A key aspect of MBS is the holding of everything that happens in supervision within a container of mindfulness. Crane et al. (2010) wrote, “The essential premise here is that the whole of the teaching (and training) process is mindfulness-based” (p.79). Likewise, the whole of supervision is mindfulness-based. By maintaining a thread of mindfulness, the supervisor plays an important role supporting teachers to sustain the intention to practice what they teach. The particular characteristics of this circle are the following:
The essence of MBS is an embodiment of the principles and process of mindfulness. These have been represented by Kabat-Zinn (1990) as the attitudinal qualities of the following: non-judging (awareness of experience as it is, seeing with kindness when we are adding interpretation and judgement and stepping back), patience (allowing time for experience to unfold at its own pace), beginner’s mind (keeping a freshness and aliveness to the present moment), trust (developing a trust in the validity of our own experience and intuition), non-striving (moving into non-doing, letting things be as they are), acceptance (being with reality in a compassionate way) and letting go (coming back to immediacy of present experience, disentangling from unhelpful habits).
The way in which the teacher embodies the spirit and essence of the practices is a key ingredient of mindfulness-based classes (Crane et al. 2010). The teacher communicates this through their own sense of being. Supervision is also imbued with curiosity and a willingness to be fully present to whatever arises. The supervisor is likewise embodying the same spirit and so implicitly invites the supervisee to speak, listen, think, reflect, sit, feel, write and hold their body through a kindly and curious awareness of this present moment.
The movement of compassion towards suffering is an essential part of embodied mindfulness-based teaching. Research shows that increases in compassion and mindfulness are an important influence in changing the nature of the relationship between cognitive reactivity and outcome (Kuyken et al. 2010). Compassion has many different threads including kindness, empathy, generosity and acceptance as well as courage, tolerance and equanimity. The supervisor holds these qualities within the process of MBS, which in turn allows space for the supervisee to connect with compassion for themselves and their participants. This implicit embodiment of compassion mirrors how compassion is primarily conveyed within MBSR/MBCT. Therefore, it is important that teachers are sustained in their capacity to imbue their teaching with compassion. Effective supervision can challenge the supervisee to explore difficult places which, without the counter balance of compassion, may trigger reactive patterns of avoidance, fixing, judging and blaming. A compassionate atmosphere can guide the supervisee away from judgemental patterns towards a more creative and balanced space. Supervisees can begin to see “a thought as thought, an emotion as emotion, a habit as a habit and begin to take the ‘I’ out of the process” (Feldman and Kuyken 2011, p. 153).
Care must be taken to fully understand compassion and not misinterpret it as the need to be warm and supportive in a way that creates inappropriate comfort, as supervision can sometimes have a challenging edge to it as well. Several interviewees spoke of this important edge in the supervision process:
There is something that irritates me, that if you are a mindfulness teacher/supervisor you have to be lovely, warm, cuddly and compassionate. You know I can be and I am not. We do have a responsibility around holding, to be fierce and confront. We are holding the integrity here. (Emily)
A sense of common humanity is an important aspect of supervision by encouraging the teacher to include themselves in the teaching process:
An enormous amount of what I do is helping people to ground themselves and teach from their wobbles rather than trying to get rid of them. It is a practice that has to be developed over time. I don’t just say it, we do it. We do it a lot in the supervision session, we FOFBOC (Feet on floor, Bum on chair) (The Mindfulness in Schools Project 2013). And I encourage them to use that in their teaching, with any opportunity to teach from that wobble. Can I create an environment where we can play with that in supervision? And hopefully that can then be taken out into their work. (Diane)
A key guiding intention of supervision is upholding integrity through supporting and developing the supervisees’ teaching practice and how they relate to it. There are a number of elements of integrity that are addressed in supervision.
The integrity of the MBSR/MBCT programme itself is a central element of supervision. The Bangor, Exeter and Oxford mindfulness-based interventions: treatment assessment criteria (MBI: TAC) (Crane et al. 2012a, 2013; Crane et al. 2012b) is increasingly being used as a tool in supervision. The MBI: TAC describes six domains essential to the teaching of MBIs, namely coverage, pacing and organisation of session curriculum; relational skills; embodiment of mindfulness; guiding mindfulness practices; conveying course themes through interactive inquiry and didactic teaching; and the management of the group learning environment. As an assessment tool, it aims to assess integrity in three areas, namely the teacher’s competence (the extent to which the approach is carried out as originally intended), their level of adherence (the extent to which the teacher includes the key curriculum elements of an MBSR/MBCT course) and differentiation (the extent to which the teacher excludes elements that are not part of the MBSR/MBCT model and programme). In addition to being an assessment tool, it provides a structure and framework for teachers and supervisors to reflect on teaching with integrity.
