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Ethics, Values, Virtues, and Character Strengths in Mindfulness-Based Interventions: a Psychological Science Perspective

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Abstract

This paper comments on an article by Monteiro, Musten, and Compson (Mindfulness 6: 1-13, 2015) and a series of replies that explored the issue of ethics training for participants in contemporary mindfulness-based interventions (MBIs). The perceived need for explicit ethical training stems from concerns about potentially harmful or misguided applications of secular MBIs, particularly in settings whose activities may be inconsistent with the ethics of the Buddhist traditions from which mindfulness training originates. Much of the discussion in the target article and replies focused on whether ethical foundations of mindfulness in MBIs should remain implicit or should be taught from a Buddhist perspective. The present commentary argues that psychological science provides well developed alternatives for researchers and clinicians interested in secular approaches to ethics-related issues in MBIs. The experimental psychology literature provides a strong foundation for working with personally meaningful, prosocial values in MBIs. Positive psychology provides a complementary perspective on moral virtues and character strengths that have been widely recognized across cultures. Organizational psychology and related disciplines provide empirically based perspectives on the ethical implications of mindfulness training in the workplace. An approach to ethical issues in MBIs that is firmly grounded in psychological science and suitable for secular settings is recommended.
COMMENTARY
Ethics, Values, Virtues, and Character Strengths
in Mindfulness-Based Interventions: a Psychological
Science Perspective
Ruth Baer
1
Published online: 21 June 2015
#Springer Science+Business Media New York 2015
Abstract This paper comments on an article by Monteiro,
Musten, and Compson (Mindfulness 6: 1-13, 2015) and a
series of replies that explored the issue of ethics training for
participants in contemporary mindfulness-based interventions
(MBIs). The perceived need for explicit ethical training stems
from concerns about potentially harmful or misguided appli-
cations of secular MBIs, particularly in settings whose activ-
ities may be inconsistent with the ethics of the Buddhist tra-
ditions from which mindfulness training originates. Much of
the discussion in the target article and replies focused on
whether ethical foundations of mindfulness in MBIs should
remain implicit or should be taught from a Buddhist perspec-
tive. The present commentary argues that psychological sci-
ence provides well developed alternatives for researchers and
clinicians interested in secular approaches to ethics-related
issues in MBIs. The experimental psychology literature pro-
vides a strong foundation for working with personally mean-
ingful, prosocial values in MBIs. Positive psychology pro-
vides a complementary perspective on moral virtues and
character strengths that have been widely recognized across
cultures. Organizational psychology and related disciplines
provide empirically based perspectives on the ethical impli-
cations of mindfulness training in the workplace. An ap-
proach to ethical issues in MBIs that is firmly grounded in
psychological science and suitable for secular settings is
recommended.
Keywords Mindfulness-based interventions .Ethics .
Va l u e s .Positive psychology .Virtues and character
strengths .Worksite mindfulness training
Introduction
The relationship between Buddhist conceptions of mindful-
ness and the contemporary psychological perspectives of
mindfulness-based interventions (MBIs) has been extensive-
ly discussed (Williams and Kabat-Zinn 2013). In a recent
review, Monteiro et al. (2015) described several criticisms
of secular MBIs from the Buddhist perspective; the most
serious of these was the lack of explicit ethics training for
participants. Particular concern was expressed about work-
place applications of mindfulness training where corporate
expectations might not be consistent with traditional
Buddhist ethics. Replies to Monteiro et al. offered a range
of perspectives on this topic; the discussion focused largely
on whether ethical foundations of mindfulness should re-
main implicit or should be taught from a Buddhist perspec-
tive. Much of the psychological literature on evidence-based
ways of working with ethics-related issues in MBIs was not
addressed.
The present commentary argues that psychological science
provides well-developed alternatives to both Buddhist-based
and implicit approaches for researchers and clinicians interest-
ed in secular perspectives on ethical issues in MBIs. The ex-
perimental psychology literature provides a strong foundation
for explicit work with personally meaningful prosocial values
in MBIs. Positive psychology provides a complementary per-
spective on moral virtues and character strengths that have
been widely recognized across cultures. Organizational psy-
chology and related disciplines provide empirically based per-
spectives on the ethical implications of mindfulness training in
*Ruth Baer
rbaer@email.uky.edu
1
Department of Psychology, University of Kentucky, 115 Kastle Hall,
Lexington, KY 40506-0044, USA
Mindfulness (2015) 6:956969
DOI 10.1007/s12671-015-0419-2
the workplace. Following an overview and discussion ofthese
bodies of literature, I argue for a psychological science-based
approach that is theoretically sound, empirically supported,
and suitable for contemporary secular settings.
Ethical Training in MBIs
Monteiro et al. and several of the replies noted that in
Buddhist traditions, mindfulness training is accompanied
by explicit instruction in ethical conduct as part of the
eightfold path to the cessation of suffering. This founda-
tional Buddhist teaching includes two components within
the domain of wisdom (right view, right intention), three
devoted to ethical behavior (right speech, right action,
right livelihood), and three devoted to mental or meditative
development (right effort, right concentration, right mind-
fulness). The term right signifies that each element of the
path leads to reduced suffering for self or others (Amaro
2015; Monteiro et al. 2015); for example, right livelihood
means earning oneslivinginawaythatisbenevolentand
causes no harm. Ethical behavior in Buddhist traditions is
further described in the five precepts: to refrain from kill-
ing, stealing, lying, sexual misconduct, and misuse of in-
toxicants. These are sometimes expressed in more general
terms (nonharming of living beings, nonharmful speech,
etc.) and are understood not as commandments from a
higher authority but rather as pragmatic ways of facilitat-
ing ones own awakening and the well-being of others
(Amaro 2015).
According to some authors, the absence of explicitly taught
ethics in secular MBIs is a source of concern because it could
lead to the development of wrong mindfulness (Monteiro et al.
2015) or mindfulness used for harmful purposes. A commonly
cited example is the provision of mindfulness training within
businesses or corporations whose profit-driven activities may
lead to degradation of the environment, harm to the economy,
or mistreatment of their employees. Some authors have sug-
gested that the availability of worksite mindfulness training
unfairly implies that employees are solely responsible for their
own stress levels and disregards sources of stress within the
organization. It has also been suggested that without clear and
explicit ethical foundations, the practice of nonjudgmental
acceptance could promote acquiescence with unethical busi-
ness practices and passive tolerance of oppressive working
conditions (Purser 2015). To address these concerns,
Monteiro et al. suggested that explicit teaching of Buddhist-
conceptualized ethics in secular MBIs should be explored. In
response, some of the commentaries agreed while others ar-
gued that ethics training is already implicit in secular MBIs
and that explicit ethical training is unnecessary or could be
problematic.
Implicit Ethics in MBIs
Three points are commonly made in support of the argument
that an ethical foundation is implicit in MBIs. First, many
providers of MBIs (psychologists, physicians, social workers)
are bound by codes of professional ethics that require them to
do no harm and to work from a standpoint of beneficence and
respect. The code of conduct for psychologists notes that eth-
ical practice requires Ba personal commitment and lifelong
effort to act ethically; to encourage ethical behavior by stu-
dents, supervisees, employees and colleagues; and to consult
with others concerning ethical problems^(APA 2010).
