Journal of Behavioral Medicine

, Volume 11, Issue 4, pp 333–352 | Cite as

Compliance with an outpatient stress reduction program: Rates and predictors of program completion

  • Jon Kabat-Zinn
  • Ann Chapman-Waldrop


The rate at which medical patients physician-referred to an 8-week stress reduction program completed the prescribed intervention was measured and predictors of compliance sought. Seven hundred eighty-four consecutive patients who enrolled in the program over a 2-year period were studied. Of these, 598 (76%) completed the program and 186 (24%) did not. Multiple regression analysis showed that (1) among chronic pain patients, only sex discriminated between completers and noncompleters, with females more than twice as likely to complete the program as males (odds ratio=2.4; 95% CI=1.2, 4.4); (2) among patients with stress-related disorders, only the OC scores of the SCL-90-R discriminated between completers and noncompleters (odds ratio=2.0; 95% CI=1.2, 3.4). Completion rates for specific diagnoses are reported and discussed. The high rate of completion observed for this intensive program in health behavior change is discussed in terms of the design features and therapeutic modalities of the intervention.

Key words

compliance stress pain meditation 


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  1. Bandura, A. (1982). Self-efficacy mechanism in human agency.Am Psychol. 37: 122–147.Google Scholar
  2. Benson, H. (1975).The Relaxation Response, William Morrow, New York.Google Scholar
  3. Champman-Waldrop, A., and Kabat-Zinn, J. (1987). Patient evaluation of multiple relaxation techniques. Poster presented at the 8th Annual Meeting of the Society of Behavioral Medicine, Washington, D.C., March.Google Scholar
  4. Derogatis, L. R. (1983).SCL-90-R Manual II, Clinical Psychometric Research, Towson, Md.Google Scholar
  5. DiMatteo, M. R., and DiNicola, D. D. (1985).Achieving Patient Compliance, Pergamon, New York.Google Scholar
  6. Goleman, D. (1977).The Varieties of the Meditative Experience, Dutton, New York.Google Scholar
  7. Hanh, T. N. (1975).The Miracle of Mindfulness, Beacon, Boston.Google Scholar
  8. Haynes, R. B. (1979). Introduction. In Haynes, R. B., Taylor, D. W., and Sackett, D. L. (eds.),Compliance in Health Care, Johns Hopkins University Press, Baltimore, Md., p. 2.Google Scholar
  9. Inglefinger, J. A., Mosteller, F., Thibodeau, L. A., and Ware, J. H. (1983).Biostatistics in Clinical Medicine, Macmillan, New York, p. 170.Google Scholar
  10. Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results.Gen. Hosp. Psychiat. 4: 33–47.Google Scholar
  11. Kabat-Zinn, J. (1983). Assessment of body image in chronic pain patients: The Body Parts Problem Assessment Scale. In Melzack, R. (ed.),Pain Measurement and Assessment, Raven Press, New York, pp. 227–231.Google Scholar
  12. Kabat-Zinn, J., and Skillings, A. (1988). In preparation.Google Scholar
  13. Kabat-Zinn, J., Lipworth, L. and Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain.J. Behav. Med. 8: 163–190.PubMedGoogle Scholar
  14. Kabat-Zinn, J., Lipworth, L., Burney, R., and Sellers, W. (1986a). Four year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance.Clin. J. Pain 2: 159–173.Google Scholar
  15. Kabat-Zinn, J., Sellers, W., and Santorelli, S. (1986b). Symptom reduction in medical patients following stress management training. Poster presented at the Association for the Advancement of Behavior Therapy, 20th Annual Convention, Chicago, Nov.Google Scholar
  16. Kabat-Zinn, J., Goleman, D., and Chapman-Waldrop, A. (1986c). Relationship of cognitive and somatic components of anxiety and depression to patient preference for alternative relaxation techniques. Poster presented at the 7th annual meeting of the Society of Behavioral Medicine, San Francisco, March.Google Scholar
  17. Kirschenbaum, D. S. (1987). Self-regulatory failure: A review with clinical implications.Clin. Psychol. Rev. 7: 77–104.Google Scholar
  18. Kirschenbaum, D. S., and Tomarken, A. J. (1982). On facing the generalization problem: The study of self-regulatory failure. In Kendall, P. C. (ed).,Advances in Cognitive-Behavioral Research and Therapy, Vol. 1, Academic Press, New York, pp. 121–200.Google Scholar
  19. Kristeller, J. L., and Rodin, J. (1984). A three-stage model of treatment continuity: Compliance, adherence, and maintenance. In Baum, A., Taylor, S. E., and Singer, J. E. (eds).Handbook of Psychology and Health, Vol. IV, Lawrence Erlbaum, Hillsdale, N.J., pp. pp. 85–112.Google Scholar
  20. Kutz, I., Borysenko, J. Z., and Benson, H. (1985). Meditation and psychotherapy: A rationale for the integration of dynamic psychotherapy, the relaxation response, and mindfulness meditation.Am. J. Psychiat. 142(1): 1–8.Google Scholar
  21. Sackett, D. L., and Snow, J. C. (1979). The magnitude of compliance and noncompliance. In Haynes, R. B., Taylor, D. W., and Sackett, D. L. (eds.),Compliance in Health Care, Johns Hopkins University Press, Baltimore, Md, pp. 11–22.Google Scholar
  22. Thera, N. (1962).The Heart of Buddhist Meditation, Samuel Weiser, New York.Google Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Jon Kabat-Zinn
    • 1
  • Ann Chapman-Waldrop
    • 2
  1. 1.Division of Preventive and Behavioral Medicine, Department of MedicineUniversity of Massachusetts Medical SchoolWorcester
  2. 2.Science DivisionSiena CollegeLoudonville

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