Mechanisms of Mindfulness Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Low Back Pain (2015-2018)
Abstract
Up to 80% of Australians experience back pain and 10% have significant disability as a result. This translates into substantial economic cost with far reaching psychological, emotional and social implications. Unfortunately, the treatment options for chronic low back pain (CLBP) are limited and typical pharmacological approaches entail potentially serious side-effects (e.g., opioid addiction). Hence, there is a critical need for the development and evaluation of innovative interventions that have the capacity to target the multidimensional nature of CLBP. Research indicates that psychosocial interventions for CLBP are viable treatment approaches that entail few (if any) deleterious side effects and can have benefit beyond pain reduction. Cognitive Therapy (CT) and Mindfulness Meditation (MM) have both been found to be feasible and efficacious for CLBP. A promising recent trend has been the recalibration of traditional CT that integrates mindfulness-based meditation strategies. This approach, referred to as Mindfulness-Based Cognitive Therapy (MBCT), has been successfully applied to problems such as depression; however, the ECF candidate (Dr Day) and her previous collaborators are among the first to adapt and establish the feasibility and potential efficacy of MBCT for the treatment of pain. The proposed research builds upon the candidate¿s past research and will extend investigation of this approach into the context of CLBP. The proposed, theoretically driven, randomised controlled trial will examine the effects and mechanisms (i.e., mediators and moderators) of CT, MM, and MBCT to determine if these theoretically distinct interventions work via unique mediators and for whom, under what circumstances is each approach most suitable. Furthering our understanding of treatment mechanisms will lead to the development of streamlined interventions designed to efficiently maximise benefit for individuals with CLBP.