According to Kabat-Zinn (2011), candid communication be-
tween teachers of mindfulness-based stressreduction (MBSR)
assists colleagues in identifying and challenging their own and
othersbehavior that might inadvertently cause harm. Linehan
(1993) formalized this principle by making a therapistscon-
sultation group an essential component of dialectical behavior
therapy (DBT), a well-supported mindfulness-based treatment
for borderline personality disorder. The consultation group
helps therapists manage the stress of working with potentially
suicidal clients, conduct the therapy in DBT-consistent ways,
and maintain an ethical stance.
Second, many definitions in the contemporary psycholog-
ical literature describe mindfulness as having two elements:
what one does when practicing (i.e., paying attention to
present-moment experiences) and how one does it (the nature
or qualities of the attention). Examples are shown in Table 1
and suggest that mindful awareness is generally agreed to be
nonjudgmental, open, accepting, curious, compassionate, and
kind. In a commentary on Monteiro et al., Grossman (2015)
described these characteristics as virtuous and suggested that
the practice of mindfulness cultivates an inherently ethical
stance toward self and others.
Finally, Kabat-Zinn (2005)andSegaletal.(2013)noted
that MBSR and MBCT are offered with a spirit of compassion
and kindness. Teachersembodiment of these qualities, as
well as frequent reminders in the meditation instructions to
be nonjudgmental, open, and curious, is believed to help par-
ticipants learn to treat themselves with more warmth and
friendliness. Several studies have shown increases in self-
compassion following MBSR and MBCT (Keng et al. 2012;
Kuyken et al. 2010). A few have shown increased empathy for
others following MBSR (Birnie et al. 2010; Shapiro et al.
1998). Using a behavioral task to avoid the pitfalls of self-
report, Condon et al. (2013) found that participants who had
just completed an 8-week mindfulness course were three times
more likely than a control group to offer their chair in a
waiting room to a confederate struggling with crutches. This
study compared two mindfulness training protocols; one in-
cluded compassion meditation, the other did not. Participants
in these two conditions were equally likely to offer help, sug-
gesting that explicit instruction in compassion-based practices
Mindfulness (2015) 6:956969 957
may not be necessary to cultivate increases in kindness toward
others through mindfulness training.
In summary, proponents of the implicit approach to ethics
in MBIs note that the entire enterprise is suffused with com-
passion and ethical awareness. Teachers are bound by codes of
ethical conduct, mindfulness itself is inherently ethical, and
the practice of mindfulness cultivates kindness and compas-
sion toward self and others.
Teaching Buddhist-Based Ethics in MBIs
Monteiro et al. and several of the replies argued that the im-
plicit approach to ethical training in secular MBIs may not be
sufficient to prevent ethically problematic applications of
mindfulness training and suggested that explicit teaching of
Buddhist-based ethics could be helpful. Most of these authors
offered little specificity about how such training might be
conducted, but several pointed to examples in the published
literature. These include spiritual self-schema therapy (Avants
and Margolin 2004), meditation awareness training (MAT;
Shonin et al. 2014a), mindfulness-integrated cognitive behav-
ioral therapy (MiCBT; Cayoun 2011), and mindfulness-based
symptom management (MBSM; Monteiro and Musten 2013;
Monteiro et al. 2010).
Spiritual self-schema therapy for addictive and HIV risk
behavior is an 8-week group program that integrates a cogni-
tive model of self with BanonsectarianBuddhistframework
suitable for people of all faiths^(Avants et al. 2005,p.167).
Participants typically have been engaging in high-risk sexual
behavior (e.g., prostitution), stealing and lying (to acquire
drugs or conceal drug-related activities), and harmful ways
of earning money (drug dealing). The intervention provides
explicit instruction in the five ethical precepts and the eight-
fold path, including right livelihood, right speech, and right
action. The primary goal is to help participants develop a
spiritual self-schema that is incompatible with HIV risk be-
haviors. Lapses are characterized as reactivations of addict
self-schemas rather than moral failings. Participants are
encouraged to view their behavior Bwith compassion, without
judgment, and with the goal of targeting and eliminating the
addict self-schema, rather than targeting and punishing
themselves^(p. 272). Several studies of this treatment have
reported reductions in HIV-risk behavior and increases in
qualities such as generosity, morality, renunciation, and
wisdom (Margolin et al. 2006; Margolin et al. 2007).
Meditation awareness training (MAT; Shonin et al. 2014a)
is an 8-week intervention delivered in group or individual
format. It is described as secular yet designed to provide a
more traditional and comprehensive approach to meditation
than is found in MBSR and MBCT. Mindfulness is an integral
component of the program but not the exclusive focus. MAT
also includes methods that cultivate citizenship, ethical and
compassionate awareness, generosity, patience, and insight
into Buddhist conceptions of impermanence and nonself.
Weekly sessions are led by experienced meditators and in-
clude a didactic component, group discussion, and a guided
meditation or mindfulness exercise. Several studies support
the efficacy of MAT for improving psychological well-being
in a variety of populations as well as job satisfaction and
performance in worksite settings (Shonin et al. 2014b,c,d;
Va n G o r d o n e t a l . 2014).
Mindfulness-integrated cognitive behavioral therapy
(MiCBT; Cayoun 2011)isan812-week program designed to
address a broad range of psychological disorders and general
stress conditions. It integrates mindfulness meditation with ex-
posure procedures, interpersonal skills training, and exercises
for developing empathy, compassion, and ethical behavior.
The ethical training component includes explicit discussion of
the five precepts, which participants are encouraged to apply in
daily life using behavioral experiments. For example, they
might attempt to refrain from killing insects or telling lies for a
week. If they find it necessary to engage in these behaviors, they
are encouraged to be fully aware of all associated sensations. No
published studies have evaluated the efficacy of MiCBT.
Mindfulness-based symptom management (Monteiro and
Musten 2013) is an 8-week group program for people with
Tabl e 1 Contemporary psychological descriptions of mindfulness: what and how
Author(s) What How
Kabat-Zinn (1994,2003) Paying attention, or the awareness that
arises through paying attention
on purpose, in the present moment, and nonjudgmentally;
with an affectionate, compassionate quality, a sense of
openhearted friendly presence and interest
Marlatt and Kristeller (1999) Bringing ones complete attention to
present experiences
on a moment-to-moment basis, with an attitude of
acceptance and loving kindness
Bishop et al. (2004) Self-regulation of attention so that is
it maintained on immediate experience
with an orientation characterized by curiosity, openness,
and acceptance
Germer et al. (2005) Awareness of present experience……with acceptance: an extension of nonjudgment that
adds a measure of kindness or friendliness
Linehan (2015) The act of focusing the mind in the
present moment
without judgment or attachment, with openness to
the fluidity of each moment
958 Mindfulness (2015) 6:956969
mood-, stress-, and pain-related conditions. It combines ele-
ments of MBSR, MBCT, and Buddhist philosophy and in-
cludes five skillful habits based on the precepts of Buddhist
ethics in substantially adapted form. For example, refraining
from killing is relabeled as respect for mortality; the associated
habits include noting sensations and negative thoughts, notic-
ing how negative emotions lead to physical problems, and
physical exercise. The precept about intoxicants is relabeled
as mindful consumption; recommendations include noting the
sensations, thoughts, and emotional effects of eating and sati-
ation, taking time for lunch, and limiting snacks. Many of
these strategies are included in MBIs that do not claim to have
an explicit ethical component; thus, the Buddhist influence
seems largely implicit. No published studies have evaluated
the efficacy of this program.
