Tag Archives: MBCT

Learning to Teach MBCT Practices Via the Web: Technology Supporting Teacher Development

By Zindel Segal, PhD and Sona Dimidjian, PhD

Online Training for Teaching Mindfulness In Your Clinical Practice

Z MindfulNoggin_email_adIt was February in 2010, Sona and I were at the end of the fourth day of teaching together a five-day intensive training in MBCT. We were sitting in the lodge of the meditation retreat center in Joshua Tree, California enjoying the beauty, silence, and spaciousness of our surroundings and beginning to engage a question raised by participants in that workshop, like many before them and many to come: how do I carry all that I have learned back into my daily life and work setting? It is a common reaction among participants who have taken MBCT clinical workshops. It usually surfaces towards the end of the training and is expressed in questions such as ‘what comes next?’ or ‘how can I support my learning?’. As we reflected on these questions, we realized that some of the searching arose from the very natural apprehension about returning to solo practice after days of instructed group learning and returning to the hustle and bustle of daily life after engaging deeply the practices of MBCT in a retreat setting. At the same time, however, we also heard in these questions a desire for more support, guidance and community in their intention to integrate the skills and practices they had learned over the week. We began to wonder about ways in which we could support such intentions, building on what we could provide during in person workshops. How could we best support practitioners as they worked to strengthen the experiential and content learning that comes with personal practice and clinical implementation?

mmb-enroll-imgThe issue resurfaced in an interesting way, during our collaboration to develop an online version of Mindfulness Based Cognitive Therapy. We evaluated this digital version of MBCT – called Mindful Mood Balance – in a quasi-experimental open trial with 100 recovered depressed patients at Kaiser-Permanente Colorado and got promising results, Sona Dimidjian, S. Beck, A. Felder, J. Boggs, J. Gallop, R. & Segal. Z. (in press). Web-based Mindfulness-Based Cognitive Therapy for reducing residual depressive symptoms: An open trial and quasi-experimental comparison to propensity score matched controls. Behaviour Research and Therapy. We are continuing this work on extending MBCT for patients with a recently funded, larger definitive, randomized trial that we will conduct with recovered depressed patients reporting residual depressive symptoms (R01 – MH102229). As we developed Mindful Mood Balance, we began to realize that it was one way we might respond to the questions that were raised at the Joshua Tree retreat center in 2010. Mindful Mood Balance was built to teach patients explicitly some of the core skills of MBCT, but it also might be a valuable resource for clinicians who want to get the “feel” of the MBCT curriculum as it unfolds over time and who might benefit from the structure of an 8-week program in supporting their own practice of the core elements of MBCT. With this knowledge in mind, we also began to imagine other ways in which we could offer training to clinicians on some of the more subtle and challenging aspects of delivering MBCT. We built a program that taught therapists the detailed use of one of the core MBCT skills, the three minute breathing space, which they could use with their clients. We didn’t see either of these offerings as a replacement for in person training, but as another option in the array of treatment/ training resources, with distinct advantages of being able to learn from one’s home on one’s own schedule. .

The Three Minute Breathing Space Course, for example, teaches therapists how to deliver this practice, how to perform inquiry, how to make one’s own recordings and how to integrate the practice into daily life.

Therapists can also participate in a community of learners who are taking the course at the same time. Provided there is interest and benefit, our vision would be to build more contexts for learning responsive to what clinicians find challenging in delivering MBCT.

We have partnered with eLearning experts Brian and Traci Knudson in order to integrate clinical science and leading e-Learning technology, in courseware for health care professionals who want to enhance and enrich their clinical practice through delivering compassionate and effective mindfulness-based interventions. While it is still early days, we are curious to find out whether such modern / technological means can help support others in their use of these ancient / simple practices.

zindel_segal_120x1561Zindel Segal is one of the co-founders and developers (along with John Teasdale and Mark William) of Mindfulness-Based Cognitive Therapy (MBCT). Dr. Segal, along with Sarah Bowen and Steven Hickman, will be leading a 5-Day Professional Training Retreat in MBCT on February 15-20, 2015 at the EarthRise Retreat Center in Petaluma, California. Registration is now open for this experiential training event.

