User:AcevedoBarga/sandbox

INTENTIONS FOR IMPROVEMENT: note, the changes I have made are bolded

TO DO:

- Create History section for MBCT

- Create Implications on the brain section for MBCT

- re-define/elaborate on the MBSR/MBCT program

- Edit table of contents and charts

- Add more links into text (so reader is able to connect these articles to other wiki articles)

- Expand on further readings and external links

DONE:

- Created history section for MBSR

- Expanded the details on the 8-week MBSR program

- Explained how mindfulness is supposed to help following the 8-week program

- Added to Evaluation of Effectiveness section

- Created implications on the brain sections

- Distinguished between MBCT and other mindfulness-based therapies

Mindfulness-based stress reduction (MBSR)

Mindfulness-based stress reduction (MBSR) is a mindfulness-based program designed to assist people with pain and a range of conditions and life issues that were initially difficult to treat in a hospital setting. Developed at the University of Massachusetts Medical Center in the 1970's by Professor Jon Kabat-Zinn, MBSR uses a combination of mindfulness meditation, body awareness, and yoga to help people become more mindful.^[1] In recent years, meditation has been the subject of controlled clinical research.^[2] This suggests it may have beneficial effects, including stress reduction, relaxation, and improvements to quality of life, but that it does not help prevent or cure disease.^[3] While MBSR has its roots in spiritual teachings, the program itself is secular.^[4]

History (MBSR)

In 1979 Kabat-Zinn founded the Mindfulness Based Stress Reduction Clinic at the University of Massachusetts and nearly twenty years later the Center for Mindfulness in Medicine. Both these institutions supported the successful growth and implementation of MBSR into hospitals worldwide. Today MBSR is practiced as a complementary medicine, commonly in the field of oncology.

Overview (MBSR)

MBSR has been described as "a group program that focuses upon the progressive acquisition of mindful awareness, of mindfulness".^[5] The MBSR program is an eight-week workshop taught by certified trainers that entails weekly group meetings (two-hour classes) and a one-day retreat (six-hour mindfulness practice) between sessions six and seven, homework (45 minutes daily), and instruction in three formal techniques: mindfulness meditation, body scanning and simple yoga postures. Body scanning is the first prolonged formal mindfulness technique taught during the first four weeks of the workshop, and entails quietly lying on one's back and focusing one's attention on various regions of the body, starting with the toes and moving up slowly to the top of the head.^[1][6]

According to Kabat-Zinn, the basis of MBSR is mindfulness, which he defined as "moment-to-moment, non-judgmental awareness."^[7] During the program, participants are asked to focus on informal practice as well by incorporating mindfulness into their daily routines. Focusing on the present is thought to heighten sensitivity to the environment and one’s own reactions to it, consequently enhancing self-management and coping. It also provides an outlet from ruminating on the past or worrying about the future, breaking the cycle of these maladaptive cognitive processes.

Evaluation of effectiveness (MBSR)

Mindfulness-based approaches have been tested for a range of health problems including anxiety disorder, mood disorder, substance abuse disorder, eating disorders, chronic pain, ADHD, insomnia, coping with medical conditions, with many populations including children, adolescents, parents, teachers, therapists, and physicians. As a major subject of increasing research interest, 52 papers were published on mindfulness in 2003, rising to 477 by 2012.^[1] Nearly 100 randomized controlled trials had been published by early 2014.^[9]

Some research has suggested that therapy incorporating mindfulness might help people with anxiety, depression, and stress. The quality of this research has been the subject of review, however, with mixed results.^[10][11][12] According to Cancer Research UK, while some evidence has shown MBSR may help with symptom relief and improve quality of life, there is no evidence it helps prevent or cure disease.^[3] A 2013 statement from the American Heart Association on alternative approaches to lowering blood pressure concluded that meditation techniques other than Transcendental Meditation, including MBSR, are not recommended in clinical practice to lower blood pressure.^[13] Nevertheless, MBSR can have a beneficial effect helping with the depression and psychological distress associated with chronic illness.^[14]

Preliminary evidence suggests efficacy of mindfulness meditation in the treatment of substance use disorders, however further study is required.^[15] MBSR might be beneficial for people with fibromyalgia: there is no evidence of long-term benefit but low-quality evidence of a small short-term benefit.^[16]

In 2010 a meta-analysis was conducted by Hofman and colleagues exploring the efficacy of MBSR and similarly structured programs for adults with symptoms of anxiety and depression. The meta-analysis showed that between pre and post testing there was significant medium within-group effect sizes observed on anxiety and depression and also small to medium between-group effect sizes when comparing waitlist, treatment as usual, and active treatment (MBSR), further supporting the literature that states mindfulness-based therapies can be beneficial in treating symptoms of depression and anxiety. A broader meta-analysis conducted in 2004 by Grossman and colleagues found similar effect sizes when testing the physical and mental health outcomes following MBSR treatment.

