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Mindfulness Based Therapies - An Analysis
Mindfulness-based cognitive therapy Mindfulness-based stress reduction  Mindfulness  Mindfulness-based pain management  Mindfulness (journal)  Mindfulness

Introduction
Mindfulness can be divided into two descriptions: mindful practice and mindful awareness. Mindful practice is when the participant has awareness of their thoughts. Mindful awareness is the idea that by practicing mindfulness this can lead to desired outcomes such as thinking in an open, caring, and sensitive way (Shapiro & Carlson, 2009). The reason we associate mindfulness-based therapy with the thoughts and beliefs domain is because there is a focus on meditation practices to develop an awareness of thoughts and allow these experiences to come and go with a mindfulness attitude (Shapiro & Carlson, 2009). Within mindfulness-based therapies participants are asked to become aware of negative patterns of thinking and to challenge these beliefs. Mindfulness-based therapies incorporate mindful practice and mindful awareness both incorporate the use of thoughts. Mindfulness-based therapy is an umbrella term that incorporates all mindful based therapies that incorporate mindfulness meditation practices formally or informally in psychotherapy treatment. The four most common mindfulness-based therapies are mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT) (Shapiro & Carlson, 2009). MBSR was founded by Jon Kabat-Zinn who was heavily influenced by Theravada Buddhist lineage (Husgafvel, 2018). Shapiro & Carlson, 2009, asserted MBSR was developed in 1979 by Jon Kabat-Zinn and colleagues at the University of Massachusetts Medical Center. In MBSR the clients meet over an 8-week group program and use techniques such as meditation, yoga, mindfulness techniques and applying mindfulness attitudes (kindness, acceptance, and non-judgment). They further stated that in the 1990’s experts using Cognitive Behaviour Therapy (CBT) for the treatment of depression had no effective therapy to prevent relapse in depression patients.

This led to the integration of MBSR and CBT by Segal, Williams, Teasdale, Kabat-Zinn and colleagues to create mindfulness based cognitive therapy (MBCT). MBCT uses mindfulness meditation and cognitive-behavioural conceptual framework to tackle depression relapse (Kabat-Zinn et al., 2013). Like MBCT the development of dialectical behavior therapy (DBT) was created for treatment of a mental health disorder. DBT was developed by Marsha Linehan for the treatment of borderline personality disorder (Shapiro & Carlson, 2009). The authors describe DBT as a mindfulness therapy focusing on dialect, mindfulness, and breath/body work. The other major mindfulness-based therapy is acceptance and commitment therapy (ACT). Shapiro & Carlson asserted ACT is usually delivered in individual therapy and there is a focus on context and relationships. There is a focus within ACT on exposure to feared innermost experiences and separating self from thoughts (2009). Mindfulness-based therapies focus on inner experiences, thoughts, beliefs, acceptance, awareness, and incorporate meditation into treatment practice. References ''Husgafvel, V. (2018). The “Universal Dharma Foundation” of Mindfulness-Based Stress Reduction: Non-Duality and Mahāyāna Buddhist Influences in the Work of Jon Kabat-Zinn. Contemporary Buddhism, 19(2), 275–326.https://doi.org/10.1080/14639947.2018.1572329 Shapiro, S. L., & Carlson, L. E. (2009). Mindfulness-based psychotherapy. In The art and science of mindfulness: Integrating mindfulness into psychology and the helping professions. (pp. 45–60). American Psychological Association. https://doi.org/10.1037/11885-004 Mindfulness: Diverse Perspectives on Its Meaning, Origins and Applications, edited by J. Mark G. Williams, and Jon Kabat-Zinn, Routledge, 2013. ProQuest Ebook Central, https://0-ebookcentral-proquest-com.aupac.lib.athabascau.ca/lib/athabascaebooks/detail.action?docID=1487105.''

Macro
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Underlying Assumptions
While the stated attributes assumed to make up a healthy person asserted by Gomez-Odriozola and Calvete (2021) can be identified as healthy, Mindfulness therapy may not be applicable for clients with paradigmatic values which counter the assumptions made. For example, a client who values analysis over self-empathy may not share the values and assumptions embedded within this therapy.

Causal Assumptions As well as paradigmatic assumptions, mindfulness therapy can be assessed by looking at the causal assumptions embedded within the model of practice. As stated by Gomez-Odriozola and Calvete (2021), mindfulness therapy asserts that change occurs when people evaluate themselves with kindness and compassion. As well, mindfulness therapy asserts that attention to moment-to-moment experiences prevent focusing on past struggles which can lead to disorders such as depression. While this kind of therapeutic experience may be beneficial to some clients, there are other models of therapy that assert it is helpful to look at one’s past to understand why a client is feeling and how they are behaving. The assumption around attempting to live in the moment may discount some people’s need to work through their experience in order to move forward.

