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<p>A number of books have explored the ways psychotherapy clients can benefit from learning and practicing mindfulness. This is the first volume to focus specifically on how mindfulness can deepen the therapeutic relationship. Grounded in research, chapters demonstrate how therapists' own mindfulness practice can help them to listen more attentively and be more fully present. Leading proponents of different treatment approaches—including behavioral, psychodynamic, and family systems perspectives—illustrate a variety of ways that mindfulness principles can complement standard techniques and improve outcomes by strengthening the connection between therapist and client. Also presented are practical strategies for integrating mindfulness into clinical training.</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>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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Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a mindfulness-based procedure, Meditation on the Soles of the Feet, in helping three adolescents to manage their physical aggression. This procedure required the adolescents to rapidly shift the focus of their attention from the aggression-triggering event to a neutral place on their body, the soles of their feet. Incidents of aggression across the three adolescents ranged from a mean of 14–20 per week during baseline, 4–6 per week during mindfulness training, including zero rates during the last 4 weeks of intervention. Aggression occurred a rate of about 1 per year during a 3-year follow-up. Our results suggest adolescents with autism can learn, and effectively use, a mindfulness-based procedure to self-manage their physical aggression over several years.
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OBJECTIVE: To determine whether completing a mindfulness-based stress reduction (MBSR) program would affect the general health, health-related quality of life, sleep quality, and family harmony of Spanish- and English-speaking medical patients at an inner-city health center. MATERIALS AND METHODS: An intervention group of 68 patients (48 Spanish-speaking and 20 English-speaking) completed the SF-36 Health Survey and two additional questions about sleep quality and family harmony before and after completing the 8-week MBSR program. A comparison group of 18 Spanish-speaking patients who received no intervention completed the same questionnaire at the same intervals. RESULTS: Sixty-six percent of the total intervention group completed the 8-week MBSR program. There was significant comorbidity of medical and mental health diagnoses among the intervention and comparison groups, with no differences in the mean number of diagnoses of the total intervention group, the comparison group, or the Spanish- or English-speaking intervention subgroups. Compared with the comparison group, the intervention group showed statistically significant improvement on five of the eight SF-36 measures, and no improvement on the sleep quality or family harmony items. CONCLUSIONS: MBSR may be an effective behavioral medicine program for Spanish- and English-speaking inner-city medical patients. Suggestions are given for future research to help clarify the program’s effectiveness for this population.

This study examined the effects of mindfulness-based stress reduction (MBSR) on health-related quality of life and physical and psychological symptomatology in a heterogeneous patient population. Patients (n=136) participated in an 8-week MBSR program and were required to practice 20 min of meditation daily. Pre- and post-intervention data were collected by using the Short-Form Health Survey (SF-36), Medical Symptom Checklist (MSCL) and Symptom Checklist-90 Revised (SCL-90-R). Health-related quality of life was enhanced as demonstrated by improvement on all indices of the SF-36, including vitality, bodily pain, role limitations caused by physical health, and social functioning (all P&lt;.01). Alleviation of physical symptoms was revealed by a 28% reduction on the MSCL (P&lt;.0001). Decreased psychological distress was indicated on the SCL-90-R by a 38% reduction on the Global Severity Index, a 44% reduction on the anxiety subscale, and a 34% reduction on the depression subscale (all P&lt;.0001). One-year follow-up revealed maintenance of initial improvements on several outcome parameters. We conclude that a group mindfulness meditation training program can enhance functional status and well-being and reduce physical symptoms and psychological distress in a heterogeneous patient population and that the intervention may have long-term beneficial effects.

OBJECTIVES: This study investigated the relationships between a mindfulness-based stress reduction meditation program for early stage breast and prostate cancer patients and quality of life, mood states, stress symptoms, lymphocyte counts, and cytokine production. METHODS: Forty-nine patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program that incorporated relaxation, meditation, gentle yoga, and daily home practice. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-γ, IL-4, and IL-10 were assessed pre- and postintervention. RESULTS: Fifty-nine and 42 patients were assessed pre- and postintervention, respectively. Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. Although there were no significant changes in the overall number of lymphocytes or cell subsets, T cell production of IL-4 increased and IFN-γ decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile. CONCLUSIONS: MBSR participation was associated with enhanced quality of life and decreased stress symptoms in breast and prostate cancer patients. This study is also the first to show changes in cancer-related cytokine production associated with program participation.

<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.

