Article Review Instructions

You will write three article reviews and if you choose, one extra credit article review. You will select the article yourself by searching the UWA Library Databases. The article you choose should be a research article (has a hypothesis that is empirically tested). Pick an article relevant to a topic covered in the weekly readings. Each review is worth 20 points. The review should be 1-2 single-spaced pages in a 12-point font. It is in your best interest to submit your review before it is due so you may check your originality report and correct any spelling and grammatical errors identified by the software program.

The purpose of the review is to provide students knowledge of how research is conducted and reported. The main part of your review needs to include the following information. Please comment on these aspects of the article as part of your review. Provide only the briefest summary of content. What I am most interested in is your critique and connection to weekly readings.

Reference. Listed at the top of the paper in APA style.

Introduction. Read the introduction carefully. The introduction should contain:

A thorough literature review that establishes the nature of the problem to be addressed in the present study (the literature review is specific to the problem)

The literature review is current (generally, articles within the past 5 years)

A logical sequence from what we know (the literature review) to what we don't know (the unanswered questions raised by the review and what this study intended to answer

The purpose of the present study

The specific hypotheses/research questions to be addressed.

State the overall purpose of the paper. What was the main theme of the paper?

What new ideas or information were communicated in the paper?

Why was it important to publish these ideas?

Methods. The methods section has three subsections. The methods sections should contain:

The participants and the population they are intended to represent (are they described as well in terms of relevant demographic characteristics such as age, gender, ethnicity, education level, income level, etc?).

The number of participants and how the participants were selected for the study

A description of the tools/measures used and research design employed.

A detailed description of the procedures of the study including participant instructions and whether incentives were given.

Results. The results section should contain a very thorough summary of results of all analyses. This section should include:

Specific demographic characteristics of the sample

A thorough narrative description of the results of all statistical tests that addressed specific hypotheses

If there are tables and figures, are they also described in the text?

If there are tables and figures, can they be interpreted "stand alone" (this means that they contain sufficient information in the title and footnotes so that a reader can understand what is being presented without having to go back to the text)?

Discussion. The discussion is where the author "wraps up the research". This section should include:

A simple and easy to understand summary of what was found

Where the hypotheses supported or refuted?

A discussion of how the author's findings compares to those found in prior research

The limitations of the study

The implications of the findings to basic and applied researchers and to practitioners

Critique. In your opinion, what were the strengths and weaknesses of the paper or document? Be sure to think about your impressions and the reasons for them. Listing what the author wrote as limitations is not the same thing as forming your own opinions and justifying them to the reader.

Were the findings important to a reader? Were the conclusions valid? Do you agree with the conclusions? If the material was technical, was the technical material innovative?

Conclusion. Once you provide the main critique of the article, you should include a final paragraph that gives me your overall impression of the study. Was the study worthwhile? Was it well-written and clear to those who may not have as much background in the content area? What was the overall contribution of this study to our child development knowledge base?

APA Format Review If you are unfamiliar or a bit “rusty” on your APA format, you may want to use the tutorial available through the APA website which is listed on your syllabus. Grading Criteria I will grade your paper based upon:

How well you followed directions (as indicated in this page)

How thoroughly you used examples to support the critique

How accurately you used APA format

your organization, grammar, and spelling

Integration of assigned weekly readings

Communication strategies

Deanna Buchanan

COM 600 Final Project Guidelines and Rubric

Overview The final project for this course is the creation of a leadership communication analysis and leadership communication plan.

Can we learn from the past to prepare for the future? It is a common refrain in the business world. However, nowhere are the lessons of the past more helpful than in the field of corporate communications. All of us have seen, at one time or another, a company failing to get out the proper message. Whether it is about a product recall or an unforeseen corporate crisis, companies can be slow to react and their reactions are not always the most appropriate for the situation at hand.

Being an effective leader is more than just making an impressive speech. The most important aspect of communication is not speaking, but listening. To be an effective speaker, you have to know that your message is being received and is being received in the manner that is expected. This paradox is what leads to most communications problems in the corporate world. In this course, you will explore examples of leadership communications and learn not only how they do or do not effectively reach their audiences, but the impact leadership communications can have on an organization. This experience will expose you to appropriate ways of communicating as a leader and proper strategies and approaches to leadership.

For the summative assessment in this course, you will review an example of a leadership communication, discern how the plan could be improved in reaching internal and external audiences, and determine its impact on the organization responsible for the communication. Then you will develop a leadership communication plan designed to inform future leadership communications of the organization. This summative assessment will prepare you to create future leadership communications and take advantage of future leadership opportunities.

The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules Two, Four, and Six. The final product will be submitted in Module Nine.

In this assignment, you will demonstrate your mastery of the following course outcomes:

 Evaluate the effectiveness of leadership communications of an organization for both internal and external audiences  Analyze the challenges and opportunities in creating a positive organizational culture for how they impact organizational growth  Develop strategies for developing future leadership communications directed to both internal and external audiences that are supported by systems

theory and best practices

 Develop ethical frameworks for leadership for organizational decision-making regarding the development of leadership communications  Recommend improvements to leadership communications for guiding management on effectively delivering communications

Prompt For the summative assessment in this course, you will conduct a leadership communication analysis consisting of a company overview, the analysis of a leadership communication, and leadership communication guidelines. Examples of leadership communication might include, but are not limited to memorandums to internal employees regarding organizational changes or job responsibilities, speeches or presentations by an organizational leader, interviews of an organizational leader regarding a crisis event in the organization, and so on. First, you will review several examples of leadership communications from the same organization. You will conduct your analysis by first reviewing the mission, values, and goals of the organization and describing some of its important characteristics. You will use this profile of the organization to conduct your analysis of its communications. Your analysis will focus on how effective the communications were in reaching internal and external audiences.

Then, using the information you discovered in your analysis, you will develop guidelines for the organization on how to develop future communications. This will help guide leadership on how they will develop future communications that avoid the previous issues in the communications. For both your leadership communication analysis and your leadership plan, you will be expected to support your responses with research and your own analysis when appropriate.

Specifically, you must address the critical elements listed below. Most of the critical elements align with a particular course outcome (shown in brackets).

I. Company Overview: In this section of the summative assessment, you will develop an overview of the company. This overview will serve as a profile for the company, detailing their daily operations and describing their key characteristics. This profile will be useful in your analysis and evaluation of their leadership communications.

A. Provide an overview of how the organization operates from a systems theory approach. For example, how does the organization operate on a daily basis? On a monthly basis? How do individuals with different roles interact?

