Mindfulness training hampshire,mindfulness exercises for self harm,change management strategies for conflict resolution - Good Point

03.06.2014
Everyday you wake up to an endless stream of information all vying for your precious time and attention. Feel better in 20 minutes with this free binaural mindfulness meditation with original music score, ocean surf and rain sounds, designed to un-stress you in no time.
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Estimated delivery dates - opens in a new window or tab include seller's handling time, origin ZIP Code, destination ZIP Code and time of acceptance and will depend on shipping service selected and receipt of cleared payment - opens in a new window or tab. This item will be shipped through the Global Shipping Program and includes international tracking. I am an Academic Editor of PLOS One,* where we have the laudable goal of publishing all papers that are transparently reported and not technically flawed. As always, examine the abstract carefully  when you suspect spin, but expect that you will not fully appreciate the extent of spin until you have digested the whole paper. Mindfulness-based group therapy was non-inferior to treatment as usual for patients with depressive, anxiety or stress and adjustment disorders.
There are hints of other things going on, like no reporting of how many patients were retained for analysis or whether there were intention-to-treat analyses.
The objective of non-inferiority trials is to compare a novel treatment to an active treatment with a view of demonstrating that it is not clinically worse with regards to a specified endpoint. Basically, an NI RCT commits investigators and readers to accepting null results as support for a new treatment because it is no worse than an existing one.
Suspicions are reduced when the new treatment has other advantages, like greater acceptability or a lack of side effects, or when the existing treatments are so good that an RCT of the new treatment with a placebo-control condition would be unethical. We should give evaluate whether there is an adequate rationale for authors doing an NI RCT, rather than them relying on the conventional test whether the null hypothesis can be rejected of no differences between the intervention and a control condition. The recruitment procedure is strangely described, but seems to indicate that the therapist providing mindfulness training were present during recruitment and probably weren’t blinded to group assignment and conceivably could influence it. During the recruitment procedure, GPs assessed whether medication was needed and made prescriptions before randomization occurred.
Patients receiving any psychotherapy at the start of the trial were excluded, but the authors ignored whether patients were receiving medication. This appears to be a mildly distressed sample that is likely to show some recovery in the absence of any treatment.
Okay, the authors claim these measures are great, and attach clinical importance to cut points that others no longer consider valid. I know, I’m getting technical to the point that I risk losing some readers, but the authors are setting readers up to be comfortable with a decision to focus on medians, not mean scores – making it more difficult to detect any differences between the mindfulness therapy and routine care. There are lots of problems with the ill described control condition, treatment as usual (TAU). We know enough about mindfulness therapy at this point to not worry about whether it is better than nothing at all, but should be focusing on whether is better than another active treatment and whether its effectiveness is due to particular factors. I’m again trying to avoid getting very technical here, but point out for those who have a developed interest in statistics, that there were strange things going on. Particular statistical analyses (depending on group medians, rather than means are chosen that are less likely to reveal differences between intervention and control group than the parametric statistics that are typically done. Complicated decisions justify throwing away data and then using multivariate techniques to estimate what the data were.
The power analysis is not conducted to detect differences between groups, but to be able to provide a basis for saying that mindfulness does not differ from routine care. The intervention and control group initially differed for two of the four outcome variables before they even received the intervention. We are told nothing about the distribution of diagnoses across the intervention and control group, which is very important in interpreting results and considering what generalizations can be made. Most patients in both the intervention and control groups were receiving antidepressants and about a third of them either condition were receiving a “tranquilizer” or have missing data for that variable. Twice as many patients assigned to mindfulness dropped out of treatment, compared to those assigned to routine care. The main finding of the present RCT is that mindfulness group therapy given in a general practice setting, where a majority of patients with depression, anxiety, and stress and adjustment disorders are treated, is non-inferior to individual-based therapy, including CBT. Although a growing body of research has examined the effect of mindfulness on somatic as well as psychiatric conditions, scientific knowledge from RCT studies is scarce. Patients who receive antidepressants have a reported remission rate of only 35–40%.41 Additional treatment is therefore needed for non-responders as well as for those who are either unable or unwilling to engage in traditional psychotherapy. The authors are being misleading to the point of being irresponsible in making this statement in the context of discussing the implications of their study.