Extent of practice[edit source | edit]

According to a 2014 article in Time magazine, mindfulness meditation is becoming popular among people who would not normally consider meditation.^[1] The curriculum started by Kabat-Zinn at University of Massachusetts Medical Center has produced nearly 1,000 certified MBSR instructors who are in nearly every state in the US and more than 30 countries. Corporations such as General Mills have made it available to their employees or set aside rooms for meditation. Democratic Congressman Tim Ryan published a book in 2012 titled A Mindful Nation and he has helped organize regular group meditation periods on Capitol Hill.^[1][8]

Implications on the brain (MBSR)

Grey matter concentrations in brain regions that regulate emotion, self referential processing, learning and memory processes have shown alterations proceeding MBSR. Additionally, MBSR practice has been associated with improvement of the immune system which could explain the correlation between stress reduction and increased quality of life.

External links[edit source | edit]

• Center For Mindfulness (CFM) at University of Massachusetts, where MSBR began
• Private organisation: Mindful Net
• Private company: MBSR Program

Mindfulness-based cognitive therapy (MBCT) is a psychological therapy designed to aid in preventing the relapse of depression, specifically in individuals with major depressive disorder (MDD).^[1] It's intent to address MDD specifically distinguishes MBCT from other mindfulness-based therapies such as mindfulness-based stress reduction which is applicable to a broad range of disorders, and mindfulness-based relapse prevention which is used to treat addiction. It [Mindfulness-based cognitive therapy] uses traditional cognitive behavioral therapy(CBT) methods and adds in newer psychological strategies such as mindfulness and mindfulness meditation. Cognitive methods can include educating the participant about depression.^[2] Mindfulness and mindfulness meditation, focus on becoming aware of all incoming thoughts and feelings and accepting them, but not attaching or reacting to them.^[3] This process is known as "Decentering" and aids in disengaging from self-criticism, rumination, and dysphoric mood that can arise when reacting to negative thinking patterns. Like CBT, MBCT functions on the theory that when individuals who have historically had depression become distressed, they return to automatic cognitive processes that can trigger a depressive episode.^[4] The goal of MBCT is to interrupt these automatic processes and teach the participants to focus less on reacting to incoming stimuli, and instead accepting and observing them without judgment.^[4] This mindfulness practice allows the participant to notice when automatic processes are occurring and to alter their reaction to be more of a reflection. It is theorized that this aspect of MBCT is responsible for the observed clinical outcomes.

Beyond its use in reducing depressive acuity, research additionally supports the effectiveness of mindfulness meditation upon reducing cravings for substances that people are addicted to. Addiction is known to involve the weakening of the prefrontal cortexthat ordinarily allows for delaying of immediate gratification for longer term benefits by the limbic and paralimbic brain regions. Mindfulness meditation of smokers over a two-week period totaling five hours of meditation decreased smoking by about 60% and reduced their cravings, even for those smokers in the experiment who had no prior intentions to quit. Neuroimaging of those who practice mindfulness meditation has been shown to increase activity in the prefrontal cortex, a sign of greater self-control.^[5]

Contents

[[[Mindfulness-based cognitive therapy|hide]]] 

• 1Background
• 2Applications
• 3See also
• 4Further reading
• 5References

Background[edit source | edit]

