In Reply Drs Gatchel and Licciardone comment that “not all participants attended all group sessions, but it was not stated whether the techniques taught were implemented daily or practiced at home.” In our study, 88.6% of participants attended at least 1 session. Less than 100% session attendance is typical in studies of psychosocial interventions as well as for MBSR and group CBT in real-world clinical practice. Even with studies in which participant records of home practice are obtained, the accuracy of these self-reports and the quality of home practice are unknown. In our study, among participants who completed the 52-week follow-up, 73% of those randomized to MBSR and 91% of those randomized to CBT reported having practiced or used MBSR or CBT techniques in the prior week. The retreat (attended by only 26% of MBSR participants) is a core element of MBSR and not a component of CBT interventions.
Cherkin DC, Sherman KJ, Turner JA. Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy for Chronic Low Back Pain—Reply. JAMA. 2016;316(6):663-664. doi:10.1001/jama.2016.7951