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<p>Meditative dialogue is a mindfulness method through which families and their therapists are able to access the present moment and develop acceptance, non-judgmental attitudes and attunement with one another and with the music that is always present in their lives. This process can be used to deepen empathic connections, tap into creative forces and loosen and encourage embodied and flexible interactions that alter patterns and cultivate openness to possibility and to change.</p>
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<p>Mindfulness-based approaches are increasingly employed as interventions for treating a variety of psychological, psychiatric and physical problems. Such approaches include ancient Buddhist mindfulness meditations such as Vipassana and Zen meditations, modern group-based standardized meditations, such as mindfulness-based stress reduction and mindfulness-based cognitive therapy, and further psychological interventions, such as dialectical behavioral therapy and acceptance and commitment therapy. We review commonalities and differences of these interventions regarding philosophical background, main techniques, aims, outcomes, neurobiology and psychological mechanisms. In sum, the currently applied mindfulness-based interventions show large differences in the way mindfulness is conceptualized and practiced. The decision to consider such practices as unitary or as distinct phenomena will probably influence the direction of future research. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1-21, 2011.</p>

Interest in applications of mindfulness-based approaches with adults has grown rapidly in recent times, and there is an expanding research base that suggests these are efficacious approaches to promoting psychological health and well-being. Interest has spread to applications of mindfulness-based approaches with children and adolescents, yet the research is still in its infancy. I aim to provide a preliminary review of the current research base of mindfulness-based approaches with children and adolescents, focusing on MBSR/MBCT models, which place the regular practice of mindfulness meditation at the core of the intervention. Overall, the current research base provides support for the feasibility of mindfulness-based interventions with children and adolescents, however there is no generalized empirical evidence of the efficacy of these interventions. For the field to advance, I suggest that research needs to shift away from feasibility studies towards large, well-designed studies with robust methodologies, and adopt standardized formats for interventions, allowing for replication and comparison studies, to develop a firm research evidence base.

<p>Recovered recurrently depressed patients were randomized to treatment as usual (TAU) or TAU plus mindfulness-based cognitive therapy (MBCT). Replicating previous findings, MBCT reduced relapse from 78% to 36% in 55 patients with 3 or more previous episodes; but in 18 patients with only 2 (recent) episodes corresponding figures were 20% and 50%. MBCT was most effective in preventing relapses not preceded by life events. Relapses were more often associated with significant life events in the 2-episode group. This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group, suggesting that these groups represented distinct populations. MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes.</p>

The high likelihood of recurrence in depression is linked to a progressive increase in emotional reactivity to stress (stress sensitization). Mindfulness-based therapies teach mindfulness skills designed to decrease emotional reactivity in the face of negative affect-producing stressors. The primary aim of the current study was to assess whether Mindfulness-Based Cognitive Therapy (MBCT) is efficacious in reducing emotional reactivity to social evaluative threat in a clinical sample with recurrent depression. A secondary aim was to assess whether improvement in emotional reactivity mediates improvements in depressive symptoms. Fifty-two individuals with partially remitted depression were randomized into an 8-week MBCT course or a waitlist control condition. All participants underwent the Trier Social Stress Test (TSST) before and after the 8-week trial period. Emotional reactivity to stress was assessed with the Spielberger State Anxiety Inventory at several time points before, during, and after the stressor. MBCT was associated with decreased emotional reactivity to social stress, specifically during the recovery (post-stressor) phase of the TSST. Waitlist controls showed an increase in anticipatory (pre-stressor) anxiety that was absent in the MBCT group. Improvements in emotional reactivity partially mediated improvements in depressive symptoms. Limitations include small sample size, lack of objective or treatment adherence measures, and non-generalizability to more severely depressed populations. Given that emotional reactivity to stress is an important psychopathological process underlying the chronic and recurrent nature of depression, these findings suggest that mindfulness skills are important in adaptive emotion regulation when coping with stress.
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BACKGROUND: Many antidepressant medications (ADM) are associated with disruptions in sleep continuity that can compromise medication adherence and impede successful treatment. The present study investigated whether mindfulness meditation (MM) training could improve self-reported and objectively measured polysomnographic (PSG) sleep profiles in depressed individuals who had achieved at least partial remission with ADM, but still had residual sleep complaints. METHODS: Twenty-three ADM users with sleep complaints were randomized into an 8-week Mindfulness-Based Cognitive Therapy (MBCT) course or a waitlist control condition. Pre-post measurements included PSG sleep studies and subjectively reported sleep, residual depression symptoms. RESULTS: Compared to controls, the MBCT participants improved on both PSG and subjective measures of sleep. They showed a pattern of decreased wake time and increased sleep efficiency. Sleep depth, as measured by stage 1 and slow-wave sleep, did not change as a result of mindfulness training. CONCLUSIONS: MM is associated with increases in both objectively and subjectively measured sleep continuity in ADM users. MM training may serve as more desirable and cost-effective alternative to discontinuation or supplementation with hypnotics, and may contribute to a more sustainable recovery from depression.

