a community clinic that used manualized, empirically supported
treatments. Contrary to expectation, therapist mindfulness was
inversely correlated with client outcome.
This is consistent with other findings that suggest an
inverse relationship exists between therapists’ mindfulness and
client outcomes (Bruce, 2006; Vinca & Hayes, 2007). Other
research suggests that no relationship exists between therapist
mindfulness and therapy outcome (Stratton, 2006).
What might be behind these results? It could be that “more
mindful” people are likely to score lower on self-reports of
mindfulness because they are more accurately able to describe
their “mindlessness.” Conversely, people who are less mindful
may not realize it and therefore may be inclined to rate
themselves higher on such measures.
Overall, while the psychological and physical health benefits
of mindfulness meditation are strongly supported by research,
the ways in which therapists’ mindfulness meditation practice
and therapists’ mindfulness translate to measureable outcomes
in psychotherapy remain unclear. Future research is needed to
examine the relations between therapists’ mindfulness, therapists’
regular mindfulness meditation practice and common factors
known to contribute to successful treatment outcomes.
Important next steps in research
Future research holds tremendous potential for learning more
about the neurophysiological processes of meditation and
the benefits of long-term practice on the brain. Research on
neuroplasticity may help explain the relationships among
length and quality of meditation practice, developmental stages
of meditators and psychotherapy outcomes. More research is
needed to better understand how the benefits of meditation
practice accumulate over time.
In addition, psychologists and others need to explore
other ways to increase mindfulness in addition to meditation.
Given that current research does not indicate that therapists’
self-reported mindfulness enhances client outcomes, better
measures of mindfulness may need to be developed or different
research designs that do not rely on self-report measures need
to be used. Garland and Gaylord (2009) have proposed that
the next generation of mindfulness research encompass four
domains: 1. performance-based measures of mindfulness, as
opposed to self-reports of mindfulness; 2. scientific evaluation
of notions espoused by Buddhist traditions; 3. neuroimaging
technology to verify self-report data; and 4. changes in gene
expression as a result of mindfulness. Research along these lines
is likely to enhance our understanding of mindfulness and its
potential benefits to psychotherapy.
Research is also needed on effective and practical means
of teaching therapists mindfulness practices. Future research
could investigate ways mindfulness practices and mindfulness
meditation could be integrated into trainees’ practicum and
clinical supervision. Since mindfulness-based stress reduction
has been successfully used with therapist trainees (e.g., Shapiro
et al., 2007), the technique may be a simple way for therapists
to integrate mindfulness practices into trainees’ practicum class
or group supervision. Future research questions could include:
Does therapists’ practice of mindfulness meditation in clinical
supervision with their supervisees affect the supervisory alliance
or relational skills of supervisees? Does practicing formal
mindfulness meditation as a group in practicum or internship
aid in group cohesion, self-care, relational skills or measurable
common factors that contribute to successful psychotherapy?
Given the limited research thus far on empathy, compassion,
decreased stress and reactivity, more research is needed on how
mindfulness meditation practice affects these constructs and
measurable counseling skills in both trainees and therapists.
For example, how does mindfulness meditation practice affect
empathy and compassion for midcareer or late-career therapists
who are experienced at mindfulness?
Shapiro and Carlson (2009) have suggested that mindfulness
meditation can also serve psychologists as a means of self-care
to prevent burnout. Future research is needed on not only how
the practice of mindfulness meditation helps facilitate trainee
development and psychotherapy processes, but also how it
can help therapists prevent burnout and other detrimental
outcomes of work-related stress.
In addition, despite abundant theoretical work on ways
to conceptually merge Buddhist and Western psychology to
psychotherapy (e.g., Epstein, 2007, 1995), there is a lack of
literature on what it looks like in session when a therapist uses
mindfulness and Buddhist-oriented approaches to treat specific
In conclusion, mindfulness has the potential to facilitate
trainee and therapists’ development, as well as affect change
mechanisms known to contribute to successful psychotherapy.
The field of psychology could benefit from future research
examining cause and effect relationships in addition to
mediational models in order to better understand the benefits
of mindfulness and mindfulness meditation practice. n
Daphne M. Davis, PhD, is a postdoctoral fellow at the Trauma
Center at Justice Resource Institute in Brookline, Mass.
Jeffrey A. Hayes, PhD, is a professor of counseling psychology at
the Pennsylvania State University department of educational
psychology, counseling and special education.
This article is based on “What Are the
Benefits of Mindfulness? A Practice Review of
Psychotherapy-Related Research,” from the APA
journal Psychotherapy (Vol. 48, No. 2).
Take the CE test.
MONITOR ON PSYCHOLOGY • JULY/AUGUST 2012