Effectiveness of Mindfulness Based Cognitive Restructuring

CHAPTER V

SUMMARY, CONCLUSION AND RECOMMENDATION

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The final chapter included the summary of the research, findings obtained and the conclusions derived from the study. The recommendations will provide directions for the future research.

5.1 Summary

Adolescence is periods of growth from puberty to adulthood are the stage of transition from dependency to autonomy. Therefore, adolescents are faced with various types of stress from school, physical dissatisfaction and relationship with parents, friends and romantic partners. During this period, females are experiencing higher level of psychological pain than males. The stressful life situations create mental pain and hopelessness which leads to suicide among adolescents. This study tried to develop and assess the effectiveness of mindfulness based cognitive restructuring program to reduce the significant variables of suicidal ideation among the adolescents in Kerala, India. Pressures from family, friends, schools and cultural issues and constantly rising expectations and personal factors are the causes of psychological pain, hopelessness and suicidal ideation in adolescents’ life. Hence this research is intended to help adolescents who experience high level of stress every day.

The study is anchored on the development and effectiveness of the mindfulness based cognitive restructuring program on psychache, hopelessness and suicidal ideation of the selected female adolescents in South Indian State of Kerala. It was conducted in two phases. Phase 1 focused on the development of the intervention program (Mindfulness Based Cognitive Restructuring, MBCR) using a descriptive research design. Phase II centered on testing the effectiveness of the newly developed intervention program (MCSRS) in reducing psychache, hopelessness and thereby reducing suicidal ideation. Phase II utilized true experimental research method specifically between subjects: two independent groups design with pretest and posttest. For this purpose 150 female adolescents were selected in the district of Calicut, Kerala, India. From this 36 students were chosen as participants of the study. They were randomly assigned into control group (18 students) and experimental group (18 students). The research participants who belonged to the experimental group received the treatment (MBCR) while those in the control group did not. After the treatment, both groups underwent the post-test to determine the effectiveness of the intervention program (MCSRS) using the psychache, hopelessness and suicidal ideation scales. The null hypothesis was tested at 0.05 level of significance. The statistical techniques utilized in the study were mean, standard deviation, t test for dependent and independent samples and Cohen’s d.

Summary of the Findings

The following are the summary of the findings of the study:

The composition of the of the Mindfulness Based Cognitive Restructuring program (MBCR) is as follows:
The eight modular, 16 sessions intervention program MBCR designed by the researcher as an effective self-help tool in reducing psychache, hopelessness and thereby reducing suicidal ideation of the adolescents.
The elements of MBCR program sessions aimed to acquire the importance of awareness and acceptance in present life and restructuring negative thinking pattern to get meaning and importance of life.
One of the main concerns is to understand that suicide is not a solution the problems.
The MBCR module I: sessions 1 and 2 General Introduction and Meditation practice (calming the mind), module II: Session 3 and 4 Object focused meditation and identifying automatic thoughts (knowing the present), module III: Session 5 and 6 Identify the cognitive distortions and breathing exercise (being aware of cognitive distortions), module IV: Session 7 and 8 Body scan and self-talk

(challenging irrational belief), module V: Session 9 and 10 Mindful walking and identifying emotions (realizing the effect of emotions in life), module VI: Session 11 and 12 Space breathing and development of rational thought (hoping for the future), module VII: Session 13 and 14 Yoga and positive self-affirmation (realizing meaning in life), module VIII: Session 15 and 16 Goal setting and conclusion (saying yes, I can).

