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Teaching Counselors Self-Care Through Mindfulness Practices


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Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, gong, and conscious relaxation exercises). Three methods of evaluating this 15-week 3-credit mindfulness-based stress reduction (MBSR) course for counseling students indicated positive changes for students in learning how to manage stress and improve counseling practice. Students reported positive physical, emotional, mental, spiritual, and interpersonal changes and substantial effects on their counseling skills and therapeutic relationships. Information from a focus group, qualitative reports, and quantitative course evaluations were triangulated; all data signified positive student responses to the course, method of teaching, and course instructor. Most students reported intentions of integrating mindfulness practices into their future profession.
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Teaching Counselors Self-Care Through
Mindfulness Practices
Montana State University
Few counseling programs directly address the importance of self-care in reducing
stress and burnout in their curricula. A course entitled Mind/Body Medicine and the
Art of Self-Care was created to address personal and professional growth opportu-
nities through self-care and mindfulness practices (meditation, yoga, qigong, and
conscious relaxation exercises). Three methods of evaluating this 15-week 3-credit
mindfulness-based stress reduction (MBSR) course for counseling students indicated
positive changes for students in learning how to manage stress and improve coun-
seling practice. Students reported positive physical, emotional, mental, spiritual, and
interpersonal changes and substantial effects on their counseling skills and thera-
peutic relationships. Information from a focus group, qualitative reports, and quan-
titative course evaluations were triangulated; all data signified positive student
responses to the course, method of teaching, and course instructor. Most students
reported intentions of integrating mindfulness practices into their future profession.
Faculty in counseling training programs often voice the importance of self-
care in reducing stress and burnout for students during and after their
graduate training, but few programs specifically address this issue in their
curricula. To address this perceived need, a course was developed to pro-
vide students with personal and professional growth opportunities through
self-care and mindfulness practices. Course methods included participation
in experiential and academic activities. A focus group, qualitative reports,
and quantitative course evaluations were used to assess course impact on
Although burnout is a broad notion within American society, it was orig-
inally coined to refer to the physical and emotional exhaustion that can
occur for human service providers. Moore and Cooper (1996) found that
mental health professionals suffer from both emotional exhaustion and the
Teachers College Record Volume 108, Number 9, September 2006, pp. 1881–1900
Copyright rby Teachers College, Columbia University
usual organizational sources of stress. Baker (2003) described the potential
for compassion fatigue and vicarious traumatization for these workers.
These stressors may have harmful effects on counseling students’ effective-
ness and success by reducing their capacity for attention, concentration, and
decision-making (Shapiro, Shapiro, & Schwartz, 2000). According to Moore
and Cooper (1996), mental health professionals in particular are subject to
severe levels of stress due to working in an emotionally exhaustive envi-
ronment. Learning to deal with stress and forestall burnout is a critical
dimension of professional development.
Self-care practices are self-initiated behaviors that promote good health
and well-being (Bickley, 1998). The importance of providing counselors
with tools for self-care while they are being trained and early in their ca-
reers has been increasingly recognized (Baker, 2003; Brems, 2001; Kuyken,
Peters, Power, & Lavender, 2003; Weiss, 2004); however, the demands of
the curricula and clinical training often leave little room for directly teach-
ing these strategies, and it is viewed as the individual responsibility of the
individual student to engage in these practices. The quality of training
programs is compromised if the rhetoric of practitioner growth, develop-
ment, and self-care is not matched by specific means for trainees to learn
and practice methods of self-care.
A perceived need in counselor training led the instructor (J. C. Christ-
opher) to develop a graduate course entitled Mind/Body Medicine and the
Art of Self-Care. The goals of the course were to familiarize students in an
accredited counseling program with mindfulness practices and their rele-
vance to counseling and to provide students with methods for self-care and
the prevention of burnout. The underlying philosophy behind the course
was derived from the Mindfulness-Based Stress Reduction (MBSR) Pro-
gram developed by Jon Kabat-Zinn (1990) at the University of Massachu-
setts Medical Center in 1979. The central tenet of Kabat-Zinn’s program is
mindfulness, a Buddhist concept based on cultivating awareness ‘‘with the
aim of helping people live each moment of their lives—even the painful
ones—as fully as possible’’ (Kabat-Zinn, 1993, p. 260). In contrast with re-
laxation training—in which the ultimate goal is to replace a less desirable
physical and mental state, such as anxiety, stress, fear, or pain with a more
desirable state, like calm, relaxation, or peace—the ultimate aim of mind-
fulness practices is to be present to whatever our experience is at the mo-
ment. As Kabat-Zinn (1993) observed, ‘‘acknowledging present-moment
reality as it actually is, whether it is pleasant or unpleasant, is the first step
towards transforming that reality and your relationship to it’’ (p. 261).
The extensively researched MBSR program has been used with over
10,000 medical patients and has been found to be beneficial for a variety of
medical conditions, including chronic pain, heart disease, gastrointestinal
disorders, anxiety, depression, and extreme skin conditions (Kabat-Zinn,
1882 Teachers College Record
1982; Kabat-Zinn & Chapman-Waldrop, 1988; Kabat-Zinn, Lipworth, &
Burney, 1985; Kabat-Zinn et al., 1992; Kabat-Zinn et al., 1998). Other
mindfulness-based studies have demonstrated improvements in quality of
life, health-related quality of life, general health, sleep quality, and immune
function, and decreases in psychological distress and physical symptoms
and conditions (Carlson, Speca, Patel, & Goodey, 2004; Davidson et al.,
2003; Lawson & Horneffer, 2002; Roth & Robbins, 2004; Williams, Kolar,
Reger, & Pearson, 2001).
