Self-compassion in the context of cancer: development and evaluation of an mHealth integrated self-compassion intervention for people with newly diagnosed cancer

People who are diagnosed with cancer face myriad psychological, social and physical challenges. They are at greater risk for anxiety and depression and many patients experience distress. However, few patients seek psychological care. The aim of this project is to develop a low-threshold supportive mHealth intervention that helps patients cope with the emotional consequences of their diagnosis. Self-compassion, a way of responding to difficulties with kindness and wise, caring action (rather than, for example, self-criticism), is a way of self-relating that can increase well-being and reduce distress. In this project, theory and research on self-compassion are integrated with an iterative, participatory design approach. Co-creative workshop rounds with patients and nurses are conducted to develop an intervention that is tailored to their wishes, needs and experiences. After a co-design phase of two years, a cross-sectional pilot study is conducted to evaluate the feasibility and outcomes of the intervention.

Contact person: Judith Austin; Stans Drossaert, Ernst Bohlmeijer

Enhancing full recovery in patients with bipolar disorder

Bipolar disorder (BD) is a severe mental disorder. Besides clinical recovery, it is important to also strive for improvement of mental well-being and personal recovery. We will conduct a randomized controlled trial to assess the effectiveness of an 8-week positive psychology intervention (“Living well with bipolar disorder”) adjusted for people with BD and delivered in groups of 6-8 people. We are interested whether the intervention improves well-being, personal recovery, psychopathology, self-compassion, positive relationships, dampening of positive affect and relapse rates. The objective of the study is to assess whether the positive psychology intervention offered to BD patients in remission in addition to care as usual (CAU) is more effective than CAU only. The intervention includes several exercises, for example on (self-)compassion, positive emotions, optimism and positive relationships. People with BD were involved in the development process to improve the fit of the intervention to the target group.

Contact person: Jannis Kraiss; Ernst Bohlmeijer

Brein de baas – Cognitive Bias Modification

Although people who are addicted to alcohol are mostly conscious about the long-term negative consequences of their drinking pattern, their impulsive processes gain control over their behavior. In this research project we focus on influencing this impulsive process by offering cognitive bias modification (CBM) training to outpatients in addiction care and problem drinkers from the general public. In a randomized controlled trial, 140 outpatients from Tactus Addiction Care received computerized CBM next to their treatment as usual. In this training, patients were asked to push pictures of alcohol away on the screen and pictures of non-alcohol towards them.
Next to this RCT with outpatients, a mobile app was developed to make the CBM training easier to use and more accessible to a larger public, like problem drinkers from the general public. After a succesful pilot with the breindebaas app, we are working on an improved version.

Contact person: Melissa Laurens, Marloes Postel

‘Working to sustainable mental health’

Scientific substantiation of the Mindfit treatment model

Within mental health care there are several new developments: the importance of positive mental health, short-term treatment and the increasing digitization. Central to these developments are shared-decision-making and the client’s self-direction. Based on these developments, Mindfit (a primary mental health care institution) invented a unique treatment model. The model focuses on both symptom reduction and the promotion of positive mental health. This corresponds to the sustainable mental health model (SMHM) of Bohlmeijer and Westerhof (in press), in which psychological complaints and mental well-being are two different complementary indicators of mental health. Mindfit wants to scientifically substantiate and evaluate their treatment model. However, it is too premature to do a randomised controlled trial. Therefore, six different studies will be conducted examining the different phases op the Mindfit Treatment model. The aim is to develop insights and instruments that contribute to the optimization and standardization of an innovative treatment practice in primary mental health care that concentrates on establishing sustainable mental health.

Contact persons: Pauline van Schuffelen; Ernst Bohlmeijer

ACT online for older adults with anxiety in primary care

In this researchproject, the (cost)-effectiveness of a blended Acceptance and Commitment Therapy (Voluit Leven) is compared to treatment as usual in treating anxiety and enhancing positive mental health in adults aged 55-75 with anxiety complaints. Over 300 participants were recruited in 37 general practices in the Netherlands, where treatments were provided by mental health counselors working in these practices.  Exploratively, it will be examined to what extent certain baseline characteristics are predictive of outcome (effect modification) and to what extent changes in emotion regulation, behavioral avoidance, quality of the relationship with the mental health counselor and time spent on the intervention, mediate treatment outcomes.

Contact persons: Maartje Witlox (Rijksuniversiteit Leiden), Philip Steenhoven, Ernst Bohlmeijer

Preparing for and recovering from spinal surgery: can eHealth with pain education and positive psychology help?

