View source for Mindfulness (psychology)

Modern [[clinical psychology]] and [[psychiatry]] since the 1970s have developed a number of therapeutic applications based on the concept of  [[Mindfulness (Buddhism)|mindfulness]]  ([[Pali]] ''sati'' or [[Sanskrit]] ''smriti'')  in [[Buddhist meditation]].

==Definitions==
Several definitions of '''mindfulness''' have been used in modern Western psychology. According to various prominent psychological definitions, ''Mindfulness'' refers to a psychological quality that involves
<blockquote>bringing one’s complete attention to the present experience on a moment-to-moment basis,<ref name="Baer defines">"Mindfulness is a way of paying attention that originated in Eastern meditation practices. It has been described as “bringing one’s complete attention to the present experience on a moment-to-moment basis” (Marlatt & Kristeller, 1999, p. 68) and as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (Kabat-Zinn, 1994, p. 4)" - Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review, by Ruth A. Baer, available at http://www.wisebrain.org/papers/MindfulnessPsyTx.pdf</ref></blockquote>
or involves
<blockquote>paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally,<ref name="Baer defines"/></blockquote>
or involves
<blockquote>a kind of nonelaborative, nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is<ref>"a kind of nonelaborative, nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is" - Bishop et al. (2004:232)</ref></blockquote>
Bishop, Lau, and colleagues (2007)<ref name=bishopetal2004/> offered a two component model of mindfulness:
<blockquote>The first component [of mindfulness] involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation toward one’s experiences in the present moment, an orientation that is characterized by curiosity, openness, and acceptance.<ref name=bishopetal2004>{{cite journal |author=Scott R. Bishop, Mark Lau, Shauna Shapiro, Linda Carlson, Nicole D. Anderson, James Carmody, Zindel V. Segal, Susan Abbey, Michael Speca, Drew Velting & Gerald Devins |year=2004  |title=Mindfulness: A proposed operational definition  |journal=Clinical Psychology: Science & Practice  |publisher=  |volume=11  |issue=3  |pages= 230–241  |url= http://www.oup.com/  |doi=10.1093/clipsy.bph077 |issn=0969-5893 |pmid=}} (see also this page's bibliography)</ref>{{rp|232}}</blockquote>

In this two-component model, self-regulated [[attention]] (the first component) involves [[consciousness|conscious]] [[awareness]] of one's current thoughts, feelings, and surroundings, which can result{{citation needed|date=November 2010}} in [[metacognitive]] skills for controlling concentration. [[Orientation (mental)|Orientation]] to experience (the second component) involves accepting one's [[mindstream]], maintaining open and curious attitudes, and thinking in alternative categories (developing upon [[Ellen Langer]]'s research on [[decision making|decision-making]]). Training in mindfulness and mindfulness-based practices, oftentimes as part of a quiet [[meditation]] session, results{{citation needed|date=November 2010}} in the development of a [[Beginner's mind]], or, looking at experiences as if for the first time.

==Historical development==
In 1979 Dr. [[Jon Kabat-Zinn]] founded the Mindfulness-Based Stress Reduction program at the University of Massachusetts to treat the chronically ill,<ref>"The Stress Reduction Program, founded by Dr. Jon Kabat-Zinn in 1979..." - http://www.umassmed.edu/cfm/stress/index.aspx</ref> which sparked a growing interest and application of mindfulness ideas and practices in the medical world<ref>"Much of the interest in the clinical applications of mindfulness has been sparked by the introduction of [[Mindfulness-Based Stress Reduction]] (MBSR), a manualized treatment program originally developed for the management of chronic pain (Kabat-Zinn, 1982; Kabat-Zinn, Lipworth, & Burney, 1985; Kabat-Zinn, Lipworth, Burney, & Sellers, 1987)." - Bishop et al, 2004, "Mindfulness: A Proposed Operational Definition"</ref>{{rp|230-1}} for the treatment of a variety of conditions in people [[Positive Psychology|both healthy and unhealthy]]. Many of the variety of mindfulness-based clinical treatments we have today are mentioned on this webpage below.

Much of this was inspired by teachings from [[Eastern World|the East]], and particularly from the Buddhist traditions, where mindfulness is the 7th step of the [[Noble Eightfold Path]] taught by [[Siddhartha Gautama]], The Buddha, who founded [[Buddhism]] almost 2,500 years ago. Although originally articulated as a part of what we know in the West as Buddhism, there is nothing inherently religious about mindfulness, and it is often taught independent of religious or cultural connotation.<ref>"[[Kabat-Zinn]] (2000) suggests that mindfulness practice may be beneficial to many people in Western society who might be unwilling to adopt [[Buddhist]] traditions or vocabulary. Thus, Western researchers and clinicians who have introduced mindfulness practice into mental health treatment programs usually teach these skills independently of the [[religious]] and [[cultural]] traditions of their origins (Kabat-Zinn, 1982;Linehan, 1993b)." - Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review by Ruth A. Baer</ref><ref>"Historically a Buddhist practice, mindfulness can be considered a universal human capacity proposed to foster clear thinking and open-heartedness. As such, this form of meditation requires no particular religious or cultural belief system." - Mindfulness in Medicine by Ludwig and [[Kabat-Zinn]], available at http://jama.ama-assn.org/cgi/content/short/300/11/1350</ref>


