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Intervention Summary

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Mindfulness-Based Stress Reduction (MBSR)

Mindfulness-Based Stress Reduction (MBSR), a form of psychoeducational training for adolescents and adults with emotional or psychological distress due to medical conditions, physical pain, or life events, is designed to reduce stress and anxiety symptoms, negative mood-related feelings, and depression symptoms; increase self-esteem; and improve general mental health and functioning. The program is based on the core principle of "mindfulness"--a mental state whereby one attends to and purposefully manages one's awareness of what is happening in the moment. MBSR helps participants to develop a mindful cognitive state and incorporate it into everyday life as a coping resource to deal with intense physical, emotional, and situational stressors.

MBSR is structured as a 10-session, manual-driven program and includes 31 hours of instruction by professionally trained teachers, who deliver the sessions in a group setting over 8 weeks. The program is theoretically grounded in secularized Buddhist meditation practices, mind-body medicine, and the transactional model of stress, which suggests that people can be taught to manage their stress by adjusting their cognitive perspective and increasing their coping skills to build self-confidence in handling external, stressful situations. Using didactic exchanges and experiential assignments, MBSR teachers assist participants in learning to exercise increased self-regulation, empowerment, and choice in their mental and physical health states by developing insight into the conditioned, automatic reactions and habits that underlie and support their negative cognitive and physical health behaviors. MBSR teachers also incorporate different meditation practices in program delivery, including three primary forms:

  • Mindfulness meditation, a formal daily practice of introspection and self-observation without judgment. In the most common forms of this meditation, the participant mentally focuses on the process of breathing or on the movement of the feet while slowly walking without looking down.
  • Body scan, which focuses one's awareness on his or her body. While lying down or sitting, the participant directs attention to each part of the body, noticing any pain, tension, lack of sensation, or sense of comfort, becoming more at ease by focusing on the body instead of the mind.
  • Gentle yoga, a mental focusing through movement that creates a calming of the mind's continuous and ruminative thinking. Participants use yoga postures to quiet the mind and strengthen concentration.

Becoming certified as an MBSR teacher involves a rigorous education and training process based on established standards of practice. Regular meditation practice, participation in extended residential training, and continuing education are required for MBSR teachers to maintain certification.

In the studies reviewed for NREPP, adult cancer patients, adult female fibromyalgia patients, and psychologically symptomatic adolescents received MBSR, with variations in the number and duration of individual MBSR sessions and the overall program duration.

Descriptive Information

Areas of Interest Mental health treatment
Outcomes Review Date: March 2012
1: Stress and anxiety symptoms
2: Mood disturbance
3: Depression symptoms
4: Self-esteem
5: General mental health symptoms and functioning
Outcome Categories Mental health
Ages 13-17 (Adolescent)
26-55 (Adult)
55+ (Older adult)
Genders Male
Female
Races/Ethnicities Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Non-U.S. population
Settings Outpatient
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History The Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School helped pioneer the integration of mindfulness into mainstream medicine and health care in 1979 with the development of MBSR. Since that time, more than 19,000 patients have completed training in MBSR through the center's Stress Reduction Program. In 1981, the center launched its first professional MBSR education program. As of November 2011, 739 U.S. and international MBSR programs were registered on the center's Web site. Hundreds of implementations of MBSR have been evaluated in the United States and internationally since 1981, and in 2011 the National Institutes of Health funded 93 open clinical trials on mindfulness interventions and 24 on MBSR.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations MBSR materials have been translated into Bulgarian, Croatian, Czech, Danish, Dutch, Farsi, Finnish, French, German, Greek, Hebrew, Hungarian, Indonesian, Italian, Japanese, Korean, Mandarin Chinese, Norwegian, Polish, Portuguese, Romanian, Russian, Slovenian, Spanish, Swedish, Turkish, and Vietnamese.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories IOM prevention categories are not applicable.