Low back pain is highly prevalent worldwide, affecting up to 80% of the population at least once in their lifetime, whilst 10% of these patients develop chronic pain. Spinal lumbar fusion surgery can be used to treat patients with certain types of low back pain. However, there are no guarantees the pain will be gone after surgery. About 65% to 75% of spinal surgeries are effective in achieving reduction of pain and improvement of physical functioning. Nonetheless, recovering from surgery is often accompanied by moderate to severe postoperative pain, with a worldwide prevalence of 40-60%.

To prepare spinal surgery patients for the procedure and help them cope with possible surgery-resistant pain, an eHealth application (app) is being developed. Because surgery is just one event in a patients’ lifetime full of health-related experiences, the current eHealth application focuses on long-term, sustainable recovery by providing pain education, procedural information and elements of positive psychology (including value based activities and acceptance). The content of the application is created with the help of future users, i.e. patients and health care professionals. Individual interviews and focus groups are held, clarifying wishes and needs for the app, resulting in a prototype of the app. To test the usability and feasibility of this prototype, a feasibility study will be performed at the orthopedic centre (OCON) in Hengelo.

Contact person: Annemieke van der Horst; Saskia Kelders; Karlein Schreurs; Ernst Bohlmeijer

Butterfly effect of self-compassion in crisis line volunteers.

Volunteers in care are playing an increasingly important role in society due to the ageing of the population. Because there is a great demand on them, volunteers are at risk of increased mental wellbeing. This project focuses on the mental well-being of crisis line volunteers. The central research question is: 'Does self-compassion and gratitude among workers of telephone helplines lead to more mental wellbeing and less distress and to a better use of compassion in direct contact with the callers or chatters?’ Because little is known about the mental well-being of crisis line volunteers, the first part of this project is to gain insight into the role of demographic, stressors (from caller/chatter, organization and policy), and organizational resources in predicting mental wellbeing and distress in crisis line workers. The second part of this project uses the job demands-resources model to study the moderating (or mediating) role of self-compassion and gratitude on the exhaustion and motivational process in crisis line volunteers. At the end of this project, a short training intervention will be designed, aimed at increasing (self-)compassion. This intervention will be tested for feasibility in a pilot study.

Contact person: Renate Willems (Hogeschool Rotterdam), Stans Drossaert, Ernst Bohlmeijer

Recovery and mental health among patients with eating disorders

The overall aim of this PhD study is to better understand eating disorder recovery from a mental health perspective. This goal is addressed in several ways. For instance, by systematically examining empirical knowledge from patients who have recovered themselves. Also, quantitative approaches are used. The relationship between psychopathology and well-being is examined in both cross-sectional and longitudinal study designs with relatively novel approaches such as latent growth, and psychometric network modelling.

Contact person: Sander de Vos, Mirjam Radstaak, Ernst Bohlmeijer, Gerben Westerhof

SENSE-IT: Aiming for the improvement of emotional awareness in patients with severe borderline personality disorder.

In his doctoral research Youri Derks focuses on the question how wearable biosensor technology and mobile coaching can improve psychotherapeutic clinical treatment of mental health patients with borderline personality disorder (BPD).  

Contact person: Youri Derks, Mathijs Noordzij, Ernst Bohlmeijer

Wearable technologies and monitoring

  • Real-time tele-monitoring of physiological processes and self-reported craving to reduce relapse rates in alcohol addiction. In her Doctoral Research Hendrika van Lier examines the experience and physiology of people receiving treatment for alcohol addiction. In addition, she tests the validity of the wearable bio-sensors she uses, and provides a comprehensive literature review on viable theoretical frameworks with essential parameters for real-time and real world alcohol craving research.
  • If we know better, do we do better: self efficacy through wearable technologies.
    Elizabeth Nelson studies how information from wearable technology empowers people in maintaining healthy behavior. In addition, the effects of healthy office interventions is studied longitudinally in her doctoral research. Finally, a new embodiment scale will be developed for wearable technologies.
  • Biofeedback for aggression regulation problems in the forensic ambulatory care
    The question whether real-time biofeedback can be a relevant support factor in aggression regulation treatments for adolescents and young adults is the main topic of the doctoral research of Annemieke ter Harmsel. In a Randomised Controlled Trial she will examine both Treatment as Usual (TAU) as well as TAU with real time biofeedback added to answer the question whether biofeedback can be seen as a relevant adjuvans.

Contact person: Matthijs Noordzij