Mindfulness-Based Group Therapy for Men With Situational Erectile Dysfunction: A Mixed-Methods Feasibility Analysis and Pilot Study

The Journal of Sexual Medicine - Tập 15 - Trang 1478-1490 - 2018
Jennifer A. Bossio1,2, Rosemary Basson3, Miriam Driscoll3, Shauna Correia3, Lori A. Brotto1,4
1University of British Columbia, Department of Obstetrics and Gynaecology, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada
2University of British Columbia, Department of Urologic Sciences, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada
3University of British Columbia, UBC Sexual Medicine Program, Department of Psychiatry, Vancouver General Hospital Blusson Centre, Vancouver, BC, Canada
4Women’s Health Research Institute, Vancouver, BC, Canada

Tóm tắt

Abstract Introduction

Recent advances in sexual health research support the benefits of mindfulness-based therapy (non-judgmental present-moment awareness) for the treatment of women’s sexual dysfunction.

Aim

To determine whether it is feasible to implement an adapted, empirically supported treatment protocol for female sexual dysfunction to the specific needs of men with situational erectile dysfunction (ED).

Methods

A mixed-methods approach was taken for this feasibility pilot study. A total of 10 men (Mage = 40.3, SD = 14.01, Range = 20–67) with a diagnosis of situational ED were recruited to participate in a 4-week mindfulness-based treatment group. The group was adapted from protocols shown to be effective for women with sexual dysfunction and edited to include content specific to situational ED. Sessions were 2.25 hours in length, included daily home-practice activities, and integrated elements of psychoeducation, sex therapy, and mindfulness skills. Men completed questionnaires (International Index of Erectile Functioning, Relationship Assessment Scale, Five Facets of Mindfulness Questionnaire, a treatment expectation questionnaire) at 3 time points (prior to treatment, immediately after treatment, and 6 months after treatment). 5 men (Mage = 44.4, SD = 15.76, Range = 30–67) participated in qualitative exit interviews.

Main Outcome Measure

Findings support the feasibility of adapting a mindfulness-based group treatment for situational ED.

Results

With respect to feasibility, the dropout rate was 10%, with 1 participant who did not complete the treatment. Comparisons between Time 1 and Time 3 self-reports suggested that this treatment protocol holds promise as a novel means of impacting erectile functioning (Cohen’s d = 0.63), overall sexual satisfaction (Cohen’s d = 1.02), and non-judgmental observation of one’s experience (Cohen’s d = 0.52). Participants’ expectations for the treatment were generally positive and correlated to self-reported outcomes (r = .68–.73). Qualitative analyses revealed 6 themes: normalization, group magic, identification of effective treatment targets, increased self-efficacy, relationship factors, and treatment barriers.

Clinical Implications

In a shift toward a biopsychosocial framework for the treatment of men’s sexual dysfunction, clinicians may consider incorporating mindfulness to address psychosocial and psychosexual components of dysfunction.

Strength & Limitations

This is the first study—to our knowledge—to adapt mindfulness protocols for use with men’s sexual dysfunction. Because this is a pilot study aimed at feasibility, the sample size is small and no control group was included, thus conclusions about efficacy and generalizability cannot be made.

Conclusion

The current study suggests that a mindfulness group therapy framework offers a feasible and potentially promising treatment avenue for men with situational ED.


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