Quality of Research
Review Date: March 2012

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Carlson, L. E., Ursuliak, Z., Goodey, E., Angen, M., & Speca, M. (2001).The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Supportive Care in Cancer, 9(2), 112-123.  Pub Med icon

Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62(5), 613-622.  Pub Med icon

Study 2

Sephton, S. E., Salmon, P., Weissbecker, I., Ulmer, C., Floyd, A., Hoover, K., et al. (2007). Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial. Arthritis and Rheumatism, 57(1), 77-85.  Pub Med icon

Study 3

Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-Based Stress Reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77(5), 855-866.   Pub Med icon

Supplementary Materials

Cassileth, B. R., Lusk, E. J., Brown, L. L., & Cross, P. A. (1985). Psychosocial status of cancer patients and next of kin: Normative data from the profile of mood states. Journal of Psychosocial Oncology, 3, 99-105.

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-Based Stress Reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43.  Pub Med icon

Hoffman, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of Mindfulness-Based Therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169-183.

Peck, J. R., Smith, T. W., Ward, J. R., & Milano, R. (1989). Disability and depression in rheumatoid arthritis: A multi-trait, multi-method investigation. Arthritis and Rheumatism, 32(9), 1100-1106.  Pub Med icon

Thompson, E. A., & Budzynski, H. K. (1989). Interpretation of the Symptoms of Stress (SOS) Inventory. Seattle: Department of Psychosocial and Community Health, University of Washington.

Thompson, E. A., & Budzynski, H. K. (2001, March). Symptoms of Stress Inventory: A self assessment. Seattle: Department of Psychosocial and Community Health, University of Washington.

Outcomes

Outcome 1: Stress and anxiety symptoms
Description of Measures Stress and anxiety symptoms were measured by three instruments:

  • The Symptoms of Stress Inventory (SOSI), a 94-item self-report instrument designed to measure the frequency of physical, psychological, and behavioral symptoms of stress. Using a 5-point scale ranging from 0 (never) to 4 (almost all the time), respondents rate the frequency with which they experienced various stress-related symptoms during a designated timeframe (e.g., over the past week). Sample items include "flushing of your face," "sweating excessively even in cold weather," "severe itching," "irregular heart beats," and "rapid breathing." Responses to items are used to calculate the SOSI Total Score and scores for 10 symptom subscales: Peripheral Manifestations, Cardiopulmonary Symptoms, Central-Neurological Symptoms, Gastrointestinal Symptoms, Muscle Tension, Habitual Patterns, Depression, Anxiety/Fear, Emotional Irritability, and Cognitive Disorganization.
  • The State-Trait Anxiety Inventory (STAI), a 40-item self-report instrument with 20 items to measure current (or state) anxiety and 20 items to measure dispositional (or trait) anxiety. Each item is a statement about feelings or general tendencies, which respondents rate in regard to how they are feeling at the moment (State Anxiety subscale) and more generally (Trait Anxiety subscale), using a 4-point scale ranging from 1 (not at all) to 4 (very much so). Scores are calculated separately for the State Anxiety and Trait Anxiety subscales, and each subscale score ranges from 20 to 80, with higher scores indicating a higher level of anxiety.
  • The Perceived Stress Scale (PSS), a 10-item self-report instrument that measures the degree to which situations in one's life have been stressful. Using a 5-point scale ranging from 0 (never) to 4 (very often), respondents rate the frequency with which they experienced stressful situations during the prior month. Sample items include "In the last month, how often have you been upset because of something that happened unexpectedly?" and "In the last month, how often have you felt that you were unable to control the important things in your life?"
Key Findings In one study, a randomized clinical trial (RCT) was conducted with a convenience sample of cancer outpatients presenting to a university-based oncology clinic. Participants were randomly assigned to the intervention group, which received 90-minute weekly sessions of MBSR over 7 weeks, or the wait-list control group. Participants in the wait-list control group were given the opportunity to receive MBSR after the posttreatment assessment.

The SOSI was administered to both groups to assess past-week symptoms of stress at baseline and 7-9 weeks later, after the intervention group completed the sessions of MBSR (posttreatment). Baseline scores were subtracted from posttreatment scores to calculate a change score. Results indicated that at the posttreatment assessment, participants in the intervention group had fewer symptoms of stress than participants in the control group, as indicated by the SOSI Total Stress change score (p < .01) and change scores for the symptom subscales of Habitual Patterns (p < .01), Cardiopulmonary Symptoms (p < .05), Muscle Tension (p < .05), and Emotional Irritability (p < .05).

