NHS Education for Scotland Good Practice Guidelines Trainee Journey in Mindfulness and the development of competency guidelines

The following describes recommended good practice guidance in the trainee journey for a practitioner in a health related field who wishes to utilize mindfulness in a clinical context and to run mindfulness groups for clients.  This is adapted from a document prepared for the “Doing Well for People with Depression” project in 2005, and is supplemented by guidelines developed by the Centre for Mindfulness Research and Practice at the University of Bangor.

 

Practitioner Level

Suitable trainees will have a professional qualification in a clinical related field and preferably some degree of experience in group facilitation.

 

It is expected that at practitioner level, the trainee will have:

 

1.


  • Familiarity with the 8 week course curriculum (Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy) through participation in an 8 week programme or the equivalent delivered in a different format of teaching and through the reading of core texts: “Full Catastrophe Living”, by Jon Kabat Zinn and “Mindfulness Based Cognitive Therapy for Depression”, by Teasdale, Williams and Segal. 

2.


  • Attended a mindfulness practice / supervision group on a monthly basis for at least 6 months.

3.


  • Maintained contact with trainers and other practitioners, for example, through joining the e-mail group, Scotmig or attending a local practice group.

4.


  • Developed a commitment to the daily personal practice of mindfulness, though engaging in formal practices (meditation and body-focussed work such as yoga), and informal application of mindfulness in everyday life.

5.


  • Maintained interest in and commitment to the on-going participatory learning process (for example, through relevant reading, contact with the mindfulness network, and attendance at meditation or yoga classes, attendance at a teacher-led meditation retreat, or something similar).

6.


  • Taken part in discussions as to the clinical applications and suitability of these approaches for patients in trainee’s clinical field of expertise (with appropriate adaptations if necessary for safe practice), with awareness-raising of other professionals, and in providing feedback / taster sessions in their respective clinical or community settings.

7.


  • Willingness to seek out appropriate supervision and consultation during the planning and delivery of their first patient based mindfulness programme, and for future programmes as appropriate.

8.


  • If at all possible, attended a mindfulness teacher development programme perhaps in the context of a retreat, as run at the Centre for Mindfulness at the Universities of Bangor or Massachusetts, or an equivalent programme in Scotland.

9.


  • If conditions have allowed, co-facilitated a mindfulness course with a more experienced practitioner or trainer.

At the end of a recommended 12 month period, the practitioner will have a relatively sustained personal mindfulness practice.  They will be able to start adapting mindfulness approaches to their own clinical setting and running courses for clients.

A trainee, who already has extensive experience of a personal mindfulness practice, is likely to have a faster journey to competent practitioner. Such a background is an advantage, but not a guarantee as to suitability.  Some may have suitable qualities for teaching through alternative life experiences, personal qualities / maturity and professional experience of group facilitation and training.  Others who may exceed these minimum suggested requirements may turn out not to be effective trainers in mindfulness if they do not possess the nine areas of competence described below. 

 

Maintaining Practitioner Level


It would be expected that a mindfulness practitioner makes a commitment to maintaining and building upon the skills they have developed with personal practice and application in clinical settings.  Good practice would recommend:

  • Ongoing commitment to a personal mindfulness practice through daily formal and informal practice and attendance on teacher-led retreats.
  • Maintaining contact with mindfulness colleagues and network in order to share experience and to work collaboratively.
  • Seeking opportunities for supervision of group work and enquiry into personal practice by an experienced teacher / practitioner.
  • Ongoing commitment to further learning and development of mindfulness through reading, review of the research literature, attending conferences or training events and connection with mindfulness teachers.
  • Ongoing commitment to engage in further training in order to develop skills in delivering mindfulness based approaches.

 

Supervisor and Trainer Level


This is the ability to supervise mindfulness teachers and train staff in becoming mindfulness teachers.  This level requires ongoing skills development in mindfulness practice and delivery, including ongoing reflective practice, the supervision of one’s work and the building up of a body of experience through the delivery of numerous patient based groups, taster and orientation sessions, staff training, and supervision and so on.  It involves a deep commitment to personal practice with duration of at least two years, and seeking regular support for one’s own practice in the context of teacher-led group or retreat.  It involves a commitment to further training, ongoing participatory learning and a commitment to adhere to the ethical and moral principles underlying mindfulness practice, namely, taking a non-judgemental stance, the development of self-awareness and a self-reflective practice and the development of compassion. 

 

Nine areas of competency for mindfulness based teachers (therapists & trainers)


The following are developed by the University of Bangor’s Centre for Mindfulness and are recommended competencies of mindfulness teachers. 

Competent teaching of mindfulness-based approaches arises from understanding and skills in the following areas:

  • Mindfulness
    Core presence within self and with the group; groundedness; centredness; awareness; teaching out of one's own process and the immediate experience of the group; articulating and embodying the essence of formal and informal mindfulness practice in ways that come out of the teacher’s own experience and also reflect the heart and spirit of the approach.
  • Interconnection 
    Working through a relational process with clients thatembodies connectivity, kindness, compassion and mutuality.
  • Teaching skills
    Translating mindfulness practice into practical, readily accessible language throughout the teaching – within the practices, within the inquiry process and during didactic and information-giving elements of the programme; covering the curriculum; appropriate responses to choice points; clear communication; working within a mindfulness approach that does not veer into other strategies such as a problem solving or therapy style.
  • Working with the difficult
    A willingness to embrace and as appropriate move in close with difficulties and challenges that individuals bring and that arise within the group of teaching process.
  • Working with context
    Well developed skills, knowledge and experience of the client group - only teaching with clients with whom one has been trained to work; theoretical understanding and experience in adapting the programme to particular client groups.
  • Group process skills
    Well developed skills in working with and facilitating groups; understanding group development processes, and the effect of the group on the individual; interactive teaching and sensitivity for what it is that different people need in any moment in a teaching situation; an appropriate co-leader process.
  • Interpersonal skills
    Ability to establish effective interpersonal relationships with participants – warmth, acceptance and respect; ability to maintain appropriate roles and boundaries with participants.
  • Ethical integrity
    A high level of ethical integrity, including respect for all participants, their inner resources and their boundaries, as well as awareness of one’s own limitations, ambitions and agendas so that they affect this work as little as possible. This includes working sensitively with cultural diversity and respecting difference.
  • Organisational skills
    ability to effectively organise the teaching time and space, the course components: marketing, initial interviews, administration, evaluations and room preparation.