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Mindfulness-Based Stress Reduction (MBSR)

Train the Trainers Program

Mindfulness & Neurobiological

Tools for Healing - A Training Resource

By Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T

Mindfulness-Based Stress Reduction (MBSR)

8-Week Program

Mindfulness-Based Stress Reduction (MBSR) Train the Trainer Certificate Program

8 CEU's in an 8 weekly session awarded by COPING.US Training Programs (CE Broker Tracking #: 20-680150). This Program is approved by Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling for: LMHC's,LMFT's, LCSW's & CMSW's and Florida Board of Nursing for: RN's, ARNP's, LPN's & Clinical Nurse Specialists


Resource for Course on Coping.us:

1. Mindfulness-Based Stress Reduction - A Neurobiological Approach at: http://coping.us/mindfulnessneurobiology/mbsrstressmanagement.html

2. Pain Management - A Neurobiological Approach at: http://coping.us/mindfulnessneurobiology/painmanagement.html

3. Stress Managment at: http://coping.us/mindfulnessneurobiology/stressmanagement.html


Program Description:

This program is geared to train mental health professionals who want to present the 8 Week Mindfulness-Based Stress Reduction program known as MBSR in their respective offices, agencies, hospitals or community. The MBSR program is an evidence based program to alleviate clients’ unhealthy stress in their lives as well as an effective tool used in an interdisciplinary setting for Non-Medication Management of Pain. The program will review the research in both stress and pain management as well as put the participants through an 8 week MBSR course with daily follow-up which includes practicing the specific meditation exercise presented in each weekly session along with daily logs on the formal and informal practice of these exercises and reviewing relevant Literature, Videos, Reading and Apps which the trainees can include in their own future MBSR programs they will conduct.

 

Learning Objectives: 

After participating in the program the participants will:

1. Learn about the underlying methodology, philosophy and intentionality of the MBSR program by reviewing all the relevant literature and research made available in this training program

2. Learn about each of the key components of the 8 weekly sessions which include overview of the psychology behind the meditation exercise to be presented that week along with supportive documentation which expands the theoretical underpinnings of the therapeutic model presented.

3. Learn about the daily exercises they will put their clients through when they present their own MBSR training programs including how to assist clients to keep a daily log as they practice the specific meditation presented in their weekly class.

4. Learn about the various assessment which can be utilized to assess if their clients first need the MBSR program to address their stress and/or pain and then to do follow up assessments once their clients complete their MBSR program.

Mindfulness-Based Stress Reduction (MBSR)

Train the Trainer Certificate Program

Location: Troy University Tampa Bay Site 5201 W. Kennedy, Suite 110, Tampa, FL 33609

Time: Wednesdays 5:30 to 8:00 pm

8 CEU's in an 8-weekly session Program (CE Broker Tracking #: 20-680150)

Pre-requisite to enroll in the 8 week program is:

Introduction to MBSR (3 CEU’s)(CE Broker Tracking #20-748178)


(NOTE: Enrollment for this program is 10 students only for each term)

Watch this site for news when the Intro and 8 week programs will be scheduled

On this Web's page you will find all of the PowerPoints, links to online video’s and Handouts for this 8 week program.

 

What you need to have before the first week session: Please download on your phone, tablet or computer the JKS Series #1, #2 & #3 which are the Mindfulness Meditations by Dr Jon Kabat Zinn which will be used in this program.

Outline of 8 Week MBSR Program


Week 1:

In class: Cover the specifics of conducting the 8-week program and introduce the participants Meditations beginning with the Body Scan Meditation (45 min) - JKZ Series #1 and

Introduce Mindfulness with the Raisin Exercise and the 9-Dot Puzzle.

Video for in class:

1. Shel Silverstein's The Missing Piece Click Here to Watch Video

2. Mindful Chair Yoga Click here for: A Brief 15 Minute Beginner's Practice

Handout:

Week 1 Handout: The Missing Piece Click here to download Handout

Alternative PowerPoints for in class:

1. What is Stress & Its Impact on Health Click Here to Download the PowerPoint

2. Neurobiology of Improving One’s Mental Health Click Here to Download the PowerPoint

3. Low Self-Esteem: The Hidden Roadblock to a Full Healthy Self-Rolling Life Click Here to Download the PowerPoint

Post In-person Class Practice: Read The Body Scan Meditation. Do the Body Scan at least six times this week. Just let your experience be your experience. Record your experiences this week on your daily chart form.

Week 1 Practice Log Click Here to Download

Week 1: Handout Body Scan Click Here to Download

Reading Homework:

Mindfulness & NeurobiologicalTools for Healing A Training Resource at: 

http://coping.us/mindfulnessneurobiology.html

Week 2:

In class: Use the Sitting Meditation (40 min) JKZ Series 1 #3

along with assorted readings and videos

Video: 

1. The Little Engine That Could Click Here to View Video

2. Mindful Chair Yoga Click here for: A Complete Beginners Practice (40 min)

PowerPoint in class: You can Do It! Lessons from the Little Engine that Could Click Here to Download

Handout: What Percentages of Each Engine are You in Your Self-Care Click Here to Download

Post In-person Class Practice: Read the description of the Sitting Meditation. Between now and next week, practice at least six times, alternating the Sitting Meditation with the Body Scan. Just let your experience be your experience. Record your experiences this week on your daily chart form.

