Mindfulness in a clinical world: Exploring evaluation and treatment integrity
Abstract
Mindfulness Based Stress Reduction (MBSR; Kabat-Zinn, 1990) and Mindfulness Based Cognitive Therapy (MBCT; Segal, Williams & Teasdale, 2002) offer a method of training in which participants learn to become less reactive to personal experience, thereby decreasing suffering and increasing wellbeing (Didonna, 2009). MBCT and MBSR, and adaptations thereof, are underpinned by the assumption that training in mindfulness increases levels of mindfulness, and these increases mediate positive outcomes. Given that rumination and experiential avoidance are known to be common in many adverse mental health states and are implicated in their maintenance (e.g. Hayes et al., 1996;
Nolen-Hoeksema, 1998), there has been much clinical and research interest in MBSR and MBCT, with benefits reported for patients with chronic fatigue syndrome (Suraway et al., 2005), psychosis (Chadwick et al., 2005); depression in primary care (Finucane & Mercer, 2006); recurrent suicidal depression (Barnhofer et al., 2009); bipolar disorder (Williams et al., 2008); generalized anxiety disorder (Craigie et al., 2008); and treatment resistant depression (Eisendrath et al., 2008; Kenny & Williams, 2007). MBCT seems to offer particular benefits to patients with recurrent depression, and is recommended as a treatment of choice by the UK National Institute of Health and Clinical Excellence for patients with three of more episodes of depression (NICE, 2009).
As the evaluation of mindfulness-based intervention outcomes has developed, so the focus of attention has been drawn to measuring mindfulness. This shift is being explored in a number of ways; at its core is the evolving development of mindfulness measures. With increasing dissemination of mindfulness-based interventions comes the threat to intervention implementation and treatment fidelity. Whilst there has been considerable focus within psychotherapeutic intervention outcome research that the assessment of intervention integrity is essential, little focus has been drawn on the assessment of MBSR and MBCT intervention integrity in research, training program and practice contexts. This address will explore the multi-faced nature of measuring mindfulness, the development
and evaluation of mindfulness-based interventions delivered in a clinical setting, and steps towards ensuring teacher competency and treatment fidelity.
Bio
Catrin Eames is a Lecturer in the Division of Psychology, University of Liverpool, and an Honorary Lecturer at Bangor University. Catrin works closely with the Centre for Mindfulness Research and Practice (CMRP), Bangor University, and has led a number of investigations of mindfulness-based interventions, with clinical and non-clinical samples, both within and external to the NHS. Catrin has a core interest in translational research, exploring the transition from evidence-based research to practice and the means by which the implementation of evidence-based interventions are successful, and is a co-developer
of the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC),
alongside colleagues from Bangor, Oxford, and Exeter Universities.
What makes a good measure? – assessing validity and reliability
Abstract TBC
Bio (see http://www.gla.ac.uk/researchinstitutes/healthwellbeing/staff/stewartmercer/)
Current mindfulness measures and their suitability for research and clinical practice
Abstract
There's substantial evidence that mindfulness-based therapies can reduce symptoms and improve well being for individuals with physical and mental health problems. In order to evaluate these interventions and understand why they are effective, it is necessary to measure the construct, mindfulness. The aim of this review was to identify available measures of mindfulness and consider their psychometric properties, interpretability and utility for research and clinical practice. A systematic research of the literature identified nine measures, all of which are in the relatively early stages of development. The measures were based on several different conceptualisations of mindfulness and therefore a significant degree of variation between measures was present. The psychometric properties of each measure were discussed and summarised and directions for future research considered.
Bio
Jane has recently completed her doctorate at Edinburgh University and is currently working as a clinical psychologist in the area of physical health at the Cumberland Infirmary. After completing the 8-week MBSR course for staff in 2010 she was inspired to use mindfulness in her clinical practice and to conduct research in this area. Her thesis research focused on MBSR and quality of life in people with chronic physical health conditions and included a systematic review of current mindfulness measures. Jame's dissertation is available online here.
