Other variations of mindfulness. Mindfulness has also been a useful contribution to psychology in other forms aside from MBCT and MBSR. Particularly, derivatives of mindfulness-based programs have been applied to eating awareness training, relapse prevention, compassion-focused therapy, for individuals with anxiety, and in an acceptance-based context to improve self-esteem (Germer, 2013). Overall, the four predominantly used mindfulness-based treatment programs are MBSR, MBCT, dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT; Germer, 2013).
ACT as a modality embodies three categories which include acceptance, values-based living, and mindfulness (Hayes & Smith, 2005). ACT utilizes certain key components of mindfulness and additionally addresses ways for an individual to change (Hayes & Smith, 2005). ACT therapy views thoughts as acting in the function of a lens that predicts interpretation of one’s outer experiences (Hayes & Smith, 2005). For instance, if individuals are stuck within a lens of psychological pain, they may communicate to themselves that they are depressed (Hayes & Smith, 2005). ACT closely resembles mindfulness-based practices in that this modality has the viewpoint that attempting to rid oneself of pain merely amplifies it and forms it into a more traumatic phenomenon (Hayes & Smith, 2005). ACT further identifies that there is not a correct or incorrect way for one to be mindful. Namely, a central goal of ACT is for one to experience oneself in a conscious way within the context of the present moment (Hayes & Smith, 2005).
Hofmann and Asmundson (2008) stated that techniques found within the ACT modality are compatible with those in CBT and thus are both equally effective at treating psychological issues. Hofmann and Asmundson further stated that both ACT and CBT modulate emotions through manipulating emotional cues or responses. However, although both target emotional regulation in their treatment, they target different parts of the emotional process. Specifically, CBT promotes emotional regulation strategies which are antecedent based, whereas ACT strategies and mindfulness-based strategies counteract emotional regulation strategies that are maladaptive and reactive based (Hofmann & Asmundson, 2008).
Yoga-MBCT, or Y-MBCT, is another variation of MBCT (Pradhan, 2015). This model differs from other therapeutic modalities that often utilize either only the meditational or the physical components of yogic philosophy individually (Pradhan, 2015). The Y-MBCT model uses concentrative yoga and mindfulness meditation in order to modify one’s lifestyle to align with the middle way concept outlined by the Buddha (Pradhan, 2015). The middle way is encouraged to be used as a middle ground between hedonism and shaming of the self (Pradhan, 2015). As well, Y-MBCT entails a self-help methodology in which direct experience within the context of daily life is encouraged (Pradhan, 2015).
CBT as a modality uses mindfulness even when the terminology of mindfulness is not at the forefront of this practice (Germer, 2013). Namely, CBT uses techniques of enhancing emotional awareness, facilitating flexibility in relation to awareness as well as identification of behavioral avoidance, and situational-based exposure to cues of emotional nature (Germer, 2013). Hence, one can observe that awareness is an integral part of practice in CBT which parallels mindfulness-based philosophies. CBT also has a focus on teaching clients to distance themselves from and decenter from their thoughts (Segal et al., 2013). In CBT, the patient is encouraged to generate a new relationship to their negative thought by viewing it from a distance, evaluating its accuracy, and then acquiring an alternative perspective to the negative feeling or thought (Segal et al., 2013). CBT also parallels mindfulness practice through its focus on the present moment (Varvogli & Darviri, 2011).
Segal et al. (2013) described that the central difference between CBT and mindfulness-based approaches is that CBT focuses on alteration of thought content through distancing or decentering of thoughts, while mindfulness approaches view the decentering to thoughts as being the end to the process. Furthermore, Segal et al. (2007) noted that MBCT differs from traditional cognitive behavioral approaches to depression in that participants are encouraged to view thoughts as being transient as opposed to components of self-identity (as cited in Gause & Coholic, 2010). Segal et al. (2007) further described that mindfulness separates one from the negative thought narrative that one assumes to be one’s identity when one is depressed (as cited in Gause & Coholic, 2010).
Kang and Whittingham (2010) described that DBT is another modality that has roots in mindfulness. DBT is a behavioral therapy that was devised originally for treatment of individuals with borderline personality disorder (Kang & Whittingham, 2010; Read, 2013). DBT was devised by Dr. Marsha Lineham, who observed that CBT was not optimally effective at treating individuals experiencing borderline personality disorder (Read, 2013). CBT lacked effectiveness in treatment since it relied on individuals to change their beliefs and behaviors, which is difficult for individuals with borderline personality disorder to implement (Read, 2013). DBT is a combination of the CBT components of regulating emotions and reality testing with meditative practices from Buddhism (Read, 2013). The specific components of Buddhist meditative practice that were drawn upon to formulate DBT were acceptance, awareness, and toleration of distress (Read, 2013). Furthermore, DBT uses mindfulness principles of self-compassion and nonjudgmental attentional focus to the present moment (Baer, 2005). Kang and Whittingham (2010) further described that DBT encourages individuals to radically accept what is occurring within the context of the present moment while simultaneously changing environments and behaviors. As well, DBT encourages the skills of letting go of attachments that are not effective, reducing judgmental thinking, and possessing an ultimate goal of being aware of present experience (Baer, 2005).
Fiegenbaum (2007) noted that a modified version of DBT exhibited efficacy on binge-eating disorder and chronic depression populations (as cited in in Kang & Whittingham, 2010). DBT has overall been found to be as effective as other treatment methods for major depression (Read, 2013). Kang and Whittingham (2010) described that DBT enacts change in therapy by creating a tension between opposite thoughts and behaviors in therapy.
