Efficacy of Mindfulness
Benefits of mindfulness to therapist and client. Mindfulness is an important tool for mental practitioners to possess in that it permits individuals to further hone therapeutic presence for their clientele. Geller (2013) defined therapeutic presence as a mode of being which is reflective of the therapist’s complete engagement with the client on a moment-to-moment basis. When a therapist has engagement in relation to therapeutic presence, Geller (2013) described that clients are more apt to delve further into the issues in their lives causing them pain. Also, clients report that they feel safe and supported when they engage in therapy with a therapist who is present. Effective therapy is thus described as being contingent upon presence of therapeutic engagement. Therapeutic presence also permits the therapist to absorb the expressions of the client that are verbal or nonverbal in nature (Geller, 2013).
Mindfulness practice is affiliated with this therapeutic presence in that mindfulness meditation can assist therapeutic professionals at developing presence (Campbell & Christopher, 2012; Gehart & McCollum, 2008). Goldstein (2013) further explained that listening to another individual with usage of compassion and loving-kindness when others are speaking even when the words are untrue or unkind is deemed as being part of mindfulness practice. Conspicuously, this is a useful tool for therapists to possess in that they may be presented with clients who conflict with their value set, which can create friction in the therapeutic alliance. Therapists who are mindfulness-based practitioners are also thought to differ from traditional therapists in that they engage in observing experiences within the present moment as they unfold (Gehart & McCollum, 2008). Conversely, traditional therapists have a proclivity to reflect on experiences retrospectively as opposed to allowing immersing themselves in the experiences as they unfold (Gehart & McCollum, 2008).
Studies have also exemplified the utility of this present-oriented stance in therapy. Namely, therapists in training immersed in a MBSR program exhibited lower levels of stress, lower levels of negative emotional states, less rumination, less anxiety, and higher levels of positive emotion and self-compassion (Shapiro, Brown, & Biegel, 2007). Therapist practice of MBSR was also affiliated with overall increased usage of mindfulness by part of clientele (Shapiro et al., 2007). Mindfulness can also enhance the self-confidence of therapists in relation to their counseling skills. Namely, Greason and Cashwell (2009) conducted a study on counseling students at the master’s degree or doctoral level and found that mindfulness practice is a predictive variable of counseling self-efficacy. Another study, conducted by Aggs and Bambling (2010), had 47 mental health professionals partake in an 8-week mindful therapy training program. The results of this study indicated that the participants, as compared to baseline scores, exhibited increases in knowledge acquisition, in mindfulness in their clinical work, in their ability to induce mindful states of consciousness, and higher well-being ratings throughout the training sessions (Aggs & Bambling, 2010). Thus, this study showed that mindfulness training programs can augment knowledge and skill outcomes in relation to therapists, which can in turn aid one’s therapeutic practice (Aggs & Bambling, 2010). A criticism of this study is that there was a limited sample size used for the study in that only 47 mental health professionals were used. Furthermore, Aggs and Bambling noted that the individuals in the study tended to develop accepting and even-tempered attitudes as opposed to attention-regulation skills. Hence, only selected components of mindfulness were embodied, and this might also occur in the general population of therapists in training as well when they attempt to practice this skill.
In addition to enhancing therapeutic presence, mindfulness is useful for mental health professionals in that it allows them to reduce their overall stress levels (Hutchinson & Dobkin, 2009). More particularly, a randomized controlled pilot study conducted by Shapiro, Astin, Bishop, and Cordova (2005) indicated that 8-week MBSR intervention with health care professionals had the potential to reduce stress and enhance self-compassion in the individuals. One can observe that stress reduction is helpful for individuals in the mental health field since being in a more calm mind state can assist in establishing a calm environment for clients to disclose. Hutchinson and Dobkin (2009) aligned with this hypothesis in saying that one is able to provide higher quality health care if personal and professional stress is appropriately managed.
Mindfulness within the psychological field seems to parallel its usage in the medical profession in which it is integrated with the goals of promoting well-being amongst workers and facilitating patient healing (Hutchinson & Dobkin, 2009). Moreover, individuals who work within the mental health profession are said to be exposed to an immense number of trauma-ridden events and subjects (Berceli & Napoli, 2006). Hence, mindfulness-based trauma prevention programs have also been formulated for mental health practitioner which assists them in maintaining inner tranquility despite what they are exposed to in working with a populace of individuals with mental health issues (Berceli & Napoli, 2006). As well, establishing a personal mindfulness practice connects back to Buddhist philosophy in which it is thought that the most effective way that an individual can help another is through engaging in self-compassion and assisting him or herself first (Gilbert & Choden, 2013).