One of the strengths of MBSR, in contrast to most stress reduction pro-
grams, is that participants are exposed to three different forms of practice:
yoga, meditation, and a body-scan awareness exercise. Research indicates
that participants often find one of the three practices more beneficial or
preferred for personal reasons (Kabat-Zinn, Chapman, & Salmon, 1997).
Kabat-Zinn and colleagues found that individuals who experience anxiety
somatically (e.g., physical symptoms such as gastrointestinal distress) prefer
meditation, while those who experience anxiety cognitively (e.g., racing
thoughts) prefer yoga (Kabat-Zinn et al., 1997). Therefore, various practices
are available in MBSR to best meet the physical, affective, and cognitive
needs of the individual. This may help to explain why MBSR has been
found to have high compliance rates, even after 3 years (Kabat-Zinn &
Chapman-Waldrop, 1988; Miller, Fletcher, & Kabat-Zinn, 1995).
Recently, researchers have been evaluating MBSR as a tool for helping
university students, especially allied health students, cope with stress. Sta-
tistically significant results from a controlled study of undergraduate stu-
dents showed that MBSR participants had decreased levels of depression
and anxiety and had a greater sense of control and adaptability skills (Astin,
1997). Shapiro, Schwartz, and Bonner (1998) found similar reductions in
state and trait anxiety, and increased scores on measures of spiritual ex-
perience and empathy in an 8-week MBSR program with medical and
premedical students. Another study with medical students found a signif-
icant decrease in total mood disturbance among participants as compared
with a control group (Rosenzweig, Reibel, Greeson, Brainard, & Hojat,
2003). Bruce, Young, Turner, Vander Wal, and Linden (2002), using both
quantitative and qualitative methods, found that an 8-week MBSR program
for nursing students decreased psychological symptoms and, to a lesser
degree, physical symptoms; increased health-related quality of life; and
enhanced awareness of physical, emotional, and mental responses to stress,
such as new abilities to ‘‘let go’’ of stress, and decreased feelings of being
rushed or disoriented. Given the focus of counseling programs, it was
Teaching Counselors Self-Care Through Mindfulness Practices 1883
surprising to find no published studies that examined the application of
mindfulness practice to counseling curricula or students, apart from our
own recent research (Christopher et al., in press; Schure, Christopher, &
Christopher, in press).
Unlike the above studies, the course described in this article is not a sup-
plemental 8-week program, but a semester-long (15 weeks) 3-credit elective
course integrated into the curriculum that not only teaches techniques for
stress reduction but also directly addresses the issue of how mindfulness
practice and transformation can be integrated into the students’ clinical
practice. The two primary goals of personal and professional growth are
operationalized through six course objectives: (1) to provide students with
techniques and skills for self-care, (2) to foster students’ understanding of
indigenous traditions of contemplative practice from both Eastern and
Western cultures, (3) to foster students’ awareness of mind/body medicine
and contemporary attempts to adapt contemplative practice to health care,
(4) to foster students’ awareness of mind/body research regarding the ef-
fectiveness of contemplative practice in behavioral medicine, (5) to foster
students’ awareness of ethical considerations in the application of mind/
body medicine, and (6) to foster students’ awareness of the impact of cul-
ture, especially cultural understandings of well-being, on the counseling
process. Consequently, the course is interdisciplinary in nature, drawing on
source materials from behavioral medicine, religious studies, psychological
and medical anthropology, cross-cultural psychology, and psychiatry (see
the appendix for course readings). The course entails both academic and
experiential learning.
The course is taught by a core faculty member of a counseling graduate
program accredited by the Council for Accreditation of Counseling and
Related Educational Programs (CACREP). The instructor is a licensed
counselor and psychologist who has been a licensed yoga teacher and
meditation practitioner for over 20 years. He began teaching MBSR in a
community hospital 2 years prior to developing and teaching the course.
The experiential component of the class is loosely based on Kabat-Zinn’s
(1990) MBSR program. The course meets twice a week and includes 75-
minute mindfulness practice using hatha yoga, sitting meditation, qigong
(an ancient Chinese practice for cultivating health), and conscious relaxa-
tion techniques. Participants are required to practice outside class for at
least 45 minutes four times a week. Students meet once a week in pairs to
process their practice activity during the semester. The academic compo-
nent of the course includes an introduction to readings about the
1884 Teachers College Record
mindfulness practices (including both authors indigenous to the specific
traditions and contemporary Western interpreters), applications to psycho-
therapy and behavioral medicine, and current research. Students present
four 15-minute overviews of self-selected empirical research on aspects of
mind/body medicine, and each student is responsible for cofacilitating a
discussion of the readings twice during the semester. An important feature
of the course is an intellectual and experiential journal intended to provide
students with the opportunity to process and discuss both their reaction to
the concepts in the readings and the contemplative practices. A minimum of
60 typed journal pages must be completed by the end of the semester.
Students are graded on attendance and participation, journal writing, and
research presentations.
To assess the impact of the course, three methods of evaluation were used: 4
years of quantitative course evaluations, a focus group, and 4 years of
qualitative reports. The results from the focus group and qualitative reports
are summarized from recently published research articles (Christopher et
al., in press; Schure et al., in press).
