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Based on promising results with adults, Acceptance and Commitment Therapy (ACT) presents as a treatment opportunity for depressed adolescents. We present a pilot study that compares ACT with treatment as usual (TAU), using random allocation of participants who were clinically referred to a psychiatric outpatient service. Participants were 30 adolescents, aged M = 14.9 (SD = 2.55), with 73.6% in the clinical range for depression. At posttreatment on measures of depression participants in the ACT condition showed significantly greater improvement statistically (d = 0.38), and 58% showed clinically reliable change with a response ratio of 1.59 in favor of ACT. Outcomes from 3-month follow-up data are tentative due to small numbers but suggest that improvement increased in magnitude. Measures of global functioning showed statistically significant improvement for both conditions, although clinical change measures favored only the ACT condition. The results support conducting a larger trial of ACT for the treatment of adolescent depression.
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Children and adolescents with Asperger syndrome occasionally exhibit aggressive behavior against peers and parents. In a multiple baseline design across subjects, three adolescents with Asperger syndrome were taught to use a mindfulness-based procedure called Meditation on the Soles of the Feet to control their physical aggression in the family home and during outings in the community. They were taught to shift the focus of their attention from the negative emotions that triggered their aggressive behavior to a neutral stimulus, the soles of their feet. Prior to training in the mindfulness-based procedure the adolescents had moderate rates of aggression. During mindfulness practice, which lasted between 17 and 24 weeks, their mean rates of aggression per week decreased from 2.7, 2.5 and 3.2 to 0.9, 1.1, and 0.9, respectively, with no instances observed during the last 3 weeks of mindfulness practice. No episodes of physical aggression occurred during a 4-year follow-up. This study suggests that adolescents with Asperger syndrome may successfully use a mindfulness-based procedure to control their aggressive behavior.
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OBJECTIVE: The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored. We performed a randomized, controlled study on the effects on brain and immune function of a well-known and widely used 8-week clinical training program in mindfulness meditation applied in a work environment with healthy employees. METHODS: We measured brain electrical activity before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N = 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine. RESULTS: We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine. CONCLUSIONS: These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function. These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research.

Western psychotherapy tends to regard the mind and mental distress in terms of differing theoretical models. Mental distress can be also be usefully viewed as the result of erroneous reification—the confusing of symbols and concepts with reality. This paper describes the theory and practice of analytic meditative therapy. Inspired by non-dual Buddhist and other eastern wisdom traditions, it uses meditative and cognitive processes to control anxiety, deconstruct reified symbols and encourage contemplative resting in non-dual mental space, where reality and its appearance are coemergent and coalesced but distinct, and healing occurs naturally without the need for any specific additional effort.
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<p>The purpose of this paper is to provide an overview of how Buddhist philosophy can be applied in the treatment of individuals with substance abuse problems (alcohol, smoking, and illicit drug use) and other addictive behaviors (e.g., compulsive eating and gambling). First I describe the background of my own interest in meditation and Buddhist psychology, followed by a brief summary of my prior research on the effects of meditation on alcohol consumption in heavy drinkers. In the second section, I outline some of the basic principles of Buddhist philosophy that provide a theoretical underpinning for defining addiction, how it develops, and how it can be alleviated. The third and final section presents four principles within Buddhist psychology that have direct implications for the cognitive-behavioral treatment of addictive behavior: mindfulness meditation, the Middle Way philosophy, the Doctrine of Impermanence, and compassion and the Eightfold Noble Path. Clinical interventions and case examples are described for each of these four principles based on my research and clinical practice with clients seeking help for resolving addictive behavior problems.</p>

This study reviews literature concerning any effects meditation may have upon the psychological health and practice of psychotherapists. A number of anecdotal accounts were explored in order to extract key claims made for meditation. These claims were found to include that meditation promotes attentive ability, a calm psychophysiological state, heightened awareness, and a reflexive self (an objective, observant sub-personality). It was suggested that these effects were personally therapeutic, and that this could facilitate therapists' practice. Of the experimental studies reviewed, most found that meditation had significant positive effects upon various measures of psychophysiological health. These included increases in measures of self-efficacy and attentional absorption, and decreases in indicators of anxiety, stress, and depression. However, many experimental studies were methodologically flawed. These problems were often related to characteristics of meditation that render it problematic to investigate. For example, it may take at least one year of daily practice to bring about effects, and researchers have found it difficult to complete experiments where randomly assigned participants all adhere to such a demanding regimen. In addition, current quantitative research techniques may not be sophisticated enough to allow the effects of meditation to be accurately gauged. It is suggested that qualitative techniques could be more successful in exploring the effects of meditation.