 

 

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Staying : turning towards what is difficult [ Part I]

By Char Wilkins,

charwilkinsChar Wilkins, MSW, LCSW is a mindfulness-based psychotherapist who works with individuals, couples and groups incorporating the intention and skills of mindfulness as a foundation from which to explore one’s life. She leads  MBSR, and Mindful Eating/Conscious Living (MECL) retreats for our Professional Training Institute and programs in her own practice for the general public.

When challenging or unwanted thoughts, emotions or behaviors arise most of us want to avoid or distract ourselves. We may use food, drugs, work or exercise to temporarily sooth, comfort or numb the difficult internal experience. Unfortunately, repeatedly coping in this way creates a habituated pattern that carries with it more shame and fear, and the hope of change slips further away into a seemingly endless out-of-control cycle.

There is of course, a reason why in mindfulness-based work we turn towards what we believe to be so difficult that if we don’t run, we won’t survive. And that is because when we come to know the taste, texture, temperature, shape, sound and movement of the unwanted thought, emotion or sensation, it is no longer a lurking shadow threatening to overwhelm us. It is felt and known for what it is: just a thought. Observed and held in awareness without judgment, it takes its right-sized place in the scope of who we are. Turning toward the difficult offers the possibility of freeing ourselves from the very patterns we fear the most.

Perhaps you’re thinking that this “staying with thing” is not the way you want to spend your day off. It’s not a comfortable thing to do. It just doesn’t have the same feeling that you get when you’re angry, depressed or anxious and think: ” A day at the beach is what I need.” or “A hot fudge sundae would do the trick right about now.”   But one getaway is never enough, is it?  And then, of course, returning is too much. This jumping back and forth we do is wearisome. That’s why the practice of mindfully staying with what is here right now, is so important. Ultimately it conserves energy, time, wear and tear on body and soul, and so much drama is avoided.

I’m aware that I ask participants in MBSR, MBCT and MECL programs to do a very challenging thing: be present to what is arising in the moment and to allow it to be known. It isn’t easy to not turn away from, to not disassociate, to not to run.  Bolting is the norm. If it doesn’t feel good, leave. Leave the person, place or thing. I’m not suggesting that you stay if you’re being abused. I’m talking about the everyday moments when we think, “I wouldn’t have to get so angry if only he wouldn’t ____________.  If she’d just ______________, I’d be happy.” As I’ve sat with clients and participants over the years, I’ve watched so much “bolting,” that recently I thought a new reality TV show entitled “Extreme Bolting might get higher ratings than the X Games since more people bolt than Cave Dive, go Wingsuit Flying or attempt Extreme Ironing. Look it up, it’s worth it.

In Part 2, I’ll share how in working with women who have experienced abuse or trauma mindfulness of the body can help them learn how to stay with what is difficult.

Listen on Monday September 9, 2013 from 12:00pm-1:00pm to Char Wilkins, MSW, LCSW, in a special teleconference  exploring how we sometimes use food which temporarily soothes, comforts or submerges the difficult internal experiences.

 

When listening is everything you ever wanted

The UC San Diego Center for Mindfulness has partnered with Susan Woods and Char Wilkins to offer a 5-day program entitled: Advanced Training for MBCT and MBSR Teachers: Embodying Mindful Presence and Investigating Mindful InquiryJune 9-14, 2013 at the EarthRise Retreat Center in Petaluma, CA. The following is the second in a series of periodic posts by Susan and Char, sharing their vision and wisdom in formulating and offering this training, and exploring the territory of teaching mindfulness in general. We invite you to get to know them through this series and perhaps to reflect on your own relationship to mindfulness teaching.

CharWilkinsBy Char Wilkins, LCSW

On the opening page of Mark Nepos’s book Seven Thousand Ways to Listen, he quotes an epigraph by Abraham Heschel:

 [We] will not perish for want of information; but only for want of appreciation . . . What we lack is not a will to believe but a will to wonder . . . Reverence is one of [our] answers to the presence of mystery . . .