B. Explain the mission, vision, and goals of the organization. For example, what is the mission statement of the organization? What are the employees expected to follow and abide by?

C. Determine the role of key leaders of the organization in the development and delivery of organizational communications. D. Determine the most important internal and external audiences of the organization and justify your response. E. Describe the current culture of the organization. Your response should be a general description of the work environment and the morale of

employees.

II. Analysis of Leadership Communications: In this section of the summative assessment, you will analyze the leadership communications of the organization. You will focus on how well the messages reach internal and external audiences, as well as the impact of the messages on the culture of the organization. Your analysis should consider both the messages themselves as well as the role leadership played in the development and delivery of the messages.

A. Evaluate the communications for how effectively leadership met the needs of internal stakeholders. B. Evaluate the communications for how effectively leadership met needs of external stakeholders. C. Analyze the communications for determining their impact on the culture of the organization.

D. Explain the approach of the organization to issues of ethics. Your response should be a general explanation regarding the overall process (or lack thereof) of the organization regarding issues of ethics. For example, is it clear how issues of ethics would be handled by leadership? What steps were or were not taken into account for ethical concerns?

E. Explain how issues in organizational culture inhibit opportunities for organizational growth. For example, how might interpersonal issues that arise from communications inhibit organizational growth?

III. Leadership Communication Guidelines: In this section of the summative assessment, you will develop strategies that will serve as guidelines for developing future leadership communications of the organization. You will also develop an ethical framework that will guide the organization in addressing issues of ethics regarding the development and delivery of leadership communications.

A. Develop leadership communication strategies that will allow future leadership communications of the organization to account for the needs of internal and external stakeholders.

B. Develop leadership communication strategies that will allow future leadership communications of the organization to account for challenges with the message receiver.

C. Recommend improvements directed to the organization for developing and delivering communications regarding meeting the needs of internal and external stakeholders and overcoming challenges with the message receiver.

D. Recommend improvements directed to the organization for developing and delivering communications regarding the role that leadership will have when following your developed guidelines.

E. Predict the social and cultural impact of the proposed leadership guidelines on internal and external stakeholders. For example, how might leadership communications developed under this plan impact the organizational culture? How might they influence the effectiveness of leadership?

F. Develop an ethical framework that will be used in the leadership guidelines and justify your framework. For example, how is this framework an improvement over the organization’s previous approach to ethical issues?

G. Develop leadership communication strategies that will allow future leadership communications of the organization to account for ethical issues using the ethical framework you developed.

H. Explain how your leadership communication guidelines are informed by systems theory and best practices for organizational leadership communications.

I. Explain how these developed strategies and recommended improvements would help guide leadership in effectively delivering future leadership communications.

Milestones Milestone One: Organization Profile In Module Two, you will compose a paper that shares your analysis of the company you have chosen from the provided Final Project Subject list or one of your own choosing. You will conduct some research on the organization’s culture, leadership, and communications. Compose a paper that shares your analysis of the organization. Discuss the organization’s culture (e.g., work environment, morale of employees), organizational operations, who the key leaders are and how they affect communications, the organization’s mission, vision, and goals, and the internal and external audiences receiving the communications. This milestone will be graded with the Milestone One Rubric.

Milestone Two: Leadership Communication Critique In Module Four, you will discuss the impact of the leadership communications of your chosen organization. This exploration will be the next step into the world of evaluating effective communication processes for a company, which is a key component of the final project. First, complete a SWOT analysis for your chosen organization. Then, compose a paper that shares your analysis. Critique the company’s process based on your understanding of systems theory as well as other leadership evaluative methods. You also have the option of creating a TED Talk-type video essay (in lieu of a paper) in which you make the case, as a speaker, for your position. If you choose the video essay, you may record your submission with a camcorder, webcam, or even your smartphone. This milestone will be graded with the Milestone Two Rubric.

Milestone Three: Recommendations for Optimal Leadership Communications In Module Six, you will formulate your recommendations on guidelines for optimal leadership communications, taking into account considerations such as company culture, ethics, and systems theory. You will consider the impact of optimal leadership communications on an organization and its alignment with your present understanding of systems theory. Submit your assignment as a PowerPoint or Prezi media presentation. You may submit speaker’s notes with your presentation, if you wish. This milestone will be graded with the Milestone Three Rubric.

Final Su bmission: Leadership Communication Analysis and Leadership Communication Plan In Module Nine, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final product. It should reflect the incorporation of feedback gained throughout the course. The content generated in the three previous milestones will serve as the foundation for this work. This submission will be graded with the Final Project Rubric.

Deliverables Milestone Deliverable Module Due Grading

One Organization Profile 2 Graded separately; Milestone One Rubric

Two Leadership Communication Critique 4 Graded separately; Milestone Two Rubric

Three Recommendations for Optimal Leadership Communications

6 Graded separately; Milestone Three Rubric

Final Submission: Leadership Communication Analysis and Leadership Communication Plan

9 Graded separately; Final Project Rubric

Final Project Rubric Guidelines for Submission: Your leadership communication analysis and leadership communication plan should be 12 to 15 pages in length with 12-point Times New Roman font and double spacing.

Critical Elements Exemplary Proficient Needs Improvement Not Evident Value

Company Overview: Organization

Operates [COM-600-03]

Meets “Proficient” criteria and response demonstrates a sophisticated awareness of systems theory and how it relates to organizational operations

(100%)

Provides an overview of how the organization operates from a systems theory approach

(90%)

Provides an overview of how the organization operates from a systems theory approach but provided overview is cursory or contains inaccuracies

(70%)

Does not provide an overview of how the organization operates from a systems theory approach

(0%)

3.16

Company Overview: Mission, Vision, and

Goals [COM-600-01]

N/A

100%

Explains the mission, vision, and goals of the organization

(100%)

Explains the mission, vision, and goals of the organization but explanation is cursory

(70%)

Does not explain the mission, vision, and goals of the organization

(0%)

4.75

Company Overview: Key Leaders

[COM-600-03]

Meets “Proficient” criteria and response demonstrates a sophisticated awareness of how key leaders of the organization are involved in organizational communications

(100%)

Determines the role of key leaders of the organization in the development and delivery of organizational communications

(90%)

Determines the role of key leaders of the organization in the development and delivery of organizational communications, but determination is cursory or contains inaccuracies

(70%)

Does not determine the role of key leaders of the organization in the development and delivery of organizational communications

(0%)

3.16

Company Overview: Internal and

External [COM-600-01]

Meets “Proficient” criteria and justification demonstrates keen insight into what makes the determined audiences the most important for the organization

(100%)

Determines the most important internal and external audiences of the organization and justifies response

