Is self-help mindfulness-based cognitive therapy beneficial for healthcare staff? A pilot randomised controlled trial

1. Stress: The stress subscale of the Depression Anxiety Stress Scales (DASS-21). The DASS-21 is a short version of the 42-item DASS. The DASS-21 is a set of three 7-item self-report scales designed to measure stress, depression, and anxiety. Each of the 21 items describes a negative state and participants are asked to use a 4-point Likert-type scale to rate the extent they have experienced this state over the past week. The DASS-21 subscales have been found to validly measure stress, anxiety and stress; in non-clinical populations, as well as tapping a more general dimension of psychological distress. The internal consistency and concurrent validity of the scale and subscales have been reported to be in the acceptable to excellent ranges.
2. Compassion for Others: The Compassion Scale adapted for this study. We will use an adapted version of Neff and Pommier’s scale. This 24-item scale measures compassion directed towards others and is based upon a definition of compassion adopted from Neff’s model of self-compassion. Neff’s model proposed that compassion entails kindness, common humanity, and mindfulness. The compassion scale is composed of six subscales based on six factors: kindness vs indifference, common humanity vs separation, and mindfulness vs disengagement. The internal consistency, concurrent and convergent validity of the scale have been reported to be good. The adapted version includes 10 additional questions to broaden to scope of the measure in order to measure multiple aspects of compassion for others.
3. Sickness Absence: The number of days of sickness absence in the three months prior to the intervention and in the three months following the intervention, as recorded by the trust Human Resources department, will be used as a measure of days of sickness absence taken by participants

1. The anxiety and depression subscales of the Depression Anxiety Stress Scales (DASS-21): The anxiety and depression subscales of the DASS-21 will be used as a secondary outcome measure in the pilot and main trial. The internal consistency and concurrent validity of the scale and subscales have been reported to be in the acceptable to excellent ranges.
2. Five-Facet Mindfulness Questionnaire – Short Form (FFMQ-SF): This 24-item scale assesses five facets of mindfulness. It has been reported to have good indices of reliability and validity. The FFMQ-SF will be used in the pilot and main trial to asses whether the MBCT-SH intervention has the intended effect of increasing mindfulness skills.
3. Self-compassion Scale – Short Form (SCS-SF): The SCF-SF will be included in the pilot and main trial as a secondary outcome measure. Self-compassion is an important aspect of mindfulness (Kuken et al., 2010) not included in the FFMQ-SF. The 12-item SCS-SF yields a total self-compassion score. It has reported to have good reliability, validity, and internal consistency (Cronbach’s alpha = 0.86). Further, it was found to have the same factor structure and to correlate almost perfectly with the longer form of the SCS (r = 0.98).
4. Short Warwick-Edinburgh Mental Well-being Scale (SWEMWS): The short version of the Warwick-Edinburgh Mental Wellbeing Scale is a 7-item measure of wellbeing. This will be used in the pilot and main trial to evaluate the effects of the intervention beyond changes in symptoms of psychological distress. It has been found to have good reliability, validity and internal consistency.
5. The Maslach Burnout Inventory (MBI): The MBI will is a 22-item self-report inventory using a Likert scale that measures three facets of job-related burnout: emotional exhaustion, depersonalisation, and reduced personal accomplishment. Several studies have found mindfulness-based interventions to be effective in decreasing job burnout as measured using the
MBI. The MBI is the most widely used measure of burnout in the field, and its psychometrics and validity are well evidenced.
6. Intervention adherence: The number of participants in the MBCT–SH intervention group who sufficiently complete the intervention will be recorded via self-report questions on the post-intervention questionnaire. Sufficient completion of the intervention is defined in line with the MBCT literature as at least 50% adherence to the intervention. In this study, 50% adherence for participants in the MBCT self-help intervention condition is defined as:
6.1. Reading at least 50% of the MBCT-SH book
6.2. Engaging with at least 4 mindfulness practices during the intervention
7. Participant Engagement: Participant engagement will be measured using a brief questionnaire that participants in the intervention group will be asked to complete weekly. The questionnaire will participants to indicate the duration and frequency of their engagement with the intervention materials (for example, time spent reading the book, number of chapters/pages read or online modules completed) and mindfulness exercises and practices (for example, duration and frequency of practice), on a Likert-type scale, in the past week. After the intervention has ended, all participants will be asked the same questions but in reference to the duration of the intervention.