Abstract
Objectives
How to best implement mindfulness interventions within different stages of psychosis (high risk for psychosis, first episode psychosis (FEP), established psychosis) remains relatively unexplored. Understanding where and how mindfulness research has been conducted at different stages of illness can guide future research, and improve intervention acceptability and treatment effects.
Methods
An evidence mapping approach was taken to systematically search and identify where and how mindfulness research has been conducted across stages of psychosis. Papers were examined for intervention approaches and safety concerns, and content analysis examined practitioner recommendations to identify recommendations within and across stages of illness.
Results
A paucity of research relating to the application of mindfulness in the treatment of psychotic illness exists for the high risk stage, with some research in FEP. The majority of research examines mindfulness approaches for the chronic stage of illness. Intervention formats for different stages of psychosis varied widely. Across all stages of psychosis, authors recommended adaptations for cognitive impairments (e.g., shorter exercises for impacted attention), longer interventions, and more helpful ways of explaining mindfulness and encouraging practice. Few stage-specific recommendations emerged beyond the potential helpfulness of compassion-based practices within earlier stages of illness where self-stigmatization often emerges.
Conclusions
Recommendations for how to best adapt mindfulness to early intervention in psychosis are needed, and future research needs to better understand risks and utility of different mindfulness practices for different stages of illness.
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DR: Collaborated with the design and execution of the study, performed the literature search and data collection, collaborated with material preparation and data analysis, and collaborated on drafting and final version of the manuscript. SE: Collaborated with the design and execution of the study and material preparation and data analysis, as well as with the drafting and final version of the manuscript, and provided DR with research supervision. BN: collaborated on the aims of the study and provided review of the final manuscript. TH: collaborated on the aims of the study and provided review of the final manuscript. MOS: collaborated with the design and execution of the study and material preparation and analysis, as well as the drafting and final version of the manuscript, provided DR with research supervision, and approved the final manuscript. DR, SE, and MOS contributed to study conception and design. Literature search was performed by DR. Material preparation, data collection, and analysis were performed by DR, SE, and MOS. The first draft of the manuscript was written by DR, SE, and MOS, and all authors commented on the final version of the manuscript. All authors read and approved the final manuscript. MOS and SE provided DR with research supervision including oversight and assistance during project design, data collection, data analysis and manuscript drafting. MOS provided final manuscript approval.
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Reich, D., Evans, S., Nelson, B. et al. Evidence Map of Mindfulness for Stages of Psychosis: State of the Literature and Implications for Future Research. Mindfulness 12, 1860–1877 (2021). https://doi.org/10.1007/s12671-021-01611-x
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DOI: https://doi.org/10.1007/s12671-021-01611-x