Outcomes of a Multimodal Resilience Training Program in an Outpatient Integrative Medicine Clinic.

OBJECTIVE: To investigate the outcomes of resilience training (RT) in an outpatient clinical setting on symptom relief for current or recurrent depression, as well as perceived stress and state and trait anxiety.

DESIGN: Observational effectiveness study.

SETTINGS/LOCATION: Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN.

PARTICIPANTS: A total of 728 men and women age 18 years and older who participated in the RT program between December 1, 2007, and November 31, 2012. Of these individuals, 371 were considered study contributors and completed at least one questionnaire both before (pre-RT) and after (post-RT) completion of the program. The remaining participants were considered study non-contributors and did not complete any questionnaires.

INTERVENTIONS: RT is a mindfulness-based program that synergizes elements of mindfulness meditation with nutrition and exercise into a cohesive intervention.

OUTCOME MEASURES: Depressive symptoms, as well as state and trait anxiety and perceived stress.

RESULTS: Among the 371 RT participant contributors, depressive symptoms, perceived stress, and state and trait anxiety improved significantly from pre-RT to post-RT. Furthermore, among participants with depression at baseline, Center for Epidemiologic Studies Depression Scale-10 scores decreased by a mean of 44.0% (from 17.5 to 9.8), a value below the cutoff for significant depressive symptoms. Baseline perceived stress scores were the most predictive of program success.

CONCLUSIONS: This study provides evidence that a multimodal RT program delivered in a real-world clinical setting improves symptoms of depression, anxiety, and stress. Limitations of this effectiveness study include a homogeneous population of mostly white women and a large amount of randomized, imputed, and missing data. Future work should include a randomized controlled trial and potentially studies to separate RT into the three components to determine which may be primarily responsible for the improved outcomes.