The effects of a combination of cognitive interventions and loving-kindness meditations (C-METTA) on guilt, shame and PTSD symptoms: results from a pilot randomized controlled trial.
Meike Müller-Engelmann, Luisa Bahnemann, Stella Kümmerle
European journal of psychotraumatology January 1, 2024 DOI: 10.1080/20008066.2024.2308439
Summary
C-METTA, a novel intervention combining cognitive techniques and loving-kindness meditation, significantly reduced PTSD symptoms, trauma-related guilt, and shame. In a trial with 32 trauma-exposed patients, those receiving C-METTA experienced a large effect size of -1.09 for PTSD symptoms and even larger reductions for guilt (-2.85) and shame (-2.14) compared to a wait-list group. This innovative approach shows promise in addressing the emotional challenges associated with PTSD, potentially enhancing treatment for stress-related disorders.
Abstract
Background: Trauma-related guilt and shame are crucial for the development and maintenance of PTSD (posttraumatic stress disorder). We developed an intervention combining cognitive techniques with loving-kindness meditations (C-METTA) that specifically target these emotions. C-METTA is an intervention of six weekly individual treatment sessions followed by a four-week practice phase.Objective: This study examined C-METTA in a proof-of-concept study within a randomized wait-list controlled trial.Method: We randomly assigned 32 trauma-exposed patients with a DSM-5 diagnosis to C-METTA or a wait-list condition (WL). Primary outcomes were clinician-rated PTSD symptoms (CAPS-5) and trauma-related guilt and shame. Secondary outcomes included psychopathology, self-criticism, well-being, and self-compassion. Outcomes were assessed before the intervention phase and after the practice phase.Results: Mixed-design analyses showed greater reductions in C-METTA versus WL in clinician-rated PTSD symptoms (d = -1.09), guilt (d = -2.85), shame (d = -2.14), psychopathology and self-criticism.Conclusion: Our findings support positive outcomes of C-METTA and might contribute to improved care for patients with stress-related disorders. The study was registered in the German Clinical Trials Register (DRKS00023470).