MiCBT Research (Selected Studies)

Research and Publications on Mindfulness-integrated CBT.

The relative efficacy of mindfulness versus distraction: The moderating role of attentional bias

Tuesday, December 04, 2018

Shires A 1,2, Sharpe L 1, Newton John TRO 2. 

1 School of Psychology, University of Sydney, Sydney, New South Wales, Australia
2 Clinical Psychology Department, Graduate School of Health, University of Technology Sydney, New South Wales, Australia


This study investigated whether the ability to disengage quickly from pain‐related stimuli moderated the relative efficacy of a mindfulness‐based intervention versus distraction in response to an experimental pain task. 

Methods: Participants (n = 100) completed a dot probe task with eye tracking and were then randomized (2:2:1) to receive a mindfulness‐based interoceptive exposure task (MIET), distraction instructions or no instructions (control group) before engaging in the cold pressor test. 

Results: Participants who were allocated to the MIET condition reported a significantly higher pain threshold and distress than the distraction group, although not significantly higher than the control group. Those in the MIET group had improved tolerance compared to both the distraction and control groups. Difficulty disengaging from pain‐related stimuli, as measured by the duration of the first fixation on sensory words, was found to moderate the relative efficacy of mindfulness versus distraction in terms of pain threshold and distress, but not tolerance. Those with difficulty disengaging from sensory pain words benefited less from the MIET. Duration of first fixation on sensory and affective pain words were highly correlated, and duration of first fixation on affective pain words also moderated the relative efficacy of MIET and distraction on threshold, but not distress.

Conclusions: These results show that a single brief session of a mindfulness task was sufficient to change an acute pain experience in comparison with a distraction task, and that those who disengaged quickly from pain words benefited most. 

Significance: This study demonstrated the efficacy of a novel, exposure‐based mindfulness technique for pain tolerance and showed that those who disengaged easily from pain stimuli benefited most. This brief task could be clinically useful, particularly for those who are not overly focused on their pain symptoms.

European Journal of Pain. 2018;00:1–12. https://doi.org/10.1002/ ejp.1340

Effects of MiCBT on post-traumatic stress disorder and major depression in women following a motor vehicle accident

Wednesday, May 23, 2018

Mina Nazari Kamal, Rehele Samouie, Nafiseh Ghaebi 

The aim of this study was to investigate the effectiveness of MiCBT in reducing symptoms of post-traumatic stress disorder and major depression in women who survived a traumatic accident in Tehran. PTSD and depression questionnaires were used. Three months after their accident, 30 survivors of road accidents with PTSD and major depression in Tehran were randomly assigned to an experimental/MiCBT group (n = 15) and a control group (n = 15). Eight weekly individual therapy sessions were held, following which analysis of covariance was used to analyze the data. The results show a significantly greater reduction in symptoms of PTSD and major depression from pre- to post-treatment in the MiCBT group than in the control group. The beneficial effects of MiCBT were maintained at 3-month follow-up. The results suggest that this approach may have lasting benefits for individuals with traumatic and depressive symptoms. 

Manuscript in preparation

Mindfulness-Integrated CBT (MiCBT) for Reducing Distress in Parents of Children with Intellectual Disability (ID): a Case Series

Tuesday, May 15, 2018

Raphaella Osborn1 Mary Girgis1 Stephanie Morse1 Jovana Sladakovic1 Ian Kneebone1 Alice Shires1 Seeta Durvasula2 Lynette Roberts1

1 Graduate School of Health University of Technology Sydney Ultimo Australia
2 University of Sydney Sydney Australia


Caring for a child with an intellectual disability (ID) is associated with significant psychological distress. Interventions include cognitive behavioural therapy (CBT) and Mindfulness-based Stress Reduction (MBSR). Mindfulness-integrated CBT (MiCBT) may offer a balance between CBT’s change focus and MBSR’s acceptance focus for these parents. Five participants were recruited and provided one to one MiCBT tailored to parental carers of children with ID. Four participants completed the Depression Anxiety Stress Scales 21 (DASS-21) pre-treatment and post-treatment. Reliable change analysis was used to identify clinically reliable change. One participant dropped out after four sessions, four completed eight of the available eight sessions. Two participants reported reductions in depressive and stress symptoms, and one of these, additionally reported a reduction in anxiety symptoms. All four participants who completed treatment rated the treatment as acceptable. MiCBT shows promise as an intervention to assist parental carers of children with ID.