To enhance psychological adjustment, Vipassana meditation assists individuals to perceive the transitory nature of the self. Because the consequences of this potentially troubling insight are not well understood, changes in self-concept and ego defense mechanisms of two cohorts (N1=222, N2=216) of young (M = 18.03 years) Thai participants who attended separate seven-day Vipassana meditation retreats and a nontreated control group (N = 281) were compared. Multivariate statistical analysis revealed positive gains in all areas of self-representation among meditators relative to controls (p < .001). Ego defense mechanisms of the meditation participants also underwent significant change (p < .0001) with coping becoming characterized by greater maturity and tolerance of common stressors. Increases in Buddhist beliefs were significantly correlated with heightened self-esteem and less impulsiveness (ps < .001). Theoretical and applied implications of the findings are discussed.

<p>This study investigated the effects of imagery on flexibility and the relations among verbal and non-verbal and spontaneous and adaptive flexibility measures. Finally, the effects of brain damage on flexibility and imagery were investigated. Historical and more recent concepts of the cognitive rigidity flexibility dimension were discussed with special emphasis on the effects of brain damage. Forty female and fourteen male volunteer students were tested with verbal and non-verbal flexibility tests. Measures of spontaneous flexibility were the Word Fluency Test and the Five Point Test and measures of adaptive flexibility were the Stroop Test and a newly introduced concept identification test, assessing imagery and interference concepts. Furthermore, a questionnaire to assess individual imagery styles was employed as well as the vocabulary and block design subtests of the WAIS. The results of brain damaged subjects were compared to a matched control group. Furthermore, z-score profiles were prepared to compare the test patterns between the different patient groups. Four dimensions of cognitive flexibility-rigidity were found in healthy subjects. Furthermore it was found that individual imagery styles had little influence on the performance in flexibility tests. A trend was showing that "habitual verbalizers" had no advantage in solving the tests and had in fact more difficulty with the identification of non-verbal concepts. No significant gender effects were found. Brain damaged patients performed significantly more poorly than normal subjects in all flexibility tests. Several test- and subject variables that effect the performance on flexibility tests were discussed. It was concluded that rigidity-flexibility measures represent different dimensions depending on stimulus mode and type of task. It was further concluded that behavioral rigidity-flexibility is not only the function of test variables, but also of various subject variables namely imagery style, intelligence, age, gender and brain damage. In healthy people, the performance on one test was not found to be predictive for the performance on another flexibility test. On the other hand, in brain damaged subjects rigid behavior seems to extend to a wider range of test performance. Finally, different performance patterns were described for different lesion sites in brain damaged.</p>

The goal of this course is to explore meditative and contemplative tradition in various cultures and spiritual traditions, and study the ways in which contemplative practice can contribute to psychotherapy, both indirectly through the meditative practice of the therapist, and directly through application in the therapy proper.

While much attention has been devoted to examining the beneficial effects of Mindfulness-Based Stress Reduction programs on patients' ability to cope with various chronic medical conditions, most studies have relied on self-report measures of improvement. Given that these measures may not accurately reflect physiological conditions, there is a need for an objective marker of improvement in research evaluating the beneficial effects of stress management programs. Cortisol is the major stress hormone in the human organism and as such is a promising candidate measure in the study of the effects of Mindfulness-Based Stress Reduction programs. In conjunction with other biological measures, the use of cortisol levels as a physiological marker of stress may be useful to validate self-reported benefits attributed to this program. In the current manuscript, we review the available literature on the role of cortisol as a physiological marker for improvement with regards to mindfulness practice, and make recommendations for future study designs.

Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.

<p>This article presents the case of a mindfulness-based group therapy that was implemented in a residential treatment facility. The case presented comprised a group of adolescent males with disruptive behavior disorders. The group was designed to be appropriate for the unique demographics of the clients, with the intent to help the clients enhance and develop improved impulse control skills. The contents of the group were gathered and adapted from various mindfulness-based therapies. Attending the presented mindfulness group was found to produce increases in self-reported mindfulness skills and improvements in behavioral compliance. Recommendations are made for running similar groups.</p>