An appropriately referenced statement about primary care populations like what this study was recruited would point to the lack of diagnosis on which prescription of medicaton was based, unnecessary treatment with medication of patients who would not be expected to benefit from it, and poor monitoring and follow-up of patients who could conceivably benefit from medication if appropriately minutes. This RCT has numerous flaws in its conduct and reporting that preclude making any contribution to the current literature about mindfulness therapy. What is most fascinating is that the study was framed as a noninferiority trial and therefore null results are to be celebrated. I would love to see the reviews this paper received, almost as much as any record of what the authors intended when they planned the study. Please, some psychotherapy researcher with a null trial sitting in the drawer, test the waters by dressing the study up as a noninferior trial and submitted to BJP. The article provides a non-intention-to-treat analysis of a comparison of mindfulness to an ill specified control condition that would not qualify as an active condition.
The accumulation of literature is such that we need less mindfulness therapy research, not more. To conduct research in patient populations, investigators must have hypotheses and methods with the likelihood of making a meaningful contribution to the literature commensurate with all the extra time and effort they are asking of patients. Finally, the publication of this null trial as a noninferiority trial pushes the envelope in terms of the need for preregistration of design and analytic plans for trials. All views that Professor Coyne expresses are his own and do not necessarily reflect those of PLOS or other institutional affiliations.
In a review of research into the benefits of mindfulness, the American Psychological Association found that many studies show that practicing mindfulness reduces stress. This entry was posted in Emotional Awareness, Happiness, Meditation, Mindfulness, Stress Reduction, Uncategorized and tagged emotions, happiness, life purpose, meditation, mindfulness, stress reduction by admin.
About.MeCarol KnoxIn partnership with Avanoo, Carol has created a 30-day program, called Calming the Storm.


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Een mindfulness training kan helpen bij het starten en volhouden van de zoektocht naar een leven dat meer in balans is.
Mindfulness kan namelijk, zeker in het begin, een hele opgave zijn wanneer je dit alleen wil doen.
Wanneer je de behoefte hebt aan wat extra begeleiding tijdens het mediteren dan is een mindfulness training zeker het overwegen waard.
Er zijn tegenwoordig vele manieren om een mindfulness training te volgen en ze worden meestal wel ergens in de buurt aangeboden. Voordat een training overwogen wordt is het advies om eerst te kijken of mindfulness wel iets voor je is.
Learn about brain entrainment technology that will take you from a Beta state, through Alpha and down to a deep Theta meditation state, that will increase your ability to focus and is ideal for learning and personal development.
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Beyond that, we leave decisions about scientific quality to post-publication commentary of the many, not a couple of reviewers whom the editor has handpicked. The logic sounds just like US Senator George Aiken famously proposing getting America out of the war it was losing in Vietnam by declaring America had won and going home. And then the weird mention of outcomes being analyzed with “ordinal mixed models.”  Have you ever seen that before? It is assumed that the comparator treatment has been established to have a significant clinical effect (against placebo).
Consistent with a large literature, a recent systematic review of NI HIV trials  found the overall methodological quality to be poor, with a high risk of bias. Demonstration that the treatment is as good as existing treatments might warrant marketing of the new treatment or dissemination into existing markets.
Suitable support would be a strong record of efficacy for a well defined control condition.
The study thus does not have clear evidence of an appropriate randomization procedure and initial blinding. We will need to see – we are not told in the methods section – but I suspect a lot of medication is being given to both intervention and control patients.
Patients experiencing stress or adjustment reactions were thrown in with patients who had mild or moderate depression or anxiety disorders. The authors’ not controlling for the medication was received is going to be a big problem later. For instance, The Hospital Anxiety and Depression Scale (HADS) is a fatally flawed instrument, even if still widely used. My standing gripe with this choice is  that TAU varies greatly across settings, and often is so inadequate that at best the authors are comparing whether mindfulness therapy is better than some unknown mix of no treatment and inadequate treatment. The authors state that most of the control patients were receiving CBT, but don’t indicate how they knew that, except for case records.
Were the authors really interested in that question rather than whether mindfulness is better than routine care in initially designing a study and its analytic plan? Thus, intervention and control conditions are not comparable in important baseline characteristics.
