Mindfulness

Definition, components, techniques, helpful skills/attitudes, benefits, therapies, social work relevance, practice approach.


Three sections follow:

  1. Background Material that provides the context for the topic

  2. A suggested Practice Approach

  3. A list of Supporting Material / References

Feedback welcome!

Background Material

Definition

Most writers, when discussing mindfulness, offer a definition. This usually incorporates words such as ‘non-judgemental’, ‘open’, ‘awareness’, ‘attending to’, ‘present moment’, ‘discerning’, ‘intentionally’, and ‘on purpose’.

  • Mindfulness can be defined simply as “moment-by-moment awareness” (Mojoyinola, 2014).

  • Mindfulness is defined as the awareness that arises out of intentionally attending in an open and discerning way to whatever is arising in the present moment (Aitkens & Shapiro, 2017; Shapiro, 2009).

  • Mindfulness is the act of being present in each moment. It is paying attention in a particular way: on purpose, in the present moment, and non-judgementally. Mindfulness means being aware of what’s happening now and staying there with an attitude of acceptance. This assists people to become more aware of their ways of being, i.e. their thought processes and habits, how they experience and react to emotions and physical sensations, and how these influence their behaviour and daily lives (McCusker, 2020).

Components

As well as defining mindfulness, most writers expand on their definition by examining components or characteristics of mindfulness. Tan and Ken (2009), Boone (2014) and Brown (2018) settle on two components:

  1. Attention to, or awareness of, thoughts, feelings and sensations from moment to moment without getting lost in them

  2. Maintaining a sense of acceptance (i.e. being curious, open and non-judgemental) of sensations, thoughts or feelings that may arise.

Techniques

Mindfulness and mindfulness techniques are not the same thing. Mindfulness refers to paying attention, being present, having no conscious purpose, and feeling no judgment. Mindfulness has to do with working with the mind by knowing it, shaping it, freeing it, and paying attention to how life is experienced every moment.


Mindfulness techniques are particular ways to acquire mindfulness (Kelly & Okolo, 2016). These techniques help people practice mindfulness (Kelly & Okolo, 2016; Mayo Clinic Staff, 2020; Therapist Aid, 2015 & 2017):

  • Mindfulness meditation – a breathing exercise. Aitkens and Shapiro (2017) suggest mindfulness meditation is not ‘zoning out’ but more a way to ‘zone in’ on one’s experience. It involves learning to watch thoughts, feelings, and sensations as they arise and pass, without becoming caught up in them. It helps cultivate general mindfulness in everyday life.

  • Body scan – paying close attention to physical sensations throughout one’s body.

  • Mindful eating – an exercise to make one intimately aware of the food one is eating.

  • Five senses – notice what each of five senses are experiencing.

  • Mindfulness walk – while walking, becoming aware of and accepting one’s body and surroundings.

Helpful Skills / Attitudes

Before mindfulness can be practiced, it requires certain abilities and attitudes. It requires one to be cognitively and affectively able to attend to the present moment and be capable of perception and introspection. It requires one to have the willingness to endure uncomfortable feelings (Mojoyinola, 2014).


There is a consensus that observing, non-judging and non-reacting constitute the core of mindfulness (Antonova et al., 2021):

  • Observing involves deliberately turning toward and noticing present-moment experiences during daily activities, such as body sensations during walking, showering and eating, or sensory stimuli, such as sounds, smells, or sights.

  • Non-judging taps into the tendency to judge one’s experiences, emotions, feelings and thoughts, as irrational, inappropriate, or bad, as well as the tendency to be critical of oneself more generally. Mindfulness avoids judging.

  • Non- reactivity refers to the ability to be aware of the distressing feelings, thoughts or images without getting caught up in them, noticing them in a decentred way, letting go of them, and returning to feeling calm soon after they have passed.

Mindfulness meditation is cultivated by the following seven foundational attitudinal elements: non-judging, patience, beginner’s mind, trust, non-striving, acceptance, and letting go:

  • Non-judging—being able to be with whatever arises in the moment in a gentle, kind, and encouraging manner.

