ارزیابی کاهش استرس مبتنی بر ذهن آگاهی: داستان تجزیه و تحلیل تنش برای تدوین و فرموله سوالات تمرکز گروهی

The primary purpose of this analysis was to learn how therapeutic community (TC) residents describe Mindfulness-Based Stress Reduction (MBSR) delivered as part of their substance use recovery experience. A secondary purpose was to develop focus group questions guided by TC residents' descriptions. Two researchers independently analyzed 38 written stories about stress in the TC. The researchers used conventional content analysis; independent analysis was followed by consensus dialogue to identify key words and code definitions. Three themes emerged from the content analysis: utility, portability, and sustainability. Participants talked about MBSR as a tool which helped them “manage” their recovery, noting that they used MBSR techniques in the TC and off-site. They believed they could use MBSR even after exiting the TC. Three focus group questions were formulated, one for each theme. Content analysis of stories of stress provided substantive guidance for formulating focus group questions which incorporated the voice of participants through familiar terms and friendly language.

THE THERAPEUTIC COMMUNITY (TC) approach is an effective treatment for substance use disorders. TCs provide a highly structured social learning environment in which the community is the key agent of behavioral change (De Leon, 2000). TC residents progress through treatment in stages, each giving them more privileges and, thus, more responsibility and opportunity to exercise judgment. A confrontational style of peer-based learning is an implicit component of TC treatment that most likely affects dropout by contributing to environmental stress. Dropout rates are reported to be as high as 40% within the first 30 days in TC treatment (De Leon, 1999). Mindfulness-Based Stress Reduction (MBSR) is an evidence-based mediator of stress in clinical and nonclinical settings (Bishop, 2002). MBSR programs help individuals cultivate a nonreactive, nonjudgmental attitude toward objects, events, and ideas by highlighting their impermanence through an intentional focus on the breath and sensations in the body (Kabat-Zinn, 1990). In a 4-year behavioral therapies trial, MBSR classes were integrated into the TC program as an adjunct to treatment to reduce stress and promote retention (Marcus et al., 2007). The purposes of this article are (a) to describe conventional content analysis undertaken as first-level evaluation of MBSR incorporated into TC treatment and (b) to identify key questions for focus group discussion, the second-level evaluation