Quantitative course evaluation scores based on the Aleamoni Course/In-
structor Evaluation Questionnaire indicated positive student responses to
the course, method of teaching, and course instructor. Table 1 indicates the
scores received on a 4.0 scale in the five domains of Attitude, Method,
Content, Interest, and Instructor. The Overall category indicates the aver-
age/mean score of each year the course was taught, and the Mean indicates
the average of each domain.
According to Aleamoni (personal communication, September 28, 2005),
the categories General Course Attitude, Method of Instruction, Course
Table 1. Aleamoni Scores
Year Attitude Method Content Interest Instructor Overall
1 4.00 3.88 3.85 3.92 3.86 3.90
2 3.95 3.90 3.70 3.60 3.96 3.83
3 3.85 3.70 3.63 3.65 3.70 3.70
4 3.56 3.34 3.66 3.47 3.75 3.57
Mean 3.84 3.71 3.71 3.66 3.82 3.75
Note. Scores from 3.0 to 3.59 are considered by department standards to ‘‘exceed
expectations,’’ and those between 3.60 and 4.0 are considered ‘‘extraordinary.’’
Teaching Counselors Self-Care Through Mindfulness Practices 1885
Content, Interest and Attention of Students, and Instructor were factor
analytically determined subscales resulting in four items comprising each of
the subscales except for the Instructor subscale, which has five items. The
General Course Attitude subscale represents the students’ overall percep-
tion of the course, taking into account all the elements that they have been
exposed to over the duration of the course. The Method of Instruction
subscale represents the students’ perception of how the course was taught,
taking into account all the elements that relate to presentation of the subject
matter and involvement of students in the learning process. The Course
Content subscale represents the students’ reactions to the course material,
including textbooks and examinations. The Interest and Attention subscale
represents the students’ perception of how well the course and instructor
were able to hold their interest and attention during the class sessions. The
Instructor subscale represents the students’ perception of the instructor’s
manner, personality, attitude, and effectiveness in the classroom.
According to the evaluative scores, students found the course to be con-
sistently effective in the five primary domains of Attitude, Method, Content,
Interest, and Instructor over a 4-year period. These quantitative results are
consistent with the positive data gathered via written and spoken evalua-
tions as summarized in the next two sections.
A focus group was used to evaluate the fourth year of the course near the
conclusion of the semester. Focus group research is a qualitative-data-gath-
ering method that allows researchers to gain a variety of perspectives (Pat-
ton, 2002) and has been shown to be a useful tool in gathering evaluative
data from students (Christopher, 2000). A moderator’s guide was developed
largely based on the descriptions provided through a six-volume focus
group instructional series (Morgan & Krueger, 1998). The guide included
the purpose of the focus group, probing ideas, a brief listing of group
control and facilitation techniques, and a list of questions for discussion. The
questions were open-ended and included, Why did you take this course?
What is the first thing that comes to mind when you consider the course?
What do you like most about the class? What do you like least about the
class? Discuss the strengths and weaknesses associated with the class or-
ganization. Would you like to make any other comments?
The focus group was conducted with 11 participants, ranging in age
from early 20s to mid-50s, who were first- and second-year master’s-level
graduate students in mental health counseling, school counseling, and
family counseling. The focus group was tape recorded, and field notes were
taken during and immediately after the session was completed. The tape
1886 Teachers College Record
was transcribed verbatim, and inductive content analysis was used to iden-
tify the primary themes in the data (Patton, 2002; Strauss & Corbin, 1990).
Students found the class to be of high quality and a valuable growth
experience both personally and professionally. Suggestions were made
about how the course could be improved; however, none of the themes
demonstrated any problems of substance associated with the class. Results
are summarized by question asked.
Why Did You Take This Course?
Students indicated that they wanted to learn more about the mind-body
connection in depth; several had heard about or tried some mind-body
practices (e.g., yoga) and how to manage their stress and use relaxation
techniques with clients. Several students mentioned taking the class for
themselves because they had heard that self-care techniques would be
practiced in class. One student thought that the course would be easy, but
experienced significant personal growth, realizing that he or she had been
avoiding looking at certain psychological issues by staying busy.
What Is the First Thing That Comes to Mind When You Consider the Course?
The students described various changes as a result of taking the course,
including physical, emotional, mental, and spiritual changes. Several stu-
dents indicated that it was refreshing to have a class that was taught in a
nontraditional format. Students also described being more patient, aware,
conscious, and able to focus. One student described a new ability to recen-
ter, stating, ‘‘Focusing on things that . . . are in the present, and not nec-
essarily stressing out about things that are in the future or things that have
already happened . . . just focusing on what’s real instead of letting the stress
overwhelm me.’’
The students talked about significant personal changes and how these
changes influenced therapy with clients. One student mentioned that being
able to be present with themselves allowed them to transfer that presence to
the therapeutic environment. Another student noted that they were able to
gain a greater connection to those around them, including clients, instead
of being hurried and defensive.
What Do You Like Most About the Class?
Several students commented on the instructor, indicating that they enjoyed
his manner, the fact that he was emotionally present and available, that he
Teaching Counselors Self-Care Through Mindfulness Practices 1887
‘‘walks his talk’’ in terms of practicing mindfulness himself, and that he was
willing to deviate from the syllabus to teach areas in which the students
indicated interest. The students also brought up that they enjoyed the
What Did You Like Least About the Class?
Opinions varied regarding how many practices should be reviewed during
the semester; some would have preferred exposure to more practices, while
others preferred learning fewer practices in more depth. Students also had
differing preferences regarding the 60 typed pages of journal writing re-
quired over the semester that summarized their reactions to course read-
ings and their personal practice. Some students disliked the assignment and
the required minimum of pages, and some disliked having to word-process
their journals. Others disagreed, stating that there were many benefits from
journal writing.