There is a longing for connection that we all experience and repeatedly hear as participants in our MBCT and MBSR programs speak of disappointment, fear and hope.  And we notice that as we cultivate the ability to listen to each one of them, we begin to hear the themes of need and desire that weave us together in our collective humanness. We begin to hear that indeed, no one is alone in the tangle we call life.

reflectionsNepo believes that if we limit our existence to only what we know, we blind ourselves to the “mystery.” Mystery is about open-eyed wonder, appreciation and gratitude. So when we engage in mindful listening, in which our conditioned mind and heart open in sincere and kindly curiosity, we create a pathway not only to the mystery of what is present in each moment, but to the possibility of a peaceful connection to self and others.

We ask our clients and participants to listen not because it’s a Mindful Rule, but because listening is a threshold between our inner and outer worlds. It’s an entryway to pause in, a vantage point from where we can see our own limiting beliefs and also the possibility of choice. From this doorway we can begin to hear harmonies that strike a chord within, where perhaps before we only heard the dissonance that isolated and left us feel disconnected from ourselves and others.

In our teaching, we become aware that it isn’t the dissemination of information that connects people intra and interpersonally, but rather being listened to- their story heard and appreciated. We may call it group dynamics or breaking the isolation or normalizing, but in the end I believe it is simply the reverence of listening. This is what MBCT and MBSR offer teacher and participants: the possibility of discovery through wonder and freedom through listening.

Petaluma: Training in Mindfulness-Based Cognitive Therapy

text & photos by Dzung Vo
Windswept Trees. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/18/13)
Gratitude
Hope
Connectedness

these three words
express my experience with
the Mindfulness-Based Cognitive Therapy (MBCT) Teacher Training
which is a very skillful application
of mindfulness for preventing relapse of chronic depression in adults

Sitting View. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/17/13)

the five-day training was an interesting hybrid
of a meditation retreat
and professional training workshop
i was fascinated to watch my mind going back and forth
between “just being”
enjoying the breathtaking natural environment
walking, eating, and sitting mindfully
being fully in each breath
and “doing”
watching my analyzing, planning, comparing and judging mind at work

breathing in, i am aware of my thinking
breathing out, i smile …

View from Hill. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/18/13)

how lucky i am
to be able to consider this experience
part of my “work”
more and more, as my work comes from the heart
the line between my profession and my bodhisattva path
begins to dissolve…

Deer Having Dinner. MBCT Training, Earthrise Retreat Center, Petaluma, California (2/18/13)
"May Peace Prevail on Earth." MBCT Training, Earthrise Retreat Center, Petaluma, California (2/21/13)

the faculty
(zindel segal, sarah bowen, and steve hickman)
brought tremendous warmth, gentleness
and clarity of vision
in teaching and embodying the training
the students brought a depth and diversity
of practice and experience
and a bright curiosity

it gives me great hope
to see these practices
skillfully adapted and offered to the world

it gives me great humility
to be a part of this growing “professional sangha”

MBCT Petaluma Class of 2013. Earthrise Retreat Center, Petaluma, California (2/22/13)
MBCT Teacher Training, Petaluma, Class of 2013

i bow deeply to all of you

Dzung Vo and Ken Ginsburg, Philadelphia, 11-21-11I have long had a dream to teach mindfulness practice to adolescents suffering from chronic illness and chronic stress. With my position at the British Columbia Children’s Hospital–and the luxury of having a more functional health care system with sufficient time to spend with my patients and explore issues deeply–I have finally had a chance to start making this a reality.

(see more photos on my flickr set)

Experienced Teachers Reflect on the Opportunities and Challenges of Teaching Mindfulness

With the proliferation of mindfulness and Mindfulness-Based Interventions, there is increasing demand for foundational and advanced training for teachers of these so-called “MBIs”. The UC San Diego Center for Mindfulness has partnered with Susan Woods and Char Wilkins to partially meet this demand through a 5-day program entitled: Advanced Training for MBCT and MBSR Teachers: Embodying Mindful Presence and Investigating Mindful Inquiry, June 9-14, 2013 at the EarthRise Retreat Center in Petaluma, CA. The following is the first in a series of periodic posts by Susan and Char, sharing their vision and wisdom in formulating and offering this training, and exploring the territory of teaching mindfulness in general. We invite you to get to know Susan and Char through this series and perhaps to reflect on your own relationship to mindfulness teaching.

