Mindfulness based Cognitive Therapy among Headache Sufferers: Dropout Analysis

Description

Page: 417-422

Anindita Mukherjee, Sanjukta Das, and Atanu Kumar Dogra (Department of Psychology, University of Calcutta, Kolkata, West Bengal)

In recent years, psychotherapy has gained popularity in India as a treatment for mental health problems, including other physiological disorders such as headaches and diabetes mellitus, where mental health crises are prevalent. Despite mindfulness-based cognitive therapy (MBCT) being one of the most efficacious therapies for headache control, premature dropout occurs before therapy termination. Given this context, the study aimed to identify the reasons for discontinuation, even when the therapy contract was fulfilled. The study followed three-step analyses to determine the reasons behind dropout: a) evaluating the impact of MBCT on headache reduction by comparing it with treatment as usual (TAU); b) assessing the likelihood of dropout on a module-by-module basis; c) analyzing the effectiveness of MBCT for headache reduction module-by-module to explore potential causes of dropout. The study encompassed 58 women, aged 19-35, who suffered from primary headaches at least six times a month. They did not exhibit any symptoms of other pain disorders or significant health issues. We matched them based on their headache type and demographics, then assigned them to two treatment groups of 29, using the counterbalancing technique (A-B-A). Pre-therapeutic assessments, which included the informed consent form, personal information schedule, Headache Diary Record (HDR), triggers, and the Five Facet Mindfulness Questionnaire (FFMQ), were conducted using written forms for both groups, and the HDR was administered before each module of the MBCT group. The results showed that some patients gradually stopped participating after each of the five MBCT modules, and by the end of the therapy, only twelve participants (41%) remained. The dropout rate was found to be 59%. The pre-post analysis showed that MBCT psychotherapeutic interventions were more effective in reducing the intensity and duration of headaches compared to the usual treatment. Therefore, MBCT offers a significant advantage over pharmacotherapy alone. So, dropout might not be explained by ineffective therapy. The current study explained the dropout phenomenon in the case of effective psychotherapeutic intervention.