In another study, an RCT was conducted with adolescents presenting to a hospital-based, outpatient psychiatric clinic for children and adolescents. Participants were randomly assigned to the intervention group, which received 120-minute weekly sessions of MBSR over 8 weeks as an adjunctive intervention to treatment as usual, or the control group, which received treatment as usual. Treatment as usual consisted of ongoing individual or group psychotherapy and/or psychotropic medication management.

The STAI and the PSS were administered to both groups at three time points: at baseline; 8 weeks later, after the intervention group completed the adjunctive sessions of MBSR (posttreatment); and at the 3-month posttreatment follow-up. Results indicated the following:

  • From baseline to the 3-month posttreatment follow-up, participants in the intervention group had fewer current (State Anxiety subscale of the STAI; p = .005) and dispositional (Trait Anxiety subscale of the STAI; p = .04) anxiety symptoms than participants in the control group. For participants in the intervention group, the reductions in current and dispositional anxiety symptoms from baseline to the 3-month posttreatment follow-up were associated with medium effect sizes (Cohen's d = 0.70 and 0.79, respectively).
  • Also from baseline to the 3-month posttreatment follow-up, participants in the intervention group had fewer perceived stress symptoms than participants in the control group, as indicated by the PSS (p = .02). For participants in the intervention group, the reduction in perceived stress symptoms from baseline to the 3-month posttreatment follow-up was associated with a large effect size (Cohen's d = 0.89).
Studies Measuring Outcome Study 1, Study 3
Study Designs Experimental
Quality of Research Rating 3.2 (0.0-4.0 scale)
Outcome 2: Mood disturbance
Description of Measures Mood disturbance was measured by the Profile of Mood States (POMS), a 65-item self-report inventory. Using a 5-point scale ranging from 0 (not at all) to 4 (extremely), respondents rate positive and negative adjectives to describe the mood-related feelings they experienced during the prior week. Responses to items are used to produce a Total Mood Disturbance score and scores for six symptom subscale domains: Tension-Anxiety, Depression-Dejection, Anger-Hostility, Fatigue-Inertia, Confusion-Bewilderment, and Vigor-Activity. Higher scores reflect greater mood disturbance.
Key Findings An RCT was conducted with a convenience sample of cancer outpatients presenting to a university-based oncology clinic. Participants were randomly assigned to the intervention group, which received 90-minute weekly sessions of MBSR over 7 weeks, or the wait-list control group. Participants in the wait-list control group were given the opportunity to receive MBSR after the posttreatment assessment.

The POMS was administered to both groups to assess past-week mood disturbance at baseline and 7-9 weeks later, after the intervention group completed the sessions of MBSR (posttreatment). Baseline scores were subtracted from posttreatment scores to calculate a change store. Results indicated that at the posttreatment assessment, participants in the intervention group had less mood disturbance than participants in the control group, as indicated by the POMS Total Mood Disturbance change score (p < .001) and change scores for the symptom subscale domains of Tension-Anxiety (p < .001), Depression-Dejection (p < .01), Anger-Hostility (p < .01), Confusion-Bewilderment (p < .01), and Vigor-Activity (p < .01).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 3.2 (0.0-4.0 scale)
Outcome 3: Depression symptoms
Description of Measures Depression symptoms were measured by the Beck Depression Inventory (BDI), a 21-item self-report instrument that assesses the presence and severity of depression symptoms over the past week. Responses to items were also used to produce scores for the Dysphoric Mood (cognitive/affective) and Somatic Complaints subscales developed by Peck and colleagues to discriminate between the respondent's severity of depression symptoms and physical disability relevant to his or her medical condition.
Key Findings An RCT was conducted with a sample of women who had a physician-verified fibromyalgia diagnosis (according to the criteria of the American College of Rheumatology). Participants were randomly assigned to the intervention group, which received 150-minute weekly sessions of MBSR over 8 weeks, or the wait-list control group.

