Taking the “long view” on mindfulness and mindfulness-based cognitive therapy
Welcome to the University of Oxford Mindfulness Centre’s (OMC) first blog post.
A theme running through our blog posts will be “the long view,” an idea developed by Christina Feldman in her keynote at the recent Bangor Centre for Mindfulness Research and Practice Conference. Mindfulness is finding its place in the mainstream in a range of contexts, including health, education, the criminal justice system and the work place. Although this brings exciting possibilities for new applications for mindfulness, it also raises important questions. In the long view, what will support sustainable development of this field?
First, any mindfulness-based intervention needs to be clear about its intentions, aims and context. When Jon Kabat-Zinn had the extraordinary insight to develop mindfulness-based stress reduction (MBSR), he was clear that ancient meditative practices might have much to offer people suffering with long-term health conditions. He then considered very carefully how best to offer mindfulness in mainstream North American hospital settings. The result was the 8-week MBSR programme that has now been taken by tens of thousands of people. Zindel Segal, Mark Williams and John Teasdale were equally clear when they developed mindfulness-based cognitive therapy (MBCT) for recurrent depression. Their theoretical account of depression, articulated and refined through experimental work, is the focus of MBCT 1,2. The teacher conveys the MBCT course themes in all aspects of the course, so that participants have opportunities to learn to respond resiliently to those pivotal moments that can spiral into depressive relapse. Richard Burnett, Chris Cullen and Chris O’Neill were also equally clear when they developed a mindfulness curriculum for secondary schools to support young people’s flourishing. Over at least six years and numerous iterations they considered how best to make mindfulness accessible, relevant and engaging to young people in a classroom setting. Each of these mindfulness-based interventions has a clear intention and theoretical integrity. Each carefully considers the population for whom it is intended and has selected a pedagogy that matches the context in which it is offered.
Second, let’s be “mindful of the evidence base.” There is an emerging but promising science around mindfulness and MBCT. A body of scientific research suggests some encouraging insights about the role of mindfulness in mental health, resilience and the realisation of human potential 3-10. We need to report the science responsibly, recognise its limits and try to answer the many remaining questions as best we can, using robust methods. Unexpected findings should be welcomed and reported transparently. They can often point to something far more interesting than the expected. Science can help us build theory, develop effective interventions, consider optimal ways of training MBCT teachers and reaching the people who might benefit.
Third, it is important to have leadership around training standards and best practice in the teaching of mindfulness. The last 25 or so years has seen centres like the University of Massachusetts Center for Mindfulness, the Oxford Mindfulness Centre, the Bangor Centre for Mindfulness Research and Practice and theUniversity of Exeter lead the way to build a consensus about how best to train an MBCT teacher, when someone is ready to teach MBCT and when someone is ready to train others to teach MBCT. Let’s honor thesestandards. Let’s safeguard the public so that they too will know if a teacher meets these standards. I estimate that a teacher in their early thirties might teach MBCT to 4000 people in their career, so a cohort of 20 teachers graduating a training centre might teach 80,000 people. Investing in high quality training seems a worthwhile investment. The impact of these teachers is and will be profound.
Finally, let’s keep learning through our own mindfulness practice, training and the science. No one owns or has copyrighted the best way to understand, train and transform the mind. This work is invitational, empirical, participatory and democratic.
My colleague Jud Brewer at the Center for Mindfulness put it all much more pithily an email to me, “our boat will be a sturdy one as long as our sea legs of integrity, teacher fidelity, and science are beneath us.” He embodies the learning and humility of a mindfulness researcher and teacher.
These four areas are all themes our OMC blogs will explore further as we consider the long view of what will sustain the field, ensure high standards and best serve the public. Our intention is to provide a platform for writers to explore and discuss:
- Science, including key papers, new grants, overviews of the field;
- Ancient wisdom/contemplative traditions;
- The humanities;
- How best to make MBCT accessible;
- Issues in training the next generation of MBCT teachers;
- Mindfulness as a “grassroots movement.” We want to give a voice to people to describe: their experiences of depression and mindfulness practice; why and how they chose to become mindfulness teachers or researchers – in short the the struggles, resilience and hopes involved in this work.
Watch this space for future OMC blog posts.
Willem is Professor of Clinical Psychology at the University of Oxford and Director of the Oxford Mindfulness Centre
Declaration of interests
Willem receives no payment for public engagement or consultancy, and any remuneration is paid in full to the not-for-profit charity Oxford Mindfulness Foundation. He is Director of the OMC and Principal Investigator of several NIHR and Wellcome Trust grants evaluating MBCT.
- Teasdale JD, Chaskalson M. How does mindfulness transform suffering? I: the nature and origins ofdukkha.Contemporary Buddhism 2011; 12(1): 89-102.
- Teasdale JD, Chaskalson M. How does mindfulness transform suffering? II: the transformation ofdukkha.Contemporary Buddhism 2011; 12(1): 103-24.
- Baer RA. Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology-Science and Practice 2003; 10(2): 125-43.
- Bohlmeijer E, Prenger R, Taal E, Cuijpers P. Meta-analysis on the effectiveness of mindfulness-based stress reduction therapy on mental health of adults with a chronic disease: What should the reader not make of it? Journal of Psychosomatic Research 2010; 69(6): 614-5.
- Chiesa A, Serretti A. Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research 2011; 187(3): 441-53.
- Goyal M, Singh S, Sibinga EM, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA internal medicine 2014.
- Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review 2015; 37: 1-12.
- Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis. Clinical Psychology Review 2011; 31(6): 1032-40.
- Sedlmeier P, Eberth J, Schwarz M, et al. The psychological effects of meditation: A meta-analysis.Psychological Bulletin 2012; 138(6): 1139-71.
- Zenner C, Herrnleben-Kurz S, Walach H. Mindfulness-based interventions in schools-a systematic review and meta-analysis. Frontiers in psychology 2014; 5.
Oxford Mindfulness Centre
The Oxford Mindfulness Centre (OMC) is an internationally recognised centre of excellence at the University of Oxford, and has been at the forefront of research and development in the field of mindfulness. The OMC works to advance the understanding of evidence-based mindfulness through research, publication, training and dissemination. Our world leading research investigates the mechanisms, efficacy, effectiveness, costeffectiveness and implementation of mindfulness. We offer a wide range of training, education, and clinical services, all taught by leading experts and teachers in the field, who are training the next generation of MBCT researchers, teachers and trainers. We actively engage in collaborative partnership to shape the field and influence policy nationally and internationally. Through the charitable work of the OMC, we are improving the accessibility of MBCT for those most in need.
Photo: Colorado Golden Autumn I, Michael Kirsh