| Objective: Obsessive-Compulsive Disorder is a kind of mental disease which can cause pain and affect social function seriously.Mindfulness based cognitive therapy(MBCT)has been applied to the therapy and rehabilitation of various mental diseases as ‘the third wave of cognitive behavior therapy’.This study explored the subjective experience of the therapists and patients who participated in MBCT,described the therapeutic effects and their associated influencing factors,and summarized the strategies that would benefit the patients.Methods: Three psychotherapists in Shanghai Mental Health Center and two MBCT groups of patients with OCD(a total of 11 patients who completed treatment and 2 people dropped off)were selected.All the patients were mild to moderate obsessive-compulsive disorder.Yale-Brown Obsessive-Compulsive Scale(Y-BOCS),The Hamilton Depression Scale-24(HAMD24),Hamilton Anxiety Scale(HAMA)and Xi Hanwei Residual Scale(SDS)were used to assess the effects for quantitative assessment and statistics.At the same time,the researcher conducted a participatory observation of 10-week MBCT and semi-structured interviews with the therapists and patients before and after treatment,and the transcripts were transcribed into verbatim and coded using interpretative phenomenological analysis.Results: 1,The reduction rate of Y-BOCS scores showed that 1 patient was cured after treatment,4 patients were effectively cured,6 patients were ineffective.compared with the baseline,patients got significantly lower total scores of Y-BOCS(F = 4.560,P = 0.023,partial eta = 0.338),and the score of obsessive thought was reduced significantly(F = 5.238,P=0.015),the score of obsessive behavior was not changed significantly.The patients had lower difference values of the HAMA scores(F = 5.03,P =0.017).The score of FFMQ was not changed significantly,including the aspects of observing,describing,non-judging and non-reacting,but the aspect of acting with awareness increased significantly(F=10.514,P=0.002).2,MBCT groups in the early,middle and late showed different interactive atmosphere and compliance.The group in earlier stage showed a strong sense of confidence.The group in middle stage showed anxiety or even anger mood.The group in later stage showed attachment and dismay.3,The patients with OCD had good subjective experience on the group and the therapists,and some difficulties on the use of MBCT skills.The efficacy was reflected in the reduction of symptoms,personal status,emotional management,family relationships and social function improvement.Examples of explanations,improvements in treatment program and the therapist’s empathy and guidance were effective strategies for benefiting patients.4,The therapists had good subjective experience on MBCT skills,and some uncertainties on the psychotherapy relationship and the group.The timely adjustment of treatment program,multivariate strategies,promotion of psychotherapy relationships,awareness and enhancement of teaching techniques were effective strategies for benefiting patients.Conclusion: 1,MBCT has good therapeutic effect on obsessive problems significantly.Patients generally responded that personal status,emotional management,family relations and social functions had improved,except for the reduction of symptoms.The benefits of mindfulness practice,the positive events in personal life,the positive atmosphere of group therapy and the difficulties the practical use of mindfulness affected the patient’s benefit.2,according to the results of the study,effective strategies in the application of MBCT for OCD is the timely adjustment of the treatment program,the use of multiple strategies,promoting the psychotherapy relationship,awareness and strengthen the teaching technology.The results of the study was a useful attempt on the localization of psychological treatment,and prepared for the next large sample randomized controlled study and a wide range of application. |
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