Mindfulness-based Stress Reduction (MBSR)
Mindfulness-based stress reduction, also known as MBSR, is an evidence-based group treatment program that was developed originally by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical Center. MBSR was initially designed to teach patients with chronic pain how to cope with their pain using mindfulness meditation and Hatha yoga techniques and has since been expanded to use in participants with chronic stress, emotional or physical pain, and other illnesses and concerns. The MBSR program teaches participants to cultivate an attitude of non-judgmental awareness and detached self-observation via various directed attention techniques. MBSR targets emotional and cognitive components of the pain experienced by teaching participants to observe intense feelings in the body and mind as impermanent events and not necessarily accurate or of more importance than any subsequent thought or experience. Participants learn and practice these techniques in both stationary and movement-based activities. By observing the thinking process itself and redirecting attention back to awareness of the present moment, participants learn to uncouple from the affective and cognitive components of stress and pain, which may result in a reduction of stress reactivity.
Course Format: The MBSR program follows a manualized protocol in an 8-week, 9-session group format consisting of 15-40 participants per class with 30+ hours of direct classroom contact. The group initially meets for a pre-program orientation session (2.5 hours) followed by brief individual interviews with course instructors (5-10 minutes). Subsequently, participants attend 8 weekly classes (2.5-3.5) hours in duration. An all-day silent retreat is completed during the sixth week of the program (7.5 hours). Formal and informal home assignments consist of mindfulness practices and awareness exercises. At the completion of the course, instructors encourage continuity of mindfulness practices by providing community-based resources and reading materials to participants. Participants are offered the opportunity to enroll in advanced graduate stress reduction programs provided several times per year to sustain their new lifestyle and attitudinal changes and continue to support their health and well-being.
“By observing the thinking process itself and redirecting attention back to awareness of the present moment, participants learn to uncouple from the affective and cognitive components of stress and pain, which may result in a reduction of stress reactivity.”
Instructor Requirements: Similar to other mindfulness-based interventions, the MBSR course has formal and informal instructor requirements. MBSR instructors navigate and support participants through mindfulness meditation practices and are thus required to have both personal engagement and an ongoing practice. There are various MBSR teacher training programs with different formalized requirements, yet no one centralized teacher training system exists. Standard pre-requisites of teacher training include participation in an 8-week MBSR course and attendance in a 5-7 day silent teacher-led retreat. Various academic and medical institutions such as Brown University and UMass Memorial Medical Center and the University of California, San Diego School, and individual groups and practitioners offer instructor certification. Although there are many options for training, there does not appear to be a standardized accrediting body and the literature does not expound on this.
Course Outcomes: MBSR was designed to increase participants’ present-moment awareness by building insight, compassion, and non-reactivity. According to several empirical studies and meta-analyses, MBSR has been shown to reduce pain intensity, anger, and perceived stress, and improve quality of life and social functioning.
Clinical Populations: MBSR was designed to be used by adults 17 years and older. MBSR has been scientifically studied and shown to positively affect individuals with anxiety, asthma, chronic pain, diabetes, fibromyalgia, gastrointestinal disorders, heart disease, HIV, Hypertension, Sleep Disorders, and PTSD. MBSR has also been adapted for use with teens, individuals with cancer, and major depressive disorder. While no empirically-based guidelines exist with regards to contraindications, participants should be screened on a case-by-case basis for current drug or alcohol abuse, psychopathology, and post-traumatic stress disorder to determine if they are receiving appropriate treatment by a qualified practitioner for any of these conditions, given that MBSR is not a form of group psychotherapy nor a peer support group. Instructors may refer potential participants to more appropriate empirically supported mindfulness-based interventions such as MBCT for recurrent depression or Dialectical Behavior Therapy for borderline personality disorder.
Learn More: MBSR Curriculum Guide
References
Emily is a certified yoga teacher and pursuing her PhD in Clinical Psychology at UNCG.
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