Week 2 Practice Log Click Here to Download

Week 2: Handout Sitting Meditation Click Here to Download

Reading Homework:
Self-Esteem Seekers Anonymous-The SEA's Program Manual at: http://coping.us/seasmanual.html

Laying the Foundation:Presonality Traits of Low Self-Esteem at: http://coping.us/layingthefoundation.html

Week 3:

In class:

Videos: 

1. The Actual '73 Giving Tree Movie Spoken By Shel Silverstein Click here to View Video

2. Mindfulness Chair Yoga Click here for: A 45 minute Practice

3. Sitting Meditation (10 minute) JKZ Series 2 #1

and with assorted reading and videos

Handout:The Giving Tree Keeps Giving Click Here to Download

Post In-person Class Practice: Read the description of Mindful Yoga. Practice at least six times this week, alternating Mindful Yoga 1 with the Sitting Meditation (e.g., three of each). At least one of the days, do a Body Scan. Just let your experience be your experience. Record your experiences this week on your daily chart form.

Week 3 Practice Log Click Here to Download

Week 3:Handout Mindful Yoga Click Here to Download

  • We will be using Mindful Chair Yoga: A 30 Minute Beginner Practice for Week 3 and 40 Minute Beginner Practice for Week 4 so as to learn how to help folks with physical impairments to perform Yoga Stretches in a safe manner. Click Here to View Video: Mindful Chair Yoga: A 30 Minute Beginner Practice
  • Additional Mindfulness Chair Yoga exercises are available at: MindfulChairYoga
  • There is also an additional video emphasing use of chair for Yoga 1 to use in Week 3 It is called MBSR Yoga 1 with emphasis on chair poses Click here to view.

Reading Homework:

Tools for Personal Growth at: http://coping.us/toolsforpersonalgrowth.html

Tools for Handling Loss at: http://coping.us/toolsforhandlingloss.html

Week 4

In class: Use the Mindful Chair Yoga and One-Minute Breathing Space with assorted readings 

Videos: 

1. Precious Present Click Here to View Video or Alternate Video Precious Present Click Here to View VIdeo

2. Mindful Chair Yoga Click here for:  

Cultivating a Healthy Relationship with Thoughts and Feelings (30 min)

3. Sitting Meditation (20 min) JKZ Series 2 #2

Handouts:

Handout: Reflectons on "The Precious Present" Click Here to Download

Handout: What Can We Learn from “The Precious Present?” Click Here to Download

Post In-person Class Practice: Practice at least six times this week, alternating Mindful Yoga 1 with the Sitting Meditation. Also practice One-Minute Breathing Space during the week.  Just let your experience be your experience. Record your experiences this week on your daily chart form.

Week 4 Practice Log  Click Here to Download

Week 4 Handout STOP one-minute breathing Click Here to Download

  • We will be using Mindful Chair Yoga: 30 Minute and 40 minute Beginner Practice for Week 3 and Week 4 so as to learn how to help folks with physical impairments to perform Yoga Stretches in a safe manner. Click Here to View Video: Mindful Chair Yoga: A 40 Minute Beginner Practice
  • Additional Mindfulness Chair Yoga exercises are available at: MindfulChairYoga
  • There is also an additional video emphasing use of chair for Yoga 2 to use in Week 4 It is called MBSR Yoga 2 with emphasis on chair poses Click here to view.

Reading Homework:

Tools for Handling Control Issues at: http://coping.us/toolsforhandlingcontrol.html

Tools for Anger Work-Out at: http://coping.us/toolsforangerworkout.html

Week 5

In class: Use any Sitting Meditation and Mindful Chair Yoga and introduce Soften, Soothe, Allow- with assorted readings and videos Note: Week 5 has two options. Option1: Difficult Emotions or Option 2 Dealing with Physical Pain

Videos:

1. Shel Silverstein's The Missing Piece Meets the Big O Click Here to Watch Video

2. Mindful Chair Yoga Click here for: A Practice for Legs (30 min)

3. Sitting Meditation (30 min) JKZ Series 2 #3 and Breathscape (20 min) onJKZ Series 3

4. Need to relax? Take a break for meditation from Mayo Clinic Click Here to View Video

Handouts:

Week 5 Handout: Are You a Missing Piece? Click Here to Download Handout

Week 5 Handout for both options: Five-Step Model of Mindfulness Click Here to Download
Week 5 Handout for both options: Soften, Soothe. Allow Click Here to Download

Post In-person Class Practice: Practice at least six times this week, alternating Sitting Meditation (guided or unguided) with either the Body Scan or Chair Yoga. On the first day, though, try the Soften, Soothe, Allow Meditation. The Soften, Soothe, Allow Meditation is 15 minutes long, so on that day, you will have a shorter practice session (if you’d like a full 30 minutes, you can add silent meditation on your own that day). Record your experiences this week on your daily chart form.

