Abstract
A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.
Highlights
There is no clear consensus regarding the definition of ‘mindfulness’ (Anālayo 2016); a widely cited description suggests that mindfulness involves ‘paying attention in a particular way: on purpose, in the present moment, and non-judgmentally’ (Kabat-Zinn 1994, p. 4)
The final search criteria utilised was mindfulness-based stress reduction or Mindfulness-Based Stress Reduction (MBSR) or mindfulness-based cognitive therapy or MindfulnessBased Cognitive Therapy (MBCT) or mindfulness combined with home-practice or homework or between-session practice
One aspect of mindfulness-based interventions (MBIs) posited to be important in increasing the therapeutic effects of the intervention is participants’ engagement in regular home-practice
Summary
There is no clear consensus regarding the definition of ‘mindfulness’ (Anālayo 2016); a widely cited description suggests that mindfulness involves ‘paying attention in a particular way: on purpose, in the present moment, and non-judgmentally’ (Kabat-Zinn 1994, p. 4). Mindfulness is the core attentional stance underlying all types of Buddhist meditative practice In these traditions, the formal practice of mindfulness is embedded within a larger conceptual, spiritual and practicebased ethical framework directed towards non-harming (Kabat-Zinn 2003). The formal practice of mindfulness is embedded within a larger conceptual, spiritual and practicebased ethical framework directed towards non-harming (Kabat-Zinn 2003) This includes a skilful understanding of how unexamined behaviours and an ‘untrained mind’ can contribute to human suffering and how formal meditative practices can calm and clarify the mind, refine attention and action and open the heart to transform this suffering. MBCT was developed by Segal et al (2013) and is a manualised 8-week group intervention of similar structure that integrates Kabat-Zinn’s MBSR programme, with cognitive therapy theory and exercises (see Santorelli et al (2017) for MBSR curriculum guide and Segal et al (2013) for MBCT curriculum guide)
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