The BDI was administered to both groups at three time points: at baseline; 8 weeks later, after the intervention group completed the sessions of MBSR (posttreatment); and at the 2-month posttreatment follow-up. Results indicated the following:

  • At the posttreatment assessment, participants in the intervention group had fewer overall depression symptoms than participants in the control group, as indicated by the BDI total score (p = .001), after controlling for baseline assessments. This group difference was associated with a medium effect size (eta-squared = .12).
  • Also at the posttreatment assessment, participants in the intervention group had fewer cognitive/affective symptoms and somatic complaints than participants in the control group, as indicated by the Dysphoric Mood subscale (p = .017) and the Somatic Complaints subscale (p < .001), after controlling for baseline assessments. These group differences were associated with medium effect sizes (eta-squared = .06 and .14, respectively).
  • Across all three assessment time points (from baseline to posttreatment and posttreatment to the 2-month follow-up), participants in the intervention group had fewer overall depression symptoms than participants in the control group, as indicated by the BDI total score (p = .002). This group difference was associated with a medium effect size (eta-squared = .11).
  • Also across all three assessment time points, participants in the intervention group had fewer cognitive/affective symptoms and somatic complaints than participants in the control group, as indicated by the Dysphoric Mood subscale (p = .013) and the Somatic Complaints subscale (p = .002). These group differences were associated with medium effect sizes (eta-squared = .07 and .11, respectively).
Studies Measuring Outcome Study 2
Study Designs Experimental
Quality of Research Rating 3.1 (0.0-4.0 scale)
Outcome 4: Self-esteem
Description of Measures Self-esteem was measured by the Rosenberg Self-Esteem Scale (SES), a 10-item self-report instrument. Using a 4-point Likert scale ranging from "strongly agree" to "strongly disagree," respondents rate positive and negative statements about themselves. Sample items include "On the whole, I am satisfied with myself" and "At times, I think I am no good at all."
Key Findings An RCT was conducted with adolescents presenting to a hospital-based, outpatient psychiatric clinic for children and adolescents. Participants were randomly assigned to the intervention group, which received 120-minute weekly sessions of MBSR over 8 weeks as an adjunctive intervention to treatment as usual, or the control group, which received treatment as usual. Treatment as usual consisted of ongoing individual or group psychotherapy and/or psychotropic medication management.

The Rosenberg SES was administered to both groups at three time points: at baseline; 8 weeks later, after the intervention group completed the adjunctive sessions of MBSR (posttreatment); and at the 3-month posttreatment follow-up. Results indicated that from baseline to the 3-month posttreatment follow-up, participants in the intervention group had higher self-esteem (p = .0001) than participants in the control group. For participants in the intervention group, the increase in self-esteem from baseline to the 3-month posttreatment follow-up was associated with a medium effect size (Cohen's d = 0.59).
Studies Measuring Outcome Study 3
Study Designs Experimental
Quality of Research Rating 3.2 (0.0-4.0 scale)
Outcome 5: General mental health symptoms and functioning
Description of Measures General mental health symptoms and functioning were measured by two instruments:

  • The Hopkins Symptom Checklist 90-Revised (SCL-90-R), a 90-item self-report checklist that measures current psychiatric symptoms across nine subscales. Using a 5-point scale ranging from 0 (not at all) to 4 (extremely), respondents rate items describing the symptoms they experienced during the prior 7 days. Responses to items were used to produce scores for six of the subscales: Depression, Anxiety, Obsession-Compulsion, Somatization, Interpersonal Sensitivity, and Hostility. Higher scores indicate more symptoms with greater intensity.
  • The DSM-IV-TR, Axis V: Global Assessment of Functioning (GAF), an independent therapist-rated measure that assesses general psychological and social functioning. A GAF rating is recorded at regular clinic visits for treatment as usual and extracted from the outpatient medical records for each participant at the study assessment time points.
Key Findings An RCT was conducted with adolescents presenting to a hospital-based, outpatient psychiatric clinic for children and adolescents. Participants were randomly assigned to the intervention group, which received 120-minute weekly sessions of MBSR over 8 weeks as an adjunctive intervention to treatment as usual, or the control group, which received treatment as usual. Treatment as usual consisted of ongoing individual or group psychotherapy and/or psychotropic medication management.

