Sharplin, G.R., Jones, S.B., Hancock, B., Knott, V.E., Bowden, J.A., & Whitford, H.S. (2010). Mindfulness-based cognitive therapy: An efficacious community-based group intervention for depression and anxiety in a sample of cancer patients. Medical Journal of Australia, 193(5 Suppl.), S79–82.

To assess the impact of an eight-week mindfulness-based cognitive therapy program on individuals experiencing distress as a consequence of cancer 

Participants included people with a history of cancer and those the study defined as carers. Participants were people who called the Cancer Council South Australia Helpline. They were assessed for anxiety and depression before and after a course of mindfulness-based cognitive therapy (MBCT). The MBCT program consisted of eight weekly two-hour sessions facilitated by an experienced counselor. The program sessions included these topics: stepping out of automatic pilot; dealing with barriers; mindfulness of one’s breath; staying present; acceptance; holding, allowing, letting be; thoughts are not facts; how to best take care of oneself; and using learned skills to control future mood. An optional three-hour follow-up session occurred six weeks after program completion, to reinforce mindfulness principles.

• The sample (N = 21) included 16 cancer survivors and five carers.
• Mean participant age was 52 years, with a range of 34–69 years.
• The sample was 14% male and 86% female.
• The largest number of participants had breast cancer; glioblastoma multiforme, adenoid cystic carcinoma, acute myeloid leukemia, lymphoma, liver cancer, bladder cancer, ovarian cancer, and prostate cancer were represented.
• Time since diagnosis was 3–120 months.

• Single site  
• Adelaide, South Australia, Australia

• Patients were in the transition phase after initial treatment.
• The study has clinical applicability for late effects and survivorship.

Prospective, one-group, pre/post-test design

• Beck Depression Inventory (BDI)    
• State-Trait Anxiety Inventory (STAI)
• Freiburg Mindfulness Inventory (FMI)

• Mean depression scores decreased from mild (mean: 15.0; SD = 9.07) to minimal (mean: 10.37; SD = 5.92) and for anxiety levels from clinical (mean: 43.17; SD = 13.25) to nonclinical (mean, 31.39; SD = 9.61). 
• At the three-month follow-up, depression levels remained roughly the same as they had been at baseline. Compared to pretreatment levels of mean anxiety, at three months researchers noted a slight but nonsignificant increase.
• Mindfulness level at each time point had significant negative correlations with depression and anxiety.

Poor study design and small sample prevent drawing a valid conclustion about the effect of the intervention.

• The study had a small sample size (particularly in regard to carers), with fewer than 30 participants. This fact limits generalizability.
• The study did not include an appropriate control group.
• The authors' recruitment method, using those who had called a helpline as the recruitment pool, was unusual. 
• Defining and measuring the concept of mindfulness is difficult.
• Measurement and intervention time points, in relation to cancer treatments, were unjustified; thus, the findings may have been the result of natural changes over time.
   

MBCT may be an effective intervention for cancer survivors and carers who are willing to make a time commitment for sessions and homework. Further research is warranted.