A Multisite Pre/Post Study of Mindfulness Training for Therapists: The Impact on Session Presence and Effectiveness.

Background: To date, little research has tested whether the use of mindfulness by clinicians results in actual changes in psychotherapy sessions. The purpose of this multisite study was to test whether a brief 5-week mindfulness training program could lead to improved session presence and effectiveness for trainee clinicians (n 5 31). Methods: At the end of 85 pretraining and 132 posttraining sessions, clients completed the client version of the Therapist Presence Inventory (TPI-C; Geller, Greenberg, & Watson, 2010) and the Session Rating Scale (SRS; Johnson, Miller, & Duncan, 2000). Results: Although the levels of client-rated presence did not differ between pretraining and posttraining sessions, sessions that occurred after the training were rated by clients as more effective compared to the pretraining sessions, t(170.91) 5 2.63, p 5 .01, d 5 .30. Conclusions: This study provides preliminary session outcome evidence supporting mindfulness training for clinicians.Keywords: mindfulness; psychotherapy; session presence; session effectiveness; trainingOver the past three decades, mindfulness has been found to be an effective therapeutic intervention for clients (Cullen, 2011). The positive effects of mindfulness have been demonstrated for anxiety and depression (Chiesa & Serretti, 2011a; Hofmann, Sawyer, Witt, & Oh, 2010), chronic pain (Chiesa & Serretti, 2011b), eating disorders (Wanden-Berghe, Sanz-Valero, & Wanden-Berghe, 2011), and substance abuse problems (Zgierska et al., 2009), to name a few. More recently, some have suggested that the practice of mindfulness may also be beneficial for therapists (Bruce, Shapiro, Constantino, & Manber, 2010; Davis & Hayes, 2011; Fauth, Gates, Vinca, Boles, & Hayes, 2007; O'Driscoll, 2009). The empirical literature examining mindfulness of therapists is just emerging, with existing studies generally falling into one of three broad categories: (a) studies examining personal benefits for therapists, (b) research exploring the development of clinical skills associated with the practice of mindfulness, and (c) investigations of treatment processes and outcomes of therapists who are mindful.PERSONAL BENEFITS FOR THERAPIST MINDFULNESSIn one highly cited study examining the personal benefits of mindfulness for therapists, Shapiro, Brown, and Biegel (2007) compared a cohort of graduate students who received an 8-week mindfulness-based stress reduction (MBSR) program as part of a course on stress management to a cohort of students from two other courses in which the program was not delivered. Shapiro et al. (2007) found that those who received the MBSR program, compared to the control group, showed significantly greater decreases in perceived stress, negative affect, state and trait anxiety, and rumination by the end of the course. In addition, those in the MBSR group displayed significantly greater increases in positive affect and self-compassion. Several similar studies have also found that therapists' participation in mindfulness training results in personal benefits such as decreased anxiety and depression as well as increased emotional awareness, self-compassion, well-being, and quality of life (Aggs & Bambling, 2010; Cohen & Miller, 2009; Rosenzweig, Reibel, Greeson, Brainard, & Hojat, 2003; Schure, Christopher, & Christopher, 2008; Shapiro, Astin, Bishop, & Cordova, 2005).CLINICAL SKILL DEVELOPMENT AND THERAPIST MINDFULNESSStudies have also found that the practice of mindfulness can aid beginning clinicians in developing many general clinical skills and attributes. For example, in one qualitative study, Schure et al. (2008) asked graduate students to comment on how participating in a 15-week MBSR course had impacted their work with clients. Themes that emerged from this qualitative study were increased empathy and presence, more comfort with silence, greater ability to allow clients to experience discomfort in sessions, and increased responsiveness to clients. …