Week 5 Practice Log with Physical Pain  Click Here to Download
Week 5 Practice Log with Difficult Emotions Click Here to Download

Week 5 Option 1 Handout: Turning Toward Difficult Emotions Click Here to Download

Week 5 Option 2 Handout: Turning Toward Physical Pain Click Here to Download

Reading Homework:

Growing Down - Tools for Healing Your Inner Child at: http://coping.us/growingdown.html

Week 6:

In class: Use the Mountain Meditation from Series 2 with a discussion of Dealing with Change along with assorted readings and videos

Videos: 

1. Who Moved My Cheese Click Here to View Video

2. Mindful Chair Yoga Click here for: Cultivating a Healthy Relationship wiith Thoughts and Feelings (45 min)

3..Mountain Meditation (20 Min) on JKZ Series 2 and Bodyscape (20 min) JKZ Series 3

Powerpoint: The “Who Moved My Cheese” Personal Change Agent Model Click Here to Download

Handouts: Self-Assessment of Beliefs about Change Click Here to Download

The Handwriting on the Wall Self-Assessment  Click Here to Download

Post In-person Class Practice: Practice at least six times this week, doing either a Body Scan, Chair Yoga or Sitting Meditation (guided or unguided). Also, do either the Mountain Meditation or the Lake Meditation at least once. As before, don’t expect anything in particular. Just let your experience be your experience. Record your experiences this week on your daily chart form.
Week 6 Practice Log  Click Here to Download
Week 6 Handout Conflict Management Styles Click Here to Download
Reading Homework:

Tools for Relationships at: http://coping.us/toolsforrelationships.html

Marriage Work-Out Team Building Manual at: http://coping.us/mwoteambuildingmanual.html

Marriage Work-Out A Marital Enrichment Online Workbook at: http://coping.us/marriageworkout.html

Week 7

In class: Use Lake Meditation from Series 2 with a discussion of The Three Elements of Self-Compassion along with assorted readings and powerpoints.

Video:

1. Mindful Chair Yoga Click here for: A Playful Practice (20 min)

2. Lake Meditation JKZ (20 min) Series 2  and Soundscape (27 min) JKZ Series 3

3. Video My Iceberg is Melting click here to play: https://www.youtube.com/watch?v=PvVONMyOOBU

PowerPoint: Creating the NOW Attitude “Our Iceberg is Melting” Model Click Here to Download

Handout: Overcoming Complacency in Quest of Improved Physical & Emotional Health Click Here to Download

Post in-person Class Practice: Practice at least six times this week, doing anything you’ve learned up until now (Body Scan, Sitting Meditation, Chair Yoga), with or without guidance. As before, don’t expect anything in particular. Just let your experience be your experience. Record your experiences this week on your daily chart form.

Week 7 Practice Log Click Here to Download
Week 7 Handout Three Elements of Self-Compassion Click Here to Download
Reading Homework:

PATHFINDER Parenting:Tools for Raising Responsible Children at: http://coping.us/pathfinderparenting.html

Week 8:

In Class: Use any of the Mindscape meditation and review Cultivating Mindfulness: Beginning or Deepening a Personal Meditation Practice and Suggestions for Daily Practice

Video:

1. Mindful Chair Yoga Click here for: A 45 minute Practice through Playfulness

2. Mindscape (20 min) JKZ Series 2 & Lovingkindness/Heartscape (47 min) JKZ Series 3

PowerPoint:

Clinical Assessment Tools Click Here to Download

Handouts:

Week 8: Clinical Assessment Tools Available on Coping.us Click Here to Download

Week 8: Mandala Meditation Instructions Click Here to Download

Week 8: RELAPSE System Click Here to Download

Week 8: Handout Developing a Practice of Your Own Click Here to Download

Reading Homework:

Tools for a Balanced Lifestyle: A Manual for a Guilt Free System of Healthy Living at: http://coping.us/balancedlifestyle.html

NOTE: on Reading Homework in the following MBSR Training 8 Week outline
Each week Trainees will be given selections from Coping.us to review. It is suggested that trainees go over the table of contents and select relevant topics which they believe their protential audiences in their MBSR training sessions they will conduct would be most interested in reviewing to lessen the stress, anxiety, tension and depression in their lives. These reading homework assignments are not intended to be the only sources of outside documents which trainees would like to consider to bring to their potential audiences.
NOTE: To help to enhance each of the weekly sessions be sure to utilize the tools available on coping.us listed at the beginning of this Stress Management section BELOW.

