The Clinical Handbook of Mindfulness-integrated Cognitive Behavior Therapy A Step-by-Step Guide for Therapists

The essential guide to MiCBT for therapists working in clinical settings

The Clinical Handbook of Mindfulness-integrated Cognitive Behavior Therapy offers therapists working in clinical settings a practical set of evidence-based techniques derived from mindfulness (vipassana) training and the principles of Cognitive Behavior Therapy. The increasing popularity of Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) is principally attributed to its transdiagnostic applications. It offers novel tools that address a broad range of psychological disorders both acute and chronic, including those with complex comorbidities, and helps prevent relapse.

The authoritative guide to this unique approach includes: 

• A clear explanation of MiCBT’s origins and development, structure and content, scientific underpinnings and supporting empirical evidence
• A comprehensive guide to the 10-session MiCBT program for groups and individual clients that includes worksheets and handouts for each session and suggestions to overcome common difficulties
• A presentation of the research and practical experience of the authors, noted experts in the field of MiCBT

Written for mental health therapists working with groups and individual clients, The Clinical Handbook of Mindfulness-integrated Cognitive Behavior Therapy offers an effective guide for implementing the principles of MiCBT within their professional practice.

BRUNO A. CAYOUN is a clinical psychologist, researcher and the developer of Mindfulness-integrated Cognitive Behavior Therapy. He is the founder and Director of the MiCBT Institute.

SARAH E. FRANCIS is a registered psychologist trained in a number of mindfulness-based therapies. She specializes in the research and clinical applications of Mindfulness-integrated Cognitive Behavior Therapy.

ALICE G. SHIRES is a clinical psychologist and Director of the Psychology Clinic at the Graduate School of Health, University of Technology, Sydney (UTS) and heads the UTS Mindfulness Integrated Therapies Research Clinic.

About the Authors xiv

Foreword xvi

Acknowledgments xviii

Introduction xix

About the Companion Website xxiii

Part 1 The MiCBT Approach, Theory and Validation 1

1 Principles of MiCBT 3

Definition and Purpose of Mindfulness 3

Origin and Development 5

Basic Principles 7

Structure and Content of MiCBT: The Four Stages 11

References 19

2 Theoretical Framework and Empirical Findings 23

The Co‐emergence Model of Reinforcement: A Rationale for MiCBT 24

Empirical Evidence 32

References 35

3 Preparing for Implementation 40

Importance of Commitment 40

Helpful Attitudes 42

Program Delivery 46

Client Suitability and Contraindications 46

Professional Training and Ethics 47

Resources 49

References 50

Part 2 Step-by-Step Application 53

Session 1: Therapy Contract and Commitment to Self‐Care 55

Writing a “Therapy Contract” 55

Readiness for Change 57

Three Ways of Learning 58

Importance of Neuroplasticity 62

This Week’s Practice 62

Application with Individual Clients 64

Application with Groups 67

Frequently Asked Questions 71

References 84

Session 2: Regulating Attention Through Mindfulness of Breath 85

Introduction 85

Checking Client Readiness 85

Purpose of Mindfulness of Breath 86

Practice Set‐up 87

Differentiating Mindfulness from Attentiveness 92

Normalizing Intrusive Thoughts 93

Application with Individual Clients 97

Application with Groups 100

Frequently Asked Questions 104

References 115

Session 3: Understanding and Regulating Emotions 117

Introduction 117

Checking Client Readiness 117

Mindfulness of Body Sensations 118

The Main Purpose of Learning Body Scanning 120

Implications of Co‐emergence Effects 122

Explaining the Co‐emergence Model of Reinforcement 123

Experiential Explanation of the Co‐Emergence Model 125

Example of Use of the Diary of Reactive Habits 126

Mindfulness of Body Sensation Through “Body Scanning” 127

Application with Individual Clients 129

Application with Groups 131

Frequently Asked Questions 133

References 145

Session 4: Applied Practice and Skill Transfer 147

Introduction 147

Checking Client Readiness 147

Increasing Practice Efficacy 148

Effects of Body Scanning on the Development of Insight 152

Applying the Practice and Recording Equanimity 153

Application with Individual Clients 156

Application with Groups 158

Frequently Asked Questions 160

References 173

Session 5: Integrating Mindfulness and Behavioral Methods 174

Introduction 174

Checking Client Readiness 175

Advanced Scanning: Symmetrical Scanning 176

Integrating Mindfulness with Exposure Skills 178

Application with Individual Clients 186

Application with Groups 188

Frequently Asked Questions 191

References 203

Session 6: Generalizing Self‐Confidence and Self‐Efficacy 204

Introduction 204

Checking Client Readiness 204

Advanced Scanning: Partial Sweeping 206

Extending the Integration of Mindfulness and Exposure: Bipolar and in‐vivo Exposure 209