The students differed in opinion regarding the required four presen-
tations on scientific articles during the semester; some thought it was too
many presentations, some disliked that the presentations had to be scien-
tifically based, and some had difficulty finding research-based articles on
course topics. Others disagreed, indicating that the assignments would al-
low them to convince future employers that mindfulness has growing em-
pirical support for its effectiveness in treating various mental health issues.
Discuss the Strengths and Weaknesses Associated With the Class Organization
Students responded that the course was not tightly organized, indicating
that this was good for some students and not good for others. One student
thought that the lack of structure prevented them from feeling properly
prepared for class, while other students thought that the structure fit into
the course objectives and was congruent with the goal of staying present.
One student commented that by not cutting things off unnaturally, it al-
lowed conversations to develop more deeply.
Would You Like to Make Any Other Comments?
Finally, students were asked to provide additional feedback. Many students
were concerned that the course might not be taught annually, indicating
that this would be a ‘‘big error,’’ and that the course should be required for
all counseling students. They felt that the course had positive implications
1888 Teachers College Record
for counseling, indicating that they had new control over their bodies and
breath, allowing them to be more present and less anxious with clients. One
student elaborated,
In a lot of ways, I feel like this was the most important class I’ve taken,
just learning to be present in a different way. It has huge implications
in the counseling area . . . I have this new control over my body where
I can like, take a breath, and it’s a different kind of breath than [I] ever
knew how to take, and feel like, oh, I feel calmer now, and I feel
centered, and in control of my body and I can be present to this
person instead of being anxious inside. It’s just huge.
Narratives (i.e., oral accounts and journals) offer a unique avenue of inquiry
into an individual’s or a group’s experience (Giorgi, 1985; Patton, 1999;
Van Manen, 1990) and address the limitations of quantitative research,
which relies on preselected measures and scales. Using qualitative analysis
of journal entries, the influence of the course Mind/Body Medicine and the
Art of Self-Care on counseling students was explored across four different
cohorts of students. As a final journal assignment, students were given four
questions to respond to and submit in writing:
1. How has your life changed over the course of this semester in ways
that may be related to the class?
2. Of all the practices learned in class, which one are you drawn to the
most and why? How has it impacted you?
3. How, if at all, has this course impacted your work with clients, both
in terms of being in the room and thinking about the treatment?
4. How do you see yourself integrating, if at all, any of the practices
from class into your clinical practice (or career plans)?
Participants were 33 first- and second-year master’s-level graduate students
in mental health, marriage and family, and school counseling, ranging in
age from early 20s to mid-50s, enrolled in Mind/Body Medicine and the Art
of Self-Care over 4 years. There were 27 females and 6 males; 30 were
White, 2 were Japanese, and 1 was Native American. Students received no
direction regarding the length of their answers and were informed that
completing the assignment would result in a passing grade. No student
chose to withhold his or her data from the study.
Teaching Counselors Self-Care Through Mindfulness Practices 1889
Students turned in their responses, which were stored anonymously,
entered verbatim into word-processing software, and analyzed using NVivo
qualitative data analysis software (QSR NVivo version 1.2). Responses to the
four questions were analyzed qualitatively, as described by Guba and Lin-
coln (1992), Strauss and Corbin (1994), and Patton (1987, 2002). Responses
from each question were analyzed using cross-case analysis (Huberman &
Miles, 1994). Analysis was focused on the participant’s responses to the four
open-ended questions, and data were analyzed inductively; hence, themes
emerged from the data instead of being decided a priori (Patton, 1987). A
second researcher coded a random 10% of the texts to ensure validity and
congruence. No notable differences were found in participant responses
across the 4 years. Results are summarized by question asked.
Question 1: Short-Term Impacts of Course
Five themes emerged in response to how the course had an impact on
students: (1) physical changes, (2) emotional changes, (3) attitudinal or
mental changes, (4) spiritual awareness, and (5) interpersonal changes.
1. Physical changes. Participants experienced a variety of physical effects:
(1) improvements in balance, strength, and flexibility; (2) other health ben-
efits associated with practice; and (3) increased bodily awareness and sen-
sitivity. One student noted increased leg strength, flexibility, and balance in
one leg with nerve damage, and weight loss. Some students indicated that
their bodies initially reacted negatively to practice, but that ultimately they
saw positive outcomes as a result of committing themselves to their practice.
Several students mentioned how their increased awareness of the body, and
its connectedness with the mind, has enabled them to take better care of
themselves. One student described, ‘‘As far as physical ailments, I feel as if I
know my body a lot better and I am able to recognize when I am starting to
feel ill and then I slow down and take care of myself.’’
2. Emotional changes. Students commonly mentioned having to deal with
multiple stressors in their lives and the resulting consequences of stress
overload (e.g., anxiety, depression, fears). One student described, ‘‘This
course has given me the time, space and urging to increase awareness, slow
down and be more present, and to continue to let go of fears, anxiety, self-
criticism, and doubt. . .allowing me to just be in the moment, feel, accept,
and trust.’’ The majority of students reported that as a result of the course,
they developed an increased ability to deal with strong and threatening
emotions while increasing their feelings of trust and peace in the present
1890 Teachers College Record
3. Attitudinal and mental changes. Students indicated an increased capacity
to make meaningful reflections regarding themselves and reported feeling
more ‘‘open’’ and ‘‘conscious’’ of themselves and their surroundings. One
student stated, ‘‘I am opening myself up to see beyond the grind toward
alternative ways of living and thinking.’’ Related to self-understanding, ac-
ceptance (e.g., of the ‘‘flawed self ’’) was a common term used by students to
express changes in attitude and perception.