Resources on Coping.us Related to Stress Management


Tools for Mindfulness, Meditation, Stress Management and Sleep Enhancement at: http://coping.us/mindfulnessneurobiology/mindfulnesstools.html


Pain Management - A Neurobiological Approach at:http://coping.us/mindfulnessneurobiology/painmanagement.html


Improving Your Sleep Using Mindfulness and Other Neurobiological Tools at: http://coping.us/mindfulnessneurobiology/improveyoursleep.html


Introduction to Neuroscience For Mental Health Professionals at: http://coping.us/neuroscience.html


Dealing with the Opioid and Heroin Epidemic A Training Resource at: http://coping.us/opioidheroinepidemic.html


Suicide Intervention and Prevention Strategies A Training Resource at: http://coping.us/suicideintervention.html


Behavioral Medicine for Mental Health Professionals  A Training Resource at: http://coping.us/behavioralmedicine.html


Motivational Interviewing - A Training Resource at: http://coping.us/motivationalinterviewing.html


Tools for Coping Series at: http://coping.us/toolsforcopingseries.html

 Tools Use in Mindfulness-Based Stress Reduction (MBSR)

8-Week Program


Resources Used to Develop this 8 week modified MBSR program for use in a variety of mental health settings.

  1. Santorelli, S.F., Meleo,-Meyer, F. & Koerbel, L. (2017). Mindfulness-Based Stress Reduction (MBSR) Authorized Curriculum Guide. Center for Mindfulness in Medicine, Health Care and Society at University of Massachusetts Medical School. Downloadable at:  https://www.umassmed.edu/globalassets/center-for-mindfulness/documents/mbsr-curriculum-guide-2017.pdf
  2. Palouse Mindfulness - https://palousemindfulness.com  Online Mindfulness-Based Stress Reduction (MBSR) Course Manual. Downloadable at: https://palousemindfulness.com/MBSR/manual.html
Audio Programs of Jon Kabet-Zinn's Meditations to be used in the 8 Week Course are in the first series of programs in the availabe two sets of programs which can be aquired through Better Listen: To purchase these 3 series of MBSR Meditations go to: https://www.betterlisten.com/pages/jonkabatzinnseries123
JKZ Apps Each of the three volumes of Jon Kabet-Zinn's Meditations are also available at the Apple Apps store. Each volume can be downloaded to your devices for easier availability. Each App costs $10.00.


Use of the Guided Mindfulness Meditation Audio Programs

Series 1 – Which are used in the 8 Week MBSR Course

Track 1: Body Scan Meditation

Track 2: Mindful Yoga 1

Track 3: Sitting Meditation

Track 4: Mindful Yoga 2

 

Dr Jon Kabat Zinn suggests the following:

I suggest you start by doing the body scan meditation (track # 1) for two weeks straight before going on to alternate with the guided mindful yoga 1 (track # 2) for another two weeks, one program per day. If the yoga is too strenuous for you (it is quite gentle actually, and you are encouraged to do it to your own capacity and visualize yourself doing whatever parts of it you are not yet ready to try), you can just alternate between the body scan and the guided sitting meditation (track # 3). The postures for both yoga tracks are outlined in Full Catastrophe Living.

 

The volume of my voice on the yoga tracks drops in certain places because I am speaking as I am doing the postures myself. This is not a defect in the program. Just follow along as best you can. The volume comes back up as the posture releases.

 

After four weeks with tracks 1 and 2, you can introduce the guided sitting meditation practice (track # 3) and alternate it for the next two weeks with mindful yoga 2 (track # 4), or with the body scan or mindful yoga 1, depending on your inclination. In week seven, you are encouraged to try to keep up the practice for a week without the tracks, using whatever combination of practices you care to.

 

In week eight, you are encouraged to return to the tracks, and use whichever ones make the most sense to you as you develop your own unique meditation practice, hopefully for the rest of your life. Of course, you can always combine the various practices in any way that you care to, at any time.

 

After practicing these guided meditations, you are likely to find that you are more mindful in your life at other times as well. This is a natural benefit of mindfulness practice. You can deepen this process by intentionally bringing awareness of your breathing and of your body as a whole into as many moments as you can in your everyday life. Practicing in this way can help you to see stressful situations with greater clarity


Book by John Kabat-Zinn related to Series 1 of JKZ series is:  Kabat-Zinn, J. (2013). Full catastrophe living- Using the wisdom of your body and mind to face stress. Bantam Books: New York 

Click here for Link for Book on Amazon

 

Series 2

Tracks 1, 2, 3 Sitting Meditations

Tracks 4, 5, 6 Lying Down Meditations

Track 7 Mountain Meditation

Track 8 Lake Meditation

Track 9 Silence with bells at set times: 5, 10, 20, and 30 minutes

Track 10 Silence with bells at random times

 

Dr Jon Kabat Zinn describes the Series 2 set of mediations:

The first three guided sitting meditations introduce you to the basic elements of formal mindfulness meditation practice, including both the inner and outer attitude reflected in your posture and in the quality of your attention. You can work up progressively from the ten-minute version to the twenty-minute one to the thirty-minute one as your concentration and awareness deepen over time.