By Susan Woods
What a true joy it is for me to anticipate this possibility of bringing MBCT and MBSR teachers together for this training. As the community of MBCT and MBSR teachers has grown in breadth and depth I believe it has become increasingly important to hold in awareness certain questions. What is it that helps sustain our teaching? What are our aspirations? How do we find ways to articulate and live inside the teaching process? How do we come to see the challenges of teaching as the wealth of continually opening landscapes of compassion, generosity and kindness?

At its core the Advanced training for MBCT and MBSR teachers is about supporting and strengthening the skills that characterize teaching mindfulness in the MBCT and MBSR programs.  At its deepest depth, it is about our relationship to the practice of mindfulness and to the articulation of that process. Collectively, it is my hope and belief we will weave a process of contemplative awareness that not only supports and strengthens our teaching, but that emphasizes embodying mindful presence as the heart of teaching with mindful reflective inquiry as the journey.  I look forward to joining you there.
Susan Woods

Susan Woods, MSW., LICSW is a psychotherapist in private practice and has been practicing mindfulness meditation and yoga since 1981.  She teaches MBSR and MBCT groups through her private practice and since 2005 has been immersed in teaching and developing mindfulness-based professional trainings.  She has presented on the clinical application of mindfulness at numerous conferences and is a published author on the training of health professionals in mindfulness-based skills.   www.slwoods.com

By Char Wilkins
As a teacher, the moments that inspire me to keep teaching are never the moments when I’ve cleared up a participant’s confusion for them or said something that a group member thought profound.  Rather, they are the times when coming from a genuinely curious and patient place within myself, I have mindfully attended as the participant found her own truth and understanding.  This relational field that is created between teacher and participant holds the potential of accessibility and possibility.

Is it possible for a teacher to cultivate patience, focus, curiosity and compassion to such an extent that it becomes an articulated and felt sense through his or her teaching?  This is the exploratory path of the Advanced Training for MBCT & MBSR Teachers that invites investigation of two important aspects of teaching MBCT and MBSR, that of embodied mindful presence and the facilitation of mindful inquiry.  I am delighted to be teaching alongside my colleague, Susan Woods, as we offer this program which is both deeply personal and universal in its intentional and heartfelt focus.
–Char Wilkins, LCSW

Char Wilkins, MSW, LCSW is a psychotherapist and certified MBSR teacher. She trains professionals in Adv. MBCT, MBSR and MECL (Mindful Eating/Conscious Living) and offers consultation to MBI teachers and in the use of mindfulness in psychotherapy. She considers her long standing meditation practice to be the foundation of all her work and continues to train in the Dhamma, Qigong and Tai Chi. In her private psychotherapy practice she specializes in working with women who suffer from the ramifications of childhood abuse, depression, anxiety and disordered eating.  www.amindfulpath.com

MBCT Ushers in the Next Era with Second Edition and Two Innovative Training Opportunities

Mindfulness-Based Cognitive Therapy for DepressionFew psychological interventions have engendered so much promise and delivered on that promise with such impressive clinical outcomes and research findings as Mindfulness-Based Cognitive Therapy (MBCT). The skillful “marriage” of cognitive behavioral therapy and mindfulness practice, MBCT has emerged as an effective treatment to prevent relapse in depression and is yielding good initial results in other settings and with other populations as well. With the imminent publication of the Second Edition of Mindfulness-Based Cognitive Therapy  (Guilford Publications), MBCT has entered it’s next generation, incorporating the ongoing work of co-founders Zindel Segal, Mark Williams and John Teasdale, with the input and efforts of numerous clinicians and researchers worldwide.

Zindel Segal, Ph.D.

Zindel Segal, Ph.D.

“Ten years have passed since the publication of Mindfulness Based Cognitive Therapy,” noted Zindel Segal recently, “and in that time there has been a productive engagement and interchange with clinicians and researchers who have offered and studied the program with their own patients.  Mark, John and I have been fortunate to be involved in some of these discussions and have learned from many ‘early adopters’ as well as from the increasing volume of empirical work that has evaluated and stretched MBCT to novel populations.  The second edition of MBCT gives us an opportunity to embed this ‘crowd sourced’ wisdom and feedback into an updated and expanded version of the book that offers a few refinements to the 8-week program and grapples, more generally, with the question of how the delivery of mindfulness based interventions can be optimized.”

