Mindfulness is becoming an increasingly popular way to promote resilience and wellbeing in both patients and staff in the NHS. Physiotherapist Karen Glass, who helps run mindfulness programmes for NHS staff, investigates the topic.
What is ‘mindfulness’?
Mindfulness is a way of ‘being’. It is a basic human quality of awareness. It can be which can be described as
- paying attention (learning to focus on what you choose)
- in the present moment (rather than the past or future)
- non-reactively (learning to ‘respond’ rather than ‘react’)
- non-judgementally (learning to see things as they are)
- open heartedly (bringing qualities of warmth, compassion curiosity and acceptance to your experience)
How might it work?
Mindfulness practices are a form of brain training. Regular practice is linked to changes in areas of the brain responsible for mood regulation and reactions which in turn link to bodily functions like breathing, heart rate and immunity (Campbell collaboration 2012:3).
What is the evidence for stress reduction in healthy individuals?
Most of the published research relates to mindfulness as it is taught in eight sessions held over two months – either in the form of mindfulness-based stress reduction (MBSR) or mindfulness-based cognitive therapy (MBCT).
MBSR is of particular interest in relation to supporting staff resilience and stress management. In a Campbell Systematic Review, de Vibe et al evaluated the effect of MBSR on health, quality of life and social functioning in adults.
They concluded: ‘There is moderate to high quality evidence for a consistent and moderately large effect of MBSR ... While MBSR clearly alleviated symptoms of stress and distress, it also had effects on measures of personal development and quality of life.’ The authors support the use of MBSR for stress management.
How is mindfulness used in the NHS?
MBCT is delivered as a psychological intervention in many mental health services but is not universally available, despite being recommended by NICE. MBSR type-courses and MBCT are available in some sites for staff wellbeing, but, again, provision is patchy.
As well as the recognised eight-week programmes, mindfulness-based approaches have been incorporated into many patient treatment programmes both within mental and physical health arenas.
Why is mindfulness relevant to physiotherapy?
Physiotherapists, like many NHS employees, experience high levels of stress at work. This approach can help us to manage stress and its impact on our wellbeing and clinical effectiveness.
For our patients, mindfulness approaches are asset-based with a focus on self-awareness, working with what is there, managing thoughts, emotions and physical sensations, and making wise choices about how best to take care of yourself. They actively support increased self-efficacy.
In MBSR there is a strong emphasis on movement in the form of yoga-type stretches and walking as forms of meditation practice.
As movement experts, we have a unique understanding of the body and ‘embodiment’ and how this can be a gateway to improvements in physical and mental functioning.
How do I find a local class or get started by myself?
Selected workbooks, online eight-week courses and a range of resources are listed above in the reference section. As yet, there is no accreditation process but good practice guidance for teachers has been agreed and Bangor and Oxford universities are leading the way is establishing a rigorous competency framework (MBI-TAC: http://bit.ly/1WtMDnL)
A list of teachers and training organisations is available here.
With the support of her manager Janice Miller and funding from NHS Education for Scotland (NES), the author (Karen Glass) and physiotherapy colleagues Stephanie Wilson and Aileen O’Gorman are leading staff wellbeing developments, including mindfulness.
For more information, see the ‘Fresh start’ letter in Frontline, page 4, 20 January or email karen.glass@ggc.scot.nhs.uk
- Karen Glass is a practice development physiotherapist with NHS Greater Glasgow and Clyde and is a member of the charity Mindfulness Scotland
Key reference documents
- The Mindfulness All Party Parliamentary Group’s Mindful Nation UK report.
- National Institute for Health and Clinical Excellence (NICE) guidelines for the use of mindfulness approaches in various conditions.
- de Vibe M et al. Mindfulness Based Stress Reduction (MBSR) for improving health, quality of life and social functioning in adults. Campbell Systematic Reviews 2012 doi.
- Chiesa A and Serretti A 2010; A systematic review of neurobiological and clinical features of mindfulness meditations, Psychological Medicine, 40, 1239-252.
Useful websites and resources
Explore YouTube videos
- Jon Kabat Zinn
- Professor Mark Williams’ meditations
- Professor Richard Davidson
Recommended books
- Full Catastrophe Living: How to cope with stress, pain and illness using mindfulness meditation by Jon Kabat-Zinn
- Mindfulness for Dummies by Shamash Alidina
- Mindfulness: A practical guide to finding peace in a frantic world by Mark Williams and Danny Penman
- You are Not your Pain by Vidyamala Burch and Danny Penman
- The Mindful Workplace by Michael Chaskalson
Key training and research centres
Mindfulness at work for staff
8-week courses: workbooks and online resources
- MBCT: The Mindful Way Workbook by John Teasdale and others
- MBSR: (free)
- MBSR: Mindfulness in 8 weeks by Michael Chaskalson
- MBSR: A Mindfulness-Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein
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