MINDFULNESS AND TRAUMA: IMPLICATIONS FOR TREATMENT

Mindfulness, originally a construct used in Eastern spiritual and philosophical traditions, has found new utility in psychotherapy practice. Mindfulness practice has been recently applied to treatments of several psychological and health related problems, and research is showing successful outcomes in psychological interventions incorporating mindfulness practices. Several schools of psychotherapy have theorized why mindfulness may be an effective intervention. One population which would theoretically be benefited by mindfulness practice in treatment consists of those individuals who have experienced traumatic events and are exhibiting post-traumatic stress disorder and/or related correlates of past trauma. The present paper gives a general review of the application of mindfulness to clinical psychology interventions. Additionally, we explain how mindfulness is applicable to our integrative behavioral approach to treating trauma and its sequelae. Specifically, this paper will (a) give a general overview of the conceptions and applications of mindfulness to psychology and psychotherapy and provide a brief account of the concepts origins in eastern traditions; (b) discuss the theoretical conceptualization of clinical problems that may relate to the longterm correlates of trauma; (c) describe how mindfulness, acceptance and the therapeutic relationship can address trauma symptoms and discuss a modified treatment approach for trauma survivors that incorporates mindfulness and acceptance practices into traditional exposure treatment. Address correspondence to Victoria Follette, Department of Psychology/296, University of Nevada, Reno, NV, 89557, USA; e-mail: vmf@unr.edu. Journal of Rational-Emotive & Cognitive-Behavior Therapy, Vol. 24, No. 1, Spring 2006 ( 2006) DOI: 10.1007/s10942-006-0025-2 Published Online: August 2, 2006 45 2006 Springer Science+Business Media, Inc. Understanding the long-term effects of traumatic experiences and identifying appropriate treatment for trauma survivors continue to be complex and at times controversial tasks (Brewin, 2003). While cognitive-behavioral treatments are generally considered to have the most significant empirical support for the treatment of trauma (American Psychiatric Association Work Group on ASD and PTSD, 2004; Foa, Keane, & Friedman, 2000), practices associated with the treatment of the broader range of trauma related problems continue to evolve. Our understanding of trauma symptoms has expanded to include the knowledge that outcomes associated with traumatic experiences are not limited to Post-traumatic Stress Disorder (PTSD) but rather extend across a range of intraand interpersonal problems. Therefore, in our work with trauma survivors, we have conceptualized trauma symptomology in terms of functional classes of behavior, rather than focusing on a syndromal classification of symptoms (Follette & Naugle, 2006). While a great deal is known about the treatment of basic anxiety related phenomena associated with traumatic experiences, there are a number of lacunae in our knowledge about the treatment of the broader range of problems associated with a trauma history. Certainly the current repertoire of cognitive behavioral treatments for trauma survivors has demonstrated efficacy. However, we believe that the addition of mindfulness related treatment interventions will enhance our ability to treat people who have difficulties associated with having experienced a traumatic event. The theoretical work arising from our conceptualization of functional domains of behavior has informed our present integrative behavioral treatment approach. In our approach, we work to influence behavior change by increasing both acceptance strategies and skillful behavior. Mindfulness is a core component of both of these approaches. In the present paper, we will briefly address the historical roots of mindfulness, with its origins in eastern religious traditions. We will present a short review of the application of mindfulness to clinical psychology interventions. Finally, we will discuss our view of the utility of mindfulness in our integrative behavioral approach to treating trauma and its sequelae. MINDFULNESS IN EASTERN RELIGIOUS TRADITIONS In discussing the integration of Buddhist teachings with Western psychological practices, it should be noted that there are 46 Journal of Rational-Emotive & Cognitive-Behavior Therapy