Emotion-Focused Mindfulness Therapy: A Feasibility Study for Late Life Anxiety
Condition: Anxiety
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      Canadians 65 and older experience anxiety at a rate of 6.4%, affecting more than 300,000
      people. In Ontario, 5.6% of adults 65 and older have anxiety, representing over 100,000
      people. Eastern Ontario primary care clinics report significantly higher numbers of adults 65
      and older diagnosed with anxiety at between 28% and 30%, representing approximately 4,600
      people diagnosed with anxiety. Costs to the Canadian health care system of anxiety in
      community dwelling adults aged 65 and older have been estimated at $61.2 to $119.8 million
      per 1,000,000 people. These costs can reasonably be expected to increase by 2021 when the
      percentage of older adults 65+ with mental illness is estimated to be approximately 30% of
      the older population base.

      Anxiety in older adults has been linked retaining new information and the instrumental
      activities of daily living, sleep disturbance, suicidal ideation particularly among men, and
      increased use of health care services. Present pharmacological treatments for anxiety in
      older adults have met with limited success. Mindfulness-based interventions (MBIs) are an
      area of research interest in the treatment of anxiety. The use of MBIs has shown a trend
      toward self-reported lower levels of chronic stress and psychological stress among older
      adults small scale RCTs and qualitative studies.

      Emotion focused mindfulness meditation therapy (EFMT) is a MBI that shows promise. EFMT has
      been demonstrated to reduce symptoms of anxiety in general populations. EFMT's focus on
      meditation and the felt sense of emotions, rather than learning new material, may make it a
      promising intervention for reducing symptoms of anxiety for older adults who often report
      normal aging problems such as general forgetfulness and difficulty with word recall. EFMT may
      be a potentially promising intervention that has not yet been tested in older adults. EFMT
      can be offered in primary care, community and hospital settings. Further research is required
      to determine if EFMT could reduce anxiety for older adults.
    

Detailed description: 
      The purpose of this small scale RCT is to determine the feasibility and acceptability of EFMT
      among community dwelling older adults who experience anxiety. This study has the following
      three aims: to determine if participants can be recruited, enrolled, and retained; to
      determine if participants can adhere to all components of the intervention; and to determine
      the extent to which participants who receive the intervention have decreased levels of
      anxiety compared to those who do not receive the intervention. The secondary outcomes will be
      to determine the extent to which participants who receive the intervention have improved
      sleep quality, and improved subjective memory functioning compared to those who do not
      receive the intervention.

      This will be a small pilot RCT study that will use a wait list control trial design.
      Participants will be randomly allocated to either the intervention or control group.
      Emotion-Focused Mindfulness Therapy (EFMT) is a group intervention consisting of eight weekly
      meetings of 2.5 hours with 10 - 12 participants per group. Participants are provided
      instruction that encourages noting and experiencing bodily sensations and emotions during
      meditations. Meditations are conducted in silence for between twenty and thirty-five minutes,
      and then participants are asked to journal their recollection of the meditation and
      experiences that arise for them as they journal. Following journalling, each participant
      describes their experience in meditation, with the facilitator offering empathic exploration
      to support transforming negative emotions into adaptive emotions.

      The study will be conducted in an online delivery PHIPPA protected platform and has been
      modified to accommodate electronic delivery. Maximum number of participants per group will be
      six, and each session will be 1.5 hours. Data will be collected at three points by a research
      assistant to evaluate the feasibility of EFMT for older adults and determine whether anxiety
      is influenced by the intervention.
    

Intervention name(s): Emotion-Focused Mindfulness Therapy
Intervention type(s): Other
Intervention description(s): EFMT is a group intervention of 8weekly meetings of 2.5 hours with 10 - 12 participants per group. Participants are provided instruction that encourages noting and experiencing bodily sensations and emotions during meditations. Meditations are conducted in silence for between 20 and 35 minutes. Participants are asked to journal their recollection of the meditation and experiences that arise for them as they journal. Each participant then describes their experience in meditation, with the facilitator offering empathic exploration to support transforming negative emotions into adaptive emotions.
The study will be conducted in an online PHIPPA protected platform and has been modified to accommodate electronic delivery. Maximum number of participants per group will be six, and each session will be 1.5 hours. Data will be collected at three points by a research assistant to evaluate the feasibility of EFMT for older adults and determine whether anxiety is influenced by the intervention.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This will be a small pilot RCT study that will use a wait list control trial design. Participants will be randomly allocated to either the intervention or control group
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: anxiety; aging and health; adults aged 65 and older; mindfulness based intervention; meditation