Given the mildness of disturbance and high rates of prescription of medication, we are likely dealing with a primary care sample where medications are casually distributed and poorly monitored. There were comparable, significant changes in both the intervention and control condition over time. Readers are given some information about how many sessions of mindfulness patients attended, but not the extent to which they practiced mindfulness. To the best of our knowledge, this is the first RCT performed in a general practice setting where the effect of mindfulness group therapy was compared with an active control group. Recent reviews suggest that mindfulness therapy is better than nothing and better than inactive control conditions that do not provide comparable levels of positive expectations and support. The reference is to the American STAR*D treatment study, which dealt with very different, more chronically and unremittingly depressed population. The statement would reflect the poor state of routine care for depression in the community, but would undermine claims that the control group received an active treatment with suitable specification that would allow any generalizations about the efficacy of mindfulness. Maybe the BJP is willing to sacrifice trustworthiness of the interpretation of results for newsworthiness.
I challenge anyone to find similar instances of null results for a psychotherapy trial being published in BJP except in the circumstances that make a lack of effect newsworthy because it suggests that investment in the dissemination of a previously promising treatment is not justified. We need comparisons with well specified active control groups that can answer the question of whether mindfulness therapy offers any advantage over alternative treatments, not only in efficacy, but in the ability to retain patients so they get an adequate exposure to the treatment. If authors of going to claim a successful demonstration of non-inferiority, we need to know that is what they set out to do, rather than just being stuck with null findings they could not otherwise publish. Opinions about the publishability of papers reflect only the author’s views and not necessarily an editorial decision for a manuscript submitted to PLOS One. I have pointed out how another flawed review of the efficacy of long-term psychodynamic psychotherapy represented duplicate publication . Coyne, PhD is Professor of Health Psychology at University Medical Center, Groningen, the Netherlands where he teaches scientific writing and critical thinking. Coyne is Emeritus Professor of Psychology in Psychiatry, where he was also Director of Behavioral Oncology, Abramson Cancer Center and Senior Fellow Leonard Davis Institute of Health Economics.
Daarnaast is de ervaring dat het prettig is om een mindfulness training met anderen te doen. De drukte ligt altijd op de loer en voor je het weet is je geplande oefenmomentje vervangen en vergeten.
Is digital distraction, information overload, lack of focus and stress preventing your company or team from meeting long-term business goals? If you reside in an EU member state besides UK, import VAT on this purchase is not recoverable. I am going to be critical not only of the article, but the review process that got it into British Journal of Psychiatry (BJP).
Yet, speaking for myself, and not PLOS One, I would have required substantial revisions or rejected the version of this paper that got into the presumably highly selective, even vanity journal BJP**. And finally, do the results hold for patients with any of those disorders or only a particular sample of unknown mix and maybe only representing those who could be recruited from specific settings?
These trials are frequently used in situations where use of a superiority trial against a placebo control may be considered unethical.


The people who brought you CONSORT saw fit to develop special reporting standards for NIs  so that misuse of the design in the service of getting publishable results is more readily detected.
There could be financial rewards or simply promoters and enthusiasts favoring what they would find interesting.
It would also help if the trial were pre-registered as NI, quieting concerns that it was declared as such after peeking at the data. Furthermore, the GPs administering concurrent treatment also were not blinded and might take group assignment into account in subsequent prescribing and monitoring of medication. Readers won’t be able to tell whether any improvement in the intervention condition is due to its more intensive support and encouragement that results in better adherence to medication. I considered the instrument dead in terms of reliability and validity, but like Elvis, it is still being cited. Basically, they are saying the scales are so bad that the differences between one number to the next higher or lower for pairs of items can’t be considered equal. Notoriously, a lot of the therapy done in primary care that is labeled by practitioners as CBT does not pass muster. This is in itself a risk of bias, but also raises further questions about the adequacy of the randomization procedure and blinding. Yet, this study is supposedly designed to inform us whether adding mindfulness to this confused picture produces outcomes that are not worse.
But we can’t know if that was due to the mildness of distress or effectiveness of both treatments. Studies are accumulating that indicate mindfulness therapy is not consistently better than active control conditions.
