(How) Do Therapists Use Mindfulness in Their Clinical Work? A Study on the Implementation of Mindfulness Interventions
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.
KeywordsMindfulness Implementation MBCT MBSR
We would like to thank Miguel Tamayo and Dr. Heiko Schmitz from the Kassenärztliche Vereinigung Nordrhein for their support.
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.
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 was obtained from all individual participants included in the study.
- Carmel, A., Rose, M., & Fruzzettti, A. E. (2014). Barriers and solutions to implementing dialectical behavior therapy in a public behavioral health system. Administration and Policy in Mental Health and Mental Health Services Research, 41, 608–614.Google Scholar
- Conner, C. M., & White, S. W. (2017). Brief report: feasibility and preliminary efficacy of individual mindfulness therapy for adults with autism spectrum disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-017-3312-0.
- Edwards, A. R., Evans, S., Aldao, A., Haglin, D., & Ferrando, S. J. (2014). Implementing a mindfulness-based stress reduction program in the community: lessons learned and suggestions for the future. Behavior Therapist, 37, 13–17.Google Scholar
- Epstein, M. (1995). Thoughts without a thinker: psychotherapy from a Buddhist perspective. New York, NY: Basic Books.Google Scholar
- Germer, C. K. (2016). Mindfulness: what is it? What does it matter? In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and psychotherapy (pp. 3–35). New York, NY: Guilford Press.Google Scholar
- Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76, 332–338.CrossRefPubMedGoogle Scholar
- Jung, C. (1939). Introduction. In D. T. Suzukui (Ed.), Die grosse Befreiung: Einführung in den Zen Buddhismus (pp. 7–37). Leipzig: C. Weller & Co.Google Scholar
- Jung, C. (1949). Foreword. In D. T. Suzuki (Ed.), Introduction to Zen Buddhism. New York, NY: Grove.Google Scholar
- Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness (revised edition). New York, NY: Bantam Books.Google Scholar
- Linehan, M. M. (2015). DBT skills training manual. New York: Guilford Press.Google Scholar
- Rycroft-Malone, J., Gradinger, F., Griffiths, H. O., Crance, R., Gibson, A., Mercer, S., . . . Kuyken, W. (2017). Accessibility and implementation in the UK NHS services of an effective depression relapse prevention programme: Learning from mindfulness-based cognitive therapy through a mixed-methods study. Health Services and Delivery Research, 5(14).Google Scholar
- Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance. New York, NY: Guilford Press.Google Scholar
- Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York, NY: Guilford Press.Google Scholar
- Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York, NY: Guilford Press.Google Scholar
- Tovote, A., Schroevers, M., Snippe, E., Sanderman, R., Links, T., Emmelkamp, P., & Fleer, J. (2015). Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with diabetes: a randomized trial. Psychotherapy and Psychosomatics, 84, 186–187.CrossRefPubMedGoogle Scholar
- Van Dam, N. T., Van Vugt, M. K., Vago, D. R., Schmalzl, L., D, S. C., A. O,. .. Meyer, D. E. (2017). Mind the hype: a critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspective on Psychological Science. doi: https://doi.org/10.1177/1745691617709589.
- Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. New York, NY: Guilford Press.Google Scholar
- Wupperman, P., Gintoft Cohen, M., Haller, D. L., Flom, P., Litt, L. C., & Rounsaville, B. J. (2015). Mindfulness and modification therapy for behavioral dysregulation: a comparison trial focused on substance use and aggression. Journal of Clinical Psychology, 71(10), 964–978.CrossRefPubMedGoogle Scholar