“Kindness and compassion are the ground from which we practice, the ground from which we teach, and the ground that participants may then use in cultivating their own practice.”                 (From the Second Edition)

Perhaps most notable in the new edition is a chapter solely dedicated to the topic of compassion in MBCT. Segal reports that “an oft-repeated question I hear is ‘what is the role of compassion training in MBCT?’  This reflects perhaps the pervasive interest in bringing compassion to patients who are suffering, as well as an enthusiasm for newer protocols that feature compassion training as a central intervention.  The answer with respect to MBCT is not as straightforward as checking whether formal compassion or loving kindness is or is not taught within the 8 weeks.  It revolves around the deeper question of what exactly compassion means in a clinical context and how it can help address the vulnerability or illness perpetuating factors that keep people locked into symptoms and distress.”

FREE CHAPTER PREVIEW!
In advance of the release of the Second Edition of MBCT, Chapter 8, entitled “Pausing for Reflection: Kindness and Self-Compassion in MBCT” is available for free by emailing the UC San Diego Center for Mindfulness at mindfulness@ucsd.edu and requesting a copy.

Book purchasers get access to a companion Web page featuring downloadable audio recordings of the guided mindfulness practices (meditations and mindful movement), plus all of the reproducibles, ready to download and print in a convenient 8 1/2″ x 11″ size. A separate web page for use by clients features the audio recordings only.

As innovative as the MBCT program itself, the 5-day MBCT teacher training offered through the UC San Diego Center for Mindfulness is a “wonderful opportunity to experience the intricate interweaving of mindfulness practice and cognitive therapy skills in the delivery of the 8 week program,” said Segal. “Our days are long and incorporate elements of personal practice and clinical training all held within a retreat framework that clarifies intention, observation and self-compassion in the learning process.  If you are interested in learning the MBCT program ‘from the inside’ this is the best vehicle for doing so.”

For those who already have experience teaching MBCT or Mindfulness-Based Stress Reduction (MBSR) UCSD is now offering an Advanced Training for MBCT and MBSR Teachers taught by experienced teachers and trainers Susan Woods and Char Wilkins. Intended to focus upon universal principles for teaching mindfulness-based interventions. As such, the focus for this training is less about teaching to the structure of MBCT and/or MBSR and more about intentionally embodying mindful presence and strengthening the facilitation of mindful inquiry.

What Are Your Thoughts? We would love to hear your thoughts on the approach of explicitly teaching compassion and lovingkindness practice within mindfulness-based interventions like MBCT, versus the more implicit approach described by Segal et al in the new 2nd edition of the MBCT book (free pdf copy of the chapter available upon request at  mindfulness@ucsd.edu ). Please share your thoughts and opinions below.

New training pathways for MBSR and MBCT teachers now available through UC San Diego

By Steven Hickman, PsyD, Director, UCSD Center for Mindfulness

“How can I become a teacher of Mindfulness-Based Stress Reduction?” I cannot begin to calculate how many times I have been asked this question in the past ten years as a teacher of the MBSR program. I am constantly moved and touched by the people in my classes and the tremendous change and healing that can happen through the regular practice of mindfulness. This profound impact on people has more recently manifested in a huge demand among people touched by the practice who wish to share it with others. As MBSR programs have spread across this country and the world, there is a growing (and unprecedented) need to provide well-designed training for those who wish to teach MBSR and share this practice with a wide variety of people and groups in a whole host of settings.

Susan Woods

That is why I am particularly excited to announce that two highly qualified mindfulness teachers and trainers, Susan Woods and Char Wilkins, will be teaching our first 5-Day Foundational Training in Mindfulness-Based Stress Reduction for professionalson June 2-7, 2013 at the Joshua Tree Retreat Center.  Intended to support and develop people along their path toward teaching MBSR, this intimate foundational training will provide attendees the opportunities to learn in depth about the program, but more importantly to explore it “from the inside out” in the role of teacher, through small group exercises, mindful feedback and reflection.