Mindfulness-based interventions have been shown to alleviate symptoms of a wide range of physical and mental health conditions. Regular between-session practice of mindfulness meditation is among the key factors proposed to produce the therapeutic benefits of mindfulness-based programs. This article reviews the mindfulness intervention literature with a focus on the status of home practice research and the relationship of practice to mindfulness program outcomes. Of 98 studies reviewed, nearly one-quarter (N = 24) evaluated the associations between home practice and measures of clinical functioning, with just over half (N = 13) demonstrating at least partial support for the benefits of practice. These findings indicate a substantial disparity between what is espoused clinically and what is known empirically about the benefits of mindfulness practice. Improved methodologies for tracking and evaluating the effects of home practice are recommended.
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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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<p>Interest in mindfulness and its enhancement has burgeoned in recent years. In this article, we discuss in detail the nature of mindfulness and its relation to other, established theories of attention and awareness in day-to-day life. We then examine theory and evidence for the role of mindfulness in curtailing negative functioning and enhancing positive outcomes in several important life domains, including mental health, physical health, behavioral regulation, and interpersonal relationships. The processes through which mindfulness is theorized to have its beneficial effects are then discussed, along with proposed directions for theoretical development and empirical research.</p>

<p>This article focuses on how mindfulness training (MT) programs for teachers, by cultivating mindfulness and its application to stress management and the social-emotional demands of teaching, represent emerging forms of teacher professional development (PD) aimed at improving teaching in public schools. MT is hypothesized to promote teachers' “habits of mind,” and thereby their occupational health, well-being, and capacities to create and sustain both supportive relationships with students and classroom climates conducive to student engagement and learning. After defining mindfulness and its potential applications in teacher education and PD, this article discusses emerging MT programs for teachers, a logic model outlining potential MT program effects in educational settings, and directions for future research.</p>
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Mindfulness is defined as paying attention in the present moment. We investigate the hypothesis that mindfulness training may alter or enhance specific aspects of attention. We examined three functionally and neuroanatomically distinct but overlapping attentional subsystems: alerting, orienting, and conflict monitoring. Functioning of each subsystem was indexed by performance on the Attention Network Test. Two types of mindfulness training (MT) programs were examined, and behavioral testing was conducted on participants before (Time 1) and after (Time 2) training. One training group consisted of individuals naive to mindfulness techniques who participated in an 8-week mindfulness-based stress reduction (MBSR) course that emphasized the development of concentrative meditation skills. The other training group consisted of individuals experienced in concentrative meditation techniques who participated in a 1-month intensive mindfulness retreat. Performance of these groups was compared with that of control participants who were meditation naive and received no MT. At Time 1, the participants in the retreat group demonstrated improved conflict monitoring performance relative to those in the MBSR and control groups. At Time 2, the participants in the MBSR course demonstrated significantly improved orienting in comparison with the control and retreat participants. In contrast, the participants in the retreat group demonstrated altered performance on the alerting component, with improvements in exogenous stimulus detection in comparison with the control and MBSR participants. The groups did not differ in conflict monitoring performance at Time 2. These results suggest that mindfulness training may improve attention-related behavioral responses by enhancing functioning of specific subcomponents of attention. Whereas participation in the MBSR course improved the ability to endogenously orient attention, retreat participation appeared to allow for the development and emergence of receptive attentional skills, which improved exogenous alerting-related process.
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<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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Lesion and neuroimaging studies suggest the amygdala is important in the perception and production of negative emotion; however, the effects of emotion regulation on the amygdalar response to negative stimuli remain unknown. Using event-related fMRI, we tested the hypothesis that voluntary modulation of negative emotion is associated with changes in neural activity within the amygdala. Negative and neutral pictures were presented with instructions to either "maintain" the emotional response or "passively view" the picture without regulating the emotion. Each picture presentation was followed by a delay, after which subjects indicated how they currently felt via a response keypad. Consistent with previous reports, greater signal change was observed in the amygdala during the presentation of negative compared to neutral pictures. No significant effect of instruction was found during the picture presentation component of the trial. However, a prolonged increase in signal change was observed in the amygdala when subjects maintained the negative emotional response during the delay following negative picture offset. This increase in amygdalar signal due to the active maintenance of negative emotion was significantly correlated with subjects' self-reported dispositional levels of negative affect. These results suggest that consciously evoked cognitive mechanisms that alter the emotional response of the subject operate, at least in part, by altering the degree of neural activity within the amygdala.
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