Mindfulness-Based Stress Reduction (MBSR), and its adaptations (e.g., MBCT, MBRP, etc.), along with Compassion-Based Programs (e.g., MSC, CBCT, etc.) are derived from Buddhist and other wisdom traditions in which ethical behaviors are foundational. As Mindfulness- and Compassion Based Programs (MCBPs) have evolved to meet the needs of highly distressed and at-risk populations, practices that can enhance compassion and other ethical responding have been re-integrated explicitly into MCBPs to reduce suffering. Such practices can reduce suffering in both clients and practitioners and enhance health of mind, body, and behavior in both, including (with practice) when stress is at high levels. Indeed, those who train to teach MCBPs benefit from the teacher training requirement that they have a personal and formal discipline of mindfulness and related practices to support integrity, competence, and related domains of ethical responding. Such personal practice can reduce burn out and enhance effective clinical responding in the form of conceptualization, decision making, and intervention. Providers are prone to the same cognitive biases and faulty decision making as clients when exposed to high levels of stress that can interfere with optimal emotional and information processing. Such stress, and often distress, can arise in work with challenging and at-risk clients including those who encounter difficulties with MCBPs. Interestingly, those shown to derive the most benefit from MCBPs can experience the greatest difficulties with its implementation due to trauma histories, suicidality, and severity of stress-related symptoms. How teachers of MCBPs conceptualize, respond to, and frame these difficulties can either support or interfere with clients attaining the long-term benefits of MCBPs.
This largely experiential workshop that will begin with a 90-minute didactic review of challenging experiences that can occur trans-diagnostically in MCBPs along with trans-therapeutic adaptations for those with trauma, panic, dissociation, depression, suicidality, experiential avoidance, and recurrent and unwanted mental (e.g., obsessions and brooding) or surprising and difficult to explain physical and behavioral experiences (e.g., certain sensations and movements). After opening review of the literature about difficult and surprising experiences in highly distressed groups learning MCBPs, and associated adaptations, attendees will be guided in Interpersonal Mindfulness Practice (IMP) and an application of IMP called Compassionate Case Consultation (CCC, formally MCC) that incorporates deliberate practice and Positive / Active ethics to support effective and efficient peer consultation.
Both IMP and CCC can support ethical decision making and responding when teaching MBPs individually and in group settings and efficient and intentional peer consultation practices. Attendees will practice CCC in several different dyads and in larger groups. Participants will be invited to apply CCC to personally challenging cases with whom they are encountering challenges. Dr. Molnar will role play how the IMP practice can be implemented with clients. Two volunteers, who are willing to model a client who reports difficulties or challenges, will be selected by the group. Dr. Molnar will demonstrate how highly distressing emotions and the thought, sensation, and behavioral urge elements that compose emotions can be reflected back, using IMP, in deconstructed form to our clients to support compassionate emotion regulation intra- and inter-personally. As well, she will suggest specific adaptations of MBP-related practices for these two cases and then open to the larger group’s questions about adaptations for which there is an evidence-base. Attendees will receive suggestions for continued practice and be supported through a listserv in creating their own or already established ongoing peer support groups if of interest. Attendees will experience a working lunch in which they are guided to apply the IMP informally while eating lunch provided by PBTA.
To read a brief two-page article about MCC and its origins click here and select Mindful Case Consultation. The CCC practice was refined by a regional peer consultation group, “Mindful therapists”, founded by Dr. Molnar in 2007 for peer consultation to support focused and brief case consultation that does not degrade into advice giving and other non-useful activities that do not support the intention of the consultee. The MCC approach is a formal reflective practice designed to enhance care of both therapists and clients and to strengthen mindfulness and compassion in the therapist. It incorporates the benefits of a groups’ wisdom when the group