  • Patience—accepting your tangential mind and refocusing it back to the present.

  • Beginner’s mind—allowing yourself to approach each meditation as though it was your first.

  • Trust—being able to trust one’s own experience which includes feelings and intuition.

  • Non-striving—being malleable with expectations of mindfulness practice.

  • Acceptance—embracing yourself as you are before you can expect to change.

  • Letting go—being able to let go of burdens or impediments (Kelly & Okolo, 2016).

Benefits

Mojoyinola (2014) has a number of pages outlining the benefits of mindfulness practice. These include affective benefits, interpersonal benefits and intrapersonal benefits. There is also an extensive list of how mindfulness practice it a tool for promoting positive health and psychosocial wellbeing. Other authors support many of the areas mentioned by Mojoyinola. The benefits of practising mindfulness include:

  • Reduced symptoms of depression, anxiety and stress with positive effects maintained long term (Kelly & Okolo, 2016; Mayo Clinic Staff, 2020; Therapist Aid, 2017; Thompson & van Vliet, 2018)

  • Improved memory, focus, and mental processing speed (Therapist Aid, 2017)

  • Effective for managing insomnia and high blood pressure (Mayo Clinic Staff, 2020; Thompson & van Vliet, 2018)

  • Improved ability to adapt to stressful situations (Therapist Aid, 2017)

  • Improved attention, perception, self-control and mood (Thompson & van Vliet, 2018)

  • Greater satisfaction within relationships (Therapist Aid, 2017)

  • Reduced psychosocial problems including addiction, anxiety, depression, eating disorders, chronic pain, stress, and suicidality (Kelly & Okolo, 2016)

  • Reduced rumination (repetitively going over a thought or problem) (Therapist Aid, 2017; Thompson & van Vliet, 2018)

  • Improved ability to manage emotions (Therapist Aid, 2017; Thompson & van Vliet, 2018)

Therapies

There are four main therapies that use mindfulness. Mindfulness means different things within these four therapies:

  • Mindfulness Based Stress Reduction (MBSR), an 8-week program teaching body scan exercises, sitting meditation, hatha yoga, and walking meditation. During these exercises, participants are instructed to pay attention to the object of observation (such as breath or bodily sensations) and to observe them nonjudgmentally. Whenever the mind wanders away from the object of observation, participants are instructed to gently bring their attention back to the present moment and the object of observation. Participants are required to practice these skills for at least 45 min a day, outside of 2.5-hour group meeting times.

  • Mindfulness Based Cognitive Therapy (MBCT), focusing on cognition and used for mental health conditions (e.g. depression), eating disorders and burnout.

  • Dialectical Behavior Therapy (DBT)

  • Acceptance and Commitment Therapy (ACT) (Aikens & Shapiro, 2017; Kelly & Okolo, 2016; Tan & Ken, 2019; Thompson & van Vliet, 2018).

Tan and Keng (2019) add:

  • Mindfulness-based resilience training (MBRT)

  • ·Mindfulness-based feminist therapy

  • Mindfulness-based interventions that adopt a social justice approach

  • Mindfulness-based relapse prevention (MBRP)

Relevance for Social Work

McCusker (2020) suggests mindfulness has two aspects for social workers: (i) for personal use, e.g. mitigating work-related stress and, to a lesser extent, (ii) as an intervention with to use with clients. Tan and Keng (2019) suggest mindfulness practice in social work can occur at three different levels: within the person (or inner dimension); in micro practice (through direct interventions with individuals, families, or groups); and at the level of mezzo/macro practice (through community work, advocacy, and policy). These are outlined in more detail below.