The SCL-90-R and GAF were used to assess both groups at three time points: at baseline; 8 weeks later, after the intervention group completed the adjunctive sessions of MBSR (posttreatment); and at the 3-month posttreatment follow-up. Results indicated the following:

  • From baseline to the 3-month posttreatment follow-up, participants in the intervention group had fewer psychological symptoms with less intensity than participants in the control group, as indicated by the SCL-90-R symptom subscales of Obsession-Compulsion (p = .0006), Somatization (p = .0008), Depression (p = .001), and Interpersonal Sensitivity (p = .03). For participants in the intervention group, the results of fewer psychological symptoms with less intensity from baseline to the 3-month posttreatment follow-up were associated with large effect sizes (Cohen's d = 1.11, 0.80, 0.95, and 0.82 for the Obsession-Compulsion, Somatization, Depression, and Interpersonal Sensitivity subscales, respectively).
  • Also from baseline to the 3-month posttreatment follow-up, participants in the intervention group had higher levels of general psychological and social functioning, as indicated by the GAF (p = .0001). For participants in the intervention group, the higher level of general psychological and social functioning from baseline to the 3-month posttreatment follow-up was associated with a large effect size (Cohen's d = 1.02).
Studies Measuring Outcome Study 3
Study Designs Experimental
Quality of Research Rating 3.0 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 26-55 (Adult)
55+ (Older adult)
78.9% Female
21.1% Male
100% Non-U.S. population
Study 2 26-55 (Adult)
55+ (Older adult)
100% Female 96% White
4% Race/ethnicity unspecified
Study 3 13-17 (Adolescent) 73.5% Female
26.5% Male
45.1% White
28.4% Hispanic or Latino
23.5% Race/ethnicity unspecified
2.9% Black or African American

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Stress and anxiety symptoms 3.8 3.8 2.0 3.3 2.6 3.8 3.2
2: Mood disturbance 3.8 3.8 2.0 3.3 2.5 3.8 3.2
3: Depression symptoms 3.8 3.3 2.0 3.3 2.8 3.8 3.1
4: Self-esteem 3.8 3.8 2.0 3.3 2.8 3.8 3.2
5: General mental health symptoms and functioning 3.0 3.3 2.0 3.3 2.8 3.8 3.0

Study Strengths

All three studies used gold standard self-report measures with strong psychometric properties reported in the literature, and one study provided moderate to high sample reliability statistics on internal consistency for each instrument used (Cronbach's alpha values ranged from .74 to .92). The intervention was manual driven in all three studies and delivered by trained, licensed clinical psychologists or master's-level mental health professionals. In one study, periodic meetings and discussions were held concerning session progress and the effectiveness of intervention delivery; in another study, weekly meetings were held to reinforce curriculum fidelity. All three studies compared study completers and noncompleters for differences (attrition rates ranged from 17.4% to 27.5%) and used intent-to-treat approaches in the statistical analyses. All three studies used random assignment to control for many potential confounding variables. All three studies used a variety of appropriate analyses and minimized the type I error rate (i.e., the error rate introduced in the alpha rejection level for statistical significance when multiple outcomes are tested for group differences): one study used a Bonferroni correction, and two studies added calculations of effect sizes for between-group differences. Two studies carried out prospective power analyses to minimize the type II error rate (i.e., the error rate introduced by a sample size that is too small to detect a statistically significant, between-group difference) and addressed possible outcome mediators in the statistical analyses. One study appropriately used more sophisticated data modeling to assess a broader range of mental health outcomes.

Study Weaknesses

Although institutional medical records were used to extract the GAF rating, there was no measurement of interrater reliability to control for possible varying levels of training across clinicians using the instrument. None of the three studies measured intervention fidelity or corroborated daily home practice diaries. The absence of an active treatment comparison or an attention control group in all three studies precludes eliminating the potential confounding influences of expectancy, trust in the instructors, and disappointment at being assigned to a wait-list control group on the outcomes. Two of the studies used a convenience sample (one with cancer outpatients and another with women having a diagnosis of fibromyalgia), which may have created a study bias through the inclusion of only highly motivated participants.