Maybe its publication in its present form represents incompetent reviewing and editing, or maybe a strategic, but inept decision to publish a flawed study with null findings because it concerns the trendy topic of mindfulness and GPs to whom British psychiatrists want to reach out. I have a strong suspicion that this particular paper got published because the results were dressed up as a successful demonstration of noninferiority.
Maybe the simple explanation is that the editor and reviewers do not understand what a noninferiority trial is and what it can conceivably conclude. The intervention and control conditions had significant differences in key characteristics at baseline.
We need mindfulness studies with cleverly chosen comparison conditions that allow determination of whether it is the mindfulness component of mindfulness group therapy that has any effectiveness, rather than relaxation that mindfulness therapy shares with other treatments.
He is also Visiting Professor, Institute for Health, Health Care Policy & Aging Research, Rutgers, the State University of New Jersey. He has served as External Scientific Advisor to a decade of European Commission funded community based programs to improve care for depression in the community. Studies show evidence that mindfulness increases positive emotions and decreases negative emotions and anxiety.
You might want to download the CONSORT checklist for NI and apply the checklist to the trial under discussion. Yup, some bandwagons, some fads and fashions psychotherapy are in large part due to promoters simply seeking the new and different, without evidence that a treatment is better than existing ones.
I would be much more comfortable with some sort of control over what patients were receiving in the control arm, or at least better specification. Differences become less likely when the alternative treatments are equivalent in positive expectations conveyed to patients and providers, support, and intensity in terms of frequency and amount of contact. The patient population is ill-described in ways that does not allow generalization to other patient populations.
I still hope that the current editor can improve the trustworthiness of what is published at BJP. He has written over 350 articles and chapters, including systematic reviews of screening for distress and depression in medical settings and classic articles about stress and coping, couples research, and interpersonal aspects of depression. Farb et al., found that mindfulness shifts a person’s ability to use emotion regulation strategies, enabling them to experience emotion selectively and therefore become more resilient to life’s ups and downs, among many other positive advantages. Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial. Right away, you can see how deficient the the reporting is in the abstract of the paper under discussion. If the scales are as good as the authors claim, why do the authors take the unusual step of considering them as psychometrically inadequate? Resolving this latter question of whether mindfulness is better than reasonable alternatives is now critical in this study provides no relevant data. The high rates of co-treatment confounding due to antidepressants and tranquilizers precludes determination of any effects of the mindfulness therapy.
He has been designated by ISI Web of Science as one of the most impactful psychologists and psychiatrists in the world. Carol has trained meditation techniques and practiced meditation for around fourteen years.
En wil je bruikbare handvatten en inzicht krijgen die je helpen meer balans in je leven te ervaren? We don’t know if there were any effects, or if both the mindfulness therapy and control condition benefited from the natural decline in distress of a patient population largely without psychiatric diagnoses. Life adventures have taken Carol on journeys to India, where she attended Buddhist teachings, and Thailand, where she had exposure to Vipassana meditation practices. Without a control group like a waiting list, we can’t tell if these patients would have improved any way. He also blogs and is a regular contributor to the blog Science Based Medicine and to the PLOS One Blog, Mind the Brain.
Zich weer te verbinden met wat hen raakt en daar ook echt tijd voor te maken.In de trainingen en coaching kan je ontdekken wat nodig is om je leven in overeenstemming te brengen met wat diep van binnen in je leeft. He is known for giving lively, controversial lectures using scientific evidence to challenge assumptions about the optimal way of providing psychosocial care and care for depression to medical patients. Maak een afspraak om te kijken wat voor jou Nu de meest ZINVOLLE groei-stap is.                        GRATIS ADVIESGESPREKMeteen zelf aan de slag? Ik bied je een GRATIS persoonlijk adviesgesprek aan waarin we samen kijken wat voor jou nu de meest ZINVOLLE stap is. 0640293867bekijk Zinspirit’s video over mindfulnessinspiratie quotesAls je altijd rent, kom je nooit thuis berichten Spiritueel materialisme 7 december 2015 Lichaam, leugens en liefde 3 november 2015 De woestijn, wat doet dat toch met je… 1 april 2015 Opladen versus opladen 1 april 2015 Wat is jouw verhaal?



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