Value s
In a commentary on Monteiro et al., Davis (2015) noted that
Buddhism is not the only source of guidelines about ethical
behavior and suggested that teaching Buddhist-based ethics to
people who do not identify as Buddhists could be problematic.
Instead, he recommended helping participants clarify the
values they already hold and strengthen their resolve to
embody them. Similarly, Greenberg and Mitra (2015) pointed
to the CARE for Teachers program (Cultivating Awareness
and Resilience in Education; Jennings et al. 2011,2013)
which encourages participants to develop a statement of the
values that motivated them to become teachers and to use
these values to guide their behavior. Other MBIs, particularly
acceptance and commitment therapy (ACT; Hayes et al. 1999,
2012), also include working with self-chosen values as a cen-
tral treatment strategy.
Values in ACT
ACT is based on the psychological flexibility model: a com-
prehensive theory of human functioning that integrates
mindfulness- and acceptance-based psychological processes
with personally chosen values and values-consistent behavior
(known as committed action). The mindfulness and accep-
tance processes in ACT are similar to those described in other
MBIs and include flexible attention to the present moment,
acceptance of present-moment experiences, defusion from
thoughts (similar to decentering in MBCT), and a transcen-
dent sense of self (recognition that thoughts and feelings are
transitory events that do not define the person who is
experiencing them). In ACT, values are seen as essential to
good psychological health because they intrinsically motivate
behavior that leads to a deep sense of meaning, vitality, and
engagement. The ultimate goal of ACT is to help clients
develop lives that feel rich and satisfyingthough not pain-
less or easyby the clientsown standards (Hayes et al.
2012).
When helping clients to identify their values, ACT thera-
pists typically encourage the exploration of several domains
that are important in many peopleslives.Domainsarenot
prescribed, but rather are suggested to help clients focus on
what may be most important to them. Commonly discussed
domains include relationships (with family or friends), work
(career, education, or running a household), community in-
volvement (working for worthy causes, participating in com-
munity activities), spirituality (church involvement, commun-
ing with nature, or other practices identified by the client),
and self-development (learning new skills, taking care
of ones health, engaging in satisfying leisure activities).
The importance of choosing ones own values, rather than
those imposed by authority figures or societal norms, is
emphasized.
Discussion of values in ACT also includes qualities or char-
acteristics that clients would liketoembodyinthedomainsthat
are most important to them. In the work domain, clients may
aspire to be creative, competent, or productive. In the relation-
ship domain, they may wish to be loving, kind, or supportive.
Values are distinguished from goals, in that goals can be
completed or achieved (learn a new software program,
teach coworkers to use it), whereas the underlying values
(to be competent and helpful) continue over the longer
term. Upon completion of specific goals, other ways to be
competent and helpful will present themselves. A client
who stops working may continue to value competence
and helpfulness in other settings.
Behaving in accordance with values can be stressful and
difficult. Unpleasant thoughts and emotions may arise, and
these often present obstacles to committed action.
Mindfulness and acceptance are conceptualized as ways to
help clients work constructively with emotional obstacles to
values-consistent behavior. For example, a person who values
helpfulness at work but is anxious about speaking in groups
might practice contributing to discussions with mindful accep-
tance of the unpleasant sensations (racing heart, sweating),
rather than keeping quiet in meetings to avoid the stress of
speaking up. The goal of ACT is not to decrease anxiety in
meetings, though this may occur with consistent practice.
Rather, the goal is to help the client develop a life that feels
satisfying and meaningful, even when it is distressing or
painful.
ACT has developed several tools to help clients explore
their values. The Valued Living Questionnaire (Wilson et al.
2010), which is often used as a structured interview (Wilson
and DuFrene 2008), asks clients to consider 12 potentially
valued domains: marriage, parenting, other family, friends,
work, education, recreation, spirituality, community life,
physical self-care (diet, exercise, sleep), the environment,
Mindfulness (2015) 6:956969 959
and aesthetics (art, literature, music, beauty). Clients are urged
to remember that not everyone values all of the domains; for
example, some prefer not to marry or raise children, others
may have little interest in community activities or spirituality.
Discussion centers on the self-rated importance of each area,
the clients actions in each area, and satisfaction with their
level of action. The intention is to work toward greater con-
sistency between self-rated importance of particular domains
and satisfaction with action in those domains. Clients who
discover that they have been focusing on areas of low priority
while neglecting domains they identify as important can be
helped to redirect their energies in more satisfying ways.
Mindful compassion provides a helpful way of relating to
the pain and regret associated with realizing that onesprior-
ities may have been misplaced.
ACT also uses experiential exercises to help clients identify
important values. Clients may be asked to write a brief epitaph
for their own future tombstone that captures how they would
like to be remembered; e.g., BHe participated in life and helped
his fellow human beings^(Hayes et al. 2012,p.306).
Alternatively, they might write a short speech they would like
someone to give at a birthday party in their honor; for example,
BJohn always puts the needs of his children first, guiding them
with love, patience, and respect^or BThrough her tireless vol-
unteer work, Camille has helped to make our world a safer and
cleaner place for all living beings^(Fleming and Kocovski
2013,p.32).Suchexercisesarefollowedbydiscussionof
behaviors consistent with these values, especially behavioral
changes needed to address values-behavior discrepancies.
Mindfulness skills that may be helpful in working with
barriers to committed action, such as pessimistic or self-
critical thoughts (BThis will never work,^BIve wasted too
much time^), and negative emotions (anxiety, sadness), are
also practiced.
Many studies have shown that ACT leads to significant
increases in self-reported psychological flexibility, defined as
the ability to fully contact the present moment and behave in
values-consistent ways in the presence of difficult thoughts
and feelings (Hayes et al. 2006;Ruiz2010). Treatment out-
come studies have not examined the effects of values work
independently of the other components of ACT; however,
laboratory studies suggest that even brief consideration of per-
sonal values leads to reliable changes in behavior. For exam-
ple, in a study of pain tolerance using the cold-pressor task
(immersing a hand in very cold water), Branstetter-Rost et al.
(2009) asked one group to imagine tolerating the pain for the
sake of a highly ranked personal value (e.g., swimming in icy
water to rescue a loved one), whereas a second group was
coached in how to practice mindful acceptance of the pain
with no reference to personal values, and a third group re-
ceived no instructions for tolerating the pain. All groups rated
the cold water as equally painful, but the values group toler-
ated the pain for much longer than the acceptance and
no-instructions groups (156, 69, and 36 s, respectively,
p<.001). Several ACT-based laboratory studies have reported
similar findings (Levin et al. 2012).
Values in Self-Affirmation Theory
ACT researchers often cite a body of values-based studies
conducted in the context of self-affirmation theory (Steele
1999). This theory posits that affirmation of personal values
protects against a variety of stressors by expanding partici-
pantsviews of themselves and their resources and facilitating
perspective on what is most important. Participants are asked
to write for a few minutes about a highly ranked value; most
write about relationships with family or friends, religious
faith, or kindness. Significant changes in subsequent behavior
are consistently observed (Cohen and Sherman 2014).
