There is no conflict of interest.
Citation
Ash, M. J., Walker, E. R., DiClemente, R. J., Florian, M. P., Palmer, P. K., Wehrmeyer, K., Negi, L. T., Grant, G. H., Raison, C. L., & Mascaro, J. S. (2021). Compassion meditation training for hospital chaplain residents: A pilot study. Journal of Health Care Chaplaincy, 27(4), 191–206. https://doi.org/10.1080/08854726.2020.1723189
Highlights
- The study's objective was to examine the impact of Cognitively-Based Compassion Training (CBCT) on health outcomes.
- This study used a nonexperimental comparison group design. Using survey data and statistical tests, the authors compared the outcomes between the intervention and comparison groups post-intervention, at 4 months post-intervention, and at 8 months post-intervention.
- The study found a significant relationship between CBCT participation and a reduction in measures of anxiety and burnout.
- This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to Cognitively-Based Compassion Training (CBCT); other factors are likely to have contributed.
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Intervention Examined
Cognitively-Based Compassion Training (CBCT)
Features of the Intervention
Cognitively-Based Compassion Training (CBCT) was a compassion mediation program that aimed to build and maintain compassion and lower burnout for hospital chaplains. The CBCT course included four full-day classes, held once a week for one month. The classes were taught by two certified instructors and included didactic information, group discussion, activities, and guided meditation. The CBCT classes progressed gradually, beginning with basic mindfulness techniques, and advancing to analytical exercises where participants examined how they relate to themselves and others. Participants were also asked to regularly meditate outside of class; however, this was not monitored. After the month-long class was completed, the training included eight one-hour group video calls with the instructors, held twice a month for four months.
Features of the Study
The study used a nonexperimental comparison group design to examine the impact of CBCT on health outcomes. Assignment to the intervention or waitlist comparison groups was based on participants' schedules. The authors assigned 8 chaplain residents to the intervention group and 7 chaplain residents to the waitlist comparison group. All study participants attended the same clinical pastoral education (CPE) program, and the administrators and educators were blind to study participation. The intervention group received the CBCT training in the fall. The waitlist comparison group received the CPE curriculum in the fall and the CBCT training in the spring. The comparison group also had staff support discussion phone calls twice a month for four months.
The intervention group had an equal number of males and females, with an average age of 33.4 years. Among them, 50% of the participants were Black, 25% were White, and 25% were Asian. Most of the intervention group (87.5%) had previous experience with meditation. In the comparison group, 66.7% of the participants were female, with an average age of 43.3 years. In terms of racial composition, 57.1% of the participants were Black, 14.3% were White, 14.3% were Asian, and 14.3% identified as other. Also, only 12.5% of the comparison group had meditation experience.
The data sources included the Depression and Anxiety Stress Scales (DASS) and the Professional Quality of Life Scales (ProQOL). Data were collected at four time points in the study: pre-intervention (time 1), post-intervention (time 2), four months following the intervention (time 3) and eight months following the intervention (time 4). The authors used statistical tests to compare the outcomes of the intervention and comparison groups.
Findings
Health and safety
- The study found a significant relationship between CBCT participation and reduction of anxiety and burnout post-intervention. However, the study did not find signficant relationships at the four- and eight-month follow-up measurements.
- The study also did not find significant relationships between CBCT participation and measures of depression, stress, compassion satisfaction, or secondary trauma stress at any time points.
Considerations for Interpreting the Findings
The intervention and comparison groups were significantly different in sex composition and age at baseline, but the authors did not control for the differences in their analyses. These preexisting differences between the groups—and not CBCT—could explain the observed differences in outcomes. Therefore, the study is not eligible for a moderate causal evidence rating, the highest rating available for nonexperimental designs.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to Cognitively Based Compassion Training (CBCT); other factors are likely to have contributed.