DOI: https://doi.org/10.1007/s10882-018-9602-4
Published in Journal of Developmental & Physical Disabilities, May 2018
Publisher Name: Springer US
Print ISSN: 1056-263X
Online ISSN: 1573-3580

The Purpose, Mechanisms, and Benefits of Cultivating Ethics in Mindfulness-Integrated Cognitive Behavior Therapy

Monday, October 30, 2017

The inclusion of ethics in mindfulness-based interventions (MBIs) has become a hot topic in recent years, contributing to a differentiation between what has recently been called first- and second-generation MBIs. This chapter first discusses the origins and purpose of ethics in Theravada Buddhism and the traditional understanding that developing mindfulness also aids in monitoring and preventing harmful intentions and actions, while cultivating beneficial ones, to decrease suffering. It will then describe the role and benefits of cultivating ethics in Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), a four-stage transdiagnostic approach that combines Burmese Vipassana meditation and core principles of traditional CBT. There are three principal reasons for which MiCBT dedicates a whole therapeutic stage to the development of empathy grounded in loving-kindness meditation and ethical living: (1) the cultivation of compassion, (2) the prevention of relapse into common mental health disorders, and (3) the cultivation of joy and well-being. The chapter also offers some insight into the reasons for which more advanced mindfulness states inevitably lead to the observation that ethics and compassion are interdependent, and reflects on some of the implications that this may have for MBI programs.


Cayoun B. A. (2017). The purpose, mechanisms, and benefits of cultivating ethics in Mindfulness-Integrated Cognitive Behavior Therapy. In Monteiro L., Compson J., Musten F. (Eds) Practitioner's Guide to Ethics and Mindfulness-Based Interventions. Mindfulness in Behavioral Health. Springer, Cham.

Online ISBN: 978-3-319-64924-5
Print ISBN: 978-3-319-64923-8

Effect of a brief Mindfulness-based Interoceptive Exposure Task on distress associated with Premenstrual Syndrome: A pilot study

Sunday, October 29, 2017

Joelle Fa 1 Alice Shires 2 Bruno Cayoun 3
1 Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
2 University of Technology Sydney, Sydney, NSW, Australia
3 Mindfulness-integrated CBT Institute, Hobart, TAS, Australia

Premenstrual Syndrome (PMS), when severe, is a debilitating experience shared by more than 80% of women throughout their lifetime. Many women prefer non-pharmacological treatments to avoid side effects and contraindications they may incur. Mindfulness-based strategies have demonstrated effectiveness in reducing distress in chronic pain patients, through learning greater acceptance and non-judgement of pain. However, not all women with PMS are amenable to undergo a full mindfulness-based program and maintain daily practice. Accordingly, the following pilot study applied a task extracted from a second-generation MBI, Mindfulness-integrated Cognitive Behaviour Therapy, which consisted of a self-guided 30-second mindfulness-based interoceptive exposure task (MIET), to painful and distressing sensations in 9 women who endorsed moderate to severe PMS. Participants using the MIET repeatedly over three menstrual cycles learned not to identify with pain, by focussing on the subcomponents of interoception (mass, motion, temperature and cohesiveness), while remaining equanimous.

Results did not find a significant effect of treatment on distress within session, however, distress between post-treatment and follow-up sessions showed a significant decrease F (2, 23) = 3.75, p < .05. Neither was there a significant decrease in pain catastrophising, premenstrual symptom severity, menstrual attitudes, nor emotional distress, however preliminary data showed a trending decrease on all measures. Belief in the predictability of the onset of menstruation was the only exception, which increased significantly from pre-treatment to follow-up. Despite this, participants reported the tool to be relatively acceptable, and qualitative data saw themes of increased manageability and acceptability of pain emerge.

Despite limitations, preliminary findings offer valuable insight into the feasibility of the MIET as a transdiagnostic tool as applied to a particularly complex socioemotional and physiological disorder that is PMS. Overall, our findings are sufficiently provocative to warrant further exploration of such a novel tool within an important domain of female health.

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