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The experience of mindfulness in Western therapeutic encounters; practitioner's perspective

Fairfax, H. R. J. (2009). The experience of mindfulness in Western therapeutic encounters; practitioner's perspective. (Unpublished Doctoral thesis, City University London)

Abstract

Background:

Mindfulness has become increasingly popular in recent psychotherapeutic literature that strongly indicates its use for the treatment of a variety of psychiatric disorders. It has been incorporated into cognitive behaviour based models such as Mindfulness-Based Cognitive Behavioural Therapy (MBCBT), and Dialectical Behavioural Therapy (DBT), as well as specific model of treatment for chronic pain, Mindfulness Based Stress Reduction (MBSR). These models in particular have attracted a significant amount of outcome research that consistently suggests that they are of benefit to specific clinical populations. MBCBT and DBT are recognised as evidence based treatments of choice by organisations such as the National Institute for Clinical Excellence (NICE) in the United Kingdom. Clinically, it is something that I have some limited awareness (during DBT training, and through awareness clinical literature), and have been interested in finding out more about it. Despite these findings however, there is no established definition of mindfulness, no consensus of what it does, and no shared understanding in literature of what it means to be Mindful. Furthermore, Mindfulness originated in Buddhism around 2,500 years ago and is therefore closely related to this discipline and Eastern culture in general. These are issues that have also received little attention in the research. Mindfulness therefore finds itself in a relatively unusual position in terms of therapeutic research, generally being accepted as a beneficial and helpful practice, but with no clear understanding of what it really is, or how it works. This research attempts to explore these questions further by presenting the perspectives of psychological practitioners who routinely use Mindfulness in their therapeutic practice. Working back perhaps from the outcome literature, this research attempts to capture the participant's experience of Mindfulness therapeutically, what they feel it is, how they experience it in their clinical work with clients, and what it means to them personally, professionally and culturally.

Method/ Analysis:

Given that the research is based on capturing individual, phenomenological processes, qualitative methods were seen as the most appropriate methodology. As the research involves exploring the each participant's perspective with the aim of providing general themes between accounts, Interpretative Phenomenological Analysis (IPA) was chosen. IPA also recognises the role of the researcher and their potential biases, e.g. a therapist with some basic awareness of Mindfulness, as a feature within the research methodology. Recruitment letters were sent to Community Mental Teams (CMHTs), Psychology, Psychotherapy and Psychiatry Departments, and local University throughout a specific region in the United Kingdom (Devon). Participants were required to be currently working as therapists who described themselves as using Mindfulness within their clinical practice. Five from an initial response of nine participants were interviewed. Reasons for attrition included, moving job, moving area, and pregnancy resulting in change of life circumstances. The participants were three women and two men aged between their late thirties to late fifties. Professional backgrounds included Social Work Occupational Therapy, and Core Process psychotherapy, and all worked within NHS settings, and some private work. Interviews were transcribed and subject to a thematic analysis using IPA that produced three master themes. Cohen's Kappa was used to test for inter-rater reliability.

Results/ Conclusion:

Three master themes were identified; the Culture and Context of Mindfulness, The Subjective Experience of Mindfulness and Being a Mindfulness Practitioner. These were explored in terms a concept called 'Being-With'. 'Being-With' explored the results in terms of literature concerning core therapeutic conditions, therapeutic process, and the presence of the therapist. It was concluded that this term described the interpersonal and process based nature of Mindfulness, as well as capturing the participant's perspective that Mindfulness was not a technique but a therapeutic attitude or way of being based on ongoing personal and experiential practice. The findings are critiqued and suggestions for further research discussed.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
B Philosophy. Psychology. Religion > BQ Buddhism
Departments: Doctoral Theses
Doctoral Theses > School of Arts and Social Sciences
School of Arts & Social Sciences > Psychology
URI: http://openaccess.city.ac.uk/id/eprint/19552
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