(90%)

Determines the most important internal and external audiences of the organization but determination is cursory or contains inaccuracies or justification is tenuous or illogical

(70%)

Does not determine the most important internal and external audiences of the organization and justify response

(0%)

4.75

Company Overview: Culture

[COM-600-02]

Meets “Proficient” criteria and response demonstrates a sophisticated awareness of the elements that best describe the culture of an organization

(100%)

Describes the current culture of the organization

(90%)

Describes the current culture of the organization but description is cursory or contains inaccuracies

(70%)

Does not describe the current culture of the organization

(0%)

6.33

Analysis: Internal

[COM-600-01]

Meets “Proficient” criteria and response demonstrates keen insight into the specific elements that contribute to the communication’s effectiveness in meeting the needs of internal stakeholders (100%)

Evaluates the communications for how effectively leadership met the needs of internal stakeholders (90%)

Evaluates the communications for how effectively leadership met the needs of internal stakeholders but evaluation is cursory or contains inaccuracies (70%)

Does not evaluate the communications for how effectively leadership met the needs of internal stakeholders (0%)

4.75

Analysis: External [COM-600-01]

Meets “Proficient” criteria and response demonstrates keen insight into the specific elements that contribute to the communication’s effectiveness in meeting the needs of external stakeholders (100%)

Evaluates the communications for how effectively leadership met the needs of external stakeholders (90%)

Evaluates the communications for how effectively leadership met the needs of external stakeholders but evaluation is cursory or contains inaccuracies (70%)

Does not evaluate the communications for how effectively leadership met the needs of external stakeholders (0%)

4.75

Analysis: Culture [COM-600-02]

Meets “Proficient” criteria and makes especially cogent connections between the communications and their impact on the culture of the organization (100%)

Analyzes the communications for determining their impact on the culture of the organization (90%)

Analyzes the communications for determining their impact on the culture of the organization but analysis is cursory or contains inaccuracies (70%)

Does not analyze the communications for determining their impact on the culture of the organization (0%)

6.33

Analysis: Issues of Ethics

[COM-600-04]

Meets “Proficient” criteria and response demonstrates a sophisticated awareness of how issues of ethics were handled by leadership of the organization

(100%)

Explains the organization’s approach or lack of approach to issues of ethics

(90%)

Explains the organization’s approach or lack of approach to issues of ethics but explanation is cursory or contains inaccuracies

(70%)

Does not explain the organization’s approach or lack of approach to issues of ethics

(0%)

6.33

Analysis: Organizational

Growth [COM-600-02]

Meets “Proficient” criteria and response makes especially cogent connections between issues in organizational culture and their effect on organizational growth

(100%)

Explains how issues in organizational culture affect opportunities for organizational growth

(90%)

Explains how issues in organizational culture affect opportunities for organizational growth but explanation is cursory or contains inaccuracies

(70%)

Does not explain how issues in organizational culture affect opportunities for organizational growth

(0%)

6.34

Guidelines: Internal and External Stakeholders [COM-600-03]

Meets “Proficient” criteria and developed leadership strategies demonstrate keen insight into how to meet the needs of internal and external stakeholders

(100%)

Develops leadership communication strategies that will allow future leadership communications of the organization to account for the needs of internal and external stakeholders

(90%)

Develops leadership communication strategies that will allow future leadership communications of the organization to account for the needs of internal and external stakeholders but developed strategies are cursory or contain inaccuracies

(70%)

Does not develop leadership communication strategies that will allow future leadership communications of the organization to account for the needs of internal and external stakeholders

(0%)

3.16

Guidelines: Message Receiver

[COM-600-03]

Meets “Proficient” criteria and developed leadership strategies provide keen insight into how to account for social and cultural challenges with the message receiver

(100%)

Develops leadership communication strategies that will allow future leadership communications of the organization to account for social and cultural challenges with the message receiver

(90%)

Develops leadership communication strategies that will allow future leadership communications of the organization to account for social and cultural challenges with the message receiver but developed strategies are cursory or contain inaccuracies

(70%)

Does not develop leadership communication strategies that will allow future leadership communications of the organization to account for social and cultural challenges with the message receiver

(0%)

3.16

Guidelines:

Improvements [COM-600-05]

Meets “Proficient” criteria and response demonstrates keen insight into improving the development and delivery of leadership communications for a variety of audiences (100%)

Recommends improvements directed to the organization for developing and delivering communications regarding meeting the needs of internal and external stakeholders and overcoming challenges with the message receiver (90%)

Recommends improvements directed to the organization for developing and delivering communications regarding the meeting the needs of internal and external stakeholders and overcoming challenges with the message receiver but recommendations are cursory or contains inaccuracies (70%)

Does not recommend improvements directed to the organization for developing and delivering communications regarding meeting the needs of internal and external stakeholders and overcoming challenges with the message receiver (0%)

6.33

Guidelines: Leadership [COM-600-05]

Meets “Proficient” criteria and response demonstrates a keen insight into the role that leadership must play in developing and delivering communications

(100%)

Recommends improvements directed to the organization for developing and delivering communications regarding the role that leadership will have when following developed guidelines

(90%)

Recommends improvements directed to the organization for developing and delivering communications regarding the role that leadership will have when following developed guidelines but recommendations are cursory or contain inaccuracies

(70%)

Does not recommend improvements directed to the organization for developing and delivering communications regarding the role that leadership will have when following developed guidelines

(0%)

6.33

Guidelines: Social and Cultural

[COM-600-03]

Meets “Proficient” criteria and response demonstrates keen insight into the potential social and cultural impact of the proposed leadership plan

(100%)

Predicts the social and cultural impact of the proposed leadership plan on internal and external stakeholders

(90%)

Predicts the social and cultural impact of the proposed leadership plan on internal and external stakeholders but prediction is cursory or contains inaccuracies

(70%)

Does not predict the social and cultural impact of the proposed leadership plan on internal and external stakeholders

(0%)

3.16

Guidelines: Ethical Framework

[COM-600-04]

Meets “Proficient” criteria and response demonstrates keen insight into how to guide future leadership in in avoiding ethical issues regarding communications

(100%)

Develops an ethical framework that will be used in the leadership plan and justifies framework

(90%)

Develops an ethical framework that will be used in the leadership plan and justifies response but framework is cursory or contains inaccuracies or justification is tenuous or illogical

(70%)

Does not develop an ethical framework that will be used in the leadership plan and justify framework

(0%)

6.33

Guidelines: Ethical Issues

[COM-600-04]

Meets “Proficient” criteria and response demonstrates keen insight into how to guide future leadership in addressing ethical issues regarding communications