Teachers such as [[Nhat Hanh|Thich Nhat Hanh]]<ref>Thich Nhat Hanh, The Miracle of Mindfulness (1975), Beacon Books, ISBN 0-8070-1239-4</ref> have brought mindfulness to the attention of Westerners. Mindfulness and other Buddhist meditation techniques receive support in the West from figures such as the scientist [[Jon Kabat-Zinn]], the teacher [[Jack Kornfield]], the teacher [[Joseph Goldstein]], the psychologist [[Tara Brach]], the writer [[Alan Clements]], and the teacher [[Sharon Salzberg]], who have been widely{{Who|date=February 2010}} attributed with playing a significant role in integrating the healing aspects of [[Buddhist meditation]] practices with the concept of psychological awareness and healing. [[Psychotherapists]] have adapted and developed mindfulness techniques into a promising [[cognitive behavioral therapy|cognitive behavioral therapies]] vis. Acceptance and Commitment Therapy (ACT, pronounced act) <ref>Steven C. Hayes, Get Out of Your Mind and Into Your Life (2004) New Harbinger Press</ref><ref>Russ Harris, The Happiness Trap (2008)Trumpeter Books</ref> ACT was recently reviewed by SAMHSA's National Registry of Evidence-Based Programs and Practices <ref> available at http://nrepp.samhsa.gov/ViewIntervention.aspx?id=191 on 3/9/2011 (July 2010)</ref>[[User:Henrysteinberger|Henrysteinberger]] ([[User talk:Henrysteinberger|talk]]) 01:40, 20 March 2011 (UTC)

==Scientific research==
Over the past 30 years there has been an increase in the number of published studies on mindfulness.<ref>"In the past 30 years, interest in the therapeutic uses of mindfulness has increased, with more than 70 scientific articles on the topic published in 2007." - Mindfulness in Medicine by Ludwig and [[Kabat-Zinn]], available at http://jama.ama-assn.org/cgi/content/short/300/11/1350</ref> The current body of scientific literature on the effects of mindfulness practices is promising despite the presence of many methodological weaknesses.<ref name="reviewBaer">"The empirical literature on the effects of mindfulness training contains many methodological weaknesses, but it suggests that mindfulness interventions may lead to reductions in a variety of problematic conditions, including pain, stress, anxiety, depressive relapse, and disordered eating (e.g., Kabat-Zinn, 1982;Kabat-Zinn et al., 1992; Kristeller & Hallett, 1999; Shapiro, Schwartz, & Bonner, 1998;Teasdale et al., 2000)." - Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review by Ruth A. Baer</ref><ref>"Secondly, most studies reviewed suffered from methodological deficiencies beyond merely the type of design as randomized, quasiexperimental or observational..." - Mindfulness-based stress reduction and health benefits: A meta-analysis by Grossman et. al, available at http://www.uniklinik-freiburg.net/iuk/live/forschung/publikationen/MBSR_MA_JPR_2004.pdf</ref> The current research does suggest that mindfulness practices are useful in the treatment of pain,<ref name="reviewBaer"/> stress,<ref name="reviewBaer"/> anxiety,<ref name="reviewBaer"/> depressive relapse,<ref name="reviewBaer"/> disordered eating,<ref name="reviewBaer"/> and addiction,<ref>"The potential benefits from treating addictive behaviors [with the non-rejecting and aware principles of mindfulness] has been recognized (Marlatt & Kristeller 1999), and DBT [Dialectical Behavior Therapy] has recently been evaluated for treating substance abusers (Linehan et ala, 1999)." - An Information-Processing Analysis of Mindfulness:Implications for Relapse Prevention in the Treatment of Substance Abuse, by Breslin, Zack, and McClain, available at http://home.earthlink.net/~wendylliles/articles/breslin.pdf</ref><ref>from the abstract, "Preliminary data in support of mindfulness-meditation as a treatment for addictive behavior are provided and directions for future research are discussed." - Mindfulness-Based Relapse Prevention for Alcohol and Substance Use Disorders by Witkiewitz et. al, available at http://www.ingentaconnect.com/content/springer/jcogp/2005/00000019/00000003/art00003</ref> among others. Mindfulness has been investigated for its potential benefit for individuals who do not experience these disorders, as well, with positive results. Mindfulness practice improves the immune system<ref name="Davidson study">the Conclusion of "Alterations in Brain and Immune Function Produced by Mindfulness Meditation" by Davidson et al., available at http://www.psychosomaticmedicine.org/cgi/content/full/65/4/564?ijkey=ad6454f747329753c6e432b298e4953c38cc6857</ref> and alters activation symmetries in the prefrontal cortex, a change previously associated with an increase in positive affect and a faster recovery from a negative experience.<ref name="Davidson study"/> 