<p>BACKGROUND: Many antidepressant medications (ADM) are associated with disruptions in sleep continuity that can compromise medication adherence and impede successful treatment. The present study investigated whether mindfulness meditation (MM) training could improve self-reported and objectively measured polysomnographic (PSG) sleep profiles in depressed individuals who had achieved at least partial remission with ADM, but still had residual sleep complaints. METHODS: Twenty-three ADM users with sleep complaints were randomized into an 8-week Mindfulness-Based Cognitive Therapy (MBCT) course or a waitlist control condition. Pre-post measurements included PSG sleep studies and subjectively reported sleep, residual depression symptoms. RESULTS: Compared to controls, the MBCT participants improved on both PSG and subjective measures of sleep. They showed a pattern of decreased wake time and increased sleep efficiency. Sleep depth, as measured by stage 1 and slow-wave sleep, did not change as a result of mindfulness training. CONCLUSIONS: MM is associated with increases in both objectively and subjectively measured sleep continuity in ADM users. MM training may serve as more desirable and cost-effective alternative to discontinuation or supplementation with hypnotics, and may contribute to a more sustainable recovery from depression.</p>
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Mindfulness-based cognitive therapy (MBCT), a meditation-based maintenance therapy, reduces the relapse risk in individuals suffering from major depressive disorder (MDD). However, only a few studies investigated the psychophysiological mechanisms underlying this protective effect. We examined effects of MBCT on trait rumination and mindfulness, as indicators of global cognitive style, as well as on residual depressive symptoms in a group of recurrently depressed patients (n = 78) in remission. Additionally, alpha asymmetry in resting-state electroencephalogram (EEG) was assessed. Alpha asymmetry has been found to be predictive of affective style and a pattern indicative of stronger relative right-hemispheric anterior cortical activity may represent a trait marker for the vulnerability to develop MDD. In line with previous findings, residual depressive symptoms and trait rumination decreased, whereas trait mindfulness increased following MBCT, while no such changes took place in a wait-list control group. Mean values of alpha asymmetry, on the other hand, remained unaffected by training, and shifted systematically toward a pattern indicative of stronger relative right-hemispheric anterior cortical activity in the whole sample. These findings provide further support for the protective effect of MBCT. In the examined patients who were at an extremely high risk for relapse, however, this effect did not manifest itself on a neurophysiological level in terms of alpha asymmetry, where a shift, putatively indicative of increased vulnerability, was observed.