 

The guided meditations on track 4-6 are aimed at cultivating mindfulness while lying down, preferably on your back. This may require that you learn how to “fall awake,” which is, after all, what mindfulness is about, instead of falling asleep, which is easy to do when lying down and becoming more and more relaxed.

 

The mountain meditation and the lake meditation evoke two powerful images that may help you to deepen your concentration, broaden the field of your awareness, and expand your feeling for the inward gesture involved in mindfulness practice. Ideally, the mountain meditation should be done sitting, and the lake meditation lying on your back.

 

Silence with bells provides an opportunity to practice on your own, without my guidance, once you have the feel for it from the other programs. This involves just hearing whatever is here to be heard in any moment, whether it is silence or sound.


Book by John Kabat-Zinn related to Series 2 of JKZ series is: Kabat-Zinn, J. (2005). Wherever you go, there you are: Mindfulness Meditation in every day life. Tenth Anniversary Edition. Hyperion Books: New York

Click here for Link for book on Amazon

Series 3
1. Breathscape (20 min)
2. Bodyscape (20 min)
3. Breathscape and Bodyscape – More Silence (20 min)
4. Soundscape (27 min)
5. Mindscape (20 min)
6. Dying Before You Die (30 min)
7. Nowscape (30 min)
8. Walking Meditation (10 min)
9. Heartscape (47 min)
10. Lifescape (12 min)

In his own words, Jon Kabat-Zinn introduced this series as: these Series 3 guided meditations are tools that invite and reward something more than a casual listening. They are designed to be used on a regular basis to help you develop and deepen a daily meditation practice and thus to strengthen the qualities of mindfulness (moment to moment non-judgmental awareness), compassion, including self-compassion, and lovingkindness in every aspect of your life.

Book by John Kabat-Zinn related to Series 3 of JKZ series is: Kabat-Zinn, J. (2006). Coming to Our Senses – Healing ourselves and the world through mindfulness. Hyperion Books: New York

Books for Weekly Metaphors in MBSR Train the Trainer Certificate Program


Preamble to Program:  What Do You Do with a Problem? by Kobi Yamada and Mae Besom: Click here to find on Amazon


Week 1: The Missing Piece by Shel Silverstein at:

https://www.amazon.com/Missing-Piece-Shel-Silverstein/dp/0060256710/ref=sr_1_1?ie=UTF8&qid=1544796200&sr=8-1&keywords=the+missing+piece


Week 2: The Little Engine that Could by Watty Piper and George Hauman at:

https://www.amazon.com/Little-Engine-Could-Original-Classic/dp/0448405202/ref=sr_1_1?ie=UTF8&qid=1544796480&sr=8-1&keywords=The+little+Engine+that+Could

 

Week 3: The Giving Tree by Shel Silverstein at:

https://www.amazon.com/Giving-Tree-Shel-Silverstein/dp/0060256656/ref=tmm_hrd_swatch_0?_encoding=UTF8&qid=1544796550&sr=8-1

 

Week 4: The Precious Present by Spencer Johnson at:

https://www.amazon.com/Precious-Present-Spencer-Johnson-M-D/dp/0385468059/ref=sr_1_1?ie=UTF8&qid=1544796619&sr=8-1&keywords=the+precious+present+by+spencer+johnson

 

Week 5: The Missing Piece Meets the Big 0 by Shel Silverstein at:

https://www.amazon.com/Missing-Piece-Meets-Big/dp/0060256575/ref=sr_1_2?ie=UTF8&qid=1544796200&sr=8-2&keywords=the+missing+piece


Week 6: Who Moved My Cheese by Spencer Johnson at:

https://www.amazon.com/Who-Moved-My-Cheese-Mazing/dp/0091816971/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=

 

Week 7: Our Iceberg is Melting by John Kotter & Holger Rathgeber at:

https://www.amazon.com/Our-Iceberg-Melting-Succeeding-Conditions/dp/0399563911/ref=tmm_hrd_swatch_0?_encoding=UTF8&qid=1544796919&sr=1-1

Use of Mindful Chair Yoga in the 8 Week MBSR Program

NOTE: give that the majority of the treinees in this MBSR Train the Trainer Program, will be working with people who have some limitations physically. For this reason we strongly recommend that each week one of the following Mindful Chair Yoga Videos be utilized:

Mindful Chair Yoga Practices for MBSR Program (Your choice of which to use each week)

 

Mindful Chair Yoga: A Brief 15 Minute Beginner's Practice: 

https://www.youtube.com/watch?v=k6BxZep0w44&t=43s


Mindful Chair Yoga: A Complete Beginner's Practice (40 minutes):   https://www.youtube.com/watch?v=barPap-8vnw


