned to usual care at post-treatment (primary study endpoint) and 6-month follow up. We also hypothesize that mindfulness, pain catastrophizing, and behavioral activation pre-treatment will moderate response to both active treatments, but not response to usual care. DISCUSSION: Findings will provide important new information about the efficacy and moderators of two nonpharmacologic pain management approaches delivered using technology to overcome common barriers to treatment access. The knowledge gained may lead to better patient-treatment matching and, ultimately, better pain treatment outcomes in MS. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03782246. Registered on 20 December 2018.

Mental Health Care for LGBT Older Adults in Long-Term Care Settings: Competency, Training, and Barriers for Mental Health Providers.

OBJECTIVES: To assess mental health providers' experience with LGBT older adults in long-term care (LTC) settings and perceived barriers to quality care. METHODS: Providers (N = 57) completed an online survey on demographics and practice characteristics. They were also asked about: number of LGBT residents they've worked with, relevance of LGBT issues to their practice, preparedness, willingness to learn, hours of formal/informal training, and barriers to providing care to LGBT patients. RESULTS: Respondents were 63% psychologists, 16% social workers, 14% psychiatrists, and 5% nurses, most of whom practiced in LTC consulting roles. Most providers felt working with LGBT issues was relevant to their practice and felt well-prepared and willing to learn, though they were unaware of evidence based practices (EBTs), especially for LTC settings. They had little coursework on LGBT issues, and identified lack of training, stigma, and residents concealing their identity as the greatest barriers to quality care. CONCLUSIONS: Mental health providers in LTC facilities would benefit from more training in LGBT-specific mental health problems and evidence-based treatments, and efforts to destigmatize LGBT identities in these settings might improve access to mental health care. CLINICAL IMPLICATIONS: LGBT-specific training and EBTs are needed. Facilities need to address stigma with residents and providers.

Beyond Mindfulness: Buddha Nature and the Four Postures in Psychotherapy.

We propose to incorporate the contextual view of the Buddhist teachings of the Three Turnings into applications of mindfulness in psychotherapy; specifically by applying the teaching of the Four Postures, which are expressions of innate health in ordinary life activities. This practice may expand understanding of the core mechanisms of different modalities of mindfulness and psychotherapy, thereby supporting clinicians in guiding clients on a healing path that is in natural alignment with each individual. By its allegiance to inherent wakefulness (Buddha Nature), this teaching supports clients in appreciating their own inherent health and the health of the world around them.

Development of a risk reduction intervention to reduce bacterial and viral infections for injection drug users.

Bacterial infections are widespread problems among drug injectors, requiring novel preventive intervention. As part of a NIDA-funded study, we developed an intervention based on the Information-Motivation-Behavioral Skills model, past research, injection hygiene protocols, and data collected from focus groups with 32 injectors in Denver in 2009. Qualitative responses from focus groups indicated that most participants had experienced skin abscesses and believed that bacterial infections were commonly a result of drug cut, injecting intramuscularly, and reusing needles. Access to injection supplies and experiencing withdrawal were the most frequently reported barriers to utilizing risk reduction. Implications for intervention development are discussed.