Mindfulness-Based Interventions

Mindfulness-based interventions, therapeutic approaches grounded in mindfulness, promote the practice as an important part of good physical and mental health. Mindfulness-based stress reduction, mindfulness-based cognitive therapy (MBCT), dialectal behavior therapy (DBT), and acceptance and commitment therapy (ACT) are some mindfulness-based interventions currently utilized in therapy.

Designed to deliberately focus a person’s attention on the present experience in a way that is non-judgmental, mindfulness-based interventions, whether offered individually or in a group setting, may offer benefit to people seeking therapy for any number of concerns.

• What Is Mindfulness?
• The Use of Mindfulness in Therapy
• Mindfulness Techniques Used in Therapy
• How Can Mindfulness-Based Interventions Help?

What Is Mindfulness?

At present, there is no universally accepted definition for “mindfulness.” The term has proven difficult to define due to differing beliefs of what exactly mindfulness is, differing opinions on how to achieve mindfulness, varied views about the purpose of mindfulness, and the challenge of describing the concept using medical and psychological terminology. 

In addition to its increasing popularity in the physical and mental health fields, mindfulness approaches are also being utilized in several other areas: In the United States, mindfulness exercises are often employed in schools, businesses, the entertainment industry, and the military. 

The Use of Mindfulness in Therapy

In the Western world, mindfulness-based interventions are becoming widely accepted methods of addressing the symptoms associated with many commonly experienced mental health challenges and/or emotional concerns. Mindfulness approaches have their roots in ancient Buddhist traditions such as Vipassana and Zen meditations.

Currently, there are four recognized therapy models that incorporate mindfulness practices:

• In the 1970s, Jon Kabat-Zinn, the founder of the mindfulness-based stress reduction program, was one of the first individuals to attempt to integrate Buddhist principles of mindfulness into his work in science and medicine.
• Also in the 1970s, Marsha Linehan developed DBT with the aid of certain Western and Eastern spiritual influences.
• ACT, which was introduced in the late 1980s by Steven Hayes, Kelly Wilson, and Kirk Strosahl, ​also incorporates Eastern ideas and techniques.
• At the beginning of the 21st century, Zindel Segal, Mark Williams, and John Teasdale built upon Kabat-Zinn’s work to develop MBCT. 

Though these approaches all involve mindfulness techniques, there are slight differences between each modality. MBSR and MBCT actively teach mindfulness meditation, but MBCT also integrates cognitive behavioral therapy techniques as a part of treatment. DBT and ACT do not teach mindfulness mediation but instead utilize other mindfulness exercises to promote awareness and focus attention. Additionally, while MBSR and MBCT focus on the process of developing mindfulness as well as any associated thoughts, DBT and ACT focus primarily on the cognitions experienced during the state of mindfulness.

Mindfulness Techniques Used in Therapy

Mindfulness-based approaches are most commonly delivered through the use of mindfulness meditation, though mindfulness may be achieved through a variety of techniques. During mindfulness meditation, the practitioner will typically guide the person or people in therapy to direct their focus on the present moment. The participants are trained to zone in on a particular phenomenon. If the participants become aware that their thoughts are drifting away from the present, they are encouraged to take notice of where they are and what they are doing before bringing their attention back to the present moment, without reacting or judging themselves. Therapists can help those in treatment better understand and address the emotions and physical sensations associated with their cognitions. 

Many types of mindfulness mediation are practiced, in and out of clinical settings. Mindfulness meditation is a popular technique used to achieve mindfulness, but mindfulness can be achieved without meditation. Once the knowledge of mindfulness practices is developed, those in treatment are usually encouraged to integrate mindfulness into their daily lives, especially in non-clinical environments. Mindfulness may be especially important during emotionally overwhelming experiences, as the practice can often help individuals maintain a sense of control.

Gentle yoga movements and sitting, walking, or mountain meditations may be used in mindfulness approaches as a way of heightening awareness of physical sensations. Verbal cues help the person in therapy maintain awareness of movement, breathing, and sensations throughout several different exercises. Breathing exercises, body scan meditations, and guided imagery are also often used in mindfulness approaches. Eventually, the person in therapy is encouraged to practice mindfulness in daily life. This continuation of the therapeutic process allows the individual to observe, explore, and experience mindfulness in a non-clinical environment and later examine, in session, the effects and obstacles encountered during daily life. The combined observations and examination can often become a catalyst for behavior and thought modification.

How Can Mindfulness-Based Interventions Help? 

Mindfulness is often incorporated into other therapeutic modalities as part of an integrated approach to treatment. Even small negative thoughts can accumulate and/or spiral out of control, leading to concerns such as depression, anxiety, and suicidal ideation. Mental health professionals have come to realize, however, that mindfulness can be of great benefit, as it can enable people to become better able to separate themselves from negative thoughts, emotions, and bodily sensations that may be present, often before they become too overwhelming. Those who are able to achieve this state of awareness may find it easier to then implement other therapeutic strategies to address any potentially harmful cognitions in order to prevent negative effects. Regular mindfulness practice is believed to help further psychological insight and emotional healing, over time. 

Mindfulness-based interventions, generally aimed at relieving symptoms of stress, mental health concerns, and physical pain, can be used to address and treat a range of symptoms and concerns. 

• Mindfulness-based stress reduction can often help people address stress, chronic pain, cancer, anxiety, depression, and other chronic issues. 
• MBCT often forms part of the approach to treatment of recurrent depression, anxiety, psychosis, eating and food issues, bipolar, panic attacks, attention deficit hyperactivity, and posttraumatic stress, among others.
• DBT is used primarily in the treatment of suicidal ideation, borderline personality, self-harm, substance dependence, eating and food issues, depression, and PTSD. 
• ACT is an approach often used in the treatment of anxiety, depression, substance dependence, chronic pain, psychosis, and cancer.

References:

1. Burke, C.A. (2010). Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19, 133-144. DOI 10.1007/s10826-009-9282-x. Retrieved from http://www.mindfulschools.org/pdf/burke-child-adol.pdf
2. Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67(4), 404-424. doi: 10.1002/jclp.20776. Retrieved from http://www.pmalinowski.de/downloads/chiesa%26malinowski2011.pdf
3. Hayes, S. (n.d.). About ACT. Retrieved from https://contextualscience.org/about_act
4. What is DBT? (n.d.). Retrieved from http://behavioraltech.org/resources/whatisdbt.cfm