Mindfulness is often used{{By whom|date=June 2010}} synonymously with the traditional Buddhist processes of cultivating awareness as described above, but more recently{{When|date=June 2010}} has been studied as a psychological tool capable of stress reduction and the elevation of several positive emotions or traits. In this relatively new field of western psychological mindfulness, researchers attempt to define and measure the results of mindfulness primarily through controlled, randomised studies of mindfulness intervention on various dependent variables. The participants in mindfulness interventions measure many of the outcomes of such interventions subjectively. For this reason, several mindfulness inventories or scales (a set of questions posed to a subject whose answers output the subject's aggregate answers in the form of a rating or category) have arisen. The most prominent include:

* the Attention Awareness Scale
* the Freiburg Mindfulness Inventory
* the Kentucky Inventory of Mindfulness Skills
* the Cognitive and Affective Mindfulness Scale.<ref name="Rapgay, L 2009">Rapgay, L, & Bystrisky, A. (2009). Classical mindfulness: an introduction to its theory and practice for clinical application. Proceedings of the Conference on longevity, regeneration and optimal health: integrating eastern and western perspectives Phoenicia, NY</ref>

Through the use of these scales - which can illuminate self-reported changes in levels of mindfulness, the measurement of other correlated inventories in fields such as subjective well-being, and the measurement of other correlated variables such as health and performance - researchers have produced studies that investigate the nature and effects of mindfulness.  The research on the outcomes of mindfulness falls into two main categories: stress reduction and positive-state elevation.

===Stress reduction===
Human response to stressors in the environment produces emotional and physiological changes in individual human bodies in order to cope with that stress.<ref>http://deepblue.lib.umich.edu/bitstream/2027.42/49484/2/cortisolpulseLightman.pdf</ref> This process most likely evolved to help us attend to immediate concerns in our environment to better our chances of survival, but in modern society, much of the stress felt is not beneficial in this way. Stress has been shown to have several negative effects {{Citation needed|date=June 2010}} on health, happiness, and overall wellbeing. (See [[stress (biology)]]. One field of psychological inquiry into mindfulness is [[#Mindfulness-based_stress_reduction|"mindfulness-based stress-reduction"]] or MBSR. Several studies have produced relevant findings:

* Jain and Shapiro (2007)<ref>Jain, S et al. (2007). A randomised controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33(1).</ref> conducted a study to show that mindfulness meditation may be specific in its ability to “reduce distractive and ruminative thoughts and behaviours”, which may provide a “unique mechanism by which mindfulness meditation reduces distress”.
* Arch (2006)<ref>Arch, JJ and Craske, MG, (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44(12).</ref> found emotional regulation following focused breathing. A breathing group provided moderately positive responses to emotionally neutral visual slides, while "unfocused attention and worry" groups responded significantly more negatively to neutral slides.
* Brown (2003)<ref>Brown, KW and Ryan, RM. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4).</ref> found declines in mood disturbance and stress following mindfulness interventions.
* Jha (2010)<ref>Jha, Ap et al. (2010). Examining the protective effects of mindfulness training on working memory capacity and affective experience. Emotion, 10(1).</ref> found that a sufficient meditation training practice may protect against functional impairments associated with high-stress contexts.
* Garland (2009)<ref>Garland, E et al. (2009). The role of mindfulness in positive reappraisal. Explore-The Journal of Science and Healing, 5(1).</ref> found declines in stress after mindfulness interventions, which are potentially due to the positive re-appraisals of what were at first appraised as stressors.

===Elevation of positive emotions and outcomes===
While much research centered on mindfulness seeks to reduce stress, another large body of research has examined mindfulness as a tool to elevate and sustain "positive" emotional states as well and their related outcomes:

* Fredrickson (2008)<ref>Fredrickson, BL et al. (2008). Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. ''Journal of Personality and Social Psychology'', 95(5).</ref> studied the building of personal resources through increased daily experiences of positive emotions due to meditation. She found that meditation practice showed increases over time in purpose in life, social support, and decreased illness symptoms.
* Davidson (2003)<ref>Davidson, RJ et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. ''Psychosomatic Medicine'', 65(3).</ref> found that mindfulness meditation increased brain and immune function in positive ways, but highlighted the need for additional research.
* Brown (2009)<ref>Brown, KW et al. (2009). When what one has is enough: Mindfulness, financial desire discrepancy, and subjective well being. ''Journal of Research in Personality'', 43(5).</ref> investigated subjective [[well-being]] and financial desire. He found that a large discrepancy between financial desires and financial reality correlated with low subjective well-being, but that the accumulation of wealth did not tend to close the gap. Mindfulness however was associated with a lower financial-desire discrepancy and thus a higher subjective well-being, so mindfulness may promote the perception of “having enough”.
* Shao (2009)<ref>Shao, RP and Skarlicki, DP. (2009). The role of mindfulness in predicting individual performance. ''Canadian Journal of Behavioral Science'', 41(4).</ref> used a randomised controlled study to illuminate the correlation between MBA candidates subjected to a mindfulness intervention and increased academic performance. He found mindfulness was positively related to performance for women.
* Davidson ''et. al''<ref>Richard J. Davidson et al. Alterations in Brain and Immune Function Produced by Mindfulness Meditation. Psychosomatic Medicine 65:564-570 (2003). http://www.psychosomaticmedicine.org/cgi/content/full/65/4/564?ijkey=ad6454f747329753c6e432b298e4953c38cc6857</ref> showed that mindfulness practice improves the immune system and alters activation symmetries in the prefrontal cortex, a change previously associated with an increase in positive affect and a faster recovery time from exposure to a negative experience. These changes in subjects persisted even after periods they were done meditating.