Thompson and van Vliet (2018) are more cautious; they suggest social workers need to be discerning in how they offer mindfulness to clients. While there are a number of publications on mindfulness, few of these offer a critique about whether religious practices have a place in therapy. The irony is that while Western society has wanted to distance itself from religion and spirituality in order to apply scientific rationale, it has embraced Buddhist-based mindfulness without much consideration. Thompson and van Vliet suggest social workers need to consider whether mindfulness practices undermine or contradict the faith practice of clients with a non-Buddhist belief system? Social workers should not assume everyone will consent to mindfulness interventions and should clearly explain the treatment.


1. Personal Use

Personal use of mindfulness has been found to positively impact interactions and relationships between social workers, clients and colleagues. This includes greater recognition of the negative impact of stress on thinking, concentration and decision-making, and the importance of containing emotions in interpersonal work. Mindfulness practices also enable participants to hold the emotional upset arising from the distress and trauma they hear from clients in their day-to-day interactions. It helps mitigate emotional reactions ‘spilling over’ from one exchange to another. Mindfulness contributes to “peacefully attending to the issues” (McCusker, 2020; Tan & Keng, 2019; Turner, 2018).


Crowder and Sears (2017) research supports the above. They conducted a study of seven social workers who completed the MBSR eight-week program and compared them with a control group of seven other social workers. Results suggested that the mindfulness-based intervention significantly decreased the treatment group’s perceived stress compared to those in the control group and this continued to decline for 26 weeks post-intervention. Intervention participants reported positive changes in attitudes, perspectives, behaviours, and energy in relation to their workplace relationships with peers and supervisors. Participant narratives suggested that as a result of participating in the MBSR program they experienced an improved ability to relate to co-workers, managers, and clients in a more mindful, embodied way; it gave them more hope when faced with difficulties and improved their physical and mental wellbeing. They reported being more present with clients without being so personally affected by their clients’ suffering.


Kelly and Okolo (2016) support other writers in suggesting mindfulness can enhance self-care. When embarking on a mindfulness program they suggest social workers:

  • Set realistic goals for implementing mindfulness practices: start with one or two practices a day for short amounts of time and gradually increase this as confidence mounts.

  • Expect the unexpected when starting a mindfulness practice: mindfulness practices can deepen one’s self-awareness physically, mentally, emotionally, spiritually, professionally, and financially. Mindfulness will bring to the surface things that practitioners may have been avoiding, and once conscious, these issues require follow up. Without taking the time to follow up, this increased awareness can actually increase feelings of incompetence or disappointment in oneself.

  • Utilize supervision when implementing a mindfulness practice so issues around increased self-awareness can be discussed.

2. Direct interventions with individuals, families or groups

Research also proposes that mindfulness practices have a positive impact on clinicians’ ability to work effectively with clients, e.g. McCusker (2020) and Kelly & Okolo (2016). Mindfulness can assist the practitioner in developing attention, regulation, attunement, and empathy skills. It can help the clinician’s resilience and wellbeing which improve clinician’s compassion and effective listening. Developing mindfulness:

  • Increases empathy through reducing stress, increasing self-compassion and allowing social workers to welcome the experiences of others without judgement or defense.

  • Helps social workers keep an open mind and listen to and support clients without despair and/or judgement.

  • Allows social workers to focus attention on the present; increasing awareness of the present may assist the social worker to be more comfortable with silence, potentially a very effective therapy tool.

  • Benefits the overall health of social workers—decreased stress, improved mood states, decreased ruminating and distracting thoughts, increased immune function, and reduced symptoms related to a number of physical ailments such as chronic pain, hypertension, heart disease, and cancer when mindfulness meditation is used as a self-care practice (Kelly & Okolo, 2016).

While mindfulness can also be used as an intervention to support clients through their problems, social workers should be aware that this approach can place responsibility on the individual to cope rather than examining the structures that may be causing the problem (McCusker, 2020), i.e. it is not necessarily a critical approach to social work practice. Lynn and Mensinga (2105) caution that knowledge of mindfulness and decisions about how it is used need to be adapted to one’s professional practice, depending on client characteristics’ and needs, the agency context and how the practitioner perceives their own social work identity.


