Using Mindfulness-Based Cognitive Therapy in Individual Counseling to Reduce Stress and Increase Mindfulness: An Exploratory Study With Nursing Students

The purpose of this exploratory study was to investigate the effectiveness of a modified mindfulness-based cognitive therapy intervention using individual counseling sessions to reduce stress and increase levels of mindfulness among nursing students. An AB single-subject experimental design replicated three times was implemented. Results indicated reduced stress in two out of three participants and increased mindfulness levels in all participants. Implications for college counselors and counselors working with clients in high-stress occupations are provided. Additionally, the results show promise for the use of mindfulness-based cognitive therapy in individual counseling.Keywords: mindfulness, mindfulness-based cognitive therapy, stress, college counselors, nursing, single-subject experimental designMindfulness-based cognitive therapy (MBCT) has been described as part of a third generation of cognitive therapies (Harrington & Pickles, 2009). Along with dialectical behavioral therapy and others like it, MBCT has integrated the construct of mindfulness with standard cognitive-behavioral paradigms. MBCT found its origins in the work of Kabat-Zinn's (1990) mindfulness-based stress reduction program. This 8-week group-based program consisted of Buddhist mindfulness mediation practices to help chronic pain sufferers reduce their stress associated with illness. MBCT has incorporated elements of mindfulness-based stress reduction and cognitive- behavioral therapy to help individuals become more aware of thoughts and feelings and put them into context as mental events rather than self-defining constructs (Teasdale et al, 2000). Seeing a need for an intervention to help patients who had repeatedly relapsed into depression, Segal, Williams, and Teasdale (2002) formalized MBCT as a standardized program of therapy. Designed as an 8-week program with specific guidelines for each session, MBCT was originally conceived as a group modality. Clients are placed in classes to learn the mindfulness and cognitive-behavioral (Beck, Rush, Shaw, & Emery, 1979) skills needed to regulate emotions and thoughts. MBCT involves training the mind to avoid judgmental reactions to events, thoughts, feelings and body sensations and to practice nonjudgmental awareness and acceptance (Ma & Teasdale, 2004). The key component of MBCT is mindfulness.Mindfulness, once an abstract concept in the counseling field, is reaching mainstream awareness and gaining more attention in the literature (Brown, Marquis, & Guiffrida, 2013). Derived from Zen Buddhism, mindfulness has been described as a commitment to bringing awareness back to the present moment (Harrington & Pickles, 2009). Brown and Ryan (2003) defined mindfulness as "the state of being attentive to and aware of what is taking place in the present" (p. 822). Despite a growing research base, mindfulness as a testable and operationally defined variable is still being shaped.Bishop et al. (2004) proposed an operational definition of mindfulness as a two-component skill-building approach for responding to emotional and cognitive distress. The first component involves the self-regulation of attention. Measurable skills must be obtained to reach a successful level of self-regulation of attention, including sustained attention; switching, or bringing the attention back to a focal point; and inhibition of elaborative processing, which involves the ability to maintain a state of flexible and nonjudgmental focus and awareness over a period of time. The second component includes developing an orientation to experience. In this, all thoughts, feelings and sensations are acknowledged.Mindfulness training works well in counseling in that it is a simple idea: staying focused on momentary experience (Grabovac, Lau, & Willett, 2011). The core strategy to teach clients is mindfulness meditation. Meditation has many forms but is ultimately the practiced skill of quieting the mind (Wright, 2007). …