Abstract
Mindfulness and meditation (MM) are increasingly used in trauma treatment, yet there is little research about therapist qualifications and clinical applications of these practices. We surveyed trauma therapists (N = 116) about their clinical uses, training, and personal practice of MM. Most respondents reported use of MM in trauma therapy, primarily MM-related imagery and breathing exercises and mindfulness in session or daily life. Almost a third used mindfulness-based stress reduction, mindfulness-based cognitive therapy, or mindfulness-based relapse prevention. Across all respondents, 66 % were trained by a mental health (MH) professional, 16 % were trained exclusively by a spiritual teacher, and 18 % received no training. On average, therapists used four types of MM. Less than half maintained a personal meditation practice and only 9 % reported practicing daily meditation. Therapists who were trained by a MH professional were more likely to integrate MM into trauma psychotherapy; those who were trained by a spiritual teacher were more likely to teach clients to use MM between sessions and reported more personal practice of MM. Results indicate divergence from standard recommendations for therapist personal practice and professional training in manualized uses; however, there is little guidance about requisite training and personal practice to support individualized uses of MM such as breathing exercises and imagery. Further research should address relationships of therapist training and personal practice to clinical outcomes in MM-informed trauma therapy.
Highlights
Clinical trials of mindfulness and meditation (MM) for posttraumatic stress disorder (PTSD) are in the beginning stages, MM-informed interventions are widely adopted in clinical settings that serve trauma-exposed individuals
Given the range of MM interventions and techniques that have been investigated for PTSD, we examined the degree to which therapists incorporate different types of MM interventions, such as standardized interventions (e.g., mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT)), religious/spiritual forms (e.g., Zen and kundalini), and secularized techniques into trauma treatment
A minority taught sitting mindfulness or other sitting meditation practice for clients to use between sessions (n = 47; 40.5 %), but only 31.9 % (n = 37) provide guided meditation audio or video recordings for clients to use between sessions
Summary
Clinical trials of mindfulness and meditation (MM) for posttraumatic stress disorder (PTSD) are in the beginning stages, MM-informed interventions are widely adopted in clinical settings that serve trauma-exposed individuals. A survey of Veterans Affairs hospitals found that 72 % offer MM services (VA Office of Research and Development, 2011). Despite this increasing interest, existing research has not addressed implementations of MM among practicing clinicians, in terms of the sources of therapist training and uses in trauma treatment. Given that empirical support for MM in trauma treatment is still emerging and equivocal (e.g., Kearney et al 2013a; Niles et al, 2012) and there are clinical caveats about the suitability of these practices for persons with PTSD (Vujanovic et al 2011), understanding current implementations of these practices may guide future research and formulation of treatment and training guidelines.
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