(100%)

Develops leadership communication strategies that will allow future leadership communications of the organization to account for ethical issues using the ethical framework

(90%)

Develops leadership communication strategies that will allow future leadership communications of the organization to account for ethical issues using the ethical framework but developed strategies are cursory or contain inaccuracies

(70%)

Does not develop leadership communication strategies that will allow future leadership communications of the organization to account for ethical issues using the developed ethical framework

(0%)

6.34

Guidelines: Systems Theory and Best

Practices [COM-600-03]

Meets “Proficient” criteria and response demonstrates keen insight into how each piece of the guidelines is informed by systems theory and best practices

(100%)

Explains how leadership communication guidelines are informed by systems theory and best practices

(90%)

Explains how leadership communication guidelines are informed by systems theory and best practices but explanation is cursory or contain inaccuracies

(70%)

Does not explain how leadership communication guidelines are informed by systems theory and best practices

(0%)

3.16

Guidelines: Guide Leadership

[COM-600-05]

Meets “Proficient” criteria and response demonstrates keen insight in how the guidelines will assist leadership in effectively delivering future leadership communications

(100%)

Explains how developed strategies and recommended improvements would help guide leadership in effectively delivering future leadership communications

(90%)

Explains how developed strategies and recommended improvements would help guide leadership in effectively delivering future leadership communications but explanation is cursory or contains inaccuracies

(70%)

Does not explain how developed strategies and recommended improvements would help guide leadership in effectively delivering future leadership communications

(0%)

6.34

Articulation of Response

Submission is free of errors related to citations, grammar, spelling, syntax, and organization and is presented in a professional and easy-to-read format

(100%)

Submission has no major errors related to citations, grammar, spelling, syntax, or organization

(90%)

Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas

(70%)

Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas

(0%)

5.04

Total 100%

Teaching Self-Care to Caregivers: Effects of Mindfulness-Based Stress Reduction on the Mental Health of Therapists in Training

Shauna L. Shapiro Santa Clara University

Kirk Warren Brown Virginia Commonwealth University

Gina M. Biegel Kaiser Permanente

Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.

Keywords: mindfulness, meditation, therapist training, self-care

For mental health professionals, caring for those who are emotionally stressed or distressed is often itself stressful. Therapists commonly experience “compassion fatigue” (Figley, 2002; Weiss, 2004) due to the emotional labor that is often a part of therapeutic work (Mann, 2004). Stress-related psychological problems among therapists are especially apparent among those

employed in such high-demand settings as hos- pitals (Vredenburgh, Carlozzi, & Stein, 1999) and among those working with populations who present special emotional challenges to caregiv- ers, including clients who have experienced abuse (Coppenhall, 1995), trauma (Arvay & Uhlemann, 1996) and/or have personality dis- orders (Linehan, Cochran, Mar, Levensky, & Comtois, 2000). Research suggests that psycho- logical impairment affects a significant propor- tion of direct service mental health profession- als at some point in their careers (Coster & Schwebel, 1997; Guy, Poelstra, & Clark, 1989).

The negative consequences of stress on help- ing professionals include increased depression, emotional exhaustion and anxiety (Radeke & Mahoney, 2000; Tyssen, Vaglum, Gronvold, & Ekeberg, 2001), psychosocial isolation (Penzer, 1984), decreased job satisfaction (Blegen, 1993), reduced self-esteem (Butler & Constantine, 2005), disrupted personal relationships (Myers, 1994), and loneliness (Lushington & Luscri, 2001). Stress may also harm professional ef- fectiveness because it appears to negatively impact attention and concentration (Skosnik, Chatterton, & Swisher, 2000), impinge on

SHAUNA L. SHAPIRO is in the department of counseling a Santa Clara University. She received her doctoral degree from the University of Arizona. Her research interests in- clude mindfulness, meditation, training therapists, and pos- itive psychology.

KIRK WARREN BROWN is currently an assistant professor of psychology at Virginia Commonwealth University. He received his doctorate from McGill University. Dr. Brown’s research centers on the role of attention to and awareness of internal states and behavior in self-regulation and well- being.

GINA M. BIEGEL is at the department of child and ado- lescent psychiatry, Kaiser Permanente, San Jose, CA. She has a master’s degree from Santa Clara University. Her current research interest is mindfulness-based stress reduc- tion with adolescents and health professionals.

CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Shauna L. Shapiro, Santa Clara University, 500 El Camino Real, Santa Clara, CA 95053. E-mail: [email protected]

Training and Education in Professional Psychology Copyright 2007 by the American Psychological Association 2007, Vol. 1, No. 2, 105–115 1931-3918/07/$12.00 DOI: 10.1037/1931-3918.1.2.105

105

decision-making skills (Klein, 1996; Lehner, Seyed-Solorforough, O’Connor, Sak, & Mullin, 1997), and reduce providers’ ability to establish strong relationships with patients (Enochs & Etzbach, 2004; Renjilian, Baum, & Landry, 1998). Further, stress can increase the likeli- hood of occupational burnout (Rosenberg & Pace, 2006), a syndrome that involves deper- sonalization, emotional exhaustion, and a sense of low personal accomplishment.

These findings highlight the importance of self-care for health care providers. There is ev- idence that younger and newer helping profes- sionals are particularly susceptible to occupa- tional stress (Skovholt & Ronnestad, 2003; Vander-Kolk, 1982; Vredenburgh et al., 1999). Thus, programs designed to teach self-care skills to helping professional trainees (i.e., stu- dents) may represent an important form of “pre- ventive treatment” for individuals at risk for later psychological problems (cf., Coster & Schwebel, 1997).

Quantitative and interview research examin- ing self-care and stress management for thera- pists has suggested that several facets of self- care are important, including self-awareness, self-regulation or coping, and a balancing of self and others interests (e.g., Baker, 2003; Brady, Guy, & Norcross, 1995). Self-aware- ness, defined in this context as an unbiased observation of one’s inner experience and be- havior, is thought to be foundational to self-care (Baker, 2003; Norcross, 2000; Coster & Schwebel, 1997) and important to successful therapeutic work with clients (Baker, 2003). To date, no research known to us has examined the efficacy of interventions designed to enhance self-awareness, self-regulation, or balance in therapists or therapists in training, although a recent qualitative report suggests that therapist trainees find psychological benefit from such an intervention (Newsome, Christopher, Dahlen, & Christopher, 2006). A growing body of research indicates that a stress reduction program that emphasizes the cultivation of mindfulness may enhance psychological well-being, mental health, and physical health (see Baer, 2003; Grossman, Niemann, Schmidt, & Walach, 2004, for meta-analytic reviews).