===Future directions===
The research leaves many questions still unanswered. Much of the terminology used in such research has no cohesive definition. For example, there is a lack of differentiation between "attention" and "awareness" and an interchangeable use of the two in modern descriptions. Buddhist contemplative psychology however, differentiates more clearly, as "attention" in that context signifies an ever-changing factor of consciousness, while "awareness" refers to a stable and specific state of consciousness.<ref name="Rapgay, L 2009"/>

==Reception and criticism==
Various scholars have criticized how mindfulness has been defined or represented in recent western psychology publications. [[B. Alan Wallace]] has stated that an influential definition of mindfulness in the psychology literature (by Bishop et al.<ref name=bishopetal2004/>) differs in significant ways from how mindfulness was defined  by the Buddha himself, and by much of Buddhist tradition.<ref name=wallace06>{{cite book |title=The attention revolution: Unlocking the power of the focused mind |last=Wallace |first=B. Alan |authorlink=B. Alan Wallace  |year=2006  |publisher=Wisdom Publications  |location=Boston |isbn=0861712765 |url= http://www.loc.gov/catdir/toc/ecip065/2005037195.html  |accessdate=}}</ref> For example, Wallace writes that
<blockquote>
According to one psychological paper on the topic, mindfulness is “a kind of nonelaborative, nonjudgmental present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is.<ref>[[B. Alan Wallace|Wallace]] cites his quotation to the paper by Bishop, Lau, et al., 2004</ref> .... The modern psychological account of mindfulness, which is explicitly based on the descriptions of mindfulness presented in the modern [[Vipassana]] (contemplative insight) tradition of [[Theravada Buddhism]].... is oddly at variance with the [[Gautama Buddha|Buddha’s]] own description of mindfulness, or [[sati]]: “And what monks, is the faculty of [[sati]]? Here, monks, the noble disciple has [[sati]], he is endowed with perfect [[sati]] and intellect, he is one who remembers, who recollects what was done and said long before.”<ref>[[B. Alan Wallace|Wallace]] footnotes this quotation to [[Samyutta Nikaya]] V, 197-198.</ref> .... So, rather than refraining from labeling or categorizing experiences in a nonjudgmental fashion, in the earliest, most authorititative accounts, [[sati]] is said to distinguish between wholesome and unwholesome, beneficial and unbeneficial tendencies. The contrast between the ancient and modern accounts is striking.<ref name=wallace06/>{{rp|61}}
</blockquote>
[[B. Alan Wallace|Wallace]] concludes that "The modern description and practice of mindfulness are certainly valuable, as thousands of people have discovered for themselves through their own practice. But this doesn’t take away from the fact that the modern understanding departs significantly from the Buddha’s own account of sati, and from those of the most authoritative commentators in the Theravada and Indian Mahayana traditions."<ref name=wallace06/>{{rp|62}}

[[Eleanor Rosch]] has stated that contemporary "therapeutic systems that include mindfulness"<ref>Rosch (2007) is discussing "the four therapeutic systems that include mindfulness training as a component. These systems are Mindfulness Based Stress Reduction (MBSR; Kabat-Zinn, 1990), Mindfulness Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002; Teasdale &Barnard, 1993), Dialectical Behavior Therapy (DBT; Linehan, 1993a,b), and Acceptance and Commitment Therapy (ACT; Hays, Strosahl, & Wilson, 1999). (See also Baer, 2006; and Hayes, Jacobson, Follette, & Dougher, 1994.) Patients are never just given minimalist mindfulness instructions (such as “Pay bare attention to what comes into your mind”) and then left to themselves—for good reason. I know of no cases where anyone has developed a meditation, or even relaxation, practice without considerable input." (p. 261)</ref> "could as much be called wisdom-based as mindfulness-based."<ref name=rosch07>{{cite journal |author=[[Eleanor Rosch]] |year=2007  |title=More than mindfulness: When you have a tiger by the tail, let it eat you |journal=[[Psychological Inquiry]] |publisher= |volume=18 |issue=4 |pages= 258–264 |url=|doi= 10.1080/10478400701598371 |issn= 1047-840X |pmid= }}</ref>{{rp|262}} In these therapeutic approaches
<blockquote>
Mindfulness would seem to play two roles: as a part of the therapy itself and as an umbrella justification ("empirical") for the inclusion of other aspects of [[wisdom]] that may be beyond our present cultural assumptions. Where in this is mindfulness in its original sense of the mind adhering to an object of consciousness with a clear mental focus?<ref name=rosch07/>{{rp|262}}
</blockquote>