Mindful Chair Yoga: A 45 Minute Practice: 

https://www.youtube.com/watch?v=edZXrdcz0-w


Mindful Chair Yoga: A Practice for the Legs (30 min): 

https://www.youtube.com/watch?v=6_hp2xgdt3Y&list=PLN2MXztFqfFV9RiFyu0dL4qA0wKaCY8hB


Mindful Chair Yoga (30 min) Cultivating a Healthy Relationship with Thoughts and Feelings:

https://www.youtube.com/watch?v=z4CTG2f0hRk


Mindful Chair Yoga (45 min) Cultivating a Healthy Relationship with Thoughts and Feelings: https://www.youtube.com/watch?v=i2e3B_Z8mA0


Mindful Chair Yoga: A Playful Practice (20 min): 

https://www.youtube.com/watch?v=-WBAc7uAoWU&t=88s


Mindful Chair Yoga: A 45 Minute Practice:Through Playfulness  

 https://www.youtube.com/watch?v=JD4WzEBCGpA

Mindfulness-Based Stress Reduction (MBSR):

An Evidence Based Treatment of Stress


Forward, From his own words

Dr Jon Kabat-Zinn in 2013 revised his original work on MBSR called: Full Catastrophe Living, nine years after he found the Stress Reduction Clinic at the University of Massachusetts. From the beginning of MBSR, he states that he bent over backward to structure it and find ways to speak about it that avoided as much as possible the risk of it being seen as Buddhist, ‘New Age,’ ‘Eastern Mysticism’ or just plain ‘flakey.’ To his mind this was a constant and serious risk that would have undermined his attempts to present it as commonsensical, evidence-based, and ordinary, and ultimately a legitimate element of mainstream medical care. This was a challenge given the entire curriculum he created was based on intensive training and practice of meditation and yoga which at the time pretty much defined one element of the “New Age.” He admits he was too shy and worried how his MBSR model would be accepted but then in 2011 he pointed out that: “We can observe an accelerating confluence of dharma with mainstream medicine, healthcare, cognitive science, affective neuroscience, neuroeconomics, business, leadership, primary and secondary education, higher education, the law, indeed, in society as a whole, in this now very rapidly changing world”(Kabat-Zinn, 2011, p.284). He later in this same article stated that: “The challenge for the participants was to just do the work from week to week, in other words, to practice the curriculum as it was being unfolded, and see what would happen. The emphasis was always on awareness of the present moment and acceptance of things as they are, however they are in actuality, rather than a preoccupation with attaining a particular desired outcome at some future time, no matter how desirable it might be. One major principle that we committed to was, and still is, never asking more of our patients in terms of daily practice than we as instructors were prepared to

commit to in our own lives on a daily basis” (Kabat-Zinn, 2011, p.290).

 

In his book Full Catastrophe Living (Revised Edition) 2013, Jon Kabat-Zinn reports: “By the end of eight weeks, when the program comes to an end, their smiles and more relaxed bodies are evident to even the most casual observer. Although they were originally referred to the clinic to learn how to relax and to cope better with their stress, it is apparent that they have learned a lot more than that. Our outcome studies over many years, as well as participants’ anecdotal reports, show that they often leave with fewer and less severe physical symptoms and with greater self-confidence, optimism, and assertiveness. They are more patient with and more accepting of themselves and their limitations and disabilities. They are more confident about their ability to handle physical and emotional pain, as well as the other forces in their lives. They are also less anxious, less depressed, and less angry. They feel more in control, even in very stressful situations that previously would have sent them spinning out of control. In a word, they are handling “the full catastrophe” of their lives, the entire range of life experience, including impending death in some cases, much more skillfully (Kabat-Zinn, 1990. 2013).”


Sources of Material to be used in MBSR programs:

You can get a better look at Jon Kabat-Zinn at this website: https://www.mindfulnesscds.com/ however you will need to use another site to purchase the recorded meditations used in the 8 week MBSR Program. To purchase the three series of MBSR Meditations for the 8-week program go to: https://www.betterlisten.com/pages/jonkabatzinnseries123