The literature suggests mindfulness-based interventions can have positive effects on

  • Cancer patients,

  • Transplant patients,

  • People with substance abuse problems,

  • Survivors of intimate partner violence,

  • Youth with or without mental health conditions,

  • Family caregivers pf patients with various medical conditions,

  • Elderly populations with Parkinson’s disease and chronic insomnia,

  • People with various mental disorders (Tan & Keng, 2019).

In a study involving four social workers, Turner (2018) found the mindfulness techniques were used most often with clients who suffered from anxiety, depression or sleeplessness. Techniques/therapies used included yoga, deep breathing, meditation, dialectical behaviour therapy (DBT) and mindfulness-based stress reduction (MBSR).


Boone (2014) discusses the ‘acceptance’ theme that is central to mindfulness, suggesting that mindfulness and acceptance mesh nicely with most of the major theoretical traditions within social work. Bonne points out that social work traditions include psychodynamic approaches, behavioural and cognitive approaches, family therapy approaches, systems and ecological theories, strengths-based approaches, critical theory, feminist perspectives, solution-focused and social constructivist interventions. These all lead to a practice of social work that is pragmatic, client-focused and social justice-oriented, a practice where mindfulness and acceptance rightly belong. Boone suggests that behavioural activation and brief interventions, in particular, are based on the mindfulness theme of acceptance. They do not attempt to change thoughts and feelings but encourage action.

  • Behavioural activation, a common approach for clients experiencing depression, can be considered as implicitly accepting. It does not attempt to change thoughts and feelings, but encourages the client to simply get moving, to come in contact with his or her environment—relationships, meaningful work, fun—whatever works for the client. This happens without challenging cognitive distortions or unearthing depressive schemas, thoughts and feelings.

  • Brief interventions also fit with the theme of encouraging one to actively use strategies to improve their life without trying to change thoughts and feelings. After uncovering a potential addiction issue, the brief interventions offers support to the client to engage in actions that will reduce the impact of and/or stop the addiction from occurring.

3. Mezzo/Macro Practice

At the macro level, mindfulness could be utilized as a soft skill approach to create open-mindedness and flexibility in navigating the complex terrain of social work leadership as well as the policy world, forging effective engagement and negotiation in order to facilitate social change (Tan & Keng, 2019).


4. Social Work Education Courses

As mindfulness positively impacts social workers’ skill and values, it should be integrated into social work education courses. Mindfulness practice can play a valuable role in recognising and attending to the emotional needs, stress and other related challenges that students and social workers experience across the education-practice spectrum. Such attention has been largely missing from social work discourse until relatively recently (McCusker, 2020). Mojoyinola (2014) supports the incorporation of mindfulness into social work undergraduate courses because of the benefits outlined in research studies. Mindfulness practice develops essential core values/principles of social work practice: non-judgemental attitude, empathy, compassion and counselling skills. Other studies show how mindfulness can decrease stress and anxiety, enhance self-efficacy (the belief in one’s ability to achieve) and benefit overall professional competence.

Practice Approach

Evidence exists that mindfulness practices are beneficial for social workers in their personal life, and as a tool to use in some areas with clients. If social workers decide to incorporate mindfulness into their practice approach a few points from the section immediately above are relevant.

  • One should be practising mindfulness prior to incorporating it into therapy. The mindfulness techniques mentioned above—meditation, body scan, mindful eating, five senses, mindfulness walk, for example—should be well-known via personal experience to practitioners using mindfulness in practice.

  • When starting to explore mindfulness practices the advice of Kelly and Okolo (outlined above) is worth considering, i.e. set realistic goals, expect the unexpected and utilise supervision.

  • Most, if not all, of the therapies that use mindfulness techniques require additional training, e.g. MBSR, MBCT, DBT, ACT.

  • The use of mindfulness approaches should be explained to clients and informed consent obtained prior to using them. The current faith practices of clients should be considered.

  • McCusker’s point about mindfulness practices placing responsibility on the client to change, rather than the structures around the client changing, may be relevant.