The mindfulness-based stress reduction pro- gram (MBSR; Kabat-Zinn, 1990) is based on the premise that enhancing the capacity to be mindful—that is, to attend to present moment

experience in a receptive manner—will, over time, reduce the identification with self-focused thoughts and emotions that can lead to poorer mental health (e.g., Brown, Ryan, & Creswell, in press). Clinical research conducted over the past 25 years has supported the efficacy of MBSR for reducing distress and enhancing well-being in individuals with a variety of med- ical and psychiatric conditions (see reviews by Baer, 2003; Bishop, 2002; Grossman et al., 2004). More pertinent to the present study, MBSR has also demonstrated efficacy in health care professionals and trainees (Cohen-Katz, Wiley, Capuano, Baker, Kimmel, & Shapiro, 2005; Rosenzweig, Reibel, & Greeson, 2003; Shapiro, Astin, Bishop, & Cordova, 2005; Shapiro, Schwartz, & Bonner, 1998). MBSR was designed for application to any individual facing stress, and the program can be flexibly adapted to specific populations. The research with health care providers and trainees in par- ticular suggests that beginning mental health professionals may also find benefit from the self-care skills training offered in the MBSR program.

The present study had three purposes. We first sought to test the efficacy of MBSR in enhancing the mental health of therapists in training as measured by a variety of cognitive and affective indicators. The importance of this aim lies in promoting the well-being and stress tolerance of trainees preparing to enter the de- manding counseling and psychotherapy profes- sions. Given the potential costs of stress on mental health care professionals’ well being, teaching future therapists’ ways of managing stress seems imperative. In line with past MBSR research, we predicted that relative to controls, participants in the MBSR program would show improvements in mental health and well-being.

A second purpose was to examine the processes by which MBSR achieves its beneficial effects. Namely we sought to examine whether MBSR is associated with increased mindfulness and if this change is associated with positive outcomes. Little is currently known about such processes. MBSR focuses on the enhancement of the quality of mindfulness, and it is this enhancement that is believed to be responsible for the positive effects of the intervention. With the recent development of measures of the mindfulness construct (Baer, Smith, & Allen, 2004; Brown & Ryan, 2003;

106 SHAPIRO, BROWN, AND BIEGEL

Walach, Buchheld, Buttenmuller, Kleinknecht, & Schmidt, 2006), research has begun to test these two propositions empirically. In an MBSR study with nurses, Cohen-Katz et al. (2005) found that scores on one measure of mindfulness, the Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003), increased significantly over the course of the 8-week program. In an MBSR study with cancer patients, Brown and Ryan (2003) found that increases in MAAS- assessed mindfulness were related to declines in mood disturbance and stress. The present study sought to extend this process research on mind- fulness enhancement through MBSR and the ef- fects of that enhancement. We predicted that lev- els of mindfulness would increase over the course of the 8-week MBSR program with counseling students, and that these increases would be related to positive changes in mental health.

A final purpose of this study was to explore the relation between mindfulness practice and mental health outcomes. A primary component of the MBSR program is in-class and home- based practice of several mindfulness-based skills, and it is widely believed that this skills practice is related to positive outcomes of the MBSR program (Carson, Carson, Gil, & Baucom, 2004; Shapiro, Bootzin, Figueredo, Lopez, & Schwartz, 2003). However, past re- search examining the relation between amount of mindfulness practice and degree of change in affective, behavioral, and neurophysiological outcomes has been mixed, with some reporting positive findings (Carson et al., 2004; Shapiro et al., 2003) and others null findings (e.g., Davidson, Kabat-Zinn, & Schumacher, 2003). Given the lack of clear, supportive evidence for the role of mindfulness practice on MBSR outcomes, no hypotheses concerning this relation were made in the present study. However, given the impor- tance of this issue for mindfulness intervention research, we examined associations between the type and amount of mindfulness practice per- formed and the well-being-related outcomes of the MBSR program.

Method

Participants

Study participants were recruited from a mas- ter’s level counseling psychology program at a small private Jesuit university. Student partici-

pants were enrolled in one of three graduate courses: Stress and Stress Management, Psy- chological Theory, and Research Methods. On the first day of class in all three courses, stu- dents were given a 5-minute introduction to the study procedures and invited to participate. There was no credit offered for participation, and students were told it was completely vol- untary. A total of 83 students were enrolled in these courses in the Fall, 2004 term, and 64 elected to participate in the study and gave written informed consent. Of the 22 students enrolled in the intervention course (Stress and Stress Management), all completed both the baseline measures and the postcourse measures. Of the 61 students enrolled in the two control courses, 42 completed baseline measures, and 32 completed the postcourse measures. Data for the 54 participants (88.9% female) who completed measures at both assessment points were retained for analyses. Those who com- pleted the study did not differ from noncom- pleting participants on any of the demographic or psychological variables collected at baseline, all ps � .05. The average age of the 54 retained participants was 29.2 years (SD � 9.07). The majority (76.9%) were Caucasian, and the rest were Latina/Latino (7.7%), Asian (5.8%), Filipino (3.8%), African American (1.9%), Por- tuguese, and Persian (each 1.9%); two (3.8%) declined to indicate their race or ethnicity. The majority of students were enrolled in their first year (56.9%) or second year (29.4%) of gradu- ate school; the remaining students were in their third year (11.8%) and fourth year (2%).

Study Design and Procedures

The study was conducted using a prospec- tive, nonrandomized, cohort-controlled de- sign. The MBSR intervention was offered as part of the Stress and Stress Management course, while the other two courses noted above served as cohort controls. All courses were offered in the same academic term and all three courses were required for the health psychology master’s degree in counseling psychology. During the first class in each course, students were invited to participate in the study and informed consent was obtained from those interested. All demographic and psychological measures were collected in the first week of the academic term (Time 1); all

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psychological measures were again col- lected 9 weeks later, in the final week of the term (Time 2). One PhD-level instructor taught the intervention course and one of the control courses (Psychological Theory), and a second PhD-level instructor taught the other control group course (Research Methods).