Application with Individual Clients 212

Application with Groups 214

Frequently Asked Questions 216

References 228

Session 7: Developing Interpersonal Insight 229

Introduction 229

Checking Client Readiness 229

Advanced Scanning: Sweeping en masse 230

Integrating Mindfulness with Interpersonal Skills 234

Experiential Ownership 235

Application with Individual Clients 240

Application with Groups 241

Frequently Asked Questions 243

References 254

Session 8: Mindful Communication Skills 255

Introduction 255

Checking Client Readiness 255

Advanced Scanning: Transversal Scanning 256

Assertive Communication 258

Mindful Assertiveness 261

Mindful Assertiveness and the Co‐emergence Model 264

Application with Individual Clients 265

Applications with Groups 266

Frequently Asked Questions 267

References 276

Session 9: Cultivating Compassion and Connectedness 277

Introduction 277

Checking Client Readiness 278

Advanced Scanning: Sweeping in Depth 279

Cultivating Interpersonal Connectedness and Compassion 280

Loving‐Kindness Meditation 283

Grounding Compassion in Ethical Conduct 286

Practicing the Five Ethical Challenges 288

Application with Individual Clients 290

Application with Groups 292

Frequently Asked Questions 294

References 303

Session 10: Promoting Well‐Being and Outgrowing Suffering 305

Introduction 305

Checking Client Progress 305

Assessing Results 307

Supporting Personal Growth: Ten Maturing Factors 309

Maintenance of Mindfulness Practice 310

Application with Individual Clients 312

Application with Groups 313

References 318

Part 3 Summary Checklists and MiCBT Scripts 319

Appendix 1: Summaries of Weekly Content 321

Session 1: Summary of weekly content—individuals 321

Session 1: Summary of weekly content—groups 322

Session 2: Summary of weekly content—individuals 323

Session 2: Summary of weekly content—groups 324

Session 3: Summary of weekly content—individuals 324

Session 3: Summary of weekly content—groups 325

Session 4: Summary of weekly content—individuals 326

Session 4: Summary of weekly content—groups 327

Session 5: Summary of weekly content—individuals 327

Session 5: Summary of weekly content—groups 328

Session 6: Summary of weekly content—individuals 329

Session 6: Summary of weekly content—groups 329

Session 7: Summary of weekly content—individuals 330

Session 7: Summary of weekly content—groups 330

Session 8: Summary of weekly content—individuals 331

Session 8: Summary of weekly content—groups 332

Session 9: Summary of weekly content—individuals 333

Session 9: Summary of weekly content—groups 334

Session 10: Summary of weekly content—individuals 334

Session 10: Summary of weekly content—groups 335

Appendix 2: Audio Instruction Scripts for Therapists 337

Guidelines for Therapists 337

General Introduction 337

Rationale for Mindfulness Training 338

Introduction to Progressive Muscle Relaxation Script (Session 1) 340

Progressive Muscle Relaxation Script (Session 1) 340

Introduction to Mindfulness of Breath Script (Session 2) 342

Mindfulness of Breath Script (Session 2) 342

Introduction to Part‐by‐Part Body Scanning Script (Session 3) 344

Part‐by‐Part Body Scanning Script (Session 3) 344

Withdrawing Audio Instructions Script (Session 4) 347

Introduction to Advanced Scanning Script (Session 5) 348

Symmetrical Scanning Script (Session 5) 348

Introduction to Partial Sweeping Script (Session 6) 349

Partial Sweeping Script (Session 6) 349

Introduction to Sweeping en masse Script (Session 7) 350

Sweeping en masse Script (Session 7) 351

Introduction to Transversal Scanning Script (Session 8) 352

Transversal Scanning Script (Session 8) 352

Note on Session 9 353

Introduction to Loving‐Kindness Meditation Script (Session 9) 353

Loving‐Kindness Meditation Script (Session 9) 354

Index 356

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