202 Participants Needed

Mindful Self-Compassion for PTSD

(MSC for PTSD Trial)

DR
MM
Overseen ByMechelle Monroe, LMFT
Age: 18+
Sex: Female
Trial Phase: Academic
Sponsor: University of California, Los Angeles
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants must stop taking their current medications. It is best to discuss this with the research team or your healthcare provider.

What data supports the effectiveness of the treatment Mindful Self-Compassion for PTSD?

Research shows that self-compassion, which is a key part of the Mindful Self-Compassion program, is linked to lower PTSD symptoms and better overall mental health. Studies with veterans found that self-compassion and mindfulness together can reduce PTSD symptoms and improve daily functioning.12345

Is Mindful Self-Compassion safe for humans?

Mindful Self-Compassion (MSC) programs, which include practices like loving-kindness meditation, have been shown to be safe and acceptable for participants, with studies indicating they can reduce symptoms of PTSD and depression without reported safety concerns.13567

How is the Mindful Self-Compassion treatment different from other PTSD treatments?

Mindful Self-Compassion (MSC) is unique because it focuses on cultivating self-kindness, recognizing shared human experiences, and maintaining mindful awareness of suffering, which can help reduce PTSD symptoms. Unlike other treatments, MSC is an 8-week program that includes meditations and informal practices to integrate self-compassion into daily life, potentially offering a novel approach to managing PTSD.12456

What is the purpose of this trial?

Trauma exposure, posttraumatic stress disorder (PTSD), and substance use disorder (SUD) present major threats to public health. PTSD and SUD are major correlates of disability, often resulting in severe social and occupational impairment. Comorbidity between PTSD and SUD (PTSD/SUD) is common and frequently co-occurs with other mental health ailments including depression, anxiety, and suicidality. Comorbidity may be amplified in groups vulnerable to high trauma exposure, such as women with low socioeconomic status including women experiencing homelessness (WEH). Moreover, the reciprocal nature of PTSD/SUD (substances are used to cope with PTSD symptoms; substance use can create high-risk situations for new traumas to occur), can create a cycle of trauma and symptomatology leading to a critical health disparity.PTSD/SUD can be costly and difficult to treat, with treatment completion often low and relapse rates often high. Low-cost, complementary interventions, such as self-compassion (SC) interventions, which target key mechanisms that maintain PTSD/SUD, could improve treatment outcomes. SC interventions include practices that build skills to improve emotional responses, cognitive understanding, and mindfulness. Recent research supports the benefit of SC interventions for reducing PTSD, SUD, and related comorbidities, potentially with large effects. However, sample sizes have generally been small and randomized designs infrequently used. Moreover, while SC interventions may act to improve key mechanisms of treatment response and/or symptom maintenance (e.g., emotion regulation/dysregulation, trauma-related guilt, trauma-related shame, moral injury, and craving), such mediating factors have been underexplored. To address these limitations, the present proposal will implement community-based research principles and use a two phase, mixed-method design to adapt and test a widely used SC intervention (Mindful Self Compassion; MSC) for use with a sample of WEH with PTSD/SUD. The project will be conducted in partnership with a state-funded drug treatment facility that serves women and families experiencing high health disparities.Phase I was completed in 2023 and adapted the standard MSC course for use with trauma-exposed WEH with PTSD/SUD using the ADAPT-ITT model, an eight-stage model that engages community partners to increase feasibility and acceptability of interventions for at-risk populations.Phase II will be an open-label cluster randomized clinical trial (N=202) to test the benefit of the adapted MSC at improving primary (PTSD, substance use) and secondary outcomes (depression, anxiety, hopelessness) among a sample of WEH with PTSD/SUD residing in a residential drug treatment site. MSC (n=101) will be compared to Treatment as Usual (TAU; n=101). WEH in the MSC group will complete a 6-week (six sessions plus a half-day retreat) MSC intervention.The TAU group will engage in weekly check-ins with the research team but will not receive an intervention. WEH will be assessed at baseline, immediately post-intervention, and at a 4-month follow-up. One-on-one interviews will be conducted with the MSC group to collect qualitative data on experiences. An exploratory aim will be to elucidate mechanism of treatment-response and maintenance or remission of PTSD symptoms. These potential mechanisms will include SC, emotion regulation/dysregulation, trauma-related guilt, trauma-related shame, moral injury, and craving.Results may inform treatment for PTSD/SUD in WEH and other groups experiencing high health disparities and provide valuable insights into mechanisms underlying PTSD/SUD symptoms over time. Findings are relevant to military populations, which experience high rates of PTSD/SUD, and other populations disproportionately exposed to trauma.

Eligibility Criteria

This trial is for unhoused women with PTSD and substance use disorders. Participants should be experiencing homelessness, have low socioeconomic status, and may also suffer from depression or anxiety. They must reside in a residential drug treatment site to participate.