MBSR Intervention Course

The Stress and Stress Management course consisted of 10 weekly classes, meeting 3 hours per week. The 8-week MBSR intervention began in the third week; the intervention was modeled after the well-established manualized treatment program developed by Kabat-Zinn and colleagues at the University of Massachusetts (e.g., Kabat-Zinn, 1982). MBSR includes both didac- tic and experiential elements that focus on the training of mindfulness-based meditative prac- tices. These practices are designed to cultivate an open or receptive attention to all stimuli that enter the field of awareness on a moment-by- moment basis. In particular, mindfulness prac- tices are designed to enhance participants’ on- going awareness of their sensory experiences, thoughts, feelings, somatic sensations, and be- haviors. MBSR is premised on the thesis that bringing greater awareness to actual experience in the “here and now” encourages a disengage- ment from self-related thoughts (e.g., rumina- tion) and emotions (e.g., anxiety) that can have a detrimental effect on well-being (Leary, 2004).

The MBSR intervention included weekly 2-hour sessions wherein students received train- ing in the following five mindfulness practices (adapted from Kabat-Zinn, 1982). Sitting med- itation involved a concentration of attention to the sensations of breathing, while remaining open to other sensory events, and to physical sensations, thoughts, and emotions. The body scan involved a progressive movement of atten- tion through the body from toes to head while observing physical sensations in each region. Hatha yoga consisted of stretches and postures designed to enhance mindful awareness of the body and to balance and strengthen the muscu- loskeletal system. A guided loving-kindness meditation was also taught, which involved ex- periential practice in compassion toward self and others. Finally, participants were taught in-

formal practices which emphasized bringing mindfulness into day-to-day life.

The non-MBSR portion of the course served as an overview of stress and various nonmind- fulness-based stress management techniques (e.g., humor, exercise, hypnosis, social support, acupuncture). This portion was entirely didactic in nature and did not include experiential exer- cises. Students were not instructed to practice any of the techniques discussed. Once MBSR began, students were asked to focus on the mindfulness practices.

Control Group Courses

Like the Stress and Stress Management course, both the Research Methods and Psycho- logical Theory courses met 3 hours weekly for 10 weeks under the guidance of trained instructors. Thus, the intervention and control group courses were structurally equivalent in instructor attention, weekly and total duration, and course modality (both were group-based). The control group courses were entirely didactic in nature and did not include experiential stress management exercises. The Research Methods course focused on research design, various sta- tistical analyses, and critical reading of journal articles. The Psychological Theory course of- fered an overview of psychological theories in- cluding psychodynamic, humanistic, behavior- ist, and cognitive paradigms.

Pre- and Postcourse Measures

Mindfulness. The Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003) is a 15-item instrument assessing the fre- quency with which an individual is openly at- tentive to, and aware of, present events and experiences. The scale assesses mindfulness of both internal states (e.g., emotions) and overt behavior (e.g., attention to tasks, social interac- tions, etc.) on a 6-point Likert scale. Example items of the scale include, “I could be experi- encing some emotion and not be conscious of it until some time later” and “It seems I am ‘run- ning on automatic’ without much awareness of what I’m doing.” Higher scores indicate higher mindfulness. The MAAS has demonstrated strong psychometric properties (Brown & Ryan, 2003; Carlson & Brown, 2005). In the present study, internal consistency was acceptable

108 SHAPIRO, BROWN, AND BIEGEL

(Cronbach’s alpha � .79) though slightly lower than in past research (e.g., Brown & Ryan, 2003; this and all reported sample �’s are from the Time 1 data).

Distress and well-being. In an attempt to broadly assess psychological distress and well- being, well-validated scales tapping several cognitive and affective dimensions of experi- ence were used. Positive and negative affect are primary dimensions of subjective well-being (Diener, 1984), and these were measured with the 20-item version of the Positive and Negative Affectivity Schedule (PANAS; Watson, Clark, & Tellegen, 1988). Example adjectives in- cluded interested and enthusiastic (positive af- fectivity), and distressed and afraid (negative affectivity). Scores on the 7-point scales indi- cated higher levels of both positive and negative affect. Both subscales showed acceptable levels of internal consistency in this sample (� � .88 and � � .83, respectively).

To more specifically measure levels of stress and distress, the 10-item version of the Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983; sample � � .87) was used to assess the extent to which life situations are appraised as stressful. An example item is, “In the last month, how often have you felt nervous and stressed?” Higher scores on the 5-point scale indicate higher perceived stress. Anxiety was measured at both state (“past week”) and trait (“past month”) levels using the 20-item State/Trait Anxiety Inventory (STAI; Spielberger, 1983; sample state � � .95; sample trait � � .96). Example items include, “I am tense” and “I feel strained.” The STAI is scored such that higher scores on the 7-point scale reflect higher anxiety.

Rumination is a risk factor for depression and was measured with the 12-item rumination por- tion of the Reflection Rumination Questionnaire (RRQ; Trapnell & Campbell, 1999; sample � � .94). This 12-item subscale measures “rumina- tive self-attention,” the tendency to dwell on, rehash, or reevaluate events or experiences. Higher scores on the 5-point scale indicate higher rumination. An example item is, “Some- times it is hard for me to shut off thoughts about myself.” Finally, the 26-item Self-Compassion Scale (Neff, 2003; sample � � .94) was used to measure self-compassion based on an aggregate of responses on 3 subscales: self-kindness ver- sus self-judgment, common humanity versus

isolation, and mindfulness versus overidentifi- cation. Example items include, “I try to be lov- ing toward myself when I’m feeling emotional pain” and “When times are really difficult, I tend to be tough on myself” (reversed). Higher scores on the 5-point scale indicate higher self-compassion.

Daily Mindfulness Practice Diaries

Students in the MBSR course were asked to complete daily mindfulness practice diaries for the entire 8-week intervention so as to examine the effects of practice on the study outcomes. On these diaries, to be completed at the end of each day, MBSR participants indicated the number of minutes of sitting meditation, body scan, yoga, and informal mindfulness practice performed that day.

Results

Preliminary analyses showed that students in the two control classes did not differ signifi- cantly on any of the demographic or psycholog- ical measures at the outset of the study (Time 1; all ps � .05), so all data for these two classes were combined into a single control group for further analyses. Next, analyses showed that the MBSR and control group did not differ on any of the study measures at Time 1 except aca- demic year: most control group participants (70%) were in their first academic year, com- pared to 38% of MBSR participants, �2(3) � 8.23, p � .05. Finally, Time 1, Time 2, and Time 1 to Time 2 change scores showed no gender differences in preliminary analyses (all ps � .05), so gender will not be further considered.1

MBSR Intervention Effects on Well-Being and Distress

To examine whether participation in the MBSR program (vs. participation in the con- trol courses) impacted levels of distress and well-being, we conducted 2 (group) � 2 (time) mixed factorial analyses of variance

1 Due to the low numbers of minority participants in the sample, differences in effects due to ethnic and racial status were not tested.

