Complementary Therapies in Medicine (2014) 22, 278—285 Available online at www.sciencedirect.com ScienceDirect j ourna l ho me pa g e: www.elsevierhealth.com/journals/ctim Mindfulness-based cognitive therapy for the treatment of headache pain: A mixed-methods analysis comparing treatment responders and treatment non-responders Melissa A. Day a,* , Beverly E. Thorn a , Nancy J. Rubin b a Department of Psychology, The University of Alabama, Tuscaloosa, AL, United States b Department of Psychiatry and Behavioral Medicine, The University of Alabama School of Medicine, Tuscaloosa, AL, United States Available online 9 January 2014 KEYWORDS Mindfulness-based cognitive therapy; Headache pain; Mixed-methods analysis; Responder analysis Abstract Objectives: Our recent pilot study demonstrated mindfulness-based cognitive therapy (MBCT) is a potentially efficacious headache pain treatment; however, it was not universally effective for all participants. This study sought to explore patient characteristics associated with MBCT treatment response and the potential processes of change that allowed treatment responders to improve and that were potentially lacking in the non-responders. Design: We implemented a mixed-methods analysis of quantitative and qualitative data. The sample consisted of 21 participants, 14 of whom were classified as treatment responders (≥50% improvement in pain intensity and/or pain interference) and seven as non-responders (<50% improvement). Setting: The study was conducted at the Kilgo Headache Clinic and the University of Alabama Psychology Clinic. Intervention: Participants completed an 8-week MBCT treatment for headache pain manage- ment. Measures: Standardized measures of pain, psychosocial outcomes, and non-specific therapy factors were obtained; all participants completed a post-treatment semi-structured interview. Results: Quantitative data indicated a large effect size difference between responders and non-responders for pre- to post-treatment change in standardized measures of pain acceptance and catastrophizing, and a small to medium effect size differences on treatment dose indica- tors. Both groups showed improved psychosocial outcomes. Qualitatively, change in cognitive ∗ Corresponding author. Tel.: +1 205 523 3831. E-mail addresses: day014@crimson.ua.edu, melday@uw.edu (M.A. Day). 0965-2299/$ — see front matter © 2014 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ctim.2013.12.018