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(How) Do Therapists Use Mindfulness in Their Clinical Work? A Study on the Implementation of Mindfulness Interventions

  • Johannes Michalak
  • Kira Steinhaus
  • Thomas Heidenreich


Mindfulness-based and mindfulness-informed programs such as mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), or dialectic behavior therapy (DBT) have gained widespread attention over the past few decades. One way of bringing mindfulness programs into clinical practice is via a planned implementation process where empirically validated interventions are disseminated and implemented on a large scale. However, besides this planned process, it can be observed that mindfulness has diffused into current society as well as into psychotherapy practice in an unsystematic way. To date, however, little is known about the proliferation of mindfulness in clinical practice. We investigated a randomly drawn sample of German psychological psychotherapists with regard to their use of mindfulness in clinical practice using a web survey. Additionally, the psychotherapists’ personal mindfulness practice was assessed. The overwhelming majority (82%) of psychotherapists reported using mindfulness practices at least sometimes with their patients. Programs such as MBSR and MBCT are rarely applied. Rather, therapists use individual mindfulness practices in an eclectic way. Our results show that in addition to investigating the implementation of empirically underpinned mindfulness-based programs, mindfulness researchers should also investigate the ways in which mindfulness-based practices have diffused into clinical work with individuals. Guidelines on best practice for this work will support the future integrity of mindfulness programs.


Mindfulness Implementation MBCT MBSR 



We would like to thank Miguel Tamayo and Dr. Heiko Schmitz from the Kassenärztliche Vereinigung Nordrhein for their support.

Author Contributions

J.M.: designed the study and wrote the paper. K.S.: collaborated with the design, executed the study, and analyzed the data. T. H.: collaborated in the writing and editing of the final manuscript.

Compliance with Ethical Standards

Conflict of Interest

J. M. is the Director of the Achtsamkeitsinstitut Ruhr (an institute offering mindfulness training) and Principal Investigator of several DFG (German Science Foundation) research projects. J. M. and T. H. receive royalties from mindfulness books they have authored. Kira Steinhaus declares that she has no conflict of interests.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Witten/Herdecke University institutional review board.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychology and PsychotherapyWitten/Herdecke UniversityWittenGermany
  2. 2.Esslingen University of Applied SciencesEsslingen am NeckarGermany

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