William Mikulas, in the ''[[Journal of Consciousness Studies]]'', stated that "In Western psychology, mindfulness and concentration are often confused and confounded because, although in the last few years there has been a moderate interest in mindfulness, there has not been a corresponding interest in concentration. Hence, many mindfulness-based programs are actually cultivating both concentration and mindfulness, but all results are attributed to mindfulness."<ref name=mikulas07>{{cite journal |author=William L. Mikulas |year=2007 |title=Buddhism & western psychology: fundamentals of integration |journal=[[Journal of Consciousness Studies]] |publisher= |volume=14 |issue=4 |pages=4–49 |url=http://www.ingentaconnect.com/content/imp/jcs/2007/00000014/00000004/art00001 |doi= |issn= 1355-8250 |pmid= }}</ref>{{rp|20}}

==Specific mindfulness-based therapy programs==
Since 2006 research supports promising mindfulness-based therapies for a number of medical and psychiatric conditions, notably [[chronic pain]] (McCracken et al. 2007), [[Stress (biological)|stress]] (Grossman et al. 2004), anxiety and [[Clinical depression|depression]] (Hofmann et al. 2010), [[substance abuse]] (Melemis 2008:141-157), and recurrent [[suicidal behavior]] (Williams et al. 2006).  Bell (2009) gives a brief overview of mindful approaches to [[therapy]], particularly [[family therapy]], starting with a discussion of [[mysticism]] and emphasizing the value of a mindful therapist.

===Morita therapy===
The Japanese psychiatrist [[Shoma Morita]], who trained in [[Zen]] meditation, developed [[Morita therapy]] upon principles of mindfulness and non-attachment.

===Gestalt therapy===
Since the beginnings of [[Gestalt therapy]] in the early 1940s, mindfulness, referred to as "[[awareness]]", has been an essential part{{Citation needed|date=June 2010}} of its theory and practice.

===Adaptation Practice===
The British psychiatrist, [[Clive Sherlock]] , who trained in the traditional [[Rinzai School]] of [[Zen]], developed Adaptation Practice (AP) in 1978 based on the profound mindfulness/awareness training of Zen daily-life practice and meditation. Adaptation Practice is used{{By whom|date=June 2010}} for long-term relief of depression, anxiety, anger, stress and other emotional problems.<ref>
http://www.adaptationpractice.org/the-times.php
</ref><ref>
http://www.guardian.co.uk/lifeandstyle/2004/may/04/healthandwellbeing.mentalhealth
</ref>

===Mindfulness-based stress reduction===
[[Jon Kabat-Zinn]] developed the Mindfulness-Based Stress Reduction (MBSR) over a ten-year period at the [[University of Massachusetts Medical School]]. He (1990:11) defines the essence of MBSR: "This "work" involves above all the regular, disciplined practice of moment-to-moment awareness or ''mindfulness,'' the complete "owning" of each moment of your experience, good, bad, or ugly."  Kabat-Zinn explains the non-Buddhist universality of MBSR:

<blockquote>
Although at this time mindfulness meditation is most commonly taught and practiced within the context of Buddhism, its essence is universal. … Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions. (2005:12-13)
</blockquote>

MBSR has clinically proven beneficial for people with depression and anxiety disorders.{{Citation needed|date=June 2010}} This mindfulness-based psychotherapy is practiced as a form of complementary medicine in over 200 {{Citation needed|date=February 2010}} hospitals, and is currently the focus of numerous research studies funded by the [[National Center for Complementary and Alternative Medicine]].

===Mindfulness-based cognitive therapy===
[[Mindfulness-based cognitive therapy]] (MBCT) psychotherapy combines cognitive therapy with mindfulness techniques as a treatment for [[major depressive disorder]].

===Acceptance and commitment therapy===
{{Main|Acceptance and commitment therapy}}
[[Steven C. Hayes]] and others have developed [[acceptance and commitment therapy]] (ACT), originally called "comprehensive distancing", which uses strategies of mindfulness, acceptance, and behavior change.

===Dialectical behavior therapy===
Mindfulness is a "core" exercise used in [[Dialectical behavior therapy]] (DBT), a psychosocial treatment [[Marsha M. Linehan]] developed for treating people with [[borderline personality disorder]]. DBT is [[dialectic]], explains Linehan (1993:19), in the sense of "the reconciliation of opposites in a continual process of synthesis." As a practitioner of Buddhist meditation techniques, Linehan says:
<blockquote>This emphasis in DBT on a balance of acceptance and change owes much to my experiences in studying meditation and Eastern spirituality. The DBT tenets of observing, mindfulness, and avoidance of judgment are all derived from the study and practice of Zen meditation. (1993:20-21)
</blockquote>

===Hakomi===
[[Hakomi]] therapy, under development by Ron Kurtz and others, is a [[somatic psychology]] based upon Asian philosophical precepts of mindfulness and [[nonviolence]].

