1. Qualitative Research Results Conclusions
CSO CZH/4/831
A feasibility study for a community based trial of Wellness Recovery Action Planning (WRAP) versus Mindfulness Based Cognitive Therapy (MBCT) for Depression: Qualitative Study
Methods
Background
Much of the burden of depression relates to its recurrent nature.
Guidelines support MBCT as a gold standard intervention but NHS availability is limited
The WRAP peer-delivered approach could provide an alternative but currently lacks evidence.
Neither have been fully tested against a comparable intervention.
Objective
To conduct a feasibility study leading to a trial of the effectiveness of WRAP versus MBCT for recurrent depression.
To explore how WRAP & MBCT were received, and any perceived impacts.
Design
Setting
Sample
Feasibility RCT
Community-sourced recruitment
Random allocation to intervention groups
8 week intervention
3 month follow-up
Baseline: 18 in-depth interviews with WRAP & MBCT participants.
Follow-up: In-depth interviews with participants (n=15) & facilitators (n=3)
Withdrawal interviews
Community settings in:
Edinburgh
Glasgow
Inverness
Highly experienced MBCT teachers and WRAP facilitators delivering one group of each intervention in each location.
Inclusion Criteria
Aged 18+
3+episodes of depression
Currently in remission
Exclusion Criteria
Recent experience of MBCT/WRAP.
Psychotic symptoms.
At risk of self-harm
Undertaking talking therapy.
Qualitative Research Results
Conclusions
Community-based recruitment and randomisation of self- selecting participants was highly efficient and effective
WRAP & MBCT groups well- received
Positive impact on mental health; reports of reductions in medication and/or contact with health care staff
Group delivery very important
Withdrawal from groups often related to practical issues
Few participants reported no WRAP & MBCT benefits
A full scale community-based trial can be efficiently run with minor modifications.
...when I felt my mood going down I’ve been able to practice Mindfulness techniques and that’s been able to lift my mood
(MBCT participant, Edinburgh)
WRAP & MBCT sessions were well run
WRAP & MBCT useful and worthwhile approaches with major positive impacts on participants’ mental well-being
Those with previous experience of other treatments or talking therapies preferred WRAP & MBCT (though both could be used in conjunction with medication)
The group environment was crucial: the support and advice of those with similar lived experience made WRAP & MBCT particularly powerful
WRAP is far more practical… I had 6 months psychotherapy and didn't feel very different. I had 8 weeks WRAP and feel like a new person… that says something! (WRAP participant, Glasgow)
…it’s quite remarkable […] you knew that everyone in the room knew what you felt like… and so if you talked about a particular experience you didn’t have to explain it very much… you could be quite honest, that was very refreshing
(WRAP participant, Inverness)
Contact:
Andy MacGregor or Susan McConville