An Online Compassion-Focused Intervention for those Experiencing the Menopausal Transition: A Feasibility Study
Creators: name: PICKUP, TABITHA ALICE
Publisher: name: University of Surrey
Year: 2022

description: <b>Overview</b><br>
description: <br>
description: The menopausal transition will affect half the population for potentially half of their life.
description: Menopause occurs because of decreasing ovarian functioning, either gradually (naturally) or
description: induced through treatment (i.e. cancer treatment). It has been described as a bio-psychosocial-cultural life transition, which reflects the all-encompassing effect it can have upon
description: someone’s life. Psychological interventions are indicated by menopause professional bodies
description: either as a standalone or adjuvant intervention, however, are under recommended and under
description: provisioned. This portfolio therefore contributes to research on psychological interventions
description: for the menopause by firstly reviewing current literature and then investigating a compassionfocussed intervention for the menopause.<br>
description: <br>
description: Part one of this portfolio presents a systematic literature review of psychological
description: interventions for the menopause, and a meta-analysis of psychological outcomes. The results
description: indicate that psychological interventions for the menopause offer small to medium effects
description: upon various psychological outcomes, however, more research is indicated to develop
description: effective interventions for menopausal anxiety.<br>
description: <br>
description: Part two of this portfolio presents an empirical paper that investigates the feasibility,
description: acceptability, and signal of efficacy of a low intensity, compassion-focussed intervention for
description: the menopause that was delivered entirely remotely. Research has indicated the possibility of
description: compassion being a resilience factor that could be utilised during the menopause. These
description: results suggested that the online low intensity, compassion focussed intervention was
description: feasible, acceptable, and demonstrated a signal of efficacy upon key menopause and
description: compassion outcomes. <br>
description: <br>
description: <b>Abstract 1</b><br>
description: <br>
description: The menopause transition affects half the population and can lead to a variety of experiences,
description: both physical and psychological difficulties, such as depression or anxiety. Eighty percent
description: report experiencing difficulties with 25% reporting that these are severe. As such, menopause
description: may be a critical window for mental health support, especially for those who have previously
description: struggled with poor mental health being four times more likely to have a depressive episode
description: during menopause. Psychological interventions are recommended by professional bodies as a
description: frontline intervention during menopause, either standalone or adjuvant to hormone replacement
description: therapy, although, provision is lacking. Prior reviews focus on physical outcomes, only one
description: type of psychological intervention, or do not incorporate all psychological outcomes. As such,
description: this review aimed to estimate the overall effect of psychological interventions for the
description: menopause upon clinical and non-clinical psychological outcomes and explore subgroup
description: analyses between intervention types. A systematic search of literature elicited 29 randomised
description: controlled trials (RCTs) which met inclusion criteria. Twenty-one papers, representing 1754
description: participants has suitable data to be included in the meta-analysis, remaining papers were
description: narratively reviewed. Post-data points for control and intervention groups were extracted and
description: study quality assessed using the Risk of Bias 2 tool (RoB2) from the Cochrane collaboration.
description: Psychological interventions for the menopause were found to have an overall small to medium
description: effect upon depression and psychological distress outcomes, but not anxiety. Narrative review
description: results generally supported meta-analytic findings. Subgroup analysis found significant effects
description: persisted for cognitive behavioural therapy and mindfulness interventions, but not behaviour
description: change interventions. Limitations include high risk of bias ascertained by RoB2, due to use of
description: self-report measures. Future research should seek to recruit more diverse samples and address
description: lack of effectiveness of psychological interventions upon menopausal anxiety. <br>
description: <br>
description: <b>Abstract 2</b><br>
description: <br>
description: Eighty percent of those going through the menopause have difficulties during this bio-psychosocial-cultural life transition. As such the menopause may provide a critical window to develop resilience and promote psychological wellbeing and healthy aging. Psychological therapies for menopause are indicated by professional bodies, however, provision is lacking, hence costeffective low intensity interventions could be a solution. Compassion has been indicated as apotential resilience factor during menopause and self-criticism, a vulnerability factor.Compassion Focussed Therapy (CFT) aims to support development of a compassionate mind to tackle shame and self-criticism by moving people to a compassionate motivation system. This study is the first to investigate the feasibility, acceptability and a signal of efficacy of an online, low intensity, compassionate imagery intervention for the menopause. The sample consisted of 113 participants aged 24 to 66 years old going through the menopausal transition. The intervention was a two-week remotely delivered compassionate imagery intervention, consisting of daily videos. Participants completed measures on menopause beliefs, health related quality of life, self-criticism, self-reassurance, and fears of compassion. Recruitment was successful, but attrition rates were high, possibly due to digital burnout because of the Covid19 pandemic.
description: After intervention, improvements were found for menopause beliefs, selfcriticism, and self-reassurance, representing large effects, with medium to large effects maintained at follow up. Quality of life and fears of compassion outcomes showed nonsignificant changes. Qualitative analyses supported quantitative findings. This intervention demonstrated feasibility, acceptability, and a promising signal of efficacy upon key outcomes. Results are limited by not having a control group, per-protocol analyses, and impact of the Covid19 pandemic. Further feasibility research could be beneficial, however, moving to randomised control trial with health economic analyses could also be justified.<br>