Academic journal article Journal of Cognitive Psychotherapy

Mindfulness and Cognitive Behavioral Therapy: A Commentary on Harrington and Pickles

Academic journal article Journal of Cognitive Psychotherapy

Mindfulness and Cognitive Behavioral Therapy: A Commentary on Harrington and Pickles

Article excerpt

Harrington and Pickles (this issue) raise interesting and important questions about the nature of mindfulness and its relationships to scientific clinical psychology and cognitive behavioral theory and treatment. In this commentary, we address two primary questions. First, is mindfulness a meaningful concept within scientific clinical psychology or is it religious or mystical? Second, is mindfulness compatible with cognitive behavioral therapy? We argue that mindfulness can be conceptualized as a nonreligious construct suitable for scientific study and that it can be integrated with cognitive behavioral therapy in interesting and fruitful ways.

Keywords: mindfulness; cognitive behavioral therapy

Harrington and Pickles raise interesting and important questions about the nature of mindfulness and its relationships to scientific clinical psychology in general and cognitive behavioral theory and treatment in particular. Although the psychological literature on mindfulness is expanding rapidly, the origins of mindfulness in Buddhism raise unique issues that require careful thought. In this commentary we address the two primary questions raised by Harrington and Pickles. First, is mindfulness a meaningful concept within scientific clinical psychology or is it strictly religious or mystical? Second, is mindfulness compatible with cognitive behavioral therapy (CBT)? We argue that mindfulness can be conceptualized as a nonreligious construct suitable for scientific study and that it can be integrated with cognitive behavioral therapy in interesting and fruitful ways.

For the purpose of this commentary we define CBT as the broad spectrum of empirically supported interventions that are based on behavior therapy, cognitive therapy, or their integration. Behavior therapy is often described as the application of learning theory to the modification of problematic behavior (e.g., Zinbarg & Griffith, 2008) and usually includes methods such as contingency management, skills training, and exposure-based procedures. Cognitive therapy is based on the cognitive model (e.g., Beck, 1995) and typically includes methods for identifying and modifying distorted or maladaptive cognitions in order to change emotion and behavior (Dobson, 2001). Behavior therapy and cognitive therapy have recently been described as the first and second generations or waves, respectively, of the CBT tradition (Hayes, 2004) and have been widely integrated to form interventions that combine behavioral and cognitive components.

We define mindfulness-based interventions as those that include exercises, skills, and practices designed to cultivate the ability to attend to present-moment experiences in particular ways, which we describe in more detail later. In this category we will refer to several specific examples, including Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999), Dialectical Behavior Therapy (DBT; Linehan, 1993a), Mindfulness-Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002), and Mindfulness-Based Stress Reduction (MBSR; Kabat-Zinn, 1982, 1990). Although there are theoretical and methodological differences between these interventions, they share important common elements in their conceptualizations of mindfulness (see Baer & Huss, 2008, for more detail). Three of these mindfulness-based treatments (all but MBSR) have been described as rooted in or integrated with the cognitive behavioral tradition (Hayes, Follette, & Linehan, 2004). Mindfulness-based treatments are sometimes described as a third generation or third wave of CBT (Hayes, 2004). The CBT and mindfulness-based approaches are continually evolving, and therefore these definitions are necessarily imprecise.

IS MINDFULNESS A MEANINGFUL CONCEPT IN SCIENTIFIC CLINICAL PSYCHOLOGY?

Within the community of researchers, teachers, and clinicians who are committed to evidencebased practice and engaged in mindfulness-related work, it is clearly understood that mindfulness originates in Buddhism. …

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