===Internal Family Systems Therapy===
{{Main|Internal Family Systems Model}}
[[Internal Family Systems Model|Internal Family Systems Therapy]] (IFS), developed by Richard C. Schwartz, emphasizes the importance of both therapist and client engaging in therapy from the Self, which is the IFS term for one’s "spiritual center". The Self is curious about whatever arises in one’s present experience and open and accepting toward all manifestations.

==Mindfulness meditation in organizations==
In the U.S., certain businesses, universities, government agencies, counseling centers, schools, hospitals, religious groups, law firms, prisons, the army, and other organizations offer training in mindfulness meditation.

In the U.S. business world, interest in mindfulness is rising dramatically. This shows in the popular business press, including books such as ''Awake at Work'' (Carroll, 2004) and ''Resonant Leadership: Renewing Yourself and Connecting with Others Through Mindfulness, Hope, and Compassion''.<ref>Boyatzis, R. E., & McKee, A. (2005). ''Resonant Leadership: Renewing yourself and connecting with others through mindfulness, hope, and compassion''. Boston: Harvard Business School Press.
</ref>

The website of the University of Massachusetts Medical School Center for Mindfulness in Medicine, Health Care, and Society and Carroll’s (2007) book, ''The Mindful Leader'', mention many companies that have provided training programs in mindfulness. These include Fortune 500 companies (such as Raytheon, Procter & Gamble, Monsanto, General Mills, and Comcast) and others (such as BASF Bioresearch, Bose, New Balance, Unilever, and Nortel Networks). Executives who “meditate and consider such a practice beneficial to running a corporation”<ref name="Carroll, M. 2007">Carroll, M. (2007). ''The mindful leader: Ten principles for bringing out the best in ourselves and others (1st ed.)''. Boston: Trumpeter.</ref> have included the chairman of the Ford Motor Company, [[William Clay Ford, Jr.|Bill Ford, Jr.]]; a managing partner of McKinsey & Co., [[Michael Rennie (manager)|Michael Rennie]]; and Aetna International’s former chairman, [[Michael Stephen (Aetna)|Michael Stephen]]. A professional-development program &mdash; “Mindfulness at Monsanto” &mdash; was started at Monsanto corporation by its CEO, Robert Shapiro.

Another corporation (Sounds True, an audio recordings company)<ref>Caudron, S. (2001). Meditation and mindfulness at Sounds True, ''Workforce'' V. 80 No. 6 (June 2001) P. 40-6 (Vol. 80, pp. 40-46).</ref> has mindfulness as a core value.
<blockquote>
At Sounds True, we strive to practice mindfulness in every aspect of our work. Recognizing the importance of silence, inward attention, active listening and being centered, Sounds True begins its all-company meetings with a minute of silence and maintains a meditation room on-site for employees to utilize throughout the day.<ref>Anonymous (2003). Sounds True Case Study: The Willis Harmon Spirit at Work Award Retrieved January 15, 2008, from http://spiritat.netatlantic.com/index.php/isaw_casestudies</ref> )
</blockquote>

In some newspapers, magazines, and scholarly journals in fields other than management, one can find indicators of interest in mindfulness in organizations outside of business. This includes legal and law enforcement organizations.<ref>Meditation classes raise attorneys mindfulness (2009). ''New Orleans CityBusiness''.</ref>
* Harvard Law School’s [[Program on Negotiation]] hosted a workshop on “Mindfulness in the Law & Alternative Dispute Resolution.”<ref>Program on Negotiation at Harvard Law School (2008). Program on Negotiation Webcasts.</ref>
* Police officers in Los Angeles and in Madison, Wisconsin, have received mindfulness training.{{Citation needed|date=June 2010}} Many law firms offer mindfulness classes.<ref name="Carroll, M. 2007"/>

* Mindfulness has been taught{{By whom|date=June 2010}} in prisons, reducing hostility and mood disturbance among inmates, and improving their self esteem.<ref>Samuelson, M. (2007). Mindfulness-Based Stress Reduction in Massachusetts Correctional Facilities. In C. James, K.-Z. Jon, A. B. Michael, C. James, K.-Z. Jon & A. B. Michael (Eds.), ''Prison Journal'' (Vol. 87, pp. 254-268).</ref>

* There are over 240 mindfulness programs in hospitals and clinics throughout the U. S.{{Citation needed|date=June 2010}} Many government organizations offer mindfulness training, including the Army.<ref>Rochman, B. (2009, September 6, 2009). Samurai Mind Training for Modern American Warriors. ''Time''.</ref>

