Assessing Mindfulness and Acceptance Processes in Clients: Illuminating the Theory and Practice of Change

330 Pages·2010·3.29 MB·English

by  Ruth Baer PhD

“Informed by the maxim that you can’t study what you can’t see, Baer’s book
provides the necessary psychometric underpinning to further our under-
standing of core change processes in mindfulness-based interventions.”
— Zindel V. Segal, Ph.D., Cameron Wilson Chair in
Depression Studies at the Centre for Addiction and Mental
Health and author of The Mindful Way Through Depression
“Mindfulness meditation has become a leading clinical intervention for
clients with multiple problems, ranging from pain and physical discom-
fort (mindfulness-based stress reduction) to mental health problems such
as depression (mindfulness-based cognitive therapy). Although mindfulness
training has been shown to be effective in various clinical outcome studies,
questions have been raised about the mechanisms of change that help
explain these successful results. This new book, edited by Ruth Baer, pro-
vides a variety of perspectives on potential mechanisms of change, including
decentering, psychological flexibility, values processes, emotion regulation,
self-compassion, and spiritual engagement. I highly recommend this book
as a cutting-edge approach to understanding mindfulness and acceptance
processes in clients.”
— G. Alan Marlatt, Ph.D., professor of psychology at
the University of Washington and director of the
Addictive Behaviors Research Center
“Ruth Baer has consistently been at the forefront of careful study of the
efficacy of mindfulness-based treatments. In this edited volume, she pro-
vides readers with a thoughtful review of a crucial area of study: potential
mechanisms that may underlie the efficacy of mindfulness and acceptance-
based psychotherapies. Each chapter provides a conceptual and empirical
review of a relevant process (e.g., decentering, emotion regulation), as well
as relevant assessment methods. This kind of attention to the reasons why
mindfulness-based intervention may be beneficial will help stimulate infor-
mative research in the area and also help clinicians provide therapy that
enhances these important skills.”
— Lizabeth Roemer, Ph.D., professor of psychology at the
University of Massachusetts and coauthor of Mindfulness-
and Acceptance-Based Behavioral Therapies in Practice
“In this comprehensive and much-needed book, Ruth Baer and colleagues
present the most up-to-date findings on exactly how mindfulness and accep-
tance might work to increase psychological well-being. An excellent resource
not only for mindfulness researchers and practitioners, but for anyone inter-
ested in what leads to mental health and emotional balance.”
— Cassandra Vieten, Ph.D., director of research at the Institute
of Noetic Sciences and author of Mindful Motherhood
“A fascinating journey to the heart of what actually changes in mindful-
ness and acceptance-based treatment. Ruth Baer and her colleagues offer a
brilliant and careful review of one of the most exciting areas of behavioral
research in decades. This book is highly recommended for psychotherapists,
health care professionals, and anyone seeking the very latest scientific under-
standing of psychological change.”
— Christopher K. Germer, Ph.D., clinical instructor in
psychology at Harvard Medical School and author of
The Mindful Path to Self-Compassion
“A cutting edge text which responds with rigor and clarity to the salient
questions in the field of mindfulness-based interventions, namely, what are
the mechanisms and processes of change? And how can these processes
be assessed? Baer does an excellent job weaving different perspectives and
theories from a wide range of experts to provide a pioneering response to
these compelling questions.”
— Shauna L. Shapiro, Ph.D., coauthor of The Art and
Science of Mindfulness
“This is an important and timely book. Ruth Baer has brought together
international experts in the clinical and research fields to build a criti-
cally important bridge between ancient wisdom and modern psychological
science. This book will be essential reading for students, researchers, and
practitioners of mindfulness and acceptance-based approaches.”
— Mark Williams, professor of clinical psychology at
the University of Oxford and coauthor of The Mindful
Way Through Depression
ASSESSING
MINDFULNESS
& ACCEPTANCE
PROCESSES IN
CLIENTS
Illuminating the Theory & Practice of Change
Edited by
RUTH A. BAER, PH.D.
C P
ontext ress
An Imprint of New Harbinger Publications, Inc.
Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It
is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other pro-
fessional services. If expert assistance or counseling is needed, the services of a competent professional should be sought.
Distributed in Canada by Raincoast Books
Copyright © 2010 by Ruth A. Baer
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
All Rights Reserved
Acquired by Catharine Sutker; Cover design by Amy Shoup;
Edited by Jasmine Star; Text design by Tracy Carlson

