The Feasibility and Acceptability of Personalised Smart-Messaging To Enhance Remote Mindfulness-Based Cognitive Therapy for Recurrent Depression

Mindfulness-Based Cognitive Therapy is a group psychological therapy that prevents relapse amongst people with recurrent depression. However, many people who attend MBCT do not fully benefit. This study assessed the feasibility, acceptability and initial clinical utility of personalised smart-messaging as an adjunct to remote Mindfulness-Based Cognitive Therapy (rMBCT) for recurrent depression to reduce dropout and improve outcomes.This cohort study compared 28 participants across three sites attending rMBCT, 12 participants were offered smart-messaging and 16 were not. Personalised smart-messaging protocols: 1) reminded participants of their personal motivations for attending rMBCT that were elicited at the initial assessment consultation 2) Prompted them to complete home practice relevant to each session and 3) Sent them their own advice for relapse prevention after group completion, using personal reminders that participants wrote in the final sessions of the group. Smart-messaging uptake, dropout, clinical outcomes, and qualitative experiences were evaluated.Eleven (92%) participants offered smart-messaging took it up. Participants attending rMBCT with smart-messaging reported significantly greater improvement in depression and functioning, with trends of greater improvement in generalised anxiety and lower dropout. Therapists reported that they felt the smart-messaging intervention enhanced rMBCT and improved outcomes but also described the significant administrative burden it added to setup.Personalised smart-messaging may be feasible and acceptable as an adjunct to rMBCT for recurrent depression for both patients and therapists. The addition of personalised smart-messaging has potential to improve clinical outcomes and reduce dropout, but there is an additional burden on therapists to incorporate it.