This slim manual (80 pp. with references and appendices) is packed with information.  It is Volume 37 of the series Advances in Psychotherapy – Evidence-Based Practices.  As this title would suggest, Mindfulness centers around the most up-to-date research in this field and its application to the practice of psychotherapy. 

In the opening pages, the authors start with an overview of mindfulness.  They review the particular elements common to all mindfulness practices (personal awareness, attentional allocation, and qualities of awareness).  A brief discussion of the history of mindfulness is provided as well as a comparison between Eastern and Western practices.  From there the authors continue to examine some of the most common mindfulness models, crediting the beginnings of mindfulness as an intervention to the work of Jon Kabat-Zinn, founder of mindfulness-based stress reduction (MBSR).  Other approaches discussed include mindfulness-based cognitive therapy (MBCT), mindfulness-based relapse prevention (MBRP), and more distally-related models such as dialectical behavior therapy (DBT), metacognitive therapy (MCT), compassion-focused therapy (CFT), and acceptance and commitment therapy (ACT).  The specific theories behind how mindfulness effects changes are also reviewed here.

The following segment looks at assessing mindfulness.  Mindfulness is addressed as a state and a trait, and it is examined utilizing both objective and self-report measures.  No specific biomarkers of mindfulness have been identified, yet the authors suggest several potential biomarkers based on changes in brain activity.  With respect to behavioral measures, a breath counting tool has shown some ability to measure present moment awareness, and tactile sensitivity is thought to be useful in studying several other facets of mindfulness.  Several self-report scales have utility for assessing both state and trait mindfulness.

The final section of this book centers around the application of mindfulness-based approaches to treatment, or mindfulness-based intervention (MBI).  The central idea behind MBI derives from Buddhist teachings:  pain is seen as universal and unavoidable, yet suffering is a result of our autonomic, habitual responses to experiences.  In MBI, the therapist/group leader is generally referred to as the facilitator, and the person seeking services is the participant rather than the client or patient.  The facilitator often adopts a motivational interviewing (MI) style, which includes use of techniques such as collaboration, rolling with resistance, acceptance, reflective listening, and evocation.  Modeling mindfulness is also an important part of the process; this involves displaying a sense of curiosity and maintaining non-judgment.  The authors offer additional tips for conveying mindfulness to others, such as offering choices, providing possibilities, and using supportive, exploratory language. 

The discussion of treatment concludes with a review of specific types of mindfulness practices, both formal and informal, as well as guidelines for selecting participants, determining contraindications, and so forth.  Finally, the efficacy of the most common approaches (named above) is briefly outlined.  In addition to suggestions for further resources and an extensive References section, the authors include three Appendices:  a Mindfulness Practice Record and two sample meditations.  With respect to the Body Scan and a Sitting meditations, readers are encouraged not to use these resources as scripts but rather to develop MBI based on their own practice and experience.

As both a clinical psychologist and a yoga instructor, the information in this book resonated with me.  Although this manual is research-based, it is written in clear, easy-to-understand language.  Admittedly, I was already very familiar with the material, so someone less so might desire more detail, as some areas are quite succinct.  Overall, however, I believe this volume to be an excellent overview of mindfulness in psychotherapy.  I would recommend it to any mental health practitioner with an interest in this area.

© 2017 Beth Cholette

Beth Cholette, Ph.D., is a clinical psychologist who provides psychotherapy to college students.