Another causal assumption presented by Gomez-Odriozola and Calvete (2021) is that clients can learn to assert consciousness and control over feelings, thoughts and bodily sensations. While this assertion may be true of some clients, there are many clients based on their brain chemistry and experiences of trauma that will not be able to assert control over their world, such as those who experience psychosis and people with more profound developmental disabilities. For some people, learning to live with their brains and bodies is important in terms of moving forward in a therapeutic manner. While control may be at the center of the mindfulness therapy’s causal assumption, not everyone is capable of such forms of control, leading this form of therapy to clash with the needs of some clients.

A final causal assumption found in Gomez-Odriozola and Calvete (2021)’s writing around mindfulness therapy is the assertion that change occurs through the development of strategies to relax and manage stress or nervousness. Mindfulness therapy asserts that relaxation can help reduce stress, which appears to present a narrow view of client’s worlds, discounting financial hardship, racial inequality, challenging gender roles and systematic oppression that may be out of the client’s control, compounding the stress or nervousness. The assumption that learning to relax reduces stress discounts the multiple barriers faced by clients when they engage in a therapeutic process and then take those skills out into the world.

Prescriptive Assumptions Along with the paradigmatic assumptions and causal assumptions identified within mindfulness therapy, there are also several prescriptive assumptions within the mindfulness model. As stated by Gomez-Odriozola and Calvete (2021), mindfulness therapy asserts that clients must engage in several activities to move through change, such as positive thinking, time management, commitment to a healthy lifestyle and avoidance of self-pity. When looking at avoidance of self-pity as a prescriptive assumption the previous paradigmatic assertions found in mindfulness therapy, such as the use of a non-judgmental lens, appear to be counter to the description of self-pity as harmful. Telling clients to stop feeling sorry for themselves does not come from a place of empathy or compassion that is needed within any counselling practice

References ''Gomez-Odriozola, J., Calvete, E. (2021). Effects of a Mindfulness-based Intervention on Adolescents’ Depression and Self-concept: The Moderating Role of Age. Journal of Child and Family Studies, 30(6), 1501-1515. https://0-link-springer-com.aupac.lib.athabascau.ca/article/10.1007%2Fs10826-021-01953-Z''

Common Factors
The therapist’s attitude who is practicing mindfulness-based therapy (MBT) is very important. Mindfulness is not practiced with a cool, clinical, or detached attitude but one that is fully imbued with friendly interest, care and non-judgmental acceptance (Kenny, 2021, p. 163). Horesh & Gordon (2018) also stated that the quality of awareness brought in by mindfulness practice would include sessions that are surrounded by openness or receptiveness, curiosity, and a non-judgmental attitude. There’s an emphasis on seeing and accepting things as they are without trying to change them (p. 629). Mindfulness based therapy is centered around meditation and being non-judgmental towards the self. If mindfulness can increase empathy and response flexibility and decrease reactivity, it is likely to promote therapeutic presence. (Campbell & Christopher, 2021, p. 215). We know that a strong client therapist relationship can account for significant change within the client (Duncan, 2014, p. 11). An important aspect with the common factors approach is that it can be individualized for the client (Feinstein et al., 2015) MBT brings in different mindfulness approaches such as sitting meditations, body scans, mindful eating, homework journals, and or daily worksheets. While also being culturally diverse in its teachings (Brown et al., 2013). This allows the client to be able to reach the state of mindfulness in different ways, therefore broadening MBT’s ability to help clients and their individual learning mechanisms while also being culturally diverse. Another important aspect of CF is receiving patient feedback (Feinstein et al., 2015). MBT has several measures of mindfulness that have been created to operationalize and assess the construct and can serve as a useful tool to monitor client’s changes in mindfulness over the course of treatment. (Brown et al., 2013). It’s important to see if the mindfulness strategies are even working for the client and if the intended outcome is going to be achievable. MBT is centered around an empathetic and non-judgmental environment while also being individualized in its teaching of mindfulness-based strategies. MBT can also receive feedback from the client to make sure that the tools and strategies are effective and that there is significant progress being made.

References

''Campbell, J. C., Christopher, J. C. (2012). Teaching Mindfulness to Create Effective Counselors. Journal of Mental Health Counseling, 34(3), 213–226. https://doi.org/10.17744/mehc.34.3.j75658520157258l Duncan, B. L. (2014). So you want to be a better therapist. In On becoming a better therapist:Evidence-based practice one client at a time (2nd ed., pp. 3-33). Washington, DC:American Psychological Association. http://dx.doi.org/10.1037/14392-001 Feinstein, R., Heiman, N., & Yager, J. (2015). Common factors affecting psychotherapy outcomes: some implications for teaching psychotherapy. Journal of Psychiatric Practice, 21(3), 180–189. http://dx.doi.org/10.1097/PRA.0000000000000064 Horesh, D., & Gordon, I. (2018). Mindfulness-Based Therapy for Traumatized Adolescents: An Underutilized, Understudied Intervention. Journal of Loss & Trauma, 23(8), 627–638. https://doi.org/10.1080/15325024.2018.1438047

Kenny, M. (2021). A psychiatrist’s experience of mindfulness-based cognitive Therapy. The Humanistic Psychologist, 49(1), 162–178. https://doi.org/10.1037/hum000022

Evidentiary Base
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