Mindfulness-Base Stress Reduction Review of the Literature

There has been in recent year significant research to support the use of Mindfulness-Based Stress Reduction (MSBR) with patients with various conditions in and out of medical settings. However, in 2002 the findings were that the available evidence at the time did not support a strong endorsement of this approach, but it did encourage and recommended serious investigation in the future (Bishop, 2002). In 2004 a meta-analysis of 64 studies in the previous two decades with only 20 studies meeting the criteria for acceptable quality or relevance results being that MBSR may help a broad range of individuals to cope with their clinical and nonclinical problems (Grossman, Niemann, Schmidt & Walach, 2004). MSBR was found to help clients increase their mindfulness, and wellbeing and decrease their stress and symptoms (Carmody & Baerm 2007). MBSR was found to reduce ruminative thinking and trait anxiety, as well as to increase empathy and self-compassion for individuals who came for help to address handling stress in their lives (Chisea & Serretti, 2009). MBSR was found to assist clients with social anxiety disorder to have improvement in anxiety and depression symptoms and self-esteem as well as reducing emotional reactivity while enhancing emotional regulation (Golden & Gross, 2010). MBSR assisted clients to experience reduction of symptoms of stress and mood disturbance as well as in mindfulness, spirituality and self-compassion (Birnie, Speca & Carlson, 2010). Fifteen studies were evaluated and found that MBSR has the potential for improving overall well-being, quality of life and enhanced health outcomes for its participants in it group therapy format (Merkes, 2010). MBSR was found to be the most popular of all interventions utilizing mindfulness and that it shows substantial benefit for patients who suffer with chronic health conditions (Carlson, 2012). MBSR was found to result in positive signs of healthy signs of measures of growth in greater emotional regulation (Haslam, Wirth & Robb, 2017). Perceived stress, distress tolerance, and mood states showed favorable changes from pre- to post-MBSR meaning the people who had lower stress tolerance before participating in MBSR groups were more likely to experience greater benefits than those who had higher tolerance of stress before participation in such groups (Gawrysiak, et al., 2016). Participants in MBSR groups were found to have significant improvements in the four components of Psychological Capital (Hope, Self-Efficacy, Resilience and Optimism) and a reduction in depression and anxiety (Jain & Singh, 2016). MBSR was found to have stress-reducing effects due to improvements in perseverative cognition and emotion regulation, two “transdiagnostic” mental processes that cut across stress-related disorders (Greeson, et al., 2018).

 

A number of studies focused on the impact of MBSR on social anxiety. Use of MBSR was associated with reductions in social anxiety and depression and increases in subjective well-being (Jazaieri, Goldin, Werner, Ziv & Gross, 2012).  It was found that with MBSR mindful attitude and disputing anxious thoughts/feelings predicted subsequent decreases in weekly social anxiety during MBSR (Goldin et al, 2017). MBSR used in groups with student ages 17-40 were found to have a decrease in anxiety and avoidance symptoms during social situations (Ye, 2017).

 

A preliminary Systematic review of the literature in 2011 found that studies up to that date showed that Mindfulness Based Interventions (mBIs) could have nonspecific effects for the reduction of pain symptoms and the improvement of depressive symptoms in patients with chronic pain as well as some improvements in psychologic measures related to chronic pain such as coping with pain following MBIs (Chiesa & Serretti, 2011). In 2017 another meta-analysis of 38 studies found that mindfulness meditation was associated with decrease in pain, reduction of depressive symptoms and increase in quality of life (Hilton, et al., 2017). An analysis of the mechanisms impacted by Mindfulness meditation demonstrated its effectiveness in reducing pain through multiple unique physiological mechanisms (Zeiden & Vago, 2016) including reduction of emotional reactivity, depression and stress (Brown & Becerra, 2017) and improve general mental health in patients with tension headached (Omidi & Zarger, 2015).

Strong encouragement has been made to utilize Mindfulness-Based Stress Reduction (MBSR) with patients with chronic pain because it focuses not only on the mind but also the body (Merkes, 2010). MBSR has the potential to address some of the psychosocial factors that are important predictors of poor outcomes (Cherkin, et al., 2014). A study of use of a brief 5 week 

format of MBSR found that participants demonstrated improvements of increased acceptance through decreased judgment; enhanced observational skills and decreased social isolation resulting in improve psychological health (Bergen-Cico, Possemento & Cheon, 2013). MBSR was found to contribute positively to pain management by lowering anxiety and depression, feelings of controlling pain and acceptance of higher pain which are important dimensions in patients with long-lasting chronic pain (la Cour & Petersen, 2015). Using MBSR resulted in patients revealing significant and clinically relevant improvements in level of pain disability, psychological distress, engagement in life activities, willingness to experience pain and subjective ratings of their current pain (Beaulac & Bailly, 2015). Use of MBSR with women with chronic pelvic pain has shown promise in pain reduction (Crisp, Hastings-Tolsma & Jonscher, 2016). Use of MBSR with chronic low pain demonstrated through the measurement of increase in quality of life and decrease in pain severity (Ardito, et al., 2017). MBSR was used with 

patients with painful diabetic peripheral neuropathy resulting in reduced pain intensity, pain catastrophizing, depression, perceived stress and improved health related quality of life (Nathan, et al., 2017). Clinical MBSR therapy program intervention improved affective pain, sensory pain and evaluative pain for individual detoxifying from substance abuse (Hosseni, 2017). MBSR was found to improve the quality of life for veterans who suffered sychoimmunological factors of lungs damaged from the toxic chemical in the war zone (Arefuasab, et al., 2016).