Smokers who wrote about their personal values showed great-
er willingness than controls to acknowledge the health risks of
smoking (Crocker et al. 2008). Sexually active adults who
wrote about their values were more likely than controls to
purchase condoms after viewing an educational video about
AIDS (Sherman et al. 2000). First-generation college stu-
dents who wrote about their values showed improved
grades in a biology course and greater likelihood of enroll-
ing in a subsequent course (Harackiewicz et al. 2014).
Physiological effects also have been documented.
Creswell et al. (2005) reported that students who focused
on a highly ranked value showed lower cortisol responses
to a laboratory stressor than a control group. Legault et al.
(2012) found that students who wrote about an important
value showed greater electrophysiological evidence of error
monitoring in the brain and fewer performance errors on a
laboratory task.
Values in Other MBIs
Working with values has been integrated into other empirical-
ly supported MBIs in a variety of ways. Mindfulness-based
eating awareness training (Kristeller et al. 2014) helps partic-
ipants consider the time and energy they spend thinking ob-
sessively about food, eating, and weight, rather than work,
school, family, or friends, and encourages them to increase
their involvement in these valued activities. Mindfulness-
based relapse prevention (Bowen et al. 2011) includes
discussion of reasons to stay sober, which participants
write on cards to carry with them as reminders to avoid
relapses. These reasons typically reflect important values,
such as working responsibly at a job, caring for a child,
or relating to a spouse. Acceptance-based behavior therapy
(Roemer et al. 2008), which integrates elements of ACT,
MBCT, and DBT, uses writing exercises to help clients
explore what they value in a variety of domains (work,
school, relationships, household management, community
960 Mindfulness (2015) 6:956969
involvement, self-care); it also includes goal setting and
behavior change strategies for increasing values-consistent
action in daily life.
During a sitting meditation in the final session of MBCT,
participants are asked to contemplate something they value
that provides a reason to maintain their mindfulness practice
after the group has ended. They write the values that came to
mind (such as caring for themselves or being more available to
their children) on cards to keep with them. Finally, DBT
(Linehan 2015) includes exploration of values as part of build-
ing a life that feels satisfying and meaningful. Although po-
tential values are suggested to help clients consider possibili-
ties (e.g., healthy relationships, productive work, contributing
to the community), clients are strongly encouraged to identify
values that are truly their own.
The Importance of Self-Chosen Values
Studies of self-affirmation typically ask the experimental
group to write about their most important value and the
control group to write about a low-ranked value. The con-
sistent superiority of experimental over control groups in
beneficial outcomes suggests that thinking about onesown
highly ranked values is important. This finding is consistent
with theories of optimal human functioning that emphasize
the role of autonomy. Self-determination theory (Ryan and
Deci 2000) identifies autonomy as one of three basic needs
(along with competence and relatedness) that are essential
for psychological health and life satisfaction. Ryffs(1989)
comprehensive theory of psychological well-being also in-
cludes autonomy as a critical element of healthy function-
ing. Studies of the self-concordance model (Sheldon and
Elliott 1999) show that pursuit of goals that reflect authen-
tic personal interests and values is associated with increased
goal attainment and higher overall well-being (Gillet et al.
2014;Sheldon2002).
ACT experts note that when clients are encouraged to think
autonomously about their deepest aspirations, they almost in-
variably choose prosocial values, such as meaningful work,
loving relationships, and contributions to a community (Hayes
et al. 2012). When this does not happen, e.g., a client says that
he values making a lot of money, further discussion about why
money is important is likely to reveal prosocial underlying
values, such as providing security or opportunities for
ones family. If values appear to conflict (e.g., providing
financial security for the family versus spending time
with them), discussion focuses on finding patterns of
committed action that serve both values and provide
greater overall satisfaction with life.
The prevailing tendency to identify prosocial values is be-
lieved to reflect universal human requirements for biological
survival, social interaction, and the welfare of groups
(Schwartz and Bilsky 1987,1990). That is, individuals and
societies are more likely to thrive if people take care of them-
selves, help each other, and work for the benefit of the group.
Of course, these universal needs do not invariably prevent
harmful behaviors. However, current psychological theories,
research, and treatment methods consistently suggest that en-
couraging people to identify their own most deeply held
values may promote adaptive and prosocial behaviors more
effectively than adopting a list of values prescribed or sug-
gested by others.
The Virtues and Character Strengths of Positive
Psychology
In his commentary on Monteiro et al., Davis (2015)noted
that cultures hold diverse views of the ethical qualities that
human beings should cultivate. A strong foundation for
ethical training in secular MBIs, therefore, requires discus-
sion of Bthe very general ethical question of how it is best
for a human being to be^(p. 46). It seems unlikely that any
field of study can provide a universally acceptable answer
to this question. However, psychological science has ex-
plored this critically important topic through the field of
positive psychology, which studies optimal human func-
tioning. The central tenet of positive psychology is that
mental health is more than the absence of pathology or
distress and that psychological science should include the
study of how individuals and communities can flourish and
thrive. A central concern of positive psychology is the un-
derstanding and cultivation of human virtues that define
good character or Bthe domain of moral excellence^
(Peterson and Seligman 2004,p.8).
Core Virtues
To explore whether any human virtues have been universally
recognized as exemplars of moral excellence, Peterson and
Seligman (2004; see also Dahlsgaard et al. 2005) conducted
a wide ranging review of historical and contemporary litera-
tures and developed a framework for defining and classifying
virtues and character strengths. Working with a large team of
collaborators over a 3-year period, they studied spiritual and
philosophical texts from ancient cultures that provide explicit
discussion of the nature of human virtue and are recognized
for their enduring influence on human civilization. These
included the teachings of Confucius collected in the
Analects; the virtues of Taoism described in the Tao Te
Ching; the Buddhist virtues enumerated in the eightfold
path, the five ethical precepts, and the four immeasurables;
Hindu virtues described in the Bhagavadgita; Athenian
virtues described by Plato in The Republic and Aristotle
in the Nicomachean Ethics; Judeo-Christian virtues as
described in the Ten Commandments, the two books of
Mindfulness (2015) 6:956969 961
Proverbs, and AquinassSumma Theologiae; and Islamic
virtues discussed by Alfarabi in the Selected Aphorisms.
Many secondary sources and expert commentaries were
consulted.
Although no two sets of virtues were identical, conver-
gence across these diverse traditions suggested that six core
virtues consistently recognized as necessary for good char-
acter could be identified: wisdom, courage, humanity, jus-
tice, temperance, and transcendence. In the Buddhist tradi-
tion, for example, wisdom is represented by right view and
intention; justice by precepts to refrain from killing, steal-
ing, and lying; humanity by these precepts and several of
the immeasurables (compassion, kindness, sympathetic
joy); temperance by precepts to refrain from misuse of in-
toxicants and sexual misconduct; and transcendence by the
emphasis on overcoming the suffering of continual death
and rebirth. In the Athenian tradition, Plato proposed four
core virtues: wisdom, courage, self-restraint (temperance),
and justice; Aristotle included these four and also discussed
generosity, friendliness, and charitable acts (humanity).
