Date Presented 4/20/2018
This poster describes a randomized clinical trial to explore the effects of a mind–body–spiritually integrated intervention called the Mantram Repetition Program compared with present-centered therapy in veterans with posttraumatic stress disorder. Implications for occupational therapy practice are discussed.
Primary Author and Speaker: Jill Bormann
Contributing Authors: Danielle Beck, Dorothy Plumb, Princess Osei-Bonsu, Jennifer Johnston, Carie Rodgers, Pia Heppner, Mark Glickman, Shibei Zhao, Steven Thorp, Erik Groessl, Ann Kelly
PURPOSE: The mind–body–spiritually based Mantram Repetition Program (MRP) has previously shown efficacy in a variety of patient populations including veterans with chronic illnesses, family caregivers, health care employees, and adults living with HIV (Bormann et al., 2014). The MRP is a nonpharmacological, complementary intervention that can be practiced anytime and anywhere, making it portable, practical, and easily implemented. It has also demonstrated efficacy in reducing posttraumatic stress disorder (PTSD) symptom severity in veterans when it was delivered as an adjunct to case management compared with case management alone (Bormann, Hurst & Kelly, 2013; Bormann, Thorp, et al., 2013). It has yet to be compared to an active control condition to determine its effectiveness as a standalone treatment for PTSD.
METHOD: A prospective, two-site, parallel condition, randomized controlled trial was conducted with a sample of 173 veterans diagnosed with PTSD from military-related trauma. They were recruited from two Veterans Affairs medical centers using flyers and provider referrals. Participants were block randomized to control for those taking prescribed PTSD medications. Blinded assessments were conducted at baseline, posttreatment, and 2-mo follow-up using the Clinician-Administered PTSD Scale (CAPS) and Insomnia Severity Index (ISI). Mixed effects, repeated measures models adjusting for sociodemographic factors were performed.
RESULTS: Veterans completing the MRP (n = 89) compared with present-centered therapy (n = 84) had significantly greater decreases in total CAPS scores and both avoidance and hyperarousal cluster scores and greater decreases in ISI scores at posttreatment (p < .05), accounting for the multiplicity of tests via a false discovery rate adjustment. Hyperarousal and insomnia scores also showed significantly greater decreases from baseline to 2-mo follow-up (p < .05), demonstrating lasting improvements for participants in the MRP.
CONCLUSION: These results suggest that the MRP, a nonpharmacological complementary therapy, may be a promising treatment for veterans and other people with major functional complaints of hyperarousal and insomnia. Occupational therapy practitioners can use the MRP to assist clients who have difficulty with their prescribed treatment plan because of poor concentration and symptoms of hyperarousal. These findings provide empirical support and contribute to the science of teaching mind–body–spiritually integrated programs to improve mental health of people receiving occupational therapy.
References
Bormann, J. E., Hurst, S., & Kelly, A. (2013). Responses to Mantram Repetition Program from veterans with posttraumatic stress disorder: A qualitative analysis. Journal of Rehabilitation Research and Development, 50, 769–784. https://doi.org/10.1682/JRRD.2012.06.0118
Bormann, J. E., Thorp, S. R., Wetherell, J. L., Golshan, S., & Lang, A. J. (2013). Meditation-based mantram intervention for veterans with posttraumatic stress disorder: A randomized trial. Psychological Trauma: Theory, Research, Practice, and Policy, 5, 259–267. https://doi.org/10.1037/a0027522
Bormann, J. E., Weinrich, S., Allard, C. B., Beck, D., Johnson, B., & Holt, L. (2014). Mantram repetition: An evidence-based complementary practice for military personnel and veterans in the 21st century. In C. E. Kasper & P. W. Kelley (Eds.), Annual review of nursing research (Vol. 32, pp. 79–108). New York: Springer.
