Mindfulness Training as a Clinical Intervention: A ...

1 Send correspondence to Ruth A. Baer, Department of Psychol-ogy, 115 Kastle Hall, University of Kentucky, Lexington, KY40506-0044. E-mail: based on Training in Mindfulness skills arebecoming increasingly popular. Mindfulness involves in-tentionally bringing one s attention to the internal and ex-ternalexperiences occurring in the present moment, andis often taught through a variety of meditation review summarizes conceptual approaches to mind-fulness and empirical research on the utility of Mindfulness -based interventions.

2 Meta-analytic techniques were in-corporated to facilitate quantification of findings andcomparison across studies. Although the current empir-ical literature includes many methodological flaws, find-ings suggest that Mindfulness -based interventions maybe helpful in the treatment of several disorders. Method-ologically sound investigations are recommended in orderto clarify the utility of these words: Mindfulness , meditation, meta-analysis,treatment outcome.[Clin Psychol Sci Prac 10: 125 143,2003] Mindfulness is a way of paying attention that originated inEastern meditation practices.

3 It has been described as bringing one s complete attention to the present experi-ence on a moment-to-moment basis (Marlatt & Kris-teller, 1999, p. 68) and as paying attention in a particularway: on purpose, in the present moment, and nonjudg-mentally (Kabat-Zinn, 1994, p. 4). The ability to directone s attention in this way can be developed through thepractice of meditation, which is defined as the intentionalself-regulation of attention from moment to moment(Goleman & Schwartz, 1976; Kabat-Zinn, 1982). The cur-rent Mindfulness literature describes numerous meditationexercises designed to develop Mindfulness skills (Hanh,1976; Kabat-Zinn, 1990, 1994; Linehan, 1993b).

4 Manyencourage individuals to attend to the internal experiencesoccurring in each moment, such as bodily sensations,thoughts, and emotions. Others encourage attention toaspects of the environment, such as sights and sounds(Kabat-Zinn, 1994; Linehan, 1993b). All suggest thatmindfulness should be practiced with an attitude of non-judgmental acceptance. That is, phenomena that enter theindividual s awareness during Mindfulness practice, such asperceptions, cognitions, emotions, or sensations, are ob-served carefully but are not evaluated as good or bad, trueor false, healthy or sick, or important or trivial (Marlatt &Kristeller, 1999).

5 Thus, Mindfulness is the nonjudgmentalobservation of the ongoing stream of internal and externalstimuli as they recently, Mindfulness has been a relatively unfa-miliar concept in much of our culture (Kabat-Zinn, 1982),perhaps because of its origins in Buddhism. Kabat-Zinn(2000) suggests that Mindfulness practice may be beneficialto many people in Western society who might be un-willing to adopt Buddhist traditions or vocabulary. Thus,Western researchers and clinicians who have introducedmindfulness practice into mental health treatment pro-grams usually teach these skills independently of the reli-gious and cultural traditions of their origins (Kabat-Zinn,1982; Linehan, 1993b).

6 In the current empirical literature, Clinical interventions based on Training in Mindfulness skillsare described with increasing frequency, and their popu-larity appears to be growing rapidly. According to Salmon,Santorelli, and Kabat-Zinn (1998), over 240 hospitals andclinics in the United States and abroad were offering stressreduction programs based on Mindfulness Training as ofMindfulness Training as a Clinical Intervention: A Conceptual and Empirical ReviewRuth A. Baer, University of KentuckyDOI: 2003 AMERICAN PSYCHOLOGICAL ASSOCIATION D121251997.

7 Mindfulness Training is also a central component ofdialectical behavior therapy (Linehan, 1993a, 1993b), anincreasingly popular approach to the treatment of border-line personality disorder. The empirical literature on theeffects of Mindfulness Training contains many method-ological weaknesses, but it suggests that Mindfulness inter-ventions may lead to reductions in a variety of problematicconditions, including pain, stress, anxiety, depressive re-lapse, and disordered eating ( , Kabat-Zinn, 1982; Kabat-Zinn et al., 1992; Kristeller & Hallett, 1999; Shapiro,Schwartz, & Bonner, 1998; Teasdale et al.)

8 , 2000).This review summarizes the recent literature on mind-fulness Training as a Clinical intervention. First, currentmethods for teaching Mindfulness skills are , conceptual approaches that articulate how mindful-ness skills may be helpful in treating Clinical conditions aresummarized. Finally, the empirical literature on the effectsof Mindfulness Training is review does not address transcendental meditation(TM) and other concentration-based approaches, whichhave been reviewed elsewhere (Delmonte, 1985; Smith,1975).

9 Concentration-based approaches train participantsto restrict the focus of attention to a single stimulus, suchas a word ( , a mantra), sound, object, or attention wanders, it is redirected to the object ofmeditation. No attention is paid to the nature of the dis-traction. Mindfulness meditation, in contrast, involves ob-servation of constantly changing internal and externalstimuli as they review also does not address Langer s (1989, 1997)cognitive model of Mindfulness , which includes alertnessto distinctions, context, and multiple perspectives, open-ness to novelty, and orientation in the present (Sternberg,2000).

10 Mindfulness interventions studied by Langer andcolleagues ( , Langer, 1989; Langer & Moldoveanu,2000) often include teaching participants to consider in-formation or situations from multiple perspectives orwithin new contexts in order to increase learning or cre-ativity. Although this concept of Mindfulness shares withmeditative approaches an emphasis on flexible awareness inthe present, several important differences can be s (1989) Mindfulness interventions usually involveworking with material external to the participants, such asinformation to be learned or manipulated, and often in-clude active, goal-oriented cognitive tasks, such as solvingproblems.