The supporting theoriesconcepts behind the Mindfulness Based Cognitive Restructuring program are:
Mindfulness and Cognitive Behavior theory specifically the concept on cognitive restructuring.
MBCR program come in the form of integrated psycho-educational programs, workbook activities and intervention strategies on the basis of theoretical models and empirical studies to help the adolescents to provide the way of approaching difficult situations using the mindfulness cognitive skills thereby living more adaptive lives.
The mean scores and standard deviation (SD) values of the participants’ psychache, hopelessness and suicidal ideation as measured by psychache scale, Beck Hopelessness Scale and Beck scale for suicidal ideation revealed the following:
The pretest results of the participants both in the control and experimental groups reported high level of psychache, hopelessness and suicidal ideation.
As per the posttest results, the participants in the experimental group reported lower level of adolescent psychache, hopelessness and suicidal ideation while the control group had almost the same level of adolescent psychache, hopelessness and suicidal ideation as in the pre-test results.
The statistical analysis of the significant difference within subjects results is as follows:
A significant difference was seen in the level of psychache, hopelessness and suicidal ideation of the participants in the experimental group after the intervention of the Mindfulness Based Cognitive Restructuring (MBCR) intervention program.
There was no significant difference detected in the levels of psychache, hopelessness and suicidal ideation of the participants in the control group who did not receive the treatment (MBCR).
The statistical analysis on the significant difference between subjects gave the following results:
According to the pretest results, no significant difference was found between the participants of both the experimental and the control groups ‘before’ the implementation of the intervention program (MBCR).
The posttest results in all the variables show that there is a significant difference between the participants in the experimental group and the control group ‘after’ the implementation of the intervention program (MBCR).
As regards to the extent of the effectiveness of the Mindfulness based Cognitive Restructuring program on the levels of adolescent psychache, hopelessness and suicidal ideation of the experimental group:

The Cohen’s d effect size values reveal that the Mindfulness Based Cognitive restructuring program had a large effect on the participants in the experimental group in all the variables.

5.2 Conclusions

On the basis of the findings of the current study, which explored the effectiveness of the Mindfulness Based Cognitive restructuring program, the following conclusions were drawn.

Prior to the intervention program (MBCR) the research participants had high level of psychache, hopelessness and suicidal ideation, this indicates the need for a program to reduce this feelings
There is a significant difference between the pretest and posttest scores of the participants of the experimental group in all the variables measured after the treatment (MBCR) significant was administered.
There is a significant difference between the scores of the experimental and control group in terms of the posttest results showing the effectiveness of the program (MBCR) in all the dependent variables.
The variant result of all the variables of the experimental group after the treatment proves that the intervention program has a great effect in reducing adolescents’ psychache, hopelessness and suicidal ideation.
The newly developed Mindfulness Based Cognitive restructuring program can be used as an effective tool in reducing adolescent psychache, hopelessness thereby reducing suicidal ideation of adolescents.

5.3. Recommendations

The current study proves the effectiveness of the newly developed intervention program (Mindfulness Based Cognitive Restructuring (MBCR), in reducing the adolescent psychache, hopelessness and suicidal ideation. Therefore, the researcher recommends the following for future research:

There is a need to make further studies on suicidal individuals the development of appropriate preventive intervention methods based on different culture and gender.
The study was limited to only female college adolescents, with a medium sample size of 18 participants for the experimental group. However, the analysis of the outcome data for the study hypotheses yielded statistically significant results as described in the summary of results. A study using larger sample sizes and different population must be conducted.
An in-depth study by using qualitative method to explore suicidal behavior of the adolescents in the Kerala society could be undertaken to further improve and make the intervention more comprehensive.
Mental health professionals and psychologists are encouraged to examine and implement the intervention strategies for the adolescents who are struggling with different problems.
The researcher recommends choosing the participants from different settings, urban and rural, private and public schools to show the accuracy and effectiveness of the MBCR intervention program since the current study is limited only to female students from the government schools in Kerala.
It is also recommended that teachers be trained on how to implement the current Mindfulness Based Cognitive Restructuring program as a way of helping themselves in their own pedagogical approach, and at the same time helping their students to cope with their adolescent students’ day to day problems.
The present study used the quantitative research design. Other research methods/designs may also be utilized to shed light on the findings of the study and to better describe the cause and effect of the independent and dependent variables.
The use of culture-based intervention program should be explained to find significant results among the participants.
Life-oriented Mindfulness Based Cognitive Restructuring program be incorporated along with curriculum-based or career-oriented education.
Finally, longitudinal research is necessary to confirm the strength and effectivity of the newly developed intervention program (MBCR) used in the current study.

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