Transcendence was not named explicitly as a virtue but was
judged to be implicit in many of Platos and Aristotleswrit-
ings. Peterson and Seligman (2004) proposed that the capac-
ities for these six virtues may be biologically based and may
have evolved because they contribute to survival of the
species.
Character Strengths
Peterson and Seligman (2004) also identified several char-
acter strengths through which each of the core virtues can
be achieved or expressed. Character strengths are described
as psychological processes or mechanisms that define the
virtues. For example, humanity is expressed through love,
kindness, and social intelligence; justice is expressed
through citizenship, fairness, and leadership. As with the
virtues, consistently recognized character strengths were
identified through comprehensive literature reviews. In ad-
dition to the spiritual and philosophical texts just described,
numerous other lists of character strengths from historical
and contemporary sources were studied. These included
William BennettsBook of Virtues (1993: courage, perse-
verance, honesty, friendship, loyalty, compassion, self-dis-
cipline, faith), the Boy Scout Handbook (1998:bravery,
trustworthiness, helpfulness, kindness, loyalty, thrift, cour-
tesy, reverence), Benjamin Franklinscatalogofmoralvir-
tues (1790/1961: order, industry, sincerity, justice, humility,
temperance), and Charlemagnes code of chivalry for the
knights of the Holy Roman Empire (Turner 1880:kindness,
forgiveness, mercy, humility, service; avoidance of steal-
ing, perjury, and excess in eating and drinking).
After removing redundancies, characteristics were
retained if they were morally valued and encouraged
across cultures and potentially measurable. Table 2shows
the complete list of six virtues and 24 character strengths
currently recognized within the context of positive psy-
chology, subject to change with future work (Peterson
and Park 2011).
Assessment of Virtues and Character Strengths
Most of the character strengths can be assessed using tools
(primarily self-report instruments) available before the advent
of positive psychology. Since then, researchers have devel-
oped the Values in Action Inventory of Strengths (VIA-IS;
Park and Peterson 2006), a questionnaire that assesses all 24
of the strengths. The VIA-IS conceptualizes the strengths as
individual differences that are reasonably stable and consis-
tent across time and situations, though subject to change with
experience and practice. Respondents complete the VIA-IS
online and are provided with a list of their top five strengths
(known as signature strengths) and a short description of
what each strength means. A version of the VIA-IS for youth
Tabl e 2 The six core virtues and their associated character strengths
Virtues Character strengths
Wisdom Creativity (originality, ingenuity)
Curiosity (interest, novelty-seeking,
openness to experience)
Open-mindedness (judgment,
critical thinking)
Love of learning
Perspective
Courage Bravery (valor)
Persistence (perseverance, industriousness)
Integrity (authenticity, honesty)
Zest (vitality, enthusiasm, vigor, energy)
Humanity Love
Kindness (generosity, nurturance, care,
compassion, altruistic love)
Social intelligence (emotional intelligence,
personal intelligence)
Justice Citizenship (social responsibility,
loyalty, teamwork)
Fairness
Leadership
Temperance Forgiveness (mercy)
Humility (modesty)
Prudence
Self-regulation (self-control)
Transcendence Appreciation of beauty and excellence
(awe, wonder, elevation)
Gratitude
Hope (optimism, future mindedness,
future orientation)
Humor (playfulness)
Spirituality (religiousness, faith, purpose)
962 Mindfulness (2015) 6:956969
aged 1017 years is available, as is a structured interview
(Peterson et al. 2005).
The online version for adults has been completed by over
three million people in most countries around the world
(Niemiec and Lissing 2015). All scales of the VIA-IS have
shown satisfactory internal consistency, test-retest reliability,
and convergent relationships with reports by others (see
Niemiec 2013, for a summary). Interesting correlates have
been reported. For example, life satisfaction has been consis-
tently associated with hope, zest, gratitude, curiosity, and love
(Park et al. 2004). Recovery from physical illness is associated
with bravery, kindness, and humor, coping with psychological
disorders with appreciation of beauty and love of learning
(Peterson et al. 2006). Grade point average in college students
is most strongly related to persistence, open-mindedness, love
of learning, and self-regulation (Lounsbury et al. 2009). Only
two of the 24 scales (prudence and spirituality) have been
shown to be correlated with measures of socially desirable
responding (Niemiec 2013).
Interventions that Cultivate Character Strengths
Acommonlyusedapproachtointerventioninpositivepsychol-
ogy is to help participants use their signature strengths
(identified by the VIA-IS) more frequently and in new ways.
Examples include refraining from telling white lies (authentic-
ity), speaking in support of an unpopular idea in a group dis-
cussion (bravery), doing anonymous favors for others (kind-
ness), listening to others without interrupting (fairness), helping
someone else feel at ease (social intelligence), volunteering
with a charitable organization (teamwork), and numerous
others (Peterson 2006). Studies have shown increases in
happiness and decreases in depression for several months
following such interventions (Seligman et al. 2005;Proyeretal.
2014).
Research also supports the efficacy of training programs
for some of the strengths considered singly. Gratitude inter-
ventions improve psychological well-being and may foster
prosocial behavior (McCullough et al. 2008; Emmons and
Mishra 2011). Forgiveness interventions lead to increases in
forgiveness and hope and decreases in depression and anxiety
(Wade et al. 2014). Daily self-control exercises lead to in-
creases in a general capacity for self-regulation (Baumeister
et al. 2006). Creativity training programs produce significant
increases in divergent thinking and problem solving (Scott
et al. 2004). Loving-kindness and compassion meditation lead
to increases in positive emotion and feelings of connection
with others as well as decreases in negative emotion and stress
(Hofmann et al. 2011). These meditation practices are close-
ly related to mindfulness meditation and are often taught
within the context of mindfulness training programs such as
MBSR.
Mindfulness Training and the Cultivation of Character
Strengths
The effects of MBIs on character strengths have not been com-
prehensively investigated; however, studies suggest that mind-
fulness training encourages curiosity, kindness, self-regulation,
vitality, and spirituality, and that dispositional mindfulness is
related to many of the strengths (for reviews, see Baer and
Lykin s 2011;Niemiec2014). The only intervention explicitly
designed to cultivate both mindfulness and character strengths
is mindfulness-based strengths practice (MBSP; Niemiec
2014), a newly developed 8-week group program. MBSP has
roots in MBSR and MBCT and uses several of the same exer-
cises (body scan, sitting meditation, mindful walking, mindful
eating, and the breathing space) to teach mindful awareness of
present-moment experiences. MBSP also teaches participants
to recognize and understand their own character strengths.
Mindfulness skills and character strengths then are used in com-
bination to enhance well-being and quality of life. Mindfulness
facilitates the recognition and wise use of strengths. Conversely,
when it is difficult to practice mindfulness, strengths such as
persistence or curiosity can be applied.
Some participants in MBSP choose to work primarily with
their signature strengths, others with their lower ranked ones.
The concept of the golden meanbased on Aristotleswrit-
ings and similar to the Buddhist conception of the middle
wayis used to encourage a balanced, mindful use of
strengths attuned to context. For example, strengths can be
underused or overused. Too little bravery is cowardice, too
much may be reckless; too little curiosity is apathy, too much
could be perceived as nosiness. Moreover, different situations
call for different strengths, or combinations of strengths.
