Shifting focus: Feasibility of online mindfulness meditations as an adjunct to tailored internet-delivered cognitive behaviour therapy

Abstract

Background. Public safety personnel (PSP) are at an increased risk for developing mental disorders compared to the general population. The PSP Wellbeing Course is a transdiagnostic internet-delivered cognitive behaviour therapy (ICBT) course tailored to assist PSP to manage symptoms of depression, anxiety, and posttraumatic stress injuries using cognitive behavioural strategies. While the effectiveness of this course is supported by evidence (Hadjistavropoulos, McCall, et al., 2021), incorporating mindfulness as an additional strategy to assist PSP with symptoms could potentially improve the program. Mindfulness interventions can help people learn to experience the world and their reactions to the world in open and non-judgmental ways, which may complement the existing PSP Wellbeing Course content. Objective. To examine the feasibility of mindfulness meditations in the PSP Wellbeing Course. Methods. The current study used a mixed-methods design including quantitative and qualitative data collection. Participants included 40 treatment-seeking PSP who were asked to complete five mindfulness meditations including grounding, loving kindness, awareness of breath, awareness of five senses, and body scan meditations alongside five core PSP Wellbeing Course lessons. On a weekly basis, participants indicated how often they participated in mindfulness meditation. Participants completed measures (i.e., anger, depression, anxiety, posttraumatic stress disorder, insomnia, and resilience) pre- and post-treatment, and treatment satisfaction scales post-treatment. There were 12 participants who also completed an interview about perceptions of the mindfulness meditations. Results. There were 27 (67.5%) participants who reported using the mindfulness meditations, putting in 4.8 minutes (SD = 8.1) of practice each week. The course was associated with significant improvements in the primary symptom measures, functional impairment, and resilience. Practice was not associated with improved outcomes. Most interviewed participants described the mindfulness meditations as beneficial, helping to slow down and regulate their bodies and emotions. Participants also reported challenges with the meditations, such as discomfort sitting with their feelings. Participants provided suggestions for improvement (e.g., creating shorter meditations, adding clear signals to indicate the end of meditations). Discussion. The current study demonstrates the feasibility of adding mindfulness meditations to the PSP Wellbeing Course with many PSP making use of and reporting benefits from the meditations. Nevertheless, improvements could be made to improve use of meditations. Future research appears warranted to systematically test the benefits of adding mindfulness to the PSP Wellbeing Course as well as longer term outcomes of the meditations.