In the pressured and outcome-orientated cultures in which many teachers are implementing mindfulness-based approaches, there may be drivers that push towards a dilution of integrity. This is described by some of the supervisors in the interviews and observed from our experience of training teachers, particularly within National Health Service (NHS) settings. It is important for supervisees to have space to explore how to respond to these potential dilutions with appropriate levels of firmness and flexibility.
Monitoring adherence to good practice is an important aspect of supervision because the supervisee may not have the experience to make clear judgements regarding integrity. The supervisor then plays an important role in helping them to be aware of the limits of their own competence. An interviewee spoke of this:
I supervised a new teacher who wanted to teach five MBSR courses all at once and instead of my saying, “Absolutely no, it’s impossible,” I said, “Well, can we maybe take it down to three?” I really explored with him what was going on within his body whilst we reflected on this. So it was more a sense of OK so maybe now you can see why this is a lot more complex and difficult than you thought. (Julia)
A function of supervision is to challenge practice that is poor, unethical for participants or unhealthy for teachers. At times, this requires a reflective exploration and, in some instances, a straight expression of a concern. This can be a difficult balance for supervisors who also have an intention to create a safe space for the supervisee to reflect openly. Importantly, there are some ethical processes that the supervisor cannot monitor so the contracting process needs to make sure these are taken care of (e.g. those working in health care settings will have clinical responsibility resting elsewhere.)
When considering integrity, it is also important to acknowledge and stay true to the underlying philosophy of mindfulness practice, which is based on the tradition of Buddhism, and to the MBSR and MBCT programmes that have developed from a deep understanding of this foundational base. Equally, it is important to be fully aware of the underlying theoretical and clinical roots of an approach such as MBCT. Mindfulness within secular settings, such as healthcare, is still a new field. As it grows, some interesting challenges arise around holding the essential essence of these programmes whilst also adapting for new populations and contexts. Supervision forms part of the process of shaping and monitoring future directions. As one of the interviewees stated, “In the back of my mind is always my role in preserving the integrity of the approach.” (Julia)
An important aspect of mindfulness practice is clarity of intention. This is mirrored in MBS, which aims to be clear regarding its intentions, to reconnect supervisees with their intentions for engaging in this work and, ultimately, provide a duty of care for the people in the class and the teacher. A range of intentions and functions of MBS were identified through the interviews.
We have drawn upon the influential ideas from other areas of supervision to categorise these intentions into three main functions. Kadushin (1976) described and defined these functions under the headings of Educational, Supportive and Managerial; Proctor (1988), also describes three areas, defining them as Formative, Restorative and Normative; and, based on these models, Hawkins and Shohet (2006) adapted this to their area and also defined three areas as Developmental, Resourcing and Qualitative. Using the three main functions in this way covers the breadth and depth of the intentions that were identified throughout all of the interviews. They have been combined together to form examples against the three main functions (Kadushin 1976; Hawkins and Shohet 2006; Proctor 1988) in Table 1. The functions and intentions may vary in prominence depending on the context that the supervisee is working within. For example, within an assessed training or research trial context, assessment and evaluation play a greater role, whilst the supportive function may be uppermost if the supervisee is teaching in an unsupportive context.
The developmental stage of the supervisee emerged as a feature that strongly shaped the supervision process. One of the key works describing a developmental approach to supervision comes from Stoltenberg and Delworth (1987), whose work holds that the process of supervision evolves as the supervisee develops their practice. As we use the MBI: TAC, we have been able to see how different levels of experience/training are linked to different competencies. Subsequently, it follows that different level of training/experience lead to differing needs and characteristics within MBS.
Table 2 shows a summary of the way we see stages of development aligned to the stages of competence in the MBI: TAC (Crane et al. 2012a, 2012b, 2013) and informed by a developmental approach to supervision described by Stoltenberg and Delworth (1987).