When completing income tax forms, persistence, prudence,
and integrity may be more adaptive than creativity and humor.
No peer-reviewed trials of MBSP have been published. A
pilot study (described in Niemiec 2011) showed substantial
improvements in flourishing, engagement in absorbing
activities, and use of signature strengths in daily life for
participants in MBSP. In an unpublished study, Briscoe
(2014) reported similar changes. Ongoing trials are examining
the efficacy of MBSP for a variety of settings and populations.
Mindfulness Training in the Workplace
Worksite stress reduction programs have been available since
well before the widespread use of secular MBIs. An early
review (Murphy 1984) noted that corporate expectations for
such programs typically include improvements in productivi-
ty, job satisfaction, and morale, as well as reduced medical and
disability costs, absenteeism, and turnover. The content of
such programs typically reflects contemporaneous psycholog-
ical research on treatment methods. Relaxation training
Mindfulness (2015) 6:956969 963
became a staple of worksite stress management in the 1970s;
cognitive restructuring was incorporated in the 1980s
(Flaxman and Bond 2006). It is not surprising that
mindfulness-based methods are popular now.
Experts in worksite stress reduction have long recog-
nized the importance of both individual-directed and
organization-directed interventions (Ganster et al. 1982).
The former teach stress management to workers, whereas
the latter focus on modifying workplaces to be less stress-
ful. Murphy (1984) acknowledged the potential injustice of
offering stress management to employees while making no
effort to improve poorly designed work environments but
concluded that worker-directed programs can have signifi-
cant benefits and Bshould not be discarded simply because
they do not attempt to reduce or eliminate objective
stressors in the work environment^(p. 13). Bond (2004)
noted that even in well-designed work environments, job-
related stressors such as difficult customers and seasonal
deadlines cannot be entirely eliminated; neither can exter-
nal stressors that influence work performance (e.g., family
discord). Bond (2004) argued for a comprehensive ap-
proach that includes both healthy working conditions (rea-
sonable demands, supportive supervisors) and training pro-
grams for employees wishing to learn stress management
skills.
Several MBIs have been studied as worksite interventions.
ACT has been shown to lead to improvements in employees
mental health, work performance, and propensity to innovate,
as well as reductions in burnout and illness-related absences.
Mediation analyses consistently show that these effects can be
attributed to increases in psychological flexibility, defined as
present-moment awareness combined with values-consistent
behavior (Flaxman and Bond 2010; Flaxman et al. 2013).
MBSR has been shown to reduce stress and burnout and im-
prove life satisfaction in health care professionals (Irving et al.
2009). Several case studies of workplace MBSP programs
reported improvements in employeesability to resolve dis-
putes, reduce interpersonal tension, and manage stress
(Niemiec and Lissing 2015). Wolever et al. (2012) developed
a 12-week mindfulness-based program designed specifically
for workplace delivery and reported significant improvements
in stress, sleep quality, and autonomic balance in a large group
of employees of an insurance company.
When organizations (or individuals within them) are en-
gaging in harmful or unethical practices, employees are be-
lieved to be the most effective source of corrective action
(Miceli and Near 2005). Through a process known as whis-
tle-blowing, employees who report illegal or unethical activi-
ties can have a significant impact on organizational behavior
(Vadera et al. 2009). Miceli et al. (2012) noted that most em-
ployees who observe wrongdoing do not report it but that
those who do are more likely to have a proactive personality
style characterized by the tendency to take action to influence
their environment. The Proactive Personality Scale (Bateman
and Crant 1993) measures this style with items such as, BIfeel
driven to make a difference in my community and even the
world,^and BNo matter what the odds, if I believe in some-
thing, I will make it happen.^The effects of MBIs on whistle-
blowing have not been studied. However, in a variety of pop-
ulations within and outside of the workplace, mindfulness
training has been shown to encourage characteristics similar
to the proactive personality style, including autonomy, envi-
ronmental mastery, purpose in life, clarity about personal
values, and willingness to engage in values-consistent behav-
ior in difficult circumstances (Carmody et al. 2009; Flaxman
and Bond 2010; Meeten et al. 2015). It therefore seems un-
likely that worksite mindfulness training will encourage pas-
sive acquiescence with corporate wrongdoing.
Two additional arguments support this position. First
claims that nonjudgmental acceptance promotes resignation
and helplessness are unfounded. Both MBSR and MBCT pro-
vide clear and frequent cautions against this misunderstand-
ing. Kabat-Zinn (2013) states that acceptance Bhas nothing to
do with passive resignation^but rather, Bwillingness to see
things as they are,^and an attitude that Bsets the stage for
acting appropriately in your life, no matter what is happening^
(p. 28). The MBCT manual (Segal et al. 2013) makes similar
points, noting that nonjudgmental acceptance disrupts mal-
adaptive chains of behavior and facilitates wise decision mak-
ing in difficult situations. Thus, upon observing unethical be-
havior in the workplace, an employee with mindfulness skills
is likely to recognize and acknowledge the thoughts and feel-
ings that arise (anger, disappointment, worry, etc.), accept
them nonjudgmentally as valid responses to the situation, re-
flect on potential courses of action, and choose values-
consistent behavior. In contrast, employees without mindful-
ness training may be more susceptible to denial of what oc-
curred, avoidance of the people involved or those with the
power to help, unhelpful emotion-driven behavior such as
temper outbursts or excessive drinking, and unproductive ru-
mination about the inadequacies of the work environment or
their own failure to address the situation.
Second, the APA ethics code (APA 2010) includes guide-
lines for psychologists who respond to third-party requests for
services and who work with organizations. Psychologists
hired by managers to provide training for employees must
consider how their services will be used and avoid exposing
participants to harm or exploitation. They must communicate
clearly with all parties about who is the client, the goals for
training, and the limits of confidentiality. A psychologist who
realizes that a corporate employer is hoping for increased
compliance with unethical practices or oppressive working
conditions is required to work toward constructive resolution
of this ethical conflict. Although many providers of MBIs are
not psychologists, other mental health disciplines have similar
ethical principles.
964 Mindfulness (2015) 6:956969
A recent study raises questions about the effects of an ex-
plicitly Buddhist-based approach to worksite mindfulness
training on employeesadherence to corporate agendas.
Work er s attitudes toward their employers were examined in
a study of MAT (Shonin and Van Gordon 2014; Shonin et al.
2014a), an 8-week meditation-based intervention described
earlier that teaches Buddhist concepts such as nonself and
impermanence. Middle managers in a variety of workplaces
reported that MAT helped them to be Bless preoccupied with
their own agenda and entitlements^and better able to Balign
their roles with corporate strategy^(Shonin and Van Gordon
2014). Shonin et al. (2014a) suggested that, Bvia the
meditation-induced understanding that there is not a self that
exists inherently, independently, or as a permanent entity, em-
ployees can begin to dismantle their emphasis on the I,the
me, and the mine, and can better synchronize their own
interests with those of the organizations^(p. 819). The authors
also claimed that their findings may Brebut several established
systems of thought within occupational psychology^(p. 820),
one of which is the widely endorsed need for organization-
directed work-well-being interventions. That is, rather than
addressing problems in the work environment such as inflex-
ible hours, conflicting demands, and poor support infrastruc-
ture, the authors suggest that it may be more efficacious to
modify employeesBinternal (i.e., psychological) working
environment^(p. 818) through meditation.
