Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2010. / Typescript. Includes bibliographical references (p. 64-67).

Mindfulness meditation is increasingly being incorporated into psychotherapeutic interventions. However, whilst much research has addressed the question of whether mindfulness-based interventions work, less has been directed at how they work. The current thesis describes four studies that explored potential mechanisms by which mindfulness interventions may bring about change. Study 1 employed a correlational design to examine whether mindfulness practice is associated with increased attentional control. Studies 2 to 4 used experimental methods to examine the ways in which individual mindfulness-based techniques might exert their effects on a health- related behaviour (chocolate consumption). Study 1 (N=125) showed no evidence that meditation practice was associated with reduced attentional bias (assessed using dot-probe and emotional Stroop tasks). Study 2 (N=135) showed that a cognitive defusion task (but not an acceptance task) helped individuals to resist chocolate over a five-day period. There was evidence to indicate that the defusion task worked by interrupting automatic links between chocolate-related thoughts and chocolate consumption. Study 3 (N=108). however, failed to find evidence that the defusion strategy worked either by reducing automaticity or increasing the accessibility of competing goals. Study 4 (N=60) further showed that the defusion strategy did not influence chocolate cravings. In conclusion, the current research demonstrated the need to go beyond merely describing the positive effects of mindfulness on changing self-control related behaviours. The findings also highlighted the potential problems of current mindfulness-based interventions due to their complexity, and that one mindfulness-based intervention does not 'fit' all health-related behaviours to bring about change. Ensuring the population maintains a healthy diet is important. Brief mindfulness training may be a useful means of helping people choose more healthy options. Further dismantling design studies were however advised before the evidence can be used to inform public health policy and services.

This study explored and described the experiences of students with self-reported symptoms of anxiety and depression who participated in a mindfulness-based intervention. The study was conducted in collaboration with the Student Counselling Career and Development Centre (SCCDC) at the Nelson Mandela Metropolitan University (NMMU). The study utilised a qualitative research approach and nine participants were selected through purposive, non-probability sampling. The data were collected by means of semi-structured interviews and participants‟ brief written reflections of their individual experiences. Content analysis produced ten themes categorised according to the components of the biopsychosocial/spiritual (BPSS) model. The most prevalent theme identified, describing participants‟ experience of the mindfulness-based intervention, was an enhanced perception of emotional regulation. This finding confirmed the outcomes of previous studies that also found an increase in emotional regulation related to mindfulness-based interventions. Results also shed new light on the perceived personal changes participants experienced in relation to body awareness, increased attentional regulation, social interactions, and spiritual experiences. In addition, participants verbalised present moment awareness and an accepting non-judgmental attitude as central to the biopsychosocial/spiritual changes and benefits they experienced. Recommendations for further research include investigating the impact of mindfulness-based interventions on attentional control and social interactions.

This study investigated the discharge practice of a Community Mental Health Team (CMHT) by examining records (electronic and file) of clients discharged between April 2005 and March 2006. Out of a total of 211 discharged clients a random sample of 20 clients was selected to examine the extent to which records and reasons for discharge adhere to current CMHT policies and guidelines. In addition, a sample of clients who had been engaged by the CMHT for 6 months or less was compared to a sample of clients who have been engaged for 1 year or longer to establish whether these differed in sociodemographic characteristics, diagnoses and extent of service provision. The majority of clients discharged during the specified period consisted of clients engaged for 6 months or less. The sampling process revealed that a proportion of these included clients seen for one-off assessments or duty calls, indicating that there is room for improvement to clarify referral criteria (e.g. to GPs) and the role of the CMHT. Similarly, the examination of recording practice also revealed room for improvement in the closing of care packages electronically and inclusion of required information in discharge letters. Almost 50% of clients in the sample were discharged following a decline of any further intervention the reasons for which it will be important to investigate in the form of an audit or survey of service user’s views. Clients engaged for 6 months or less and 1 year or longer seemed to differ mostly in terms of employment rates, diagnosis and previous inpatient admission and mental health act sections. The findings are discussed in relation to the limitations of this study, implications for the service and further research.

