What Role Does Mindfulness Play in CBT?
The general scientific premise of mindfulness is that, by training the mind to focus on the present moment (including pleasant and unpleasant experiences), people become less reactive and more reflective. This shift in the way that people deal with their difficult thoughts and emotions is believed to promote positive psychological outcomes.
There are several different approaches to integrating mindfulness into psychotherapy, and these vary in terms of intensity, style and method. For example, therapists may simply recommend reading books or websites about mindfulness to their clients, whereas other therapists might take the lead in teaching patients mindfulness exercises during therapy sessions.
Mindfulness-based interventions have been shown to reduce symptoms of anxiety and depression, particularly in combination with cognitive behavioural therapy. However, research on the effectiveness of mindfulness alone is sparse. Furthermore, studies that directly compare MBIs to CBT have exhibited mixed results. Despite these limitations, the body of literature on mindfulness is growing and more rigorous methodologies are emerging. In particular, there is increasing interest in the role of mindfulness in facilitating the integration of other treatment modalities.
Mindfulness Play in CBT
As such, it is important for therapists to be aware of the current state of research in this area and to understand how mindfulness can be incorporated into their work.
The therapists’ own mindfulness experience and practice can also help them choose the type of mindfulness exercise to introduce and guide their patients. For example, a therapist with a deep and extensive personal mindfulness practice can embody from the inside the attitudes they want to convey to their clients, and be better able to recognize how different feelings and thoughts arise during mindfulness exercises.
In addition, the therapist’s own experience of mindfulness can contribute to their ability to guide their patients in exploring their underlying beliefs and assumptions about how the world works. This is an important aspect of the psychotherapy process and is often referred to as the ‘theoretical underpinnings’ of psychotherapy.
Taking the time to explore these beliefs and assumptions can be a powerful way to increase understanding of how patients’ distressing moods and behaviours develop, and of how they may maintain and intensify their symptoms. Moreover, a mindfulness-based approach can be an effective tool in dismantling the cognitive processes that drive and maintain these unhelpful mood states and behaviors.
There is currently some evidence that mindfulness can facilitate the process of change in CBT, for example by increasing the number and intensity of ‘cognitive restructuring’ events in the therapy model. This is where a patient’s therapist supports them to challenge unhelpful beliefs, and replace them with more adaptive alternatives.
Mindfulness can also help therapists gain a greater level of awareness and presence in their own therapeutic relationship with their clients, and can therefore enhance the quality of their therapeutic work. This is a crucial element in developing the therapeutic alliance and creating an environment of safety for clients to explore difficult thoughts, emotions and experiences. A therapist’s own experience of mindfulness can also help them to more skilfully guide their clients through the MBI experience.