  • If one needs more information about brief interventions and behavioural activation (as highlighted by Boone above), these topics are covered elsewhere on this website. The link can be found in the ‘contents’ button.

Supporting Material / References


Aikens, K., & Shapiro, S. (2017). The concept of mindfulness in integrative preventive medicine. In R. H. Carmona & M. Liponis (Eds.), Integrative preventive medicine. Oxford University Press. doi: 10.1093/med/9780190241254.003.0005


Antonova, E., Schlosser, K., Pandey, R., & Kumari, V. (2021). Coping with COVID-19: Mindfulness-based approaches for mitigating mental health crisis. Frontiers in Psychiatry, 12(563417). doi: 10.3389/fpsyt.2021.563417


Boone, M. S. (2014). Introduction: Mindfulness and acceptance in social work. In M. S. Boone (Ed.). Mindfulness and acceptance in social work: Evidence-based interventions and emerging applications. New Harbinger Publications. Retrieved from https://matthewsboone.weebly.com/uploads/5/8/4/7/58476469/boone_2014_mindfulness___acceptance_in_social_work_introduction.pdf


Brown, R. C. (2018). Mindfulness and resilience in social work practice. Social Work Focus, 3(1), 32-33. Australian Association of Social Workers.


Crowder, R., & Sears, A. (2017). Building resilience in social workers: An exploratory study on the impacts of a mindfulness-based intervention. Australian Social Work, 70(1), 17-29. http://dx.doi.org/10.1080/0312407X.2016.1203965

Kelly, A., & Okolo, I. (2016). Mindfulness Meditation as a Self-Care Practice in Social Work. Retrieved from Sophia, the St. Catherine University repository website: https://sophia.stkate.edu/msw_papers/617


Lynn, R., & Mensinga, J. (2015). Social workers’ narratives of integrating mindfulness into practice. Journal of Social work Practice, 29(3), 255-270. doi: 10.1080/02650533.2015.1035237


Mayo Clinic Staff. (2020). Mayo mindfulness: How mindfulness helps you live in the moment. Retrieved from https://newsnetwork.mayoclinic.org/discussion/mayo-mindfulness-how-mindfulness-helps-you-live-in-the-moment/


McCusker, P. (2020). Mindfulness in social work education and practice. Retrieved from https://www.iriss.org.uk/resources/insights/mindfulness-social-work-education-and-practice


Mojoyinola, J. K. (2014). Mindfulness practice as a tool for promoting positive health, psycho-social well-being and professional competence in health social work: Implications for health social workers. Retrieved from https://www.spiritualityandsocialwork.ca/uploads/2/5/8/0/25806130/dr._mojoyinola_-_mindfulness_practice_as_a_tool_for_promoti.pdf


Shapiro, S. L. (2009). The integration of mindfulness and psychology. Journal of Clinical Psychology, 65(6), 555-560. doi: 10.1002/jclp.20602


Tan, S.Y. & Keng, S-l. (2019). Application of mindfulness-based approaches in the context of social work. In R. Ow, A. W. C Poon (Eds.). Mental health and social work, pp. 1-19. doi:10.1007/978-981-13-0440-8_11-2


Turner, R. (2018). Mindfulness techniques and their impacts in social work practice. Summer Undergraduate Research Fellowship Journal. Retrieved from https://minds.wisconsin.edu/bitstream/handle/1793/81202/Rachel%20Turner%20-%20Mindfulness%20Techniques%20and%20their%20Impacts%20in%20Social%20Work%20Practice.pdf?sequence=9&isAllowed=y


Therapist Aid. (2017). What is mindfulness? Retrieved from https://www.therapistaid.com/therapy-worksheet/what-is-mindfulness


Therapist Aid. (2015). Mindfulness exercises. Retrieved from https://www.therapistaid.com/therapy-worksheet/mindfulness-exercises


Thompson, K., & van Vliet, P. (2018). Critical reflection on the ethics of mindfulness. Australian Social Work, 71(1), 120-128. https://doi.org/10.1080/0312407X.2017.1364396