Readiness for Dissemination
Review Date: March 2012

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School. (2009). Stress reduction program: Home practice manual. Worcester, MA: Author.

Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School. (n.d.). Mindfulness-Based Stress Reduction (MBSR) professional education and training: Background readings. Worcester, MA: Author.

Detailed training schedules:

  • MBSR in Mind-Body Medicine: 7 Day Residential Training/Retreat
  • Practicum in Mindfulness-Based Stress Reduction--8 Week
  • Practicum in Mindfulness-Based Stress Reduction--Living Inside Participant-Practitioner Perspectives 9 Day Intensive
  • Teacher Development Intensive

Folders containing handouts:

  • Interpersonal Mindfulness Training
  • Practicum in MBSR: Living Inside Participant-Practitioner Perspectives
  • Quality of Mind, Quality of Care: Cultivating Mindful Practice in Health Care Settings
  • Teacher Development Intensive (TDI)--An Advanced MBSR Teacher Training/Retreat

Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Bantam Dell.

Kabat-Zinn, J. (n.d.). Guided meditation, guided yoga [2 CDs]. Worcester, MA: Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.

Kabat-Zinn, J. (n.d.). Guided sitting meditation, guided yoga [2 CDs]. Worcester, MA: Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.

Program Web site, http://www.umassmed.edu/cfm

Santorelli, S. (1984). Guided meditation, guided yoga [2 CDs]. Worcester, MA: Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.

Santorelli, S. (1984). Guided sitting meditation, guided yoga [2 CDs]. Worcester, MA: Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.

Santorelli, S. (1999). Heal thy self: Lessons on mindfulness in medicine. New York, NY: Bell Tower.

Santorelli, S. F., & Kabat-Zinn, J. (Eds.). (2011). Mindfulness-Based Stress Reduction (MBSR) professional education and training: MBSR curriculum and supporting materials. Worcester, MA: Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.

Santorelli, S. F., & Kabat-Zinn, J. (Eds.). (2011). Mindfulness-Based Stress Reduction (MBSR) professional education and training: Scientific papers from the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society 2011-1982. Worcester, MA: Center for Mindfulness in Medicine, Health Care, and Society, University of Massachusetts Medical School.

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.0 3.5 3.0 3.2

Dissemination Strengths

The core principles of the program are explained well in the materials and reflect the versatility of MBSR, which can be implemented in several settings, including schools, prisons, hospitals, and workplaces. The developer provides detailed protocols and tools for screening, assessing, and training new teachers, and the meditation and yoga exercises on CD are straightforward and easy to follow. Teachers receive training through an intensive, residential-style retreat, which includes supervised small- and large-group discussions, providing participants with an opportunity to enhance their skills. The developer offers many types of advanced training to help teachers strengthen and refine their MBSR skills. The required qualifications and certification process for teachers are rigorous and focused on the teacher's competencies, helping to promote fidelity to the model. In advanced training sessions, the developers conduct quality assurance measures to assess the participating implementers' preparedness to teach MBSR.