In organizations engaged in ethical practices, the attitudinal
shift produced by MAT might be an adaptive outcome.
Participants in Shonin et al. reported significant reductions
in work-related and general distress and improvements in
job satisfaction and performance. In qualitative interviews
(Shonin and Van Gordon 2014), they reported that work be-
came an opportunity to flourish and that their understanding of
work situations and co-workersperspectives improved. They
also expressed appreciation for their new understanding of
nonself and impermanence. However, if acquiescence with
unethical or oppressive business practices is a concern, an
approach that increases employeesalignment with their em-
ployersagendas might have disadvantages. Although the
more secular MBIs described earlier cultivate qualities that
may promote whistle-blowing, such as autonomy and clarity
about personal values, the effects of this more explicitly
Buddhist-based approach on such qualities are unclear.
Deciding What to Teach
In the early days of psychological research on the efficacy of
MBIs, Teasdale et al. (2003) argued that interventions should
be based on clear theoretical formulations of how mindfulness
can be expected to help with the specific problems to which it
is applied. MBCT, for example (Segal et al. 2002), was devel-
oped to address a well-documented problem: the tendency for
people with a history of depressive episodes to have multiple
relapses. An empirically based theory was developed to ex-
plain why depression recurs and how recurrences might be
prevented. The intervention then was designed to include spe-
cific practices and exercises that theory and previous evidence
suggested should help participants learn to manage the factors
that lead to relapse. Issues of feasibility and acceptability, in-
cluding participantswillingness to engage with the practices,
were carefully considered.
A similar framework may be helpful in considering wheth-
er and how ethics should be taught in secular MBIs. A sound
theoretical model of how ethics training will address a clearly
identified problem or facilitate a desired outcome is essential.
In the context of psychological science, theoretical models
may draw inspiration from a variety of sources, including
spiritual teachings, but must be described in terms with
established meanings within psychology and must be testable
with psychological research methods. Translation from
Buddhism to the language of psychological science can be
difficult. As noted in several of the replies to Monteiro et al.,
Buddhism and psychology have different understandings of
many important terms, including suffering (Lindahl 2015)and
insight (Purser 2015). Defining such terms in ways that permit
scientific study may introduce inconsistencies with the
Buddhist teachings.
A clear rationale for how ethics-related training should
be conducted in MBIs is also necessary. One option is to
allow the cultivation of ethical qualities to remain implicit.
In addition to the factors cited earlier in support of this
approach, Niemiec (2014) suggested that mindfulness
training implicitly encourages virtues discussed in positive
psychology: wisdom through the practice of curiosity and
the decentered perspective, courage through remaining
present with painful thoughts and feelings, humanity by
the practice of kindness and compassion, temperance
through the practice of self-regulation (of ones attention
while practicing and of ones behavior in making time to
practice), and transcendence through the understanding of
oneself as distinct from ones thoughts and feelings.
Empirical work is needed to test these ideas. MBIs also
may cultivate awareness of personal values even when ex-
plicit values work is not part of the curriculum. Kabat-Zinn
(2005) notes that mindfulness facilitates awareness of Bthe
whispered longings^of ones own heart (p, 22); presum-
ably, these reflect what participants value most deeply.
A second option is to teach ethics as they are described in
Buddhist traditions. As noted earlier, several interventions do
this, typically through explicit discussion of the eightfold path
and the five ethical precepts; some also include teachings
about impermanence and nonself. Although a small number
of controlled studies support the efficacy of these treatments,
they have been compared only to usual care or waiting lists;
thus, there is no evidence that MBIs that include explicit
Mindfulness (2015) 6:956969 965
Buddhist-based ethical training are more effective than those
that do not. Several of the replies to Monteiro et al. point out
that explicitly Buddhist foundations can be problematic in
settings where secular approaches to treatment are required.
Although it is common for MBIs to be described as secular
adaptations, several authors have raised questions about
whether this claim is defensible when consistency with the
Buddhist teachings remains an important concern (Purser
2015). Lindahl (2015) suggested that explicit adoption of
Buddhist conceptions of ethics and suffering may lead to the
perception that MBIs are trying to advance a religious per-
spective and are therefore inappropriate for some settings.
For researchers and clinicians who prefer to work explicitly
with values, virtues, character strengths, or ethical behavior in
the workplace, while remaining independent of the Buddhist
teachings, empirically based psychological approaches appear
promising. Many MBIs incorporate values work without
reference to or reliance on Buddhist ethics. Hayes (2002)
notes that ACT and Buddhist teachings have several clear
parallels but states that he made no attempt to base ACT on
Buddhism and that the parallels are an Bunexpected
confluence^showing that both are working with Btopics cen-
tral to human suffering^(p. 58). The virtues and character
strengths of positive psychology were derived from the study
of religious and philosophical traditions, including Buddhism,
but have been conceptualized in ways that intentionally em-
brace the language and methods of contemporary psycholog-
ical science. Organizational psychology and related disci-
plines (occupational psychology, personnel psychology, busi-
ness ethics) provide additional bodies of research on factors
related to ethical behavior in the workplace.
Conclusions
Discussion of explicit ethical training in MBIs raises questions
about the source of authority regarding what is ethical. Codes
of professional ethics that require respect for cultural diversity
and self-determination (e.g., APA 2010) make it problematic
for mental health and other professionals to teach ethics based
on a particular religious or spiritual framework in many con-
temporary secular settings. Methods based on self-identified
values or cross-culturally recognized virtues and character
strengths appear to have several advantages over the explicitly
Buddhist-based approaches to ethics training described earlier.
They have stronger theoretical and empirical foundations in
psychological science, can be used in a variety of secular
settings, and are appropriate for a wide range of clients, re-
gardless of their religious or spiritual orientations.
Buddhism is a rich tradition that has informed several
MBIs that now have strong empirical support for their effica-
cy. It may be tempting to assume that MBIs would be even
more effective if they were more consistent with the Buddhist
teachings; however, this is an untested proposition. It is pos-
sible that the efficacy of MBIs in Western settings is attribut-
able, at least in part, to adaptations that have made them less
consistent with the Buddhist teachings. The most important
question facing MBIs is not whether we can make them more
consistent with Buddhism but how we can maximize their
benefits for the broadest possible spectrum of participants.
When sound theory and empirical findings suggest that ex-
plicit work with ethics, values, virtues, or character strengths
may accomplish this, we should test these hypotheses using
the best available methods of psychological science and with
openness to where the findings may lead us.
Acknowledgments I thank Alex Brake, Melody Carswell, Jessica Pe-
ters, and Richard Smith for helpful comments on earlier drafts.
Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no conflict of
interest.