Research on mindfulness in the workplace has been conducted by McCormick and Hunter.<ref>McCormick, Donald W. & Hunter, Jeremy. (2008) ''Mindfulness in the Workplace: An Exploratory Study''. Presentation at the 2008 Academy of Management Annual Meeting, Anaheim, CA. A copy can be obtained by contacting Don McCormick, in the Department of Management in the College of Business and Economics at California State University Northridge.</ref> Hunter has taught a course on mindfulness to graduate students in business at [[Claremont Graduate University]], and McCormick has taught mindfulness in the business school of California State University Northridge.  In 2000, [[Susan Kaiser Greenland#Work|The Inner Kids Program]],  a mindfulness-based program developed for children, was introduced into public and private school curricula in the greater Los Angeles area.<ref>http://www.susankaisergreenland.com/inner-kids.html</ref>

==Learning mindfulness==
As [[Edel Maex]] opined: "Nobody has learned to play the piano from a book."<ref>Mindfulness, in de maelstroom van je leven (2007), Maex, Edel, Lannoo, ISBN 978-90-209-6516-2
</ref>

===Centers===
{{External links|date=August 2009}}
{{As of| 2010}} mindfulness techniques are widely available in the Western world.<ref>Database of qualified MBSR trainers throughout the world http://w3.umassmed.edu/MBSR/public/searchmember.aspx</ref> Health-care insurers sometimes refund the cost of training. Mindfulness is also sometimes taught in a derivative form as attention or awareness training.

Mindfulness is studied and taught at institutions such as:

In the United Kingdom:
* Breathworks [http://breathworks-mindfulness.org.uk/], founded in 2004, offering classes in mindfulness such as: "Living Well with Pain and Illness" and "Living Well with Stress".
* Learn Mindfulness [http://www.learnmindfulness.co.uk/], offering in person (London) and telephone/online MBSR and MBCT and mindful coaching
* Mindfulness Works Ltd. [http://www.mbsr.co.uk/], offering regular MBSR/MBCT classes in London

In the US:
* [[Mindful Awareness Research Center]] (MARC)[http://marc.ucla.edu/], founded in 2006 at [[UCLA]], offers classes and conducts research related to mindfulness, both for enhancing general well-being and treating ADHD.
* [[Nashville Mindfulness Center]][http://www.nashvillemindfulness.org], founded in 2006, offers Zen mindfulness classes in the methods of [[Thich Nhat Hanh]].
* The Insight Center [http://insightcenter.org] , founded in 2007 in West Los Angeles, teaches mindfulness meditation to the general public and provides mindfulness psychotherapy training to health professionals
* The Santa Clara University Ignatian Center for Jesuit Education [http://www.scu.edu/ignatiancenter/events/retreats/]
* Thomas Jefferson University Hospital Mindfulness Institute [http://www.jeffersonhospital.org/mindfulness] offers classes for the general public and training in teaching mindfulness for clinicians and educators.
* [[University of Massachusetts|Umass]] Medical Center (Center for Mindfulness in Medicine, Health Care, and Society)[http://www.umassmed.edu/content.aspx?id=41252], who also offer a stress reduction course.
*[[University of Pennsylvania School of Medicine|The University of Pennsylvania]] also offers a Program for Mindfulness, directed by Dr. Michael Baime [http://pennhealth.com/stress/]
*[[Naropa University]], founded in 1974 in Boulder, CO, is a non-sectarian university offering contemplative education in all its academic programs. In the 3-year Master's counseling track in [[Contemplative Psychotherapy]], the curriculum includes training in Buddhist and Western psychological approaches, as well as ongoing mindfulness meditation practice and intensive retreats.