Dissemination Weaknesses

The number of program materials may be overwhelming to potential users, and a succinct overview of the implementation approach and requirements is not available. Some of the manuals are not clearly labeled and use a small font size in the narrative format, reducing their user-friendliness. The information specifically related to MBSR is difficult to ascertain from other initiatives on the developer's Web site. The required residential training retreat is offered only two times per year, which limits its accessibility. There are no fidelity and process monitoring tools or procedures, and quality assurance is generally characterized by the developer as largely organic and unstructured. Limited guidance is provided on how, when, and under what conditions the pre- and postintervention evaluations should be used.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Mindfulness-Based Stress Reduction (MBSR) Professional Education and Training: MBSR Curriculum and Supporting Materials Included in the cost of the 7-day residential training; $40 per book if purchased separately Yes
Mindfulness-Based Stress Reduction (MBSR) Professional Education and Training: Scientific Papers From the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society 2011-1982 Included in the cost of the 7-day residential training; $40 per book if purchased separately Yes
Mindfulness-Based Stress Reduction (MBSR) Professional Education and Training: Background Readings Included in the cost of the 7-day residential training; $25 per book if purchased separately Yes
Stress Reduction Program: Home Practice Manual Included in the cost of the 7-day residential training; $20 per book if purchased separately No
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness $20 per book Yes
Heal Thy Self: Lessons on Mindfulness in Medicine $12.95 per book Yes
Jon Kabat-Zinn MBSR Class (includes 47-minute body scan, 47-minute lying yoga, 44-minute sitting meditation, and 46-minute standing yoga) (set of 4 CDs) Included in the cost of the 7-day residential training; $35 per set if purchased separately No
Saki Santorelli MBSR Class (includes 47-minute body scan, 47-minute lying yoga, 44-minute sitting meditation, and 46-minute standing yoga) (set of 4 CDs) Included in the cost of the 7-day residential training; $35 per set if purchased separately No
MBSR in Mind-Body Medicine: 7-Day Residential Training $1,525 per participant Yes
Practicum in MBSR: Living Inside Participant-Practitioner Perspectives (offered in an 8-week or 9-day intensive format) $1,800 per participant No
Teacher Development Intensive (TDI)--An Advanced MBSR Teacher Training/Retreat $2,250 per participant No
MBSR implementation supervision $125 per hour No
Teacher certification in MBSR $700 No
Consultation in MBSR $150 per hour No
Interpersonal Mindfulness Training $950 per participant No
Embodied Experience: Cultivating Wakefulness, Generosity, and Flexibility--A Training Retreat for Teachers of Mindfulness-Based Interventions $680 per participant No
Replications

Selected citations are presented below. An asterisk indicates that the document was reviewed for Quality of Research.

* Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-Based Stress Reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77(5), 855-866.  Pub Med icon

Carlson, L. E., Speca, M., Faris, P., & Patel, K. D. (2007). One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of Mindfulness-Based Stress Reduction (MBSR) in breast and prostate cancer outpatients. Brain, Behavior, and Immunity, 21(8), 1038-1049.  Pub Med icon

Chiesa, A., & Serretti, A. (2009). Mindfulness-Based Stress Reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15(5), 593-600.  Pub Med icon

Fang, C. Y., Reibel, D. K., Longacre, M. L., Rosenzweig, S., Campbell, D. E., & Douglas, S. D. (2010). Enhanced psychosocial well-being following participation in a Mindfulness-Based Stress Reduction program is associated with increased natural killer cell activity. Journal of Alternative and Complementary Medicine, 16(5), 531-538.  Pub Med icon

Fjorback, L. O., Arendt, M., Ørnbøl, E., Fink, P., & Walach, H. (2011). Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy: A systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102-119.  Pub Med icon

Gross, C. R., Kreitzer, M. J., Thomas, W., Reilly-Spong, M., Cramer-Bornemann, M., Nyman, J. A., et al. (2010). Mindfulness-Based Stress Reduction for solid organ transplant recipients: A randomized controlled trial. Alternative Therapies in Health and Medicine, 16(5), 30-38.  Pub Med icon

Nyklícek, I., & Kuijpers, K. F. (2008). Effects of Mindfulness-Based Stress Reduction intervention on psychological well-being and quality of life: Is increased mindfulness indeed the mechanism? Annals of Behavioral Medicine, 35(3), 331-340.  Pub Med icon

Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2003). Mindfulness-Based Stress Reduction lowers psychological distress in medical students. Teaching and Learning in Medicine, 15(2), 88-92.  Pub Med icon

* Sephton, S. E., Salmon, P., Weissbecker, I., Ulmer, C., Floyd, A., Hoover, K., et al. (2007). Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial. Arthritis and Rheumatism, 57(1), 77-85.  Pub Med icon

Vøllestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-Based Stress Reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4), 281-288.  Pub Med icon

Contact Information

To learn more about implementation, contact:
Merin C. MacDonald, M.S.
(508) 856-5144
merin.macdonald@umassmed.edu

Saki F. Santorelli, Ed.D., M.A.
(508) 856-2656
saki.santorelli@umassmed.edu

To learn more about research, contact:
Paul M. Galvin, Ph.D.
(508) 856-3764
paul.galvin2@umassmed.edu

Saki F. Santorelli, Ed.D., M.A.
(508) 856-2656
saki.santorelli@umassmed.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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