Subjects: Psychology >> Applied Psychology submitted time 2024-06-06
Abstract： In recent years, mindfulness interventions have been applied across various fields and have achieved significant efficacy. With the widespread adoption of mobile Internet, online mindfulness interventions are flourishing, thus holding tremendous potential. However, a prominent issue is the generally low adherence of participants in such online mindfulness interventions. Concurrently, previous studies have demonstrated that poetry is also regarded as an important supplement to psychotherapy and mindfulness intervention therapy. Yet, no research has been conducted on the integration of Chinese classical poetry and mindfulness interventions—a topic that warrants further exploration. Moreover, Chinese classical poetry possesses distinct Chinese characteristics and is a highly appreciated literary art form among the local population. Therefore, based on the above propositions, this study considers the feasibility of integrating Chinese classical poetry into mindfulness intervention and whether it can enhance participants’ adherence.
In Study 1, a 49-day online self-help mindfulness intervention incorporating Chinese classical poetry was developed based on Mindfulness Intervention for Emotional Distress (MIED) and poetry therapy. A total of 54 participants were recruited online who completed the pre- and postintervention assessments, including measures of mindfulness, perceived stress, and general well-being. The participants were required to answer additional questions regarding the feasibility of the intervention within one week postintervention. Then, the effectiveness of the intervention was analyzed using paired samples t-tests, whereas its feasibility was evaluated across five dimensions: Acceptability, Demand, Implementation, Practicality, and Limited-efficacy testing. In Study 2, 258 participants were recruited online and randomly assigned to Group A or Group B. Group A attended a mindfulness intervention program that integrated Chinese classical poetry, while Group B attended the same program without poetry. In the end, a total of 245 participants joined the study (118 in Group A and 127 in Group B). All participants were required to complete pre-, mid-, and postintervention assessments measuring mindfulness, perceived stress, and general well-being levels. Furthermore, the intervention’s effectiveness was examined using repeated measures analysis of variance (ANOVA), whereas the impact of the presence or absence of Chinese classical poetry on participants’ adherence was analyzed using chi-square tests.
The results confirmed the feasibility of the developed online self-help mindfulness intervention integrating Chinese classical poetry in terms of Acceptability, Demand, Implementation, Practicality and Limited-efficacy testing, with participants perceiving the intervention as effective. The results of Study 2 demonstrated that both programs with and without poetry significantly improved participants’ mindfulness, perceived stress, and general well-being levels. However, the former significantly enhanced participants’ adherence. In addition, compared with the overall adherence levels of current online mindfulness interventions (ranging from 35% to 92%), the participants’ adherence to the proposed online intervention with Chinese classical poetry (84.75%) is relatively high. Finally, the study also found that integrating poetry into mindfulness interventions enhanced the majority of Chinese individuals’ engagement and completion rates, regardless of their personal preferences for Chinese classical poetry at baseline.
This study represents the first integration of Chinese classical poetry into mindfulness intervention, resulting in a program enriched by Chinese cultural elements. The program facilitates the combination of outstanding traditional Chinese culture with modern psychological theories and practices, fostering their creative transformation and innovative development. Furthermore, the purely online self-help program employed in this study reduces reliance on therapists while simultaneously enhancing participants’ adherence. At the same time, this study provides more possibilities for the widespread application of mindfulness intervention and provides individuals with more choices for mental health treatment. Overall, these contributions hold significant practical significance and social value.
