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In recent years, the practice of mindfulness has

been increasingly applied to the clinical treat

ment ofboth physical and mental health prob

lems. Although mindfulness practice has its roots

in Eastern meditative and Western Christian con

templative traditions, the contemporary clinical

use of mindfulness has focused largely on the

core characteristics of mindfulness, independent

of its spiritual origin and background . In this con

text, mindfulness is often understood as aware

ness simply of what is, at the level of direct and

immediate experience, separate from concepts,

category, and expectations. It is a way of living

awake, with your eyes wide open. indfulness

as apractice is the repetitive acts of directing your

attention to only one thing.And that one thing is

the one moment you are alive. !he conceptual

i"ation and definition of mindfulness have been

a topic of recent attention #$aer, %&&'( $ishop et

al., %&&)( $rown,*yan, & Creswell, %&&+( letcher

& *ayes, %&&-. As a set of skills, mindfulness

practice has been described as the intentional

process of observing, describing, and participat

ing in reality non/udgmentally, in the moment,

and with effectiveness #i.e., using skillful means

#01nehan, 233'a. indfulness is thus the prac

tice of willingness tobe alive to the moment and

radical acceptance of the entirety of moment.

indfulness has as its goal only mindfulness.

At the same time, it is the window to freedom,

wisdom, and /oy.

!here are many ways of teaching and prac

ticing mindfulness( in fact, methods of teaching

and practicing mindfulness in the spiritual

traditions noted above have been evolving

for centuries. *ecent years have witnessed an

explosion of interest in the clinical application

of mindfulness and a rapidly expanding set

of treatments that are based on the practice of

mindfulness. In fact, a recent edited volume

included mindfulness based treatments for a

No. 18

425

1. Al though there is significant overlap betweenmind

fulness and acceptance interventions, acceptance based

models that do not principally employ mindfulness

as core practices #e.g., Acceptance and Commitment

.

4abat5inn was the first to propose an

empirically supported clinical application of

6*IA* 7 I89:08E;; ;!*A!E

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and stress symptoms among cancer patients

#Carlson, :rsuliak,

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!here is no definitive evidence regardingmechanisms of change in the clinical use ofmindfulness, though a number of theoreticalmodels have been discussed #$aer, %&&'( Warren$rown, *yan, @ Creswell, %&&+( 0ynch,Chapman, *osenthal, 4uo, @ 0inehan, %&&>.;pecific hypothesi"ed mechanisms includerelaxation #$en son, 23), metacognitivechange (cf. !easdale, ;egaB, & Williams, 233-,and replacement of a negative addiction witha positive addiction #arlatt, 233). It has also

been suggested that theprocess of change in theclinical use of mindfulness parallels that of theclinical use of exposure

are re?uired to practice particular mindfulness

exercises prior to using them with clients. In this

sense, although 9$! therapists are not re?uired

to have a personal formal practice, they are

members of a formal community of therapists

learning mindfulness. !he importance of having

a mindfulness teacher, either in person or

through books, has also been discussed.

:nfortunately, there is no empirical data todate that validates the importance of a therapistDs

personal practice for competent clinical practice(

thus, the degree to which a therapist maintains

aformal practice will, in part, be guided by the

particular model used. or therapists interested

in integrating mindfulness strategies as part of

other treatment regimens, it will, at a minimum,

be important to consider oneDs own degree of

understanding and familiarity with mindfulness

practices.

Another important consideration is the?uestionF Is mindfulness practice a means toan end or an en in itselfJ In the spiritualtraditions from which they are derived, anessential ?uality of mindfulness practice is theact of nonKstriving or nonattachment tooutcome, and the models discussed abovespecifically emphasi"e this ?uality ofmindfulness. Individuals seeking clinicalcare, however, are often expresslyinterested in aparticular outcome #e.g., feeling

better, less depressed, etc.. !herapists usingmindfulness clinically must balance thisinherent tension between the end in itself

?uality of mindfulness and the goal directed?uality of clinical care.

No.18

part of the model #4abat5inn, 233&( ;egal,

Williams, & !easdale, %&&%. It is argued that

this prere?uisite ensures both that therapists

will teach from an experiential as well as an

intellectual knowledge base and that they will

have direct understanding of the effort and

discipline re?uired of clients. In contrast, other

models such as 9$! do not prescribe a formal

mindfulness practice for 9$! therapists, though

some mindfulness activities are re?uired. or

instance, formal mindfulness is practiced at

the outset of every consultation team meeting,

which is a re?uisite part of 9$!, and therapists

yoga aspractice #i.e., sitting meditation,

=GW 9GE; I89:08E;; 6*AC!ICE WG*.4J

their own mindfulness practice #9imid/ian,

Epstein, 0inehan, ac6herson, @ ;egal, %&&2.

!he $;* and $C! approaches re?uire

that therapists be engaged in a daily formal

?uestions under discussion

developers is whether thershould be re?uired to have

Gne of the key

among treatmentapistsCinstructors

G!=E* AC!G*; !G CG8;I9E* I8 9ECI9I8. Mindfulness&based treatment a""&$aer, *. A.

'eferences

Austin, P. =. #233. (en and the brain) *oward anunderstanding ofmeditationand ccnsciousness% Cam

bridge, AFI!6ress.

+urther 'eading

4abat51nn, P. #233&. +ull caiasiro"he living) ,sing the

wisdom of !our bod! and mind toface stress-"ain-and illness%8ew 7orkF9ell 6ublishing.

0inehan, . .#233'. .ogniiioe&behaoioraltreatment of

borderline"ersonalit! disorder%8ew 7orkF