Sucich James T, Lehrer Jeremy, Breitbart Vicki, Julliard Kell N
Family Health Centers at NYU Langone, 514 49th Street, Brooklyn, NY, 11220, USA.
Columbia University, New York City, USA.
Pilot Feasibility Stud. 2022 Dec 9;8(1):250. doi: 10.1186/s40814-022-01205-x.
While mindfulness training's feasibility has been assessed in many health care settings, the feasibility of teaching mindfulness to psychotherapists of various orientations for both self- and patient-care has not been explored. The objectives of this feasibility assessment were to determine the degree to which clinic psychotherapists were willing to complete a skills-based mindfulness training program; evaluate the acceptability of integrating mindfulness interventions into an urban community mental health clinic; examine the training's influence on both personal mindfulness practice and integration into patient care; and explore the impact of a support group following the training.
Data on six aspects of feasibility were gathered through quantitative surveys, semi-structured qualitative interviews, and group observation and feedback, analyzed using grounded theory.
Sixteen therapists and one administrator attended at least one session of this voluntary program and responded to the associated surveys. At 1-year post-training, 7 participants had attended one or more group support sessions, and 4 more than 50% of sessions. The following factors were identified as contributing to the training's success: significant interest on the part of clinic staff to receive the training; diversity of the teaching staff, buy-in from clinic administration, provision of meditation scripts, role-play exercises, the variety of practices taught, and case presentations. Therapists indicated that the training helped them create a personal mindfulness practice, and several proceeded to integrate mindfulness into client sessions. A bi-weekly support group organized after the training encompassed group practice, discussion, case presentations, and information about trauma-sensitive mindfulness. Clinicians identified the following challenges to integrating mindfulness into sessions: lack of scripts in client languages other than English, the unacceptability of mindfulness to some clients' religious beliefs, the lack of appropriateness for clients facing ongoing psychosocial crises, the lack of interest on the part of some clients, and the time constraints posed by brief therapy sessions.
These findings indicate that such training may be feasible in community mental health settings given support from leadership and the presence of qualified facilitators within the organization. Adaptations to the training based on participant feedback can inform a larger scale trial that compares our protocol with another intervention in the treatment of a psychological disorder or condition identified by the participants as having responded favorably to the program.
虽然正念训练的可行性已在许多医疗环境中得到评估,但针对不同取向的心理治疗师进行自我关怀和患者关怀的正念教学的可行性尚未得到探索。这项可行性评估的目的是确定临床心理治疗师愿意完成基于技能的正念训练计划的程度;评估将正念干预措施整合到城市社区心理健康诊所的可接受性;研究该训练对个人正念练习以及将其整合到患者护理中的影响;并探索训练后支持小组的影响。
通过定量调查、半结构化定性访谈以及小组观察和反馈收集了关于可行性六个方面的数据,并使用扎根理论进行分析。
16名治疗师和1名管理人员参加了这个自愿计划的至少一次课程,并对相关调查做出了回应。在训练后1年,7名参与者参加了一次或多次小组支持课程,4名参与者参加了超过50%的课程。确定了以下有助于训练成功的因素:临床工作人员对接受训练有浓厚兴趣;教学人员的多样性、诊所管理层的支持、提供冥想脚本、角色扮演练习、所教授练习的多样性以及病例展示。治疗师表示,该训练帮助他们建立了个人正念练习,并且有几位治疗师进而将正念整合到了与客户的会谈中。训练后组织的每两周一次的支持小组包括小组练习、讨论、病例展示以及关于创伤敏感型正念的信息。临床医生确定了将正念整合到会谈中的以下挑战:除英语外缺乏客户语言的脚本、正念对一些客户宗教信仰不可接受、对面临持续心理社会危机的客户不合适、一些客户缺乏兴趣以及简短治疗会谈带来的时间限制。
这些发现表明,在组织内领导层的支持和有资质的培训人员在场的情况下,此类训练在社区心理健康环境中可能是可行的。根据参与者反馈对训练进行调整可为更大规模的试验提供信息,该试验将我们的方案与另一种干预措施进行比较,以治疗参与者认为对该计划反应良好的心理障碍或状况。