<p>Baer's review (2003; this issue) suggests that mindf ulness-based interventions are clinically efficacious, but that better designed studies are now needed to substantiate the field and place it on a firm foundation for future growth. Her review, coupled with other lines of evidence, suggests that interest in incorporating mindfulness into clinical interventions in medicine and psychology is growing. It is thus important that professionals coming to this field understand some of the unique factors associated with the delivery of mindfulness-based interventions and the potential conceptual and practical pitfalls of not recognizing the features of this broadly unfamiliar landscape. This commentary highlights and contextualizes (1) what exactly mindfulness is, (2) where it came from, (3) how it came to be introduced into medicine and health care, (4) issues of cross-cultural sensitivity and understanding in the study of meditative practices stemming from other cultures and in applications of them in novel settings, (5) why it is important for people who are teaching mind-fulness to practice themselves, (6) results from 3 recent studies from the Center for Mindfulness in Medicine, Health Care, and Society not reviewed by Baer but which raise a number of key questions about clinical applicability, study design, and mechanism of action, and (7) current opportunities for professional training and development in mindfulness and its clinical applications.</p>

<p>Mindfulness-based approaches are among the most innovative and interesting new approaches to mental health treatment. Mindfulness refers to patients developing an "awareness of present experience with acceptance." Interest in them is widespread, with presentations and workshops drawing large audiences all over the US and many other countries. This book provides a comprehensive introduction to the best-researched mindfulness-based treatments. It emphasizes detailed clinical illustration providing a close-up view of how these treatments are conducted, the skills required of therapists, and how they work. The book also has a solid foundation in theory and research and shows clearly how these treatments can be understood using accepted psychological principles and concepts. The evidence base for these treatments is concisely reviewed.* Comprehensive introduction to the best-researched mindfulness-based treatments* Covers wide range of problems &amp; disorders (anxiety, depression, eating, psychosis, personality disorders, stress, pain, relationship problems, etc)* Discusses a wide range of populations (children, adolescents, older adults, couples)* Includes wide range of settings (outpatient, inpatient, medical, mental health, workplace)* Clinically rich, illustrative case study in every chapter* International perspectives represented (authors from US, Canada, Britain, Sweden)</p>

<p>"Everyday life is so frantic and full of troubles that we have largely forgotten how to live a joyful existence. We try so hard to be happy that we often end up missing the most important parts of our lives. In Mindfulness, Oxford professor Mark Williams and award-winning journalist Danny Penman reveal the secrets to living a happier and less anxious, stressful, and exhausting life. Based on the techniques of Mindfulness-Based Cognitive Therapy, the unique program developed by Williams and his colleagues, the book offers simple and straightforward forms of mindfulness meditation that can be done by anyone--and it can take just 10 to 20 minutes a day for the full benefits to be revealed"-- "From one of the leading thinkers on Mindfulness-Based Cognitive Therapy, a pioneering set of simple practices to dissolve anxiety, stress, exhaustion, and unhappiness. Everyday life is so frantic and full of troubles that we have largely forgotten how to live a joyful existence. We try so hard to be happy that we often end up missing the most important parts of our lives. In Mindfulness, Oxford professor Mark Williams and award-winning journalist Danny Penman reveal the secrets to living a happier and less anxious, stressful, and exhausting life. Based on the techniques of Mindfulness-Based Cognitive Therapy, the unique program developed by Williams and his colleagues, the book offers simple and straightforward forms of mindfulness meditation that can be done by anyone--and it can take just 10 to 20 minutes a day for the full benefits to be revealed. "--</p>

Twenty-seven adult survivors of childhood sexual abuse participated in a pilot study comprising an 8-week mindfulness meditation-based stress reduction (MBSR) program and daily home practice of mindfulness skills. Three refresher classes were provided through final follow-up at 24 weeks. Assessments of depressive symptoms, post-traumatic stress disorder (PTSD), anxiety, and mindfulness, were conducted at baseline, 4, 8, and 24 weeks. At 8 weeks, depressive symptoms were reduced by 65%. Statistically significant improvements were observed in all outcomes post-MBSR, with effect sizes above 1.0. Improvements were largely sustained until 24 weeks. Of three PTSD symptom criteria, symptoms of avoidance/numbing were most greatly reduced. Compliance to class attendance and home practice was high, with the intervention proving safe and acceptable to participants. These results warrant further investigation of the MBSR approach in a randomized, controlled trial in this patient population. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 1–18, 2010.