Mindfulness can also potentially assist mental health practitioners in exhibiting a nonjudgmental attitude which is crucial to counseling work. Namely, this is because mindfulness practitioners approach situations with an exploratory and open attitude (Gehart and McCollum, 2008). As well, Epstein (1999) asserted that practitioners of mindfulness attend to physical or mental processes in a nonjudgmental fashion. Augmented insight into the client and the self is observed through practice of mindfulness meditation in that it permits the professional to be more open, accepting, and present-moment focused, which allows for more effective use of the self in therapy (Hutchinson & Dobkin, 2009). Hutchinson and Dobkin (2009) further noted that within the context of the medical field, mindfulness usage has permitted for a more client-centered, individualized approach to be used within therapy in which “rehumanization” occurs. Specifically, Epstein asserted that practitioners who engage in mindfulness listen in an attentive fashion to the distress of patients, refine their skills of technical quality, and engage in clarity of values so that presence, insight, and compassion can be utilized in interaction with patients. Mindful practitioners also utilize self-monitoring and are cognizant of the values and knowledge that they bring to interactions with clients (Epstein, 1999). Mindlessness, conversely, is thought to contribute to a diminished amount of professionalism in interactions with clients in addition to erroneous decisions in relation to judgments or techniques (Epstein, 1999).
Another study, conducted by Grepmair et al. (2007), examined the implication of mindfulness training in a therapist in training population. Specifically, in this study 124 inpatients were treated for 9 weeks by 18 psychotherapists in training trained in mindfulness. The therapists in training were assigned to a group of practicing Zen meditation or a control group of not practicing meditation. The results of this study indicated that the psychotherapists in training group had clients who exhibited stronger clarification and problem-solving perspectives. The clients who had a therapist based in meditation also exhibited greater symptom reduction (Grepmair et al., 2007). A potential criticism of this study is that other extraneous variables present may have contributed to the phenomena exhibited in the clients, such as a bettering of their psychological issues with time or the learning of alternative coping mechanisms.
Deatherage (1975) described that mindfulness training also was utilized on psychiatric populations in the 1970s with the goal of allowing clients to observe their thoughts. Deatherage used case studies of individuals. The clients were instructed to focus on their breath and then observe the mental processes that were occurring. Clients were then able to notice which sorts of thoughts were interrupting their ability to focus on their breath so they could notice whether they focused on thoughts that were past or future based. The individuals in the case studies yielded positive results in relation to outcome of the study; they became more in contact with their “observer”-self component, which elicited calmness in these individuals. As well, engaging in detachment from thought allowed the individuals to realize that they were the observers of their thoughts as opposed to the depressed person. Labeling of thoughts also permitted the individuals in the case studies to break connections between past thoughts and bouts of depression and anxiety, and this in turn dispersed the presence of anxiety and depression these individuals experienced in the present moment. The results of the case studies in this study were that mindfulness is beneficial in patients who are experiencing psychological issues such as depression, anxiety, or neurosis (Deatherage, 1975). However, a limitation of this study is that only case studies were utilized, which can be highly subjective as they are contingent upon an individual’s unique experience.
Tools that have been utilized to measure mindfulness in an individual similarly point to its usefulness. Specifically, Mindful Attention and Awareness Scale (MAAS) is a tool that has been used to assess unique components of mindful quality over time (Warren Brown & Ryan, 2003). It has been discovered that individuals who score high on the MAAS exhibit a heightened awareness and receptivity to inner experience in addition to more mindfulness on a behavioral basis (Warren Brown & Ryan, 2003). These individuals are more attuned to their internal emotional states and able to adjust them in order to meet primal physiological needs (Warren Brown & Ryan, 2003). Higher scoring on the MAAS is also affiliated with increased positive affect, self-esteem, optimism, and self-actualization (Warren Brown & Ryan, 2003). Warren Brown and Ryan (2003) also reported that state and dispositional mindfulness possession are predictive of behavior which is self-regulated and emotional states that are positive in quality.
In addition to these benefits, mindfulness practice also may allow an individual to more effectively utilize active listening skills in therapy. In mindfulness training one is taught to pay attention to what other individuals are saying as they are saying it (Segal et al., 2013). Mindfulness practice is thus different from general listening practices that occur in normal conversations in which people frequently attempt to determine what the other person is going to say next or how one can problem solve for the talker (Segal et al., 2013). One can observe that this is clearly a useful practice for a therapist to possess in work with clientele in that it allows for the clients to feel that they are being heard as opposed to thinking that their therapist is caught up in his or her own thoughts or perceptions of the situations clients are verbalizing.