4. Spiritual awareness. The course discussions had a profound effect on
some students’ lives by challenging them to reflect on their belief systems
and values, and their direction and purpose in life. One student stated,
‘‘This class has also led me to explore my own belief system and has ex-
panded my knowledge about differing views of the world, life and spirit-
uality.’’ Students reported being challenged to look at their worldview,
sense of spirituality, and what kind of person they want to become. Con-
sequently, the exploration of self instilled in some students a greater sense
of confidence and trust.
5. Interpersonal effects. Many students reported interpersonal changes
regarding their ability to handle social situations to which they might nor-
mally react negatively, learning to take responsibility for their own feelings
and to not take things personally. Several students perceived positive effects
on their relationships as a result of an increased capacity for empathy and
compassion toward self and others, and one student explained, ‘‘I have a
notion this is the result of becoming aware when I am being judgmental of
others or myself.’’
Question 2: Preferred Practices for Self-Care
Yoga, meditation, and qigong were the main practices taught in the course.
Students were asked their preferred practice and why. In their responses to
this question, many students selected more than one practice as their pre-
ferred practice. Twenty-five students indicated a preference for yoga, 16 for
meditation, and 11 for qi gong. Results are summarized under each practice
1. Yoga. Hatha yoga offered multiple benefits to students in the course,
including opportunities for participants to become more aware of their
bodies and connect with its gentle yet demanding physical postures. Yoga
Teaching Counselors Self-Care Through Mindfulness Practices 1891
offered several perceived benefits, including increased consciousness of
one’s body, satisfaction from challenging one’s self physically, and increased
energy, flexibility, mental clarity, and concentration. One student explained,
I have said before that yoga is an amazing high-yield investment. The
investment of an hour a day makes an immeasurable difference in the
rest of my day. For a little investment, I receive high yields. This
includes high energy, fluidity, and mental clarity. This baseline allows
me to relate better to other people and especially relate to my clients.
2. Meditation. Similar to yoga, meditation provided distinct benefits to
students in the course. Many students mentioned that paying attention to
arising thoughts and emotions in meditation was emotionally and mentally
involving. One individual mentioned that meditation allowed space to deal
with difficult emotions that arose and created a ‘‘therapy room’’ in which
feelings could be observed from a more objective position. Another student
mentioned the impact of meditation on the student’s self-concept, and an
increased ability to be patient and tolerate physical discomfort. Meditation
offered a tool for dealing with powerful emotions, and for certain students,
this led to greater self-acceptance and insight about themselves. One stu-
dent mentioned, ‘‘I have found myself face to face with my inner issues
while meditating, which has been powerful. I have felt not only the struggle
with them, but more of an acceptance of them.’’
3. Qigong. Qigong had positive impacts on several students, affecting
mood, emotion, and consciousness. One student compared its qualities to
dancelike movements and acknowledged its ability to change breath, mood,
energy, and awareness. Compared with the other practices, qigong’s gentle
movements evoked a sense of fluidity from which positive feelings and
energy flowed. Another student said, ‘‘I feel the conscious connection of my
mind, body, and emotions, and that emotional component is of great im-
portance to me.’’
Question 3: Influence on Counseling Practice
Students who took the course were seeing clients in a supervised clinical
setting. The course influenced students’ therapy practice in several ways,
including an increased comfort with silence, an ability to focus more on
their clients and the therapeutic process, and a changed view of therapy and
the healing process.
1892 Teachers College Record
1. Increased comfort with silence. Many students acknowledged an in-
creased ability to be with clients in moments of silence or discomfort without
needing to react or control the situation because of their own anxiety. One
student explained how an increased comfort with silence allowed the stu-
dent to be more present with the client’s experience, without having the
urge to fix or change the client’s feelings: ‘‘I am more comfortable with
listening, sitting in silence, and just being present.’’
2. More attentive to therapy process. Several students described an increased
ability to be attentive and responsive to their clients. One student indicated
that the course decreased her anxiety and allowed her to develop a more
objective view of her clients and the therapeutic relationship: ‘‘I think that
being mindful and more ‘centered’ allows me to look outside myself more,
and observe my clients and my relationship with them more.’’ Other par-
ticipants noted that they were now in a better position to help clients con-
nect with their feelings, needs, defenses, and coping mechanisms because
they were better able to do this for themselves and hence provided a model
for their clients.
3. Change in how therapy is viewed. The course significantly influenced
several students’ attitudes and ideas about counseling. For example, one
student recognized the roles of both physical and spiritual dimensions in
the nature of well-being and the possible benefit of exploring this with
Question 4: Plans for Integrating Mindfulness Into Future Practice
Many students indicated that they would use the ideas and practices learned
in class and apply them to their profession. Some students wanted to in-
tegrate specific practices, such as relaxation and meditation techniques, into
therapy sessions with clients who are anxious or depressed, or who have
chronic pain. Other students indicated wanting to incorporate the philos-
ophy of these meditative practices in therapy, allowing clients the space to sit
and see what arises. Yet another group of students were more comfortable
suggesting certain practices to clients as a means of empowering them to
cope with personal struggles.