Library of Congress Cataloging-in-Publication Data
Assessing mindfulness and acceptance processes in clients : illuminating the theory and practice of change / Ruth
A. Baer, editor ; Including contributions from Kelly Wilson ... [et al.].
p. cm.
Includes bibliographical references and index.
ISBN 978-1-57224-694-2
1. Mindfulness-based cognitive therapy. 2. Meditation--Therapeutic use. I. Baer, Ruth A. II. Wilson, Kelly G.
RC489.M55A87 2010
616.89’1425--dc22
2010002416
Contents
INTRODUCTION
Mindfulness- and Acceptance-Based Interventions and
Processes of Change . . . . . . . . . . . . . . . . . . . . . . . .1
Ruth A. Baer, University of Kentucky
Part 1:

Processes of Change
CHAPTER 1
Mindfulness and Decentering as Mechanisms of Change
in Mindfulness- and Acceptance-Based Interventions . . . . 25
Shannon Sauer and Ruth A. Baer, University of Kentucky
CHAPTER 2
Psychological Flexibility as a Mechanism of Change
in Acceptance and Commitment Therapy . . . . . . . . . . . 51
Joseph Ciarrochi, Linda Bilich, and Clair Godsell, University
of Wollongong, Australia
Assessing Mindfulness and Acceptance Processes In Clients
CHAPTER 3
Understanding, Assessing, and Treating Values Processes
in Mindfulness- and Acceptance-Based Therapies . . . . . . 77
Kelly Wilson, Emily K. Sandoz, Maureen K. Flynn, and
Regan M. Slater, University of Mississippi; and Troy DuFrene,
OneLife Education and Training
CHAPTER 4
Emotion Regulation as a Mechanism of Change
in Acceptance- and Mindfulness-Based Treatments . . . . 107
Kim L. Gratz and Matthew T. Tull, University of Mississippi
Medical Center
CHAPTER 5
Self-Compassion as a Mechanism of Change
in Mindfulness- and Acceptance-Based Treatments . . . . 135
Ruth A. Baer, University of Kentucky
CHAPTER 6
Spiritual Engagement as a Mechanism of Change
in Mindfulness- and Acceptance-Based Therapies . . . . . 155
Jean L. Kristeller, Indiana State University
CHAPTER 7
Meditation and Neuroplasticity:
Using Mindfulness to Change the Brain . . . . . . . . . . . 185
Michael T. Treadway, Vanderbilt University, and Sara W.
Lazar, Massachusetts General Hospital
iv
CHAPTER 8
What Does Mindfulness Training Strengthen?
Working Memory Capacity as a Functional
Marker of Training Success . . . . . . . . . . . . . . . . . . 207
Amishi P. Jha, University of Pennsylvania; Elizabeth A.
Stanley, Georgetown University; and Michael J. Baime,
University of Pennsylvania
Part 2:

Special Populations and Settings
CHAPTER 9
Acceptance and Mindfulness as Mechanisms
of Change in Mindfulness-Based Interventions
for Children and Adolescents . . . . . . . . . . . . . . . . . 225
Michael P. Twohig, Clinton E. Field, Andrew B. Armstrong,
and Angie L. Dahl, Utah State University
CHAPTER 10
Acceptance and Mindfulness as Processes of
Change in Medical Populations . . . . . . . . . . . . . . . . 251
Lance M. McCracken and Kevin E. Vowles, University of
Bath, United Kingdom; and Jennifer Gregg and Priscilla
Almada, San Jose State University, San Jose, California
CHAPTER 11
Acceptance and Commitment Training: Promoting
Psychological Flexibility in the Workplace . . . . . . . . . . 281
Paul E. Flaxman, City University London; and Frank W.
Bond, Goldsmiths College, University of London
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
v

Introduction
Mindfulness- and Acceptance-Based
Interventions and
Processes of Change
Ruth A. Baer, University of Kentucky
Psychological interventions based on mindfulness and acceptance have
attracted extraordinary interest in a very short time. The New York Times
recently described mindfulness meditation as “perhaps the most popular
new psychotherapy technique of the past decade” (Carey, 2008). Although
mindfulness meditation originates in ancient Buddhist traditions that have
evolved over many centuries, the incorporation of secular forms of mindful-
ness practice into contemporary Western settings is quite recent.
Mindfulness-based principles and practices are applied to psychologi-
cal treatment in many ways. Some therapists maintain a personal practice
of mindfulness meditation to improve their own well-being and peace of
mind and develop a more attentive, balanced, and compassionate pres-
ence during therapy sessions, but don’t teach mindfulness to their clients
(Germer, Siegel, & Fulton, 2005). Others incorporate wisdom and insight
from Buddhist teachings on concepts such as impermanence and acceptance
into their discussions with clients without explicitly teaching their clients
to engage in mindfulness practices (Shapiro & Carlson, 2009). Most of
the empirical literature, however, describes structured treatments in which
formal or informal mindfulness practices are explicitly taught as a central
therapeutic ingredient. The best known of these, which have accrued sub-
stantial support for their efficacy, are acceptance and commitment therapy