A brief summary of “mindfulness-based” therapies

I have previously written about different kinds of meditations that incorporate or embody mindfulness in their practice. This post, however, I will dedicate to other mindfulness-based approaches that are not purely meditative in nature, but are used in current psychological research on mindfulness. The most common of these are Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behaviour Therapy (DBT), and Acceptance and Commitment Therapy (ACT). Many additional approaches and therapies exist based on mindfulness (e.g., Mindfulness-Based Eating Awareness Training; MB-EAT) and acceptance (e.g., Acceptance-Based Behaviour Therapy; ABBT), as well as mindfulness-based components that are integrated in standardised treatments (e.g., mindful movement, breathing exercises, yoga, and meditation). However, for the purpose of this blog post, I will focus on the main modern mindfulness-based interventions (MBIs) that are used in the current literature.

1. Mindfulness-Based Stress Reduction (MBSR) is arguably the only modern MBI that is overtly rooted in Buddhist philosophy and was developed by Jon Kabat-Zinn in 1979. It usually includes body scan and meditation techniques, as well as some Hatha Yoga practice over an 8-week course of 2 hour classes per week. MBSR is mainly used to manage:

  • Stress and anxiety
  • Chronic conditions (e.g., chronic pain and cancer)
  • Depression

2. Mindfulness-Based Cognitive Therapy (MBCT) was developed in the 1990s by Zindel Segal, and was influenced by MBSR and Cognitive Behavioural Therapy (CBT). Both MBSR and MBCT were developed as clinical, secular interventions with no religious or spiritual requirements, and are strongly based on a mindfulness (meditation) component. In addition to MBSR components, MBCT includes some CBT techniques as well as information about major depression, and is mainly used to manage:

  • Relapse in major depression
  • Anxiety and psychosis
  • Panic attacks
  • Bipolar episodes
  • Post-traumatic stress disorder
  • Eating and food issues

3. Acceptance and Commitment Therapy (ACT) was developed by Steven Hayes and is often included amongst MBIs due to its focus on acceptance and the resemblance of some of its strategies with mindfulness approaches. Moreover, a specific mindfulness component is often taught as part of ACT courses and workshops. However, ACT is not rooted in Buddhism, nor does it usually contain any meditation practice. ACT is mainly used to manage:

  • Anxiety and psychosis
  • Depression
  • Substance dependence
  • Chronic pain
  • Cancer

4. Dialectical Behaviour Therapy (DBT) was originally developed for patients with borderline personality disorder, and is influenced by behavioural science, dialectical philosophy, and Zen practice. In terms of mindfulness, DBT primarily encourages acceptance, and a non-reinforced response to emotionally evocative situations. DBT is mainly used to manage:

  • Symptoms of borderline personality disorder
  • Self-harm
  • Substance dependence and abuse
  • Eating and food issues
  • Post-traumatic stress disorder

(See Good Therapy for an overview of these MBIs)

Despite the very brief summary of MBIs above, it becomes relatively clear that there are significant differences across MBIs in terms of background and origin, philosophy, and practice. It is beyond the scope of this blog post to discuss all the differences between them (see reference at the bottom), but the main ones do need to be highlighted.

  • Unlike MBSR and MBCT, ACT and DBT do not use formal meditation training as part of their interventions. Additionally, both ACT and DBT put a greater emphasis on changing cognitions and behaviours, rather than a direct and non-judgemental observation of experiences, as is the case in “purer” mindfulness approaches.
  • As mentioned above, there are differences regarding the background and origin of the various MBIs, reflected not only in the philosophy they adopt, but also in terms of how that translates to the components of the interventions. (MBSR was developed primarily to deal with stress, while MBCT was developed for patients with major depression, and DBT was developed for patients with borderline personality disorder).
  • Finally, even within the same MBI, interventions cited in research often vary in length, number of participants per group, course duration, home-based exercises, and delivery components. This makes it difficult not only to compare the different MBIs, but also to establish the effectiveness of one specific MBI.

Future research is thus needed to confront some of these issues. Perhaps the first step would be to reach a consensus on what actually defines a mindfulness-based intervention. This, however, is a monumental task in and of itself.

 

For an in-depth comparison between the MBIs outlined above, see Chiesa and Malinowski (2011).

 

 

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