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Chapter
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Chapter
The epidemic of burnout illuminates a public health crisis within medicine, and in oncology, with noteworthy ethical implications for sustaining the workforce. Physicians report increased time and responsibility dedicated to electronic record documentation, patient quotas, and administrative tasks that compromise their personal and professional values, physician-patient relationship, and the provision of quality, ethical care. These tasks contribute to burnout and moral distress resulting in consequences including anxiety, depression, substance abuse, and a demoralized workforce. From an ethical perspective, the physician-patient relationship will only be sustained if the medical community deliberately prioritizes physician well-being. Efforts dedicated to fostering resilience and professional fulfillment are critical. Workforce sustainability is an organizational moral imperative that ultimately advances care. Leadership has a fiduciary duty to recognize burnout and its ethical impact on overall well-being; proactively engage leaders and physicians in collaborative action planning; and improve practice environment and culture.
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Mindfulness practice and character strengths have been determined as being two separate positive psychology interventions (PPIs). However, to date, no programme has researched and investigated the effects of combining these theoretically interlinked practices together, with the aim of enhancing wellbeing from a positive psychology perspective. The current controlled study was designed to establish the effectiveness of an 8-week online mindfulness-based character strengths practice (MBSP) on wellbeing, for the general population. Nineteen participants completed the MBSP programme, and 20 participants were placed in a no-intervention control group. Self-report questionnaires, including Satisfaction With Life Scale, Flourishing Scale, Positive Psychotherapy Inventory, and a Signature Strengths Inventory Scale, were used to evaluate the levels of wellbeing and flourishing pre-and post-intervention. Wilcoxon signed-rank tests found that MBSP participants scored significantly higher in all four measures post-MBSP, whereas participants in the control group did not, with the only exception of a slight increase in satisfaction with life scores. The study found MBSP to be the first PPI programme aimed at the general population, which explicitly focuses on character strengths to elicit significant positive changes and increase levels of wellbeing. Given our preliminary results, larger samples utilising randomised control trial methods should attempt to confirm these preliminary findings. The programme's future is promising, since its application appears to have great potential to positively influence people's lives, thus moving closer to the goal of increasing societal flourishing.
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Character strengths are often referred to as the backbone of positive psychology. Mindfulness has, at its essence, character strengths (e.g., self-regulation and curiosity) and numerous correlates and outcomes relating to character strengths (e.g., kindness, perspective, creativity) are associated with mindfulness practices. Mindfulness-based strengths practice (MBSP), a manualized approach that integrates these practice areas, emphasizes how each practice can mutually enhance the other. Character strengths can be woven into mindfulness practices in order to combat meditation barriers (e.g., mind wandering; scheduling problems; body discomfort) that participants report when attempting to maintain a mindfulness practice. In turn, mindfulness practice helps individuals to be more tuned in to social situations and to inner phenomena to assist in optimal character strengths expression. Popular character strengths practices such as strengths-spotting, developing signature strengths, and targeting specific strengths are supported by the open and accepting nature of mindfulness approaches. At the same time, individuals can become more engaged and adept at mindful living practices such as mindfulness in relationships, mindful listening, mindful eating, and mindful walking by deploying their strengths. This chapter will review the MBSP program as well as the links between mindfulness, character strengths use, and positive outcomes. While the science of MBSP is young, preliminary research and case examples from MBSP programs with participants across multiple countries show promise and are presented.
Book
Since the original publication of this seminal work, acceptance and commitment therapy (ACT) has come into its own as a widely practiced approach to helping people change. This book provides the definitive statement of ACT—from conceptual and empirical foundations to clinical techniques—written by its originators. ACT is based on the idea that psychological rigidity is a root cause of a wide range of clinical problems. The authors describe effective, innovative ways to cultivate psychological flexibility by detecting and targeting six key processes: defusion, acceptance, attention to the present moment, self-awareness, values, and committed action. Sample therapeutic exercises and patient–therapist dialogues are integrated throughout. New to This Edition *Reflects tremendous advances in ACT clinical applications, theory building, and research. *Psychological flexibility is now the central organizing focus. *Expanded coverage of mindfulness, the therapeutic relationship, relational learning, and case formulation. *Restructured to be more clinician friendly and accessible; focuses on the moment-by-moment process of therapy.
Book
The Book is the Italian Edition of M-M: Linehan DBT skills training manual pp.900
Article
Although the deleterious effects of work-related stress on employee well-being and organizational effectiveness have received wide attention in the literature, few, if any, controlled experiments have been attempted to assess the effects of stress reduction interventions. In the present study, a stress management training program was evaluated in a field experiment with 79 public agency employees who were randomly assigned to treatment (« = 40) and control (n - 39) groups. The training program consisted of 16 hours of group exposure distributed over 8 weeks. Using procedures based upon those developed by Meichenbaum (1975), treatment subjects were taught to recognize and alter their cognitive interpretations to stressful events at work. Subjects were also taught progressive relaxation techniques to supplement this process. Dependent variables were epinephrine and norepinephrme excretion at work, anxiety, depression, irritation, and somatic complaints, all measured at three times (pretest, posttest, and 4 months after treatment). Treatment subjects exhibited significantly lower epinephrine and depression levels than did controls at the posttest, and 4-month follow-up levels did not regress to pretest levels. However, treatment effects were not replicated in a subsequent intervention on the original control group. The general adoption of such stress management programs was not recommended.
Article
Family law proceedings encompass a broad range of issues, including custody, maintenance, support, valuation, visitation, relocation, and termination of parental rights. The following guidelines address what are commonly termed child custody evaluations, involving disputes over decision making, caretaking, and access in the wake of marital or other relationship dissolution. The goal of these guidelines is to promote proficiency in the conduct of these particular evaluations. This narrowed focus means that evaluations occurring in other contexts (e.g., child protection matters) are not covered by these guidelines. In addition, the guidelines acknowledge a clear distinction between the forensic evaluations described in this document and the advice and support that psychologists provide to families, children, and adults in the normal course of psychotherapy and counseling.
Article
Mindfulness-integrated CBT: Principles and Practice represents the first set of general principles and practical guidelines for the integration of mindfulness meditation with well-documented and newly developed CBT techniques to address a broad range of psychological dysfunctions. • The first book to provide a strong rationale and general guidelines for the implementation of mindfulness meditation integrated with CBT for a wide range of psychological difficulties • Incorporates ancient Buddhist concepts of how the mind works, while remaining firmly grounded in well-documented cognitive and behavioural principles • Provides new insights into established understanding of conditioning principles • Includes a comprehensive list of frequently asked questions, week-by-week instructions for professionals to facilitate application of the therapy, along with case examples and the inspiring stories of former clients.
Article
Mindfulness is typically described as a form of nonjudgmental, nonreactive attention to experiences occurring in the present moment, including cognitions, emotions, and bodily sensations, as well as sights, sounds, smells, and other environmental stimuli. The cultivation of mindfulness is a central component of Eastern meditation traditions and lies at the heart of Buddhist teachings about the nature of reality and human experience. This chapter argues that mindfulness cultivates human characteristics that are central to positive psychology, including character strengths and virtues and psychological wellbeing, but it does so through acceptance-based rather than change-based methods. Because mindfulness training appears to have a broad range of outcomes, including enhancement of positive characteristics, its potential contribution to optimal human functioning warrants substantially increased attention. The chapter examines the literature supporting this view, discusses the processes or mechanisms through which this may occur, and suggests directions for future research.