Mindfulness meditation practices (MMPs) are a subgroup of meditation practices which are receiving growing attention. The present paper reviews current evidence about the effects of MMPs on objective measures of cognitive functions. Five databases were searched. Twenty three studies providing measures of attention, memory, executive functions and further miscellaneous measures of cognition were included. Fifteen were controlled or randomized controlled studies and 8 were case–control studies. Overall, reviewed studies suggested that early phases of mindfulness training, which are more concerned with the development of focused attention, could be associated with significant improvements in selective and executive attention whereas the following phases, which are characterized by an open monitoring of internal and external stimuli, could be mainly associated with improved unfocused sustained attention abilities. Additionally, MMPs could enhance working memory capacity and some executive functions. However, many of the included studies show methodological limitations and negative results have been reported as well, plausibly reflecting differences in study design, study duration and patients' populations. Accordingly, even though findings here reviewed provided preliminary evidence suggesting that MMPs could enhance cognitive functions, available evidence should be considered with caution and further high quality studies investigating more standardized mindfulness meditation programs are needed.

OBJECTIVES: Randomized controlled studies on the effectiveness of body-oriented methods of treatment for children with attention-deficit hyperactivity disorder (ADHD) are lacking. Our aim was to compare the effectiveness of two methods of treatment (yoga for children vs. conventional motor exercises) in a randomized controlled pilot study. METHODS: Nineteen children with a clinical diagnosis of ADHD (according to ICD-10 criteria) were included and randomly assigned to treatment conditions according to a 2x2 cross-over design. Effects of treatment were analyzed by means of an analysis of variance for repeated measurements. RESULTS: For all outcome measures (test scores on an attention task, and parent ratings of ADHD symptoms) the yoga training was superior to the conventional motor training, with effect sizes in the medium-to-high range (0.60-0.97). All children showed sizable reductions in symptoms over time, and at the end of the study, the group means for the ADHD scales did not differ significantly from those for a representative control group. Furthermore, the training was particularly effective for children undergoing pharmacotherapy (MPH). CONCLUSIONS: The findings from this pilot study demonstrate that yoga can be an effective complementary or concomitant treatment for attention-deficit hyperactivity disorder. The study advocates further research into the impact of yoga or body-oriented therapies on the prevention and treatment of ADHD.
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The inability to cope successfully with the enormous stress of medical education may lead to a cascade of consequences at both a personal and professional level. The present study examined the short-term effects of an 8-week meditation-based stress reduction intervention on premedical and medical students using a well-controlled statistical design. Findings indicate that participation in the intervention can effectively (1) reduce self-reported state and trait anxiety, (2) reduce reports of overall psychological distress including depression, (3) increase scores on overall empathy levels, and (4) increase scores on a measure of spiritual experiences assessed at termination of intervention. These results (5) replicated in the wait-list control group, (6) held across different experiments, and (7) were observed during the exam period. Future research should address potential long-term effects of mindfulness training for medical and premedical students.

<p>S. L. Shapiro and colleagues (2006) have described a testable theory of the mechanisms of mindfulness and how it affects positive change. They describe a model in which mindfulness training leads to a fundamental change in relationship to experience (reperceiving), which leads to changes in self-regulation, values clarification, cognitive and behavioral flexibility, and exposure. These four variables, in turn, result in salutogenic outcomes. Analyses of responses from participants in a mindfulness-based stress-reduction program did not support the mediating effect of changes in reperceiving on the relationship of mindfulness with those four variables. However, when mindfulness and reperceiving scores were combined, partial support was found for the mediating effect of the four variables on measures of psychological distress. Issues arising in attempts to test the proposed theory are discussed, including the description of the model variables and the challenges to their assessment. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–14, 2009.</p>

In this paper the author shares some of his experiences of using silence in therapy. He presents one of the modes of practicing silence, namely the meditation technique known as Contemplative Prayer, and shows advantages of using this technique in the process of self-purification and self-balancing of the therapist. The author stipulates that silence is a royal way to discovering God. Finding this divine particle within oneself and client changes the whole outlook of therapy. The therapist is no longer alone with the client, but God becomes an active participant in the therapeutic process through His love for both therapist and client.