The combination of a focus group, qualitative reports, and quantitative
evaluations indicated a favorable response to the course Mind/Body Med-
icine and the Art of Self-Care. Overall, students reported positive physical,
Teaching Counselors Self-Care Through Mindfulness Practices 1893
emotional, mental, spiritual, and interpersonal changes, and substantial
effects on their counseling skills and therapeutic relationships. Students
gave overwhelming praise to both the course and the instructor.
Students indicated that they enrolled in the course to learn about the
mind-body connection, self-care techniques, and ways of applying these
techniques with clients, which closely match the curricular goals of the
course. Students acknowledged the significant impact of the course on their
personal and professional lives. Overall, students found that they increased
their awareness/consciousness and their ability to focus and stay present as a
result of the course, which are desired effects of MBSR programs (Kabat-
Zinn, 1990). Several students reported feeling better equipped, both emo-
tionally and mentally, to deal with daily stress in their lives, which supports
similar results from related studies with college students (Astin, 1997; Bruce
et al., 2002; Shapiro et al., 1998).
Regarding physical effects, student responses supported the idea that
yoga and qigong promote flexibility, strength, and balance, and increased
immune functioning and resistance to sickness, which suggests that mind-
fulness practices may improve immune systems, as reported by Davidson et
al. (2003). Students also expressed an increased awareness of and sensitivity
to their bodies, which is congruent with findings in Bruce et al.’s (2002)
study with nursing students.
The increased ability and capacity to accept and let go of so-called neg-
ative emotions, such as fear, anxiety, and doubt, constituted a significant
theme. Findings from these studies with counseling students are congruent
with controlled MBSR studies that found lower anxiety and depression
levels (Astin, 1997; Shapiro et al., 1998; Speca, Carlson, Goodey, & Angen,
2000; Teasdale et al., 2000) and increased quality of life due to program
participation (Carlson et al., 2004; Roth & Robbins, 2004).
Increased clarity of thought and capacity for reflection were often-
mentioned beneficial mental effects of practice because students were able
to tap into previously unexplored modes of awareness and experience new
ways of relating to themselves and their worlds. These effects may be a
direct result of the process of slowing down the mind and its constant
thought patterns (e.g., Goleman, 2003; Kabat-Zinn, 1990; Welwood, 2000).
Students also reported influences on their belief and value systems, such as
an increased sense of purpose and direction, a sense of ‘‘groundedness,’’
and trust in themselves, which may be due to the readings assigned from
various cultural traditions. Similar responses were reported in Bruce et al.’s
(2002) study.
Students acknowledged changes regarding their work with clients as a
result of the course. Both the concepts covered in the course and the ex-
periential contemplative practices changed how students conceptualize and
pursue the therapeutic process. Students reported a greater capacity for
1894 Teachers College Record
empathy and compassion, and enhanced listening abilities. In counseling
sessions, such change translated into feeling more comfortable sitting in
silence with clients and being able to stay focused on the therapeutic process
at hand.
The perceived weaknesses of the course were not consistent across stu-
dents and were primarily related to preferences regarding teaching style
and course assignments such as journal writing and presentations, which
may be associated with preferred learning styles and degrees of comfort in
performing certain tasks or assignments.
These overall findings strongly support the value of mindfulness-based
courses to students preparing to be caregivers (i.e., therapists and other
health professionals). It is not common to hear students talk about signif-
icant changes across a variety of life domains that are due to taking a course
and to commit to four additional sessions of practice each week outside class
time. The fact that students have had such experiences within the context of
a university course points to the relevance of these practices in higher ed-
ucation (Tisdell, 2003).
Given the summary of this course’s evaluation and results from related
studies, it appears that university programs would benefit from incorpo-
rating similarly structured courses into counseling curricula. This study has
demonstrated that counseling students enrolled in this MBSR-based self-
care class experienced positive influences in their personal and professional
lives, supporting findings that students in other health professions, like
medicine and nursing, also benefit from MBSR (Bruce et al., 2002; Shapiro
et al., 1998). Despite limitations in the existing qualitative research noted by
Shapiro et al. (2000) and Bishop (2002), the available evidence points to a
notable positive effect of MBSR-based programs on many clinical and stu-
dent cohorts.
Counseling training programs often emphasize health promotion, self-
transformation, and spiritual balance, but the demands of the curricula and
clinical training often leave little room for teaching self-care. Mindfulness
practice has the potential to transform counseling trainees in a number of
ways, including helping them become less reactive to stress-related or anx-
iety-provoking events, such as when clients are in crisis or discussing painful
emotions. Counseling students can also gain new ways of relating to their
emotional lives, including awareness and tolerance. Instead of responding
with reactivity and defensiveness, mindfulness disciplines can assist coun-
selors to become more present and connect more intimately with them-
selves, their clients, and their supervisors (Epstein, 1995; Magid, 2002;
Rubin, 1996; Safran, 2003).
We conclude with the words of one of the counseling students:
Teaching Counselors Self-Care Through Mindfulness Practices 1895
I suppose it is this experience of connectedness that has affected my
thoughts and questions about healing most significantly. Whether it’s
moving forward or back, I ask more frequently and, I think, more
deeply what is therapy, anyway? How do we heal ourselves and what
can we provide for one another that can help? From the first tears of a
client to my DSM diagnosis to the last handshake or hug, contempla-
tion, which I think of as a spiritual awareness, is at the center of my
relationship to them; I hope that it will remain at the center of my
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SANDY NEWSOME is a master’s student in the Department of Health &
Human Development in Mental Health Counseling at Montana State Uni-
versity. She is currently completing her internship at MSU’s counseling
center. Sandy is interested in contemplative practices as it applies to coun-
seling and stress reduction.