 

In a systematic review of 23 studies using MBSR and MBCT There was found improved depressive symptoms, anxiety, stress, quality of life and physical functioning. The evidence supports the use of MBSR and MBCT to alleviate symptoms, both mental and physical, in the adjunct treatment of cancer, cardiovascular disease, chronic pain, depression, anxiety disorders and in prevention in healthy adults and children (Gotink, et al., 2015). Measures of catastrophizing, self-efficacy, acceptance, and mindfulness, and similar effects showed improvement on these measures among individuals with chronic low back pain once they received either MBSR or Cognitive Behavior Therapy (Turner, et al., 2016). Pain catastrophizing and psychological distress were identified as individual mediators of the relationship between mindfulness and depressive symptoms for people with chronic pain thus supporting the inclusion of the use of mindfulness based cognitive interventions with these individual (Brooks, et al., 2018).

 

Mindfulness-Based Stress Reduction programming has been successful in work with a number of different populations. Academic health care workers were found to have sustained improved stress management, wellbeing and daily spiritual experiences for 1 year post participation in MBSR groups (Geary & Rosenthal, 2011). In looking how participants relate to their experience in MBSR groups participants were found to develop an “observing self” with improvement of emotional health (Kerr, Josyula & Littenberg, 2011). Research demonstrated that residents living in a large urban community experienced significant reduction of distress as well as increase in awareness of everyday life (Evans, Ferrando, Carr & Haglin, 2011). Decreases in symptoms of PTSD and depressive symptoms and reduction of anxious attachment was found using MBSR with female survivors of interpersonal violence (Kelly & Garland, 2016). MBSR used with partners resulted in improved relational health among romantic partners (Khaddouma, Gordon & Strand, 2017).  MBSR was found  to help improve levels of anxiety, depression, emotional reactivity and impulsivity with homeless participants (Maddock, Hevey & Eidemeuller, 2017). Providing MBSR to college students reduced depression, anxiety, stress and anxiety sensitivity through use of a MBSR Bibliotherapy model (Hazlett-Stevens & Oren, 2017). In 2018 Mindfulness-Based Cognitive Therapy was found to be successful with college students suffering from perfectionism by reducing their self-compassion, and reducing impairment caused by perfectionism and increase in mindfulness practices by the students (James & Rimes, 2018)

 

When compared to a second internet-based intervention (Health Action Process Approach) online Mindfulness training was found to improve the mental health of its participants (Mak, et. al., 2015).  A Web-based Mindfulness 8-week training program on pain intensity, pain acceptance and life satisfaction was demonstrated as being reasonably successful and open for future research and replication (Henriksson, Wasara & Ronnlund, 2016). A meta-analysis of 15 controlled studies found that online mindfulness-based interventions do have a positive impact on improving mental health of its participants (Spijkerman, Pots & Bohlmeijer, 2016). Internet Based Mindfulness Training and Cognitive-Behavioral Training were found to improve the mental health of college students in a randomized trial (Mak et al., 2017). In 2018 a systematic review of 15 studies on the usefulness of web-based mindfulness training programs found it successful in reducing depression and anxiety and in enhancing quality of life and mindfulness skills, particularly in those with clinical anxiety (Sevilla-Llewellyn-Jones, Santesteban-Echarri, Pryor, McGorry, & Alvarez-Jimenez, 2018). There were 3 APPs compared: mindfulness-based program; cognitive behavioral psychoeducation and self-compassion program and all three were found to be efficacious in improving mental well-being and reducing psychological distress (Mak, 2018).

Summary of Findings on MBSR

It is clear that MBSR has been shown to be an effective intervention to use with clients and patients who are dealing with stress not only from medical and psychological conditions but also from natural environmental factors. It would serve mental health professionals well to utilize the MBSR model in treating their clients who have come in seeking help to alleviate their current levels of stress.

References MBSR

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Beaulac, J. & Bailly, M. (2015). Mindfulness-based stress reduction: Pilot study of a treatment group for patients with chronic pain in a primary care setting. Primary Health Care Research & Development, 16(4), 424-428. DOI: 10.1017/S1463423614000346

 

Bergen-Cico, D., Possemento, K. & Cheon, S. (2013). Examining the efficacy of a brief mindfulness-based stress reduction (Brief MBSR) program on general health. Journal of American College Health 41(6), 348-360.

 

Birnie, K., Speca, M. & Carlson, L.E. (2010). Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR). Stress and Health 2010. DOI: 10.1002/smi.1305

 

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Brooks, J.M. Blake, J., Iwanaga, K., Chin, C., Colton, B.P., Morrison, B., Deiches, J. & Chan, F. (2018). Perceived mindfulness and depressive symptoms among people with chronic pain. Journal of Rehabilitation 84 (2), 33-39.

 

Brown, A. & Becerra, R, (2017), Mindfulness for neuropathic pain: A case study. International Journal of Psychology and Psychological Therapy, 17(1),19-37

 

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