Char Wilkins

The second of our two new trainings, also taught by Susan Woods and Char Wilkins, is the 5-day Advanced Professional Training for MBCT/MBSR Teachers, June 9-14, 2013 at EarthRise Retreat Center in Petaluma, California.  The demand for advanced training in mindfulness-based interventions has grown over the years and a foundational professional training is just the beginning of becoming a skilled and knowledgeable teacher.  This ground-breaking advanced training brings together, for the first time in the U.S., both MBCT and MBSR teachers allowing for a rich learning experience.  Susan has designed a training in which there is less dependence on teaching to the curricula of either MBCT/MBSR, and greater attention to strengthening core competency skills allied with teaching mindfulness. The heart of this program lies in closely attending to and strengthening the development of universal mindfulness principles such as investigating how one comes to understand and embody mindful presence and mindful reflective inquiry.

The training model that has evolved here at UCSD has proved to be efficient and effective. By providing intense retreat-style trainings that combine personal mindfulness practice, experiential learning of the curriculum and opportunities to guide practices, engage in mindful inquiry and take part in dialogue with skilled teachers, we have found that our participants leave feeling prepared to actually begin the important work of leading Mindfulness-Based Interventions (MBI’s).

Thus begins the next phase in the development of the Professional Training programs at the UC San Diego Center for Mindfulness. This new pathway toward becoming an MBSR teacher is situated alongside intensive training in Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Relapse Prevention (MBRP), Mindfulness-Based Childbirth and Parenting (MBCP), Mindful Self-Compassion (MSC), and Mindful Eating, Conscious Living (MECL). The longer-term goal is the establishment of an entire UC San Diego Mindfulness-Based Training Institute that incorporates foundational aspects of all the MBI’s, specific training in the various curricula, opportunities for live consultation and supervision, and ultimately a process of certification in specific MBI’s. The Training Institute is only in its infancy, but arises out of this increasing demand for training and the assurance of competency in delivery of these wonderful programs that are becoming increasingly popular and are being demonstrated through rigorous research to be effective. 

Registration is now open for both the Advanced Training for MBCT/MBSR Teachers and the 5-Day Foundational Training in MBSR and we expect both to fill up quickly. Plans are also in the works to offer these trainings on an ongoing basis, so if these dates don’t work for your schedule, join our mailing list on our Professional Training website to be notified of upcoming additions to the schedule.

 

Bridging the Hearts & Minds of Youth: February Conference on Mindfulness with Youth in San Diego

Mindfulness, as a powerful and important means of cultivating health, well-being and equanimity, is nowhere more important than in our work with the young people of our society. Alongside the explosive and transformative growth of mindfulness-based programs for adults, there is a particularly heartening and vibrant effort to bring mindfulness to youth of all ages, in a plethora of settings and formats designed to have a significant impact on the lives and futures of literally millions of young people around the world.

To support and grow this important movement, the UCSD Center for Mindfulness has teamed with Stressed Teens to organize and present a first of its kind conference on February 4 and 5, 2012 entitled Bridging the Hearts and Minds of Youth: Mindfulness in Clinical Practice, Education and Research . The intention of this conference is to bring together a number of key thought leaders in the field of mindfulness, both those engaged in bringing it to youth and those whose influence extends well beyond that one area, with the hope that the synergy created by such a gathering will provide further impetus to a growing and important field.

Keynote speakers, breakout sessions and half-day workshops will form the structure of this gathering, but the intention is to create an overall atmosphere of connection, collaboration, encouragement, support and innovation that will inspire attendees to continue or begin the work of teaching mindfulness to the young people with whom they work. A full description of the conference is available on the UCSD Center for Mindfulness Professional Training website, but a  few highlights include:

Rick Hanson, author of The Buddha’s Brain and Just One Thing: Developing a Buddha Brain One Simple Practice at a Time will be presenting a public talk on Friday evening, February 3 entitled “Taking in the Good: Helping Children Build Inner Strength and Happiness” and then will provide a keynote address on Saturday at the conference itself with the intriguing title “Managing the Caveman Brain in the 21st Century”.