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(ANOVAs) on each outcome variable, using an alpha level of .05 as the criterion for sta- tistical significance. Because preliminary analyses showed that age and year in program were related to one or more of the outcomes, these measures were included as predictors where relevant. Table 1 displays the primary results of the ANOVAs. Participants in the MBSR class showed significant improve- ments on all 7 outcomes, relative to partici- pants in the control group. In support of our primary hypothesis, participants in the MBSR intervention reported significant decreases in perceived stress, negative affect, state and trait anxiety, rumination, as well as signifi- cant increases in positive affect and self- compassion. Several main effects for age were found, with older students showing lower levels of negative affect, trait anxiety, rumination, perceived stress, and higher self- compassion. No main effects of year in pro- gram were found, and there were no age � time or year � time interaction effects. Fi- nally, despite the fact that the MBSR and control groups differed in year of program, there were no year � group interaction effects on any outcome.

Do Changes in Mindfulness Occur and Are They Associated With MBSR Intervention Effects?

A second purpose of this study was to examine whether the MBSR intervention is

associated with increases in mindfulness and if so, whether the positive outcomes of MBSR participation were related to increases in mindfulness occurring over the course of the program. Table 1 shows, using a mixed fac- torial ANOVA, that MBSR participants showed significant prepost course increases in mindfulness relative to control group participants.

To test whether prepost change in mindful- ness predicted prepost change in each of the well-being/distress outcomes for the MBSR group, simple regression models were con- structed. Residualized change scores were first calculated on MAAS mindfulness and on each outcome variable (Cohen & Cohen, 1983; Judd & Kenny, 1981). In this pretreatment of the data, Time 2 scores were adjusted for their Time 1 values, so that only variance in residual change in the outcome variables was left to be explained by residual change in the mindfulness predictor. Age was not related to any of the outcome change scores so was not included as a predictor in the models. Table 2 displays the results of the regression analyses. Across the seven distress and well-being outcomes, signif- icant relations between change in mindfulness and change in outcome were found in four mod- els. Specifically, an increase in mindful atten- tion and awareness from pre- to postinterven- tion predicted a drop in rumination, trait anxi- ety, and perceived stress, and an increase in self-compassion. No predictive effects were

Table 1 Mean Scores by Group, Pre-Course (Time 1) and Post-Course (Time 2), and MBSR Intervention Effects

Variable

MBSR Control

pinterTime 1 Time 2 Time 1 Time 2 M (SD) M (SD) M (SD) M (SD)

PANAS positive affect 4.87 (0.75) 5.45 (0.94) 5.14 (0.74) 4.90 (0.95) .0002 PANAS negative affect 3.09 (0.90) 2.55 (1.01) 3.04 (1.03) 2.99 (0.89) .04 STAI anxiety, present 3.17 (1.19) 2.18 (1.09) 2.67 (1.11) 2.76 (1.01) .0005 STAI anxiety, past month 3.43 (0.90) 2.51 (0.77) 3.33 (1.05) 3.44 (1.14) .0002 PSS perceived stress 24.64 (7.81) 18.36 (5.15) 21.72 (7.14) 22.91 (7.54) .0001 RRQ rumination 3.42 (0.83) 2.78 (0.63) 3.15 (0.92) 3.11 (0.90) .0006 SCS self-compassion 18.06 (3.97) 20.92 (3.84) 19.41 (3.75) 19.22 (4.12) .0001 MAAS mindfulness 3.76 (0.80) 4.01 (0.51) 4.05 (0.64) 3.80 (0.62) .006

Note. n � 22 in MBSR group; n � 32 in control group. The pinter column shows the ANOVA Group � Time Interaction Significance Levels. RRQ � Reflection Rumination Questionnaire; PANAS � Positive Affectivity Negative Affectivity Schedule; STAI � State/Trait Anxiety Inventory; PSS � Perceived Stress Scale; SCS � Self-Compassion Scale; MAAS � Mindful Attention Awareness Scale.

110 SHAPIRO, BROWN, AND BIEGEL

found in positive and negative affect and state anxiety, all ps � .05.

Is Mindfulness Practice Time Associated With MBSR Intervention Effects?

A final purpose of the study was to determine whether amount of time spent in four mindful- ness practices was related to the well-being and distress outcomes. On average, participants in the MBSR intervention reported spending 55.92 minutes per week (SD � 50.09) in all forms of mindfulness practice. The most common prac- tice reported was informal practice (M � 60.41 min, SD � 62.74), followed by the body scan (M � 57.10 min, SD � 34.68), hatha yoga (M � 54.56 min, SD � 138.71), and then sitting meditation (M � 51.61 min, SD � 32.14). Re- peated measures analyses of variance (ANOVA) tested the effects of the mean num- ber of weekly minutes of mindfulness practice on prepost intervention changes in distress and well-being. No significant effects of total weekly mindfulness practice time over the 8 weeks of the MBSR program on prepost inter- vention changes in distress and well-being were found (all ps � .05). ANOVAs based on prac- tice time over 8 weeks in each of the four practices separately also failed to reveal signif- icant effects on prepost MBSR changes in dis- tress and well-being (all ps � .05).

Discussion

Preparation for the role of therapist can occur on both professional and personal levels. Re-

search suggests that therapists, like other help- ing professionals, are at risk for stress-related psychological problems (e.g., Dryden, 1995). Although sources of stress are well-studied in mental helping professionals, implementation of stress management interventions for this pop- ulation is lacking (e.g., Edwards, Hannigan, Fothergill, & Burnard, 2002). Training in self- care may be a useful complement to the profes- sional training of future therapists (e.g., Baker, 2003), and the present study was designed to examine the mental health effects of one ap- proach to self-care, based on the cultivation of mindfulness, for therapists in training.

In support of our primary hypothesis, this study found that a mindfulness-based stress re- duction (MBSR) program was associated with improvements in graduate counseling psychol- ogy students’ mental health. Compared to co- hort controls, students in the MBSR program reported significant prepost course declines in perceived stress, negative affect, state and trait anxiety, and rumination, and significant in- creases in positive affect and self-compassion. These findings suggest that MBSR may not only lower stress and distress but also enhance the ability to regulate emotional states, as re- flected in the declines in rumination. This may be important in warding off depressive states (Nolen-Hoeksema, Morrow, & Frederickson, 1993). In addition, the increases in self- compassion are particularly relevant to the field of counseling and therapy, as compassion for self, as well as for clients, has been posited as an essential part of conducting effective therapy (Gilbert, 2006). Research demonstrates that

Table 2 Simple Regression of Pre- to Post-Intervention Residual Change in Study Outcomes on Pre- to Post- Intervention Residual Change in Mindfulness (MAAS)

Outcome

Parameter estimates

B SE �

RRQ rumination �.56 .18 �.57**

PANAS positive affect .25 .25 .22 PANAS negative affect �.06 .38 �.03 STAI anxiety, present .59 .41 .31 STAI anxiety, past month �.79 .29 �.52**

PSS perceived stress �5.56 1.49 �.65***

SCS self-compassion 2.95 .94 .58**

Note. n � 22. MAAS � Mindful Attention Awareness Scale; RRQ � Reflection Rumination Questionnaire; PANAS � Positive Affectivity Negative Affectivity Schedule; STAI � State/Trait Anxiety Inventory; PSS � Perceived Stress Scale; SCS � Self-Compassion Scale. ** p � .01. *** p � .001.