JOHN CHAMBERS CHRISTOPHER is a professor of counseling in the
Department of Health & Human Development at Montana State University
and a senior staff psychologist at MSU’s Counseling Center. He is the re-
cipient of the 2003 Sigmund Koch Early Career Award by the Society of
Theoretical and Philosophical Psychology of the American Psychological
Association. John specializes in cultural psychology and theoretical and
philosophical psychology. He has written on the cultural, moral, and on-
tological underpinnings of theories of psychological well-being, moral de-
velopment, and psychotherapy.
PENNY DAHLEN is an assistant professor of counseling in the Department
of Health and Human Development at Montana State University, where she
coordinates the Mental Health Counseling Program. She has been a coun-
selor educator for 13 years at a variety of institutions. Her current research
includes compassion fatigue in counselors.
SUZANNE CHRISTOPHER is an associate professor of community health
in the Department of Health and Human Development at Montana State
University. She received her doctorate in the Department of Health Be-
havior and Health Education from the University of North Carolina School
of Public Health. Her primary work is conducting community-based par-
ticipatory research, and she is currently funded by the American Cancer
Society for a multiyear women’s health project with the Apsa
´alooke (Crow)
1900 Teachers College Record
... Research shows that individuals working within the helping professions experience burnout (O'Halloran & Linton, 2000;Maslach, 2003;Newsome, Chambers Christopher, Dahlen, & Christopher, 2006;Thompson, Amatea, & Thompson, 2014), which is a term first used by Freudenberger (1974) to describe helping professionals who become exhausted due to excessive demands on their energy and resources. Helping professionals may also experience compassion fatigue and vicarious traumatization (Baker, 2003). ...
... A growing literature documents the inclusion of mindfulness in academic and work settings (Birnbaum, 2005(Birnbaum, , 2008(Birnbaum, , 2009Gockel, 2010;Gockel et al., 2013;Haight, 2010;Kessen & Turner, 2012;Kroll, 2010;Lord, 2007;Lynn, 2010;Lynn & Mensinga, 2015;Newsome et al., 2006;Shier & Graham, 2011). With the intention of fostering an embodied sense of awareness in practice, there has been a renewed focus on a more holistic reflective learning, recognising the integral foundation of experiential learning for social work practice (Lynn, 2010). ...
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This article explores the underpinnings of direct social work practice, applying theoretical concepts to demonstrate how to increase practice effectiveness. Given the challenges and stresses of the profession, social workers require training that equips them with skills for every field of practice, every situation and all levels of stress. The heart of direct practice is seen as a psychophysiological integration of skills (concrete tools that practitioners use to create change in users’ lives), which provide direct practice’s skeleton or frame, and micro-skills (specific actions taken to enact a skill), which provide its flesh. The psychophysiological base of direct practice is fleshed out using concepts of embodiment and mindfulness. A practice example illustrates the application of the concepts. Benefits associated with exploring micro-skills and embodied therapeutic practice are discussed, as well as the concomitant implications of how to expose new clinicians and students to these concepts.
Counseling practice exposes clinicians to the pain and suffering of others, potentially compounding their own painful life experiences. A counselor’s personal losses and illnesses can wound them; however, they can also fuel empathy for the experiences of clients. Wounded healers can be found throughout counselor education programs, even though their woundedness – for reasons of-associated with fear or stigma – may not be readily apparent or disclosed. Woundedness can be viewed along a continuum, and self-care plays a crucial part in maintaining personal and professional wellness. This article describes using a wounded healer framework, encourages cultivating a culture of wellness, and details creative ways to incorporate self-compassion into the curriculum as a preventative effort to promote intentional self-care practices. Topics and example exercises are provided.
The polyvagal theory introduces the premise that the autonomic nervous system (ANS) has an essential role in detecting threats and calming social engagement. In busy courtrooms, the subtle nuances of communication can be missed or overlooked. Messages of threat activate an autonomic state from calm to agitated beneath conscious awareness. When shifts occur, information can be misunderstood or misinterpreted, resulting in overly defensive responses from all parties. The polyvagal theory suggests a perspective that encourages self‐reflection and awareness to counterbalance the inevitable physical and mental stress of managing todays’ courtrooms.
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Objectives Previously developed mindfulness measures focused on its intrapersonal dimensions and did not measure the interpersonal aspects of mindfulness. Furthermore, recently developed interpersonal mindfulness measures were either specific to a certain context (e.g., parenting, conjugal, teaching) or omitted/minimized the role of the body in the interpersonal dynamic. The proposed Interpersonal Mindfulness Questionnaire (IMQ) aims to operationalize the theoretical notion of embodied and embedded mindfulness by grounding it into four dimensions, each representing a set of skills that can be cultivated through training and practice: (1) Detachment from the Mind, (2) Body-Anchored Presence, (3) Attention to and Awareness of the Other Person, and (4) Mindful Responding. Methods The IMQ subscales were developed through consultations with a panel of eight graduate students and ten experts in the field. Three studies were conducted to evaluate the construct, internal consistency, reliability, convergent validity, and utility of the IMQ. Results Findings from the three studies supported the proposed four subscales of IMQ and suggested that these four subscales are independent and supported by convergent evidence. In addition, results suggested that IMQ subscales’ scores are sensitive to meditation experience and are associated with better intrapersonal and interpersonal outcomes. Conclusions IMQ subscales are valid and are consistent with the proposed embodied and embedded conception of interpersonal mindfulness. IMQ subscales are associated with intrapersonal mindfulness, but not strongly enough to be conceived as the same phenomenon. Limitations, as well as theoretical and practical implications of IMQ subscales, are thoroughly discussed.