Psychologist and well-known mindfulness researcher Amishi Jha will be offering her insights in another keynote address, entitled “From Dazed and Distracted to Attentive and Calm: What the Neuroscience of Mindfulness Reveals”. Dr. Jha will be joining the other keynote presenters, Susan Kaiser Greenland, Pamela Siegle and Chip Wood on a discussion panel on Saturday as well.

Three post-conference half-day workshops will be offered on Sunday, February 5, allowing attendees to deepen their understanding and training in working with mindfulness and youth. Workshops include one by conference co-organizer Gina Biegel, developer of the Mindfulness-Based Stress Reduction for Teens (MBSR-T); another by Randy Semple, who has adapted Mindfulness-Based Cognitive Therapy (MBCT) for children, and a wonderful session on “Nurturing Your Self in Your Work With Youth” offered by mindfulness teacher and holistic physician, Amy Saltzman.

These are just a few of the highlights of this inaugural conference that promises to be literally packed with interesting and engaging speakers, presentations and experiences. Co-organizers Steven Hickman, Director of the UCSD Center for Mindfulness and Gina Biegel, founder of Stressed Teens, hope that this will become an annual event that makes a significant contribution to the field of mindfulness with youth. If you are an educator, therapist, physician, or just a concerned and engaged parent looking to explore how you might integrate mindfulness in your work with youth, you may want to consider joining this impressive lineup of presenters in San Diego at the Catamaran Resort Hotel on February 4 and 5, 2012. Space is limited, register early and receive a $50 Early Bird Discount.

Mindfulness Based Cognitive Therapy 10 Years and Onwards: A Personal Reflection by Zindel Segal

Zindel Segal, Ph.D.

Zindel Segal, Ph.D.

Zindel Segal is one of the co-founders and developers (along with John Teasdale and Mark William) of Mindfulness-Based Cognitive Therapy (MBCT). Dr. Segal, along with Sarah Bowen and Steven Hickman, will be leading a 5-Day Professional Retreat Training in MBCT on February 19-24, 2012 at the EarthRise Retreat Center in Petaluma, California. Registration is now open for this experiential training event.

With the 10-year anniversary of the publication of Mindfulness Based Cognitive Therapy for Depression nearly upon us, it is a good time to perhaps stop and reflect on where the field stands at this juncture.

Mindfulness-Based Cognitive Therapy for DepressionFor the past decade John, Mark and I have been largely concerned with reaching the first milestone of treatment development – reliable evidence for MBCT’s effectiveness.   Data from 6 Randomized Controlled Trials and 2 meta-analyses (Hoffman, 2010; Piet & Hoogard, 2011) now indicate that Mindfulness Based Cognitive Therapy is associated with a 50% reduction in depressive relapse risk as well producing symptom relief in  anxiety disorders for both adults (Kim et al., 2010) and children (Semple & Lee, 2011).

Having addressed the efficacy question, we are still left to ponder how exactly this multi-modal treatment achieves its benefits.  For example, what is the relative contribution of cognitive therapy principles versus mindfulness practice to outcome?  What about the role of kindness and compassion, both of which are implicit in the program and, as Willem Kuyken’s work suggests, may be one of the consistent gains reported by participants?

Clarifying mechanisms of action is of more than just academic interest, as it will likely inform the approach taken to training the next generation of MBCT practitioners.  The fact that these are questions being asked shows how far we have come from the early days when MBCT was described as a form of attentional control training.

It is always hard to predict what the next 10 years will bring, but my bet is that efforts to disseminate MBCT via online technologies will start to have an impact.  Online approaches may be a response to the fact that there are still far too few MBCT instructors and too many patients seeking care.  The challenge for online MBCT will be to adapt to an internet friendly format, while holding onto the practice dimension, which however you slice it, always comes down to being a personal, non-electronically mediated experience.  It should all make for a very interesting ride.

References
Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010 Apr;78(2):169-83.
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. Clin Psychol Rev. 2011 Aug;31(6):1032-40.
Geschwind N, Peeters F, Drukker M, van Os J, Wichers M. Mindfulness training increases momentary positive emotions and reward experience in adults vulnerable to depression: A randomized controlled trial. J Consult Clin Psychol. 2011 Jul 18. [Epub ahead of print] 
Kim B, Lee SH, Kim YW, Choi TK, Yook K, Suh SY, Cho SJ, Yook KH Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder. J Anxiety Disord. 2010 Aug;24(6):590-5. Epub 2010 Apr 3.
Semple R & Lee, J (2011).  Mindfulness Based Cognitive Therapy for Anxious Children.  New Harbinger:  Oakland.