Mindfulness-based interventions (MBIs) are evidenced to be effective for a range of physical and psychological health problems for the clinical and non-clinical population. However little is known about engagement in MBIs. In order to address this research gap, this thesis begins with a meta-analysis exploring the relative odds of engaging in an MBI intervention in comparison to other active interventions (Paper 1). Although the findings were inconclusive, as most papers included in the meta-analysis reported study dropout data only, a key issue identified in this paper was the lack of a consensual definition on engagement in MBIs. Papers 2 to 4 aim to develop a coherent definition of engagement in MBIs and identify the factors associated with it. Due to the paucity of research in engagement in MBIs this thesis starts with a bottom-up approach exploring qualitatively the experience of engaging in a self-help 8-week MBI (Paper 2). This paper identifies several key hindrances of engagement in MBIs. The most striking of these hindrances is habitual perseveration. This reflects a key contradiction as MBIs are theorised to reduce perseverative habits such as rumination and worry. Paper 3 explores this empirically and supports the paradox of engagement in MBIs that rumination and worry are barriers of engagement in MBIs. In addition, two facets of engagement in MBIs, physical and psychological, are identified. In order to understand if rumination and worry are hindrances to engagement in any interventions, Paper 4 explores the model of engagement identified in Paper 3 in comparison to an active control condition. In conclusion, this thesis defines engagement in MBIs and identifies some factors associated with engagement. Implications for treatment and future research directions are discussed.

Mindfulness has recently gained attention within work contexts. Mindfulness training interventions (e.g., mindfulness-based stress reduction; MBSR) are commonly implemented for employees within organizations. Mindfulness has been associated with multiple employee performance, relational, and well-being outcomes. Although mindfulness has become a popular practice within organizations, empirical research falls behind and has not explored many potential research avenues. As leaders play influential roles within organizations, mindfulness may influence leader behaviors, to an extent that leader mindfulness affects employees. This study examined the relationship between supervisor mindfulness and leader-member exchange (LMX), which entails quality of mutual support, trust, and respect within supervisor-subordinate relationships. In addition, the proposed study sought to empirically support proposed theoretical frameworks by examining affective, cognitive, and behavioral mechanisms of empathic concern, perspective taking, and response flexibility, as mediators in the supervisor mindfulness-LMX relationship. Supervisor workload was also examined as a moderator to assess conditions under which the supervisor mindfulness-LMX relationship exists. A sample of 202 individuals who currently supervise employees was collected using the online survey platform, Amazon's Mechanical Turk. Two approaches towards mediation provided support for the mediating roles of empathic concern and response flexibility in the relationship between supervisor mindfulness and LMX. Theoretical and practical contributions, as well as limitations and future directions are discussed.

Thesis (Ph. D.)--Oregon State University, 2008. / Printout. Includes bibliographical references. Also available on the World Wide Web.

Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2009. / Directed by Craig Cashwell; submitted to the Dept. of Counseling and Educational Development. Title from PDF t.p. (viewed May 6, 2010). Includes bibliographical references (p. 137-167).

The aim of this study was to present and understand therapists’ experiences of the impact of their mindfulness meditation practice on their role in the therapeutic alliance. The topic emerged in response to extant research recommendations and researcher observations of the compatibility between mindfulness meditation outcomes and the demands on therapists for establishing effective alliances with clients. The study adopted an interpretive phenomenological analysis strategy located within the qualitative paradigm, and thus a small sample of therapists practicing mindfulness meditation were selected and interviewed on their experiences using semi-structured interviewing. Data were analysed for meaning units, which were then interpreted inductively and hermeneutically and categorized into superordinate themes. Three superordinate themes within participants’ experiences of how their mindfulness meditation practice impacts upon their role in the alliance were determined, namely: ‘self-care’; ‘insight into the structure of selfhood’; and ‘immediate mindfulness meditation during therapy’. This study found these experiences capacitated participants with compassionate interpersonal affects used for creating secure bonds with clients; skills for accurate empathic understanding; and skills and attitudes for working collaboratively with clients. Should future research confirm these findings, mindfulness meditation may be used as a tool to developed alliance formation abilities for therapists in training. Importantly, findings from this project called for a more comprehensive integration of theoretical positions on the construct of mindfulness meditation.

Mindfulness research is growing considerably, though there is very little research in the area of HIV and mindfulness. This study explored and described the experience of a sample of HIV positive people, before and after an 8 week Mindfulness Based Stress Reduction (MBSR) programme, to ascertain whether mindfulness can positively impact the CD4 count of the participants, with the consequent improvement to their immune systems. The incidence of depression, anxiety and stress levels were also explored. The research sample consisted of 17 participants recruited from a local hospital clinic. Purposive sampling was used to source participants. The mixed method approach of data gathering was made up of a pre-test post-test battery of questionnaires and blood tests. Mindfulness levels were assessed with the Five Facet Mindfulness Questionnaire (FFMQ) and Mindfulness Attention Awareness Scale (MAAS) at 3 intervals, while depression, anxiety and stress were assessed by means of the Depression Anxiety Stress Scale (DASS-21). Key findings included the following: the drop out rate for this population group was large, mindfulness practices do not always have a positive effect on immune functioning when there are other confounding variables at play, all participants reported they benefited from the 8 week MBSR course, though their results did not always indicate this. In conclusion it is proposed that mindfulness is potentially beneficial.