Mindfulness is a state of nonjudgmental awareness of the present moment and has benefit to those in the helping professions. Because research on the effect of training prospective social workers in mindfulness is limited, this qualitative study explored the benefits of mindfulness practice and education with 18 master of social work (MSW) students taking a course on mindfulness-based psychotherapies through the lens of student practice experiences. Students were expected to develop their own mindfulness practice and document their reflections in a journal over the term. Thematic analysis of journal entries revealed three primary themes: challenges to getting started, the emergence of the seven attitudinal pillars of mindfulness, and the applicability of mindfulness to clinical social work and self-care. Implications for social work education are discussed.
Aims This systematic review aimed to critically synthesize research examining trainee therapists’ experiences of learning and using mindfulness. It explored the personal and professional benefits and challenges of mindfulness training, and whether there is merit including it in core education programmes. Methods Key article databases (including PsycINFO, Web of Science, ERIC, Academic Search Premier, Medline, CINAHL Complete, Scopus, Google Scholar) were systematically searched for qualitative studies on post-graduate counselling, psychology and psychotherapy students’ experiences of mindfulness courses. Reference sections of highly relevant studies were also searched. Thirteen identified studies were subjected to data extraction, critical appraisal using the JBI Critical Appraisal Checklist for qualitative research, and synthesis. Results Thematic synthesis highlighted positive personal and professional experiences of mindfulness, such as enhanced emotional regulation and wellbeing, better therapist-client boundaries, and stronger therapeutic relationships. These followed some minor initial challenges, such as discomfort and difficulty concentrating. Conclusion Although participants of included studies were more likely to have a predisposition for mindfulness, results clearly endorse the potential of mindfulness training to complement existing counsellor training by fostering essential clinical skills, qualities and attitudes, and self-care. As some students initially find mindfulness to be challenging, issues such as individual readiness need consideration.
While providing counseling services, school counselors may experience compassion fatigue and need opportunities for support and supervision. To address the ethical imperative of self-care and provide space for school counselors to connect and renew, one district offered a retreat experience designed to renew school counselors who support K–12 students and their school communities. This practitioner research study investigated the design, delivery, and outcomes of the 1-day retreat. With all participants indicating that the retreat was very to extremely useful to them, worth their time, and applicable to their self-care, the findings suggest the value of retreats designed specifically for school counselors.
We used canonical correlation analysis to examine the predictive nature of three facets of wellness (mindfulness, emotion regulation, and perceived social support) on burnout in counselors‐in‐training (N = 136). The cognitive reappraisal construct made a significant contribution to the wellness predictor variate. Implications for counselor training programs are discussed.
Objective To investigate the impact of a structured eight-week mindfulness-based cognitive therapy (MBCT) program on counseling self-efficacy among counseling trainees. Methods Undergraduate counseling trainees were randomized to an MBCT group (n = 25) or a waitlist control group (n = 25) with a crossover trial design. Psychological measurements regarding mindfulness, empathy, self-compassion, psychological distress, counseling self-efficacy as well as neuro-physiological measures including frontal midline theta activity, respiration rate, and skin conductance were taken at baseline (T1), after intervention (T2), and six-month follow-up (T3). Results Mindfulness training could make significant positive changes in empathy, self-compassion, stress reduction, and counseling self-efficacy with this being backed up by both psychological and neuro-physiological evidence at T2. However, such differences between the two groups had greatly subsided after crossover in which carry-over effect and marked improvement were noted in the study and control group, respectively, at T3. In addition, mindfulness was the most significant determinant that contributed to counseling self-efficacy, followed by psychological distress reduction and self-compassion according to the regression models. Conclusion Integrating mindfulness into counseling training is beneficial for helping profession trainees. Practice implication Incorporating mindfulness into counseling training can enhance the necessary “being mode” qualities in counseling and address self-care issues during training.
This article describes a mindfulness-based stress reduction program presented in either English or Spanish in an inner-city setting. The demographic profile of patients who complete the Stress Reduction and Relaxation Program at the Community Health Center in Meriden, Connecticut, is presented. Mindfulness meditation is defined, and the practices of breathing meditation, eating meditation, walking meditation, and mindful yoga are described. The relationship of mindfulness practice to patients' suffering and to physical and emotional pain is discussed. The article concludes with an exploration of how mindfulness practice facilitates profound personal change as well as symptom relief and health improvement.
Cover Blurb: Researching Lived Experience introduces an approach to qualitative research methodology in education and related fields that is distinct from traditional approaches derived from the behavioral or natural sciences—an approach rooted in the “everyday lived experience” of human beings in educational situations. Rather than relying on abstract generalizations and theories, van Manen offers an alternative that taps the unique nature of each human situation. The book offers detailed methodological explications and practical examples of hermeneutic-phenomenological inquiry. It shows how to orient oneself to human experience in education and how to construct a textual question which evokes a fundamental sense of wonder, and it provides a broad and systematic set of approaches for gaining experiential material that forms the basis for textual reflections. Van Manen also discusses the part played by language in educational research, and the importance of pursuing human science research critically as a semiotic writing practice. He focuses on the methodological function of anecdotal narrative in human science research, and offers methods for structuring the research text in relation to the particular kinds of questions being studied. Finally, van Manen argues that the choice of research method is itself a pedagogic commitment and that it shows how one stands in life as an educator.