Inclusion Criteria

I am a woman aged 18 or older.
Probable PTSD as judged by the PCL-5 (score of 31 or higher)
No cognitive impairment according to a score of < 10 on the Short-Blessed Test
See 2 more

Exclusion Criteria

Judged to be cognitively impaired, as indicated by score > 10 on the Short-Blessed Screener
Do not meet other inclusion criteria

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants in the MSC group complete a 6-week intervention consisting of six sessions and a half-day retreat

6 weeks
6 sessions plus a half-day retreat

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at baseline, immediately post-intervention, and at a 4-month follow-up

4 months
Assessments at baseline, post-intervention, and 4-month follow-up

Open-label extension (optional)

Participants may opt into continuation of treatment long-term

Long-term

Treatment Details

Interventions

  • Mindful Self Compassion
Trial Overview The study tests Mindful Self Compassion (MSC), adapted for trauma-exposed women with PTSD/SUD, against Treatment as Usual (TAU). It's an open-label cluster randomized trial where participants either attend a 6-week MSC program or receive regular check-ins without intervention.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Treatment as UsualExperimental Treatment1 Intervention
Selecting appropriate attention control groups for behavioral intervention research, particularly for mindfulness-based interventions, can be problematic. Comparator groups often also improve as they tend to target related mechanisms (e.g., social support, health behaviors, improved attention). After weighing the pros and cons, a "treatment as usual" (TAU) approach was selected, whereby the MSC will be compared to TAU. However, to control for the confound of weekly compensation, TAU participants will meet with study staff seven times over the 6-week period and fill out short psychosocial surveys on non-distressing topics (e.g., personality tests, attitudes surveys) in exchange for compensation commensurate with the MSC group. We believe this will also help with retention of the TAU group over time and strike an appropriate balance between controlling for the effects of study participation while minimizing confounds that often occur with active control groups in behavioral trials.
Group II: Mindful Self Compassion ClassesExperimental Treatment1 Intervention
(MSC) is a mind-body integrative health intervention that utilizes meditations, other contemplative practices, home practices, and experiential exercises (including group discussions) to increase SC. MSC can be done in groups of 10-25. To increase feasibility of MSC for use in residential drug treatment facilities we will aim to adapt MSC to 7 sessions (6 weekly sessions in alignment with the MSC short course plus the half day retreat included in the full course to facilitate skill consolidation). Sessions will be conducted in a group-based format: prior research found group-based formats equivalent to individual-level interventions for PTSD/SUD.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials
1,594
Recruited
10,430,000+

Findings from Research

Self-compassion, which includes self-kindness, common humanity, and mindfulness, is linked to better mental health and less psychological distress, highlighting its importance in emotional well-being.
The Mindful Self-Compassion (MSC) program, an 8-week course with weekly sessions, effectively teaches participants to develop self-compassion through various meditative and practical exercises, demonstrating its potential as a therapeutic intervention.
Self-compassion in clinical practice.Germer, CK., Neff, KD.[2013]
The study involved seven participants with posttraumatic stress disorder and used semi-structured interviews to explore their experiences of developing self-compassion, revealing that self-criticism was a significant part of their identity and initially made self-compassion feel aversive and frightening.
Despite these challenges, participants found that through therapy and a supportive therapeutic relationship, they could overcome their fears and eventually experience positive emotions associated with self-compassion, suggesting that the journey from self-criticism to self-compassion is possible and can lead to improved psychological well-being.
An exploration of people's experiences of compassion-focused therapy for trauma, using interpretative phenomenological analysis.Lawrence, VA., Lee, D.[2014]
An 8-week Compassionate Mind Training (CMT) course for 55 participants led to significant improvements in self-compassion, well-being, and positive emotions, while reducing self-criticism and distress, with effects maintained at a 3-month follow-up.
The study suggests that CMT can be a beneficial intervention for enhancing psychological health in community settings, highlighting the importance of self-compassion in improving overall well-being.
Compassionate Mind Training: An 8-week group for the general public.Irons, C., Heriot-Maitland, C.[2021]

References

Self-compassion in clinical practice. [2013]
An exploration of people's experiences of compassion-focused therapy for trauma, using interpretative phenomenological analysis. [2014]
Compassionate Mind Training: An 8-week group for the general public. [2021]
Mindfulness, Self-Compassion, Posttraumatic Stress Disorder Symptoms, and Functional Disability in U.S. Iraq and Afghanistan War Veterans. [2023]
Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans. [2021]
Self-compassion, trauma, and posttraumatic stress disorder: A systematic review. [2021]
Loving-kindness meditation for posttraumatic stress disorder: a pilot study. [2022]
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