<p>In this commentary I discuss the integration of mindful procedures in cognitive therapy of generalized anxiety disorder (CAD) and attempt to answer questions concerning the effects of mindfulness on information processing and on mechanisms purported to maintain CAD in the meta-cognitive model of this disorder. Different techniques that promote mindfulness can be identified, including mindfulness meditation and attention training. These techniques are intended to disrupt repetitive styles of dysfunctional thinking. I argue that the effect of mindfulness strategies on information processing in emotional disorder can be conceptualized in meta-cognitive terms as (a) activating a meta-cognitive mode of processing; (b) disconnecting the influence of maladaptive beliefs on processing; (c) strengthening flexible responding to threat; and (d) strengthening meta-cognitive plans for controlling cognition. Although mindfulness meditation may have general treatment applications, the meta-cognitive model of CAD suggests caution in using this treatment in CAD. It is unclear which dimension of worry should be targeted, and mindfulness meditation does not contain information that can lead to unambiguous disconfirmation of erroneous beliefs about worry.</p>

<p>The mindfulness-based stress reduction (MBSR) program was designed to be long enough for participants to grasp the principles of self-regulation through mindfulness and develop skill and autonomy in mindfulness practice. It traditionally consists of 26 hours of session time including eight classes of 2-1/2 hours and an all-day class. The circumstances of some groups exclude them from participating in this standard form and a number of trials have evaluated programs with abbreviated class time. If lower program time demands can lead to similar outcomes in psychological functioning, it would support their utility in these settings and might lead to greater participation. However, the effect of variation in class hours on outcomes has not been systematically studied. To obtain preliminary information related to this question we examined effect sizes for psychological outcome variables in published studies of MBSR, some of which had adapted the standard number of class hours. The correlation between mean effect size and number of in-class hours was nonsignificant for both clinical and nonclinical samples and suggests that adaptations that include less class time may be worthwhile for populations for whom reduction of psychological distress is an important goal and for whom longer time commitment may be a barrier to their ability or willingness to participate. However, the standard MBSR format has accrued the most empirical support for its efficacy and session time may be important to the development of other kinds of program outcomes. The result points to the importance of empirical studies systematically examining this question. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–12, 2009.</p>

There is increasing evidence for the utility of mindfulness training as a clinical intervention. Most of this research has examined secular-based mindfulness instruction. The current study examined the effects of a 10-day Buddhist mindfulness meditation course on the psychological symptoms of 53 participants. A repeated-measures analysis of variance indicated reductions in overall psychological distress from the pre-course baseline to a 3-month follow-up. Correlation analyses indicated that the reported reduction in psychological distress was not influenced by social desirability bias and that the effect was not dependent on daily meditation between course completion and follow-up. Issues regarding modality of mindfulness training (secular versus Buddhist) are discussed.

<p>The purpose of this theoretical study was to investigate the potential compatibility of existential-humanistic psychotherapy and Buddhist meditation as they are practiced in the contemporary Western world. The fundamental philosophies and practices of Buddhist meditation, drawn from Tibetan, Zen, and Vipassana sources in Western publication, were presented. The principles and practices of existential-humanistic psychotherapy, represented by the works of May, Rogers, and Maslow, were next brought forth. After these presentations, the major ideologies and techniques of each discipline were compared and contrasted, with a view toward examining their essential similarities and significant points of departure. Following this examination, contemporary practices in the synthesis of existential-humanistic psychotherapy and Buddhist meditation were discussed as they exist in current usage in therapeutic situations. The voices of persons expressing opposition to a synthesis of Buddhist meditation and existential-humanistic psychotherapy were also brought forth for consideration. It was found that a sequential approach, wherein psychotherapy precedes meditation, is of overall greater benefit to the client and to both the disciplines of psychotherapy and meditation, than a blended approach. Among the reasons cited for the favoring of a linear progression from psychotherapy to meditation is a respect for the developmental tasks of each individual. In this regard, it was noted that the existential-humanistic therapy tasks of self-identification, emotional contact and expression, ego-development, and increase in self-esteem are necessary before the individual can undertake, in a serious way, the Buddhist meditational tasks of dis-identification for emotional and egoic concerns. In this light, another advantage of the sequential approach is the opportunity provided for the individual to be sufficiently prepared and matured for the discipline of meditation, which is a journey toward higher realms of consciousness not generally obtainable in existential-humanistic psychotherapy. Additionally, it was shown that although Buddhist meditation and existential-humanistic psychotherapy perform corollary functions in the enhancement of individual well-being, the intensification of present awareness, and the lifting of repressedness, there are philosophical differences that are of such sufficient degree that a separation is deemed advisable. It was further seen that a clear distinction between the two disciplines maintains the full integrity and power of each to best accomplish its stated aims. It was noted that meditative practice offers the student specific skills that facilitate the attainment of a still mind, a state of inner harmony, and a transformation and transcendence of the concerns of the pyschotherapeutic level of development.</p>

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