In 1991 Philip Barnard and John Teasdale created a multilevel theory of the mind called “Interacting Cognitive Subsystems,” (ICS). The ICS model is based on Barnard and Teasdale’s theory that the mind has multiple modes that are responsible for receiving and processing new information cognitively and emotionally. Barnard and Teasdale’s (1991) theory associates an individual’s vulnerability to depression with the degree to which he/she relies on only one of the modes of mind, inadvertently blocking the other modes.^[6] The two main modes of mind include the “doing” mode and “being” mode. The “doing” mode is also known as the driven mode. This mode is very goal-oriented and is triggered when the mind develops a discrepancy between how things are versus how the mind wishes things to be.^[7] The second main mode of mind is the “being” mode. “Being” mode, is not focused on achieving specific goals, instead the emphasis is on “accepting and allowing what is,” without any immediate pressure to change it.^[8] The central component of Barnard and Teasdale’s ICS is metacognitive awareness. Metacognitive awareness is the ability to experience negative thoughts and feelings as mental events that pass through the mind, rather than as a part of the self.^[9] Individuals with high metacognitive awareness are able to avoid depression and negative thought patterns more easily during stressful life situations, in comparison to individuals with low metacognitive awareness.^[9] Metacognitive awareness is regularly reflected through an individual’s ability to decenter. Decentering is the ability to perceive thoughts and feelings as both impermanent and objective occurrences in the mind.^[6]

Based on Barnard and Teasdale’s (1991) model, mental health is related to an individual’s ability to disengage from one mode or to easily move among the modes of mind. Therefore, individuals that are able to flexibly move between the modes of mind based on the conditions in the environment are in the most favorable state. The ICS model theorizes that the “being” mode is the most likely mode of mind that will lead to lasting emotional changes. Therefore, for prevention of relapse in depression, cognitive therapy must promote this mode. This led Teasdale to the creation of MBCT, which promotes the “being” mode.^[6]

This therapy was also created by Zindel Segal and Mark Williams, and was partially based on the mindfulness-based stress reduction program, developed by Jon Kabat-Zinn.^[10] Theories behind these mindfulness-based approaches to psychological issues function on the idea that being aware of things in the present, and not focusing on the past or the future, will allow the client to be more apt to deal with current stressors and distressing feelings with a flexible and accepting mindset, rather than avoiding, and, therefore, prolonging them.^[3]

Applications[edit source | edit]

The MBCT program is a group intervention that lasts eight weeks. During these eight weeks, there is a weekly course, which lasts two hours, and one day-long class after the fifth week. However, much of the practice is done outside of classes, where the participant uses guided meditations and attempts to cultivate mindfulness in their daily lives.^[4]

MBCT prioritizes learning how to pay attention or concentrate with purpose, in each moment and most importantly, without judgment.^[11] Through mindfulness, clients can recognize that holding onto some of these feelings is ineffective and mentally destructive. Mindfulness is also thought by Fulton et al. to be useful for the therapists as well during therapy sessions.^[12]

MBCT is an intervention program developed to specifically target vulnerability to depressive relapse. Throughout the program, patients learn mind management skills leading to heightened metacognitive awareness, acceptance of negative thought patterns and an ability to respond in skillful ways. During MBCT patients learn to decenter their negative thoughts and feelings, allowing the mind to move from an automatic thought pattern to conscious emotional processing.^[6] MBCT can be used as an alternative to maintenance antidepressant treatment, though it may be no more effective.^[13]

Evaluation of effectiveness (MBCT)

Although MBCT can be used as an alternative or adjunct therapy for depression, research shows that it is most effective with individuals who have a history of at least three or more past episodes of depression. Within that population, participants with life-event triggered depressive episodes were least receptive to MBCT.

Research supports that MBCT results in increased self-reported mindfulness which suggests increased present-moment awareness, decentering, and acceptance, in addition to decreased maladaptive cognitive processes such as judgment, reactivity, rumination, and thought suppression.

See also[edit source | edit]

• Acceptance and commitment therapy
• Dialectical behavior therapy
• Mindfulness-based stress reduction
• Mindfulness (psychology)
• Religious studies

Further reading[edit source | edit]

• Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse, by Zindel V. Segal, J. Mark G. Williams, John D. Teasdale. Guilford Press, 2002. ISBN 1-57230-706-4.
• Mindfulness: Finding Peace in a Frantic World by Professor Mark Williams & Dr Danny Penman" Rodale Books US (October 25, 2011). Piatkus UK (5 May 2011)
• Mindfulness-based treatment approaches: clinician's guide to evidence base and applications, by Ruth A. Baer. Academic Press, 2006. ISBN 0-12-088519-0.
• Mindfulness-Based Cognitive Therapy for Anxious Children: A Manual for Treating Childhood Anxiety, by Randye Semple, Jennifer Lee. New Harbinger Pubns Inc, 2010. ISBN 1-57224-719-3.
• Mindfulness Practice in the Treatment of Traumatic Stress, U.S. Department of Veterans Affairs.
• id=Mindfulnet.org The independent mindfulness information resourceInformation on MBCT., MBSR Research, applications and resources