Subjects: Other Disciplines >> Synthetic discipline submitted time 2023-10-09 Cooperative journals: 《心理科学进展》
XU Shaoqing
LIU Xinhua
ZHANG Huiping
LI Bo
TANG Xinfeng
QU Gaiping
BAO Yuqin
ZHAO Junping
FU Zhongfang
Abstract： Test anxiety directly impacts academic performance and can have extreme consequences, including school dropout, self-injury, and even suicide. Nevertheless, most current interventions for text anxiety focus on its individual components, which complicates achieving satisfactory results. Mindfulness, a method of consciousness training in Buddhist meditation, has been scientifically examined since being extracted from the Buddhist system and secularized. It has two core characteristics: (1) attention to and awareness of one’s inner experience of the present moment and (2) an open, accepting attitude toward one’s inner experience. In recent years, the academic community has applied mindfulness in interventions for test anxiety, which are collectively referred to as “Mindfulness Interventions for Test Anxiety” (MI-TA).The NIH stage model, originally proposed to promote the implementation and dissemination of psychological interventions, divides the development of interventions into six stages: basic research, intervention generation and refinement, efficacy testing, mixed efficacy-effectiveness testing, effectiveness testing, and implementation and dissemination. A closed-loop connection is formed between the stages, meaning that the development of any intervention following the model is an iterative, recursive process. Inspired by the model, we distinguished five attributes of intervention research: mechanism exploration, intervention model design, efficacy testing, effectiveness testing, and implementation and dissemination. By extension, we outlined three research orientations from past studies on MI-TA: initially testing efficacy, refining and optimizing the model, and promoting implementation and dissemination. The current status of each approach is presented and discussed in our review.First, using target analysis, we conceptualized the mechanisms by which mindfulness training affects test anxiety. For one, mindfulness training emphasizes the awareness and acceptance of bodily sensations, which helps to relax physiological indicators and tensions induced by test anxiety and promotes emotional regulation. For another, mindfulness training emphasizes the awareness and acceptance of thoughts and emotions, which helps both to reduce worrying thoughts and cognitive interference caused by test anxiety and to sustain cognitive efficacy. Last, mindfulness training can promote de-reification and self-compassion, which can help to resist the self-depreciation caused by test anxiety and safeguard self-worth.Second, by comparing the practical components and effects of single-session, short-duration mindfulness exercises with those of MI-TA of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT), we found that such exercises mostly included only focused attention (FA) meditation and lacked open monitoring (OM) meditation. Whereas FA mainly acted on the physiological indications and tension-related components of test anxiety, OM acted on the components of worrying and cognitive interference. FA and OM are different components of complete mindfulness practice and cannot be biased or replaced by each other.Regarding the core principles of MBSR, the requirements of teaching methods, and teaching objectives, we analyzed two optimized MI-TA models that integrate Dialectical Behavior Therapy (DBT) mindfulness skills and integrated self-leadership strategies. As a result, we found that both could be improved in by adhering core teaching intentions, valuing the practical experience, organically integrating the components of the intervention for test anxiety, and improving the ease of implementation. Future interventions should be designed to capture the pedagogical intention of mindfulness interventions, integrate components specific to test anxiety, and weigh the curricular structure for specific contexts of implementation.Next, based on a review of two types of studies that promote the implementation and dissemination of MI-TA by approaching real-world target groups relying on multimedia and digital self-help interventions, we propose that future real-world-based interventions should take into account the external environment (e.g., regional economic, social, and cultural factors), the internal environment (e.g., schools’ organizational characteristics, cultural climate, and communication characteristics), stakeholders (e.g., intervention providers, school administrators, parents, and students), and the implementation process, including planning, participation, implementation, evaluation, and reflection. Likewise, studies on such interventions should vigorously adhere to the framework of implementation science.Last, we propose three research perspectives in light of the original intention of the NIH stage model and the specificity of mindfulness interventions: (1) focusing on continuously testing and clarifying the efficacy mechanisms of MI-TA at each stage by following the basic guidelines for identifying efficacy mechanisms; (2) taking special consideration of the study design, intervention model, control measures, and selection and measurement of outcome indicators by using the PRagmatic Explanatory Continuum Indicator Summary(PRECIS) -2 tool; and (3) enhancing the accuracy and adequacy of the interpretation of effects in research on MI-TA by being sensitive to the basic tenets of mindfulness interventions (e.g., including open monitoring, collecting data on intervention adherence, emphasizing the learning of attitudes of mindfulness, and considering the influence of different understanding of self between Eastern and Western cultures).
Subjects: Psychology >> Clinical and Counseling Psychology submitted time 2023-07-13
XU Shaoqing
LIU Xinhua
ZHANG Huiping
LI Bo
TANG Xinfeng
QU Gaiping
BAO Yuqin
ZHAO Junping
FU Zhongfang
Abstract： Because interventions to reduce test anxiety’s detrimental consequences have remained ineffective, the academic community has begun to introduce the concept of mindfulness into such interventions following the concept’s repeated validation. The NIH stage model, aimed at promoting the implementation and dissemination of psychological interventions, divides the development of interventions into six stages: basic research, intervention generation and refinement, efficacy testing, mixed efficacy–effectiveness testing, effectiveness testing, and implementation and dissemination. In our study, we therefore organized past studies on mindfulness-based interventions for test anxiety according to the NIH’s model. First, we explored the potential mechanism underlying mindfulness when it comes to treating test anxiety. Second, we summarized three dominant approaches, labeled “initial evaluation of treatment,” “refinement of intervention,” and “promotion of implementation and dissemination,” all rooted in previous evidence. Last, considering the NIH’s model and the uniqueness of mindfulness as an intervetion, we encourage future research focused on exploring the mechanism of change and implementing pragmatic research while being sensitive to four aspects of recent studies on mindfulness: the inclusion of open monitoring, the proper assessment of treatment adherence, increasing attention to how mindful attitudes are learned, and the possible influence of different understandings of self between Western and Eastern cultures.
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