Mindful Eating: The Power of Mindfulness Practice for Client and Clinician

Char Wilkins, M.S.W, L.C.S.W.

Char Wilkins is a mindfulness-based psychotherapist who is trained to teach Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Mindfulness-Based Eating Awareness programs. Char has led several professional training retreats for the UCSD Center for Mindfulness.

By Char Wilkins
I found my way to meditation years ago out of necessity- not unlike how people come into therapy and the mindfulness-based courses I teach. Knowing how useful meditation had been in my own life, I began looking for a way to incorporate mindfulness and meditation into my psychotherapy practice for individuals and in groups. The intersection of abuse, body image and eating/food issues is insidiously woven together for many people. Each year I find myself sitting with an increasing number of women struggling with disordered eating borne out of stress and suffering.

Bringing mindfulness into working with painful and habituated coping mechanisms, whether a situational practice or an entrenched eating disorder, seemed to be an appropriate next step. Through mindful eating exercises and meditation, most of the women I see individually or in  MB-intervention programs report that food cravings lessen, they gain skills in self-regulating not only with regard to food and eating but in all areas of their lives, and they become more aware of what, how and the hunger that drives their eating or non-eating. Mindfulness isn’t a cure and it isn’t for everyone, but it can facilitate change.

There is never just one way to address any behavior that arise out of fear or ignorance, but the integration of mindfulness into a treatment plan can be useful to both therapist and client when difficulty around food/eating and body image are part of the landscape. For the healthcare professional, being fully present to the client through the lens of mindfulness provides an anchor for the clinician and a steadying presence for the client. When the pull to be directive with a client about what to do, eat or not eat arises, it’s valuable for the clinician to skillfully attend to their own feelings of anxiety, inadequacy or fear that could cloud their ability to remain fully present and non-judgmental. For the client, the introduction of mindfulness meditations and exercises offer the possibility of a skillful approach to being with difficult emotions, thoughts and behaviors, and a way to be aware of and with physical sensations in body.  Once learned, mindfulness skills are not dependent on the therapist and this helps to shift the client’s locus of control from external to internal.

When working with habituated eating patterns from a mindful stance, the goal is never weight because weight is only a symptom. Just as in meditation where relaxation is the not the goal although it is often a welcomed by-product, weight gain or loss is not the goal. Rather the focus is bringing eating into balance with other important aspects in the client’s life. Because unhealthy eating habits are often closely linked to depression and anxiety, trustworthy ways in which to develop awareness and tolerance of uncomfortable thoughts, feelings and physical sensations are an important consideration of mindful eating practices. Compassionate acceptance of what is here right now brings with it a different perspective and the possibility of choice.

The idea of “acceptance,” “non-doing” or “non-striving” often elicits feelings of agitation, frustration, inadequacy and fear of passivity from the client.  To someone used to following strict diets, excessive exercise or other regimes, cyclical binges or habituated overeating, the idea of not doing something about it can be frightening for client and clinician, even when both are aware of the merciless cycles these behaviors create. Using the principles of mindfulness and mindful eating encourages self-referral, a reduction in impulsivity and a way to steady one’s self in challenging moments.

Once trained in mindfulness meditation and mindful eating practices, a clinician might begin by introducing the concept of mindfulness through the raisin exercise or a simple breath meditation.  My colleague, Jan Chozen Bays, has simple and short, focused eating exercises in her book, Mindful Eating: a guide to rediscovering a healthy and joyful relationship with food.  And there are more and more books, trainings and workshops that can help and support healthcare professionals in this much needed eating awareness work.

Char Wilkins and Jan Chozen Bays will be co-leading a 5-day Professional Training Retreat entitled “Mindful Eating, Conscious Living” on October 2-7, 2011 in Petaluma, CA sponsored by the UCSD Center for Mindfulness. They will also be conducting a 2-day workshop entitled “Mindful Eating: Tasting Satisfaction” on June 18-19 in San Diego.