==References==
{{Reflist}}

==Bibliography==
* Bell, L. G. (2009). "Mindful Psychotherapy". ''J. of Spirituality in Mental Health'' 11:126-144.
* Bishop, S.R., Lau, M., Shapiro, S., Carlson, L., et al. (2004). [http://www.personal.kent.edu/~dfresco/mindfulness/Bishop_et_al.pdf "Mindfulness: A Proposed Operational Definition"], ''Clin Psychol Sci Prac'' 11:230–241. (also available [http://dunntastic.com/sources/Bishop%202004%20-%20Mindfulness%20A%20proposed%20operational%20definition.pdf here])
* Brantley, Jeffrey (2007). ''Calming Your Anxious Mind: How Mindfulness & Compassion Can Free You from Anxiety, Fear, & Panic''. 2nd ed.  New Harbinger. ISBN 978-1-57224-487-0.
* Bernhard, J., Kristeller, J. and Kabat-Zinn, J. (1988). "Effectiveness of relaxation and visualization techniques as an adjunct to phototherapy and photochemotherapy of psoriasis". ''J. Am. Acad. Dermatol.'' 19:572-73.
* Germer, Christopher K., Ronald Siegel, Paul R. Fulton (2005),  Mindfulness and Psychotherapy, The Guilford Press, ISBN 1-59385-139-1 ( The use of mindfulness in psychology, and the history of mindfulness )
* Grossman, P., Niemann, L., Schmidt, S., and Walach, H. (2004). "Mindfulness-based stress reduction and health benefits: A meta-analysis", ''Journal of Psychosomatic Research'' 57:35–43.
* Hofmann, S.G., Sawyer, A.T., Witt. A.A., Oh, D. (2010). "The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review" ''J Consult Clin Psychol'' 78:169-83.
* Kabat-Zinn, J. (1982). "An out-patient program in Behavioral Medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results". ''Gen. Hosp. Psychiatry'' 4:33-47.
* Kabat-Zinn, Jon (1990). ''Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness''. Dell.
* Kabat-Zinn, Jon (2005). ''Coming to Our Senses: Healing Ourselves and the World Through Mindfulness''. Hyperion.
* Kabat-Zinn, J. and Chapman-Waldrop, A. (1988). "Compliance with an outpatient stress reduction program: rates and predictors of completion". ''J.Behav. Med.'' 11:333-352.
* Kabat-Zinn, J. Chapman, A, and Salmon, P. (1997). "The relationship of cognitive and somatic components of anxiety to patient preference for alternative relaxation techniques". ''Mind/ Body Medicine'' 2:101-109.
* Kabat-Zinn, J., Lipworth, L. and Burney, R. (1985). "The clinical use of mindfulness meditation for the self-regulation of chronic pain". ''J. Behav. Med.'' 8:163-190.
* Kabat-Zinn, J., Lipworth, L., Burney, R. and Sellers, W. (1986). "Four year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance". ''Clin. J.Pain'' 2:159-173.
* Kabat-Zinn, J., Massion, A.O., Kristeller, J., Peterson, L.G., Fletcher, K., Pbert, L., Linderking, W., Santorelli, S.F. (1992). "Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders". ''Am. J Psychiatry'' 149:936-943.
* Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M.S., Cropley, T. G., Hosmer, D., and Bernhard, J. (1998). "Influence of a mindfulness-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA)". ''Psychosomat Med'' 60: 625-632.
* Kapleau, Phillip (1989). ''The Three Pillars of Zen: Teaching, Practice and Enlightenment''. Anchor Books.
* Langer, Ellen J. (1989). ''Mindfulness''. Merloyd Lawrence.
* Linehan, Marsha (1993). ''Cognitive-Behavioral Treatment of Borderline Personality Disorder''. Guilford Press.
* Massion, A.O., Teas, J., Hebert, J.R., Wertheimer, M.D., and Kabat-Zinn, J. (1995). "Meditation, melatonin, and breast/prostate cancer: Hypothesis and preliminary data". ''Medical Hypotheses'' 44:39-46.
* McCracken, L., Gauntlett-Gilbert, J., and Vowles K.E. (2007). "The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability", ''Pain'' 131.1:63-69.
* Melemis, Steven M. (2008). ''Make Room for Happiness: 12 Ways to Improve Your Life by Letting Go of Tension. Better Health, Self-Esteem and Relationships''. Modern Therapies. ISBN 978-1-897572-17-7
* Miller, J., Fletcher, K. and Kabat-Zinn, J. (1995). "Three-year follow-up and clinical implications of a mindfulness-based stress reduction intervention in the treatment of anxiety disorders". ''Gen. Hosp. Psychiatry'' 17:192-200.
* Nemcova, M. and Hajek, K. (2009). ''Introduction to Satitherapy – Mindfulness and Abhidhamma Principles in Person-Centered Integrative Psychotherapy''. Morrisville, Lulu.com. ISBN 978-1-4092-5900-8
* Ockene, J.K., Ockene, I.S., Kabat-Zinn, J., Greene, H.L., and Frid, D. (1990). "Teaching risk-factor counseling skills to medical students, house staff, and fellows". ''Am. J. Prevent. Med.'' 6.2:35-42.
* Ockene, J., Sorensen, G., Kabat-Zinn, J., Ockene, I.S., and Donnelly, G. (1988). "Benefits and costs of lifestyle change to reduce risk of chronic disease". ''Preventive Medicine'', 17:224-234.
* Saxe, G., Hebert, J., Carmody, J., Kabat-Zinn, J., Rosenzweig, P., Jarzobski, D., Reed, G., and Blute, R. (2001). "Can Diet, in conjunction with Stress Reduction, Affect the Rate of Increase in Prostate-specific Antigen after Biochemical Recurrence of Prostate Cancer?" ''J. of Urology'' 166.6:2202-2207.
* Siegel, Daniel J. (2007). ''The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being''. Norton. ISBN 978-0-393-70470-9.
* Williams, J.M.G., Duggan, D.S., Crane, C., and Fennell, M.J.V. (2006). "Mindfulness-Based cognitive therapy for prevention of recurrence of suicidal behavior", ''J Clin Psychol'' 62:201-210.
* [[J. Mark G. Williams|Williams, Mark]], [[John Teasdale]], [[Zindel Segal]], and [[Jon Kabat-Zinn]] (2007). ''The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness''. Guilford Press. ISBN 978-1-59385-128-6.