111SELF-CARE TRAINING FOR CAREGIVERS

therapists who lack self-compassion and are critical and controlling toward themselves, are more critical and controlling toward their pa- tients and have poorer patient outcomes (Henry, Schacht, & Strupp, 1990). In general, the present results support past research on the mental health benefits of MBSR for helping professionals and trainees (Cohen-Katz et al., 2005; Rosenzweig et al., 2003; Shapiro et al., 1998; Shapiro et al., 2005), while further sug- gesting that MBSR may have broad-based ef- fects on a number of cognitive and affective qualities relevant to mental health.

Supporting our second hypothesis, this study found that MBSR participation increased levels of mindfulness. It has been assumed that MBSR enhances mindfulness because this is the focus of the program. However, to date, only one published study has demonstrated that MBSR participation is associated with significant in- creases in mindfulness (Cohen-Katz et al., 2005). Further, we tested, and found partial support for our third hypothesis, namely that increases in mindfulness were related to the beneficial effects of MBSR on mental health. Increases in mindful attention and awareness were associated with declines in perceived stress, anxiety, and rumination, and increases in self-compassion. These findings provide sup- port for the claim (Shapiro, Carlson, Astin, & Freedman, 2006) that mindfulness is a central feature of MBSR that is related to the positive outcomes of the program. This latter result also supports past MBSR research showing that in- creases in MAAS-measured mindfulness are re- lated to mental health enhancement (Brown & Ryan, 2003). Together, these results suggest that the enhancement of mindfulness that is foundational to MBSR instruction may be at least partially responsible for its beneficial effects.

Although not hypothesized, this study exam- ined whether the amount of mindfulness prac- tice over the course of the MBSR program was related to changes in psychological distress and well-being. No significant relations were found, a finding of other research as well (e.g., Davidson et al., 2003). The experiential practice of mindfulness skills is an important component of the MBSR program and is believed to carry some of the responsibility for its benefits. The sample in the present study was not large, and this may have inhibited our ability to detect

significant effects for practice time. Also, the average weekly time spent in mindfulness prac- tice was quite limited, and the effects of practice on psychological outcomes may only appear when some critical threshold of practice time has been met. In this regard, it is notable that in Carson et al.’s (2004) study showing that the amount of mindfulness practice was related to a number of intrapersonal and interpersonal out- comes, the average participant practiced 32 minutes per day (224 min per week), 4 times more than the average participant in the present study. That said, it is likely that quality of practice time is potentially as relevant to out- comes as the quantity thereof.2 This issue de- serves consideration in future research.

The study findings suggest implications for further research on therapist trainee self-care. Graduate counseling and other mental health care training programs are challenged to find ways to support the health and well-being of students while offering professional training in therapy knowledge and skills (Shapiro, Shapiro, & Schwartz, 2000). That the introduction of a brief mindfulness-based intervention into the graduate curriculum demonstrated a number of mental health benefits in this study suggests that research should further explore the utility of MBSR and other awareness-based self-care programs as a complement to core trainee curricula.

Limitations and Future Research

The present study was limited in several ways and suggests several possibilities for future re- search. Most notably, this study was not a ran- domized trial. The study was cohort-controlled, as all participants were graduate counseling psychology students. No meaningful differ- ences between MBSR and control group partic- ipants were found at baseline, but the lack of randomization did not allow us to control for potential motivational differences that may have affected course selection and subsequent experience. For example, all three courses were required for the minor in health psychology, but only the control group courses were required for the general MA in counseling psychology.

2 We thank an anonymous reviewer for pointing out this distinction.

112 SHAPIRO, BROWN, AND BIEGEL

Therefore, the majority of students in the Stress Management course likely had a particular in- terest in health psychology that may have led to motivational differences from those taking the control group courses. However, motivation or expectation can create or exacerbate group dif- ferences when intervention and active control group programs are structurally divergent (Baskin, Tierney, Minami, & Wampold, 2003), and in this regard it is notable that the MBSR and control group courses in this study were structurally equivalent in course modality, in- structor attention, and both weekly class time and total course duration. However, research using randomized controlled study designs would help to control for potential motivational effects.

The sample sizes in the present study were relatively small, and research using larger sam- ples is required to test the reliability of the results found here. Also, most participants were women, and it is possible that men and women may respond differently to the MSBR program, although no evidence for gender differences has been reported in past research. Another limita- tion in generalizability is that all participants were students in a small private graduate pro- gram. These results might not apply to doctoral students or to students at larger and/or public universities. Future research could explore the effects of MBSR with other graduate psychol- ogy populations and in clinical training sites, where the effects of MBSR participation on clinician-client interaction and therapy out- comes might be explored.

Finally, future research would do well to in- clude follow-up assessments to determine whether the positive effects of the MBSR pro- gram found here are lasting. It would be espe- cially useful to know whether MBSR participa- tion, and the enhancement of mindfulness that appears to be achieved through the program, can help to inoculate beginning counselors and therapists against the stresses of their new de- manding profession. The effects of mindfulness training on positive affect and self-compassion found here may help to enhance professional skills, reflected in a greater kindness toward, and acceptance of clients and patients, and this could also be explored in future research. Future longitudinal research could help to answer these questions.

Conclusion

Recent years have witnessed an increase in the number of educational programs designed to train the “whole person,” many of them using contemplative methods (Garrison Institute, 2005). Yet research to determine the specific benefits and applications of such methods has only begun. We believe that individuals training for demanding helping professions may repre- sent a particularly suitable population for in- struction in such methods. The present study found that one contemplative approach, based on the cultivation of mindfulness, had mental health benefits for therapists in training. It is hoped this study will help to build a foundation for future research investigating a variety of potential benefits of mindfulness training for prospective therapists.

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Received June 26, 2006 Revision received December 18, 2006

Accepted December 18, 2006 �

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