Mind-Body Medicine and the Art of Self-Care: Teaching Mindfulness to Counseling Students through Yoga, Meditation, and Qigong.

Unmanaged chronic stress can have deleterious effects on the physical and psychological health of individuals. Stress may lead to or worsen disorders and diseases such as heart disease, anxiety, depression, hypertension, substance abuse, and gastrointestinal disorders (Astin, 1997; Brennan & Moos, 1990; Levy, Cain, Jarrett, & Heitkemper, 1997; D. Shapiro & Goldstein, 1982; Treiber et al., 1993; Whitehead, 1992). Stress is also a contributing factor for lifestyle behaviors that increase vulnerability to diseases such as lung cancer, cardiovascular disease, and obesity (Brennan & Moos, 1990; Roth & Robbins, 2004; Treiber et al., 1993; D. R. Williams, 1999). Stress has an impact on absenteeism rates and job performance, effectiveness, and satisfaction (Burnard, Edwards, Fothergill, Hannigan, & Coyle, 2000). Given the prevalence of these stress-related health conditions in the United States, their costs to the nation's health care system, and the loss of quality of life for individuals, it is no surprise that public health professionals are increasingly concerned over the effects of stress. For instance, the U.S. Department of Health and Human Services (2000) lists stress reduction as an objective in its publication Healthy People 2010. Health care workers are particularly vulnerable to stress overload because of high demands and unique challenges (Harris, 2001; Sharkey & Sharples, 2003; Wall et al., 1997). Burnout, defined as exhaustion of physical or emotional strength, is the most often-noted consequence of chronic stress in the workplace (Harris, 2001; Sharkey & Sharpies, 2003). Moore and Cooper (1996) found that mental health professionals experience emotional exhaustion alongside the usual organizational sources of stress, and Baker (2003) described the potential for "compassion fatigue" and "vicarious traumatization" (p. xi). These stressors may have harmful effects on counseling students' effectiveness and success by reducing their capacity for attention, concentration, and decision-making skills (S. Shapiro, Shapiro, & Schwartz, 2000). Educators have recognized the importance of providing counselors with tools for self-care early in their careers and even while they are being trained (Baker, 2003; Brems, 2001; Kuyken, Peters, Power, & Lavender, 2003; Weiss, 2004). In an extensive review of research on stress management in the education of health care professionals, S. Shapiro et al. (2000) stated that although many interventions demonstrated promising results, such as lower levels of anxiety and depression, greater capacity for empathy, and improved immunologic functioning, more research is needed. One of the most well-researched stress management programs is mindfulness-based stress reduction (MBSR). MBSR teaches mindfulness, which is the ability to attend to thoughts and emotions as they arise and to be fully conscious of the present-moment experience. Taught to more than 5,000 medical patients since its inception more than 20 years ago (Kabat-Zinn, 1990), MBSR is typically run as an 8-week course instructing mindfulness through the practice of meditation, body scan (a type of guided awareness), and hatha yoga. One of the strengths of MBSR, in contrast to most stress-reduction programs, is that it offers participants different mindfulness practices from which to choose. Research indicates that participants often find one of the three practices more beneficial or preferred for personal reasons; consequently, having options can improve compliance (Kabat-Zinn, Chapman, & Salmon, 1997). This may help to explain why MBSR has been found to have high compliance rates, even after 3 years (Kabat-Zinn & Chapman-Waldrop, 1988; Miller, Fletcher, & Kabat-Zinn, 1995). MBSR studies with varied populations have found significant decreases in anxiety/depression, mood disturbance, somatic symptoms of stress, and present-moment pain (Kabat-Zinn, Lipworth, & Burney, 1985; Kabat-Zinn et al. …