Randomized, controlled studies have documented positive physical and psychological effects of writing about traumatic stress. Some of these studies have shown that individual differences play an important role, with participants responding differently to the intervention based on their personal characteristics. In the present expressive writing experiment, the trait of mindfulness was examined as a potential moderator. Seventy-six undergraduates were randomly assigned to either expressive writing (n = 37) or a control group (n = 39). Main effects favoring expressive writing were found, and these were qualified by significant interactions with mindfulness. Specifically, individuals with higher mindfulness scores responded better to expressive writing, experiencing greater physical and psychological benefits than individuals with lower mindfulness scores.
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<p>Mindfulness refers to a set of practices as well as the psychological state and trait produced by such practices. The state, trait, and practice of mindfulness may be broadly characterized by a present-oriented, nonjudgmental awareness of cognitions, emotions, sensations, and perceptions without fixation on thoughts of past or future. Research on mindfulness has proliferated over the past decade. Given the explosion of scientific interest in this topic, mindfulness-based therapies are attracting the attention of clinical social workers, who seek to implement these interventions in numerous practice settings. Concomitantly, research on mindfulness is now falling within the scope and purview of social work scholars. In response to the growing interest in mindfulness within academic social work, the present article outlines six conceptual and methodological recommendations for the conduct of future empirical studies on mindfulness. These recommendations have practical importance for advancing mindfulness research within and beyond social work.</p>
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Mindfulness practice is an ancient tradition in Eastern philosophy that forms the basis for meditation, and it is increasingly making its way into Western approaches to health care. Although it has been applied to the treatment of many different mental health disorders, it has not been discussed in the context of therapy for sexual problems. In a previous qualitative study of female meditation practitioners who did not have sexual concerns, mindfulness practice was found to be associated with greater sexual response and higher levels of sexual satisfaction. We have recently developed a psychoeducational program for women with sexual arousal disorder subsequent to gynecologic cancer and have included a component of mindfulness training in the intervention. In this paper, we will attempt to provide a rationale for the use of mindfulness in the treatment of women with sexual problems, and will include transcript excerpts from women who participated in our research trial that illustrate how mindfulness was effective in improving their sexuality and quality of life. Although these findings are preliminary, they suggest that mindfulness may have a place in the treatment of sexual concerns.

<p>In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.</p>
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Summary This paper reviews the philosophical origins, current scientific evidence, and clinical promise of yoga and mindfulness as complementary therapies for addiction. Historically, there are eight elements of yoga that, together, comprise ethical principles and practices for living a meaningful, purposeful, moral and self-disciplined life. Traditional yoga practices, including postures and meditation, direct attention toward one's health, while acknowledging the spiritual aspects of one's nature. Mindfulness derives from ancient Buddhist philosophy, and mindfulness meditation practices, such as gentle Hatha yoga and mindful breathing, are increasingly integrated into secular health care settings. Current theoretical models suggest that the skills, insights, and self-awareness learned through yoga and mindfulness practice can target multiple psychological, neural, physiological, and behavioral processes implicated in addiction and relapse. A small but growing number of well-designed clinical trials and experimental laboratory studies on smoking, alcohol dependence, and illicit substance use support the clinical effectiveness and hypothesized mechanisms of action underlying mindfulness-based interventions for treating addiction. Because very few studies have been conducted on the specific role of yoga in treating or preventing addiction, we propose a conceptual model to inform future studies on outcomes and possible mechanisms. Additional research is also needed to better understand what types of yoga and mindfulness-based interventions work best for what types of addiction, what types of patients, and under what conditions. Overall, current findings increasingly support yoga and mindfulness as promising complementary therapies for treating and preventing addictive behaviors.

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