Measuring outcomes and processes in mindfulness based interventions for physical health conditions
Abstract
Mindfulness based interventions are gathering popularity amongst clinicians. One of the reasons for this is due to the increasing focus on scientific evidence of the effectiveness of mindfulness, across a broad range of health problems. Practitioners wishing to develop mindfulness based interventions, particularly in areas that have not previously been evaluated, should endeavour to quantify the effects of their intervention. One obstacle to do doing so is the range, suitability and quality of measurement tools. In this talk David will overview some of the tools available for measuring outcomes and processes, with a particular focus on mindfulness-based interventions in health conditions. The talk will focus on pragmatic and conceptual aspects, rather than an in depth exploration of psychometrics.
Bio
David Gillanders is Academic Director of the Doctoral Programme in Clinical Psychology at the University of Edinburgh and has extensive experience of working psychologically with people with chronic health problems from an acceptance and mindfulness perspective, using primarily Acceptance and Commitment Therapy (ACT). He has pursued research interests in acceptance and adjustment to chronic pain, as well as issues of measurement in ACT.
Mindfulness based elder care
Abstract
Mindfulness interventions are increasingly popular and researched, yet populations who might most benefit are often neglected. Frail elders and their caregivers suffer from multiple losses, pain and chronic conditions. Conventional mindfulness interventions may not be appropriate for frail elders and caregivers due to physical and cognitive limitations. However, the core of these interventions lies in the skillful application and intentions of the practitioner. Measuring the effects of these interventions can also be challenging, relying on anecdotal reports. This presentation will cover applications of mindfulness interventions for frail elders and also appropriate assessment tools.
Bio
Lucia McBee, LCSW, MPH, CYI, has worked with elders and their caregivers for over 30 years in a wide range of community, research, and institutional settings. Since her graduation from Columbia University's School of Social Work and Public Health, she has developed a pioneering practice using mindfulness, and complementary and alternative medicine (CAM) to improve the quality of life in community and nursing home settings. Ms. McBee has successfully integrated these practices into her work with elders, their families, and the staff.
Mindfulness-Based Elder Care, her book based on her innovations in adapting mindfulness and complementary and alternative medicine for elders and their caregivers was published in 2008. Ms. McBee is currently Program Coordinator of Integrative Medicine at the Center for Comprehensive Care at St. Luke’s/Roosevelt Hospital and Adjunct Faculty at Columbia University School of Social Work.
Evaluation and audit of an NHS Mindfulness service.
Abstract
This talk will describe a number of evaluation projects of the mindfulness courses that have been run regularly for the past 11 years as part of NHS Forth Valley's Primary Care Psychology service. These mainly involve outcome studies, including some long-term follow-up. These will also be used to consider how evaluation can be used routinely in mindfulness courses.
Bio
Neil Rothwell is a Clinical Psychologist with a 10 year background of running mindfulness courses in the NHS for clients and staff. He has been involved in the strategic implementation of mindfulness in the Scottish NHS, which has included running teacher training and supervision courses for staff. His interests include integrating mindfulness groups into mainstream psychological therapy provision. He is currently working freelance. He has a long-standing meditation practice in the Soto Zen tradition.
Defining Mindfulness
Abstract
When attempting to assess a construct, it is essential to have a clear widely agreed upon defintion of what the variable being measured actually is. In this presentation/dialgouge, Dr. Shapiro offers a comprehensive model of mindfulness, articulating three fundamental elements: Intention, Attention and Attitude. She posits that all three of these dimensions of mindfulness need be assessed if we are going to get a complete picture of the multidimensional construct of mindfulness.
Bio (see http://www.scu.edu/ecppm/counselingpsychology/faculty/sshapiro.cfm)
End of day reflections and panel discussion
Bio
Dr Vee Freir is a Consultant Clinical Psychologist who has been working on the NHS Education in Scotland (NES) funded project to build capacity for Mindfulness in Scottish Health Boards and, as well as facilitating 8-week groups, co-facilitates the NHS programme for training Mindfulness teachers and supervisors in Scotland. She has been working with Mindfulness in Adult Mental Health and Cancer Care since 2003 and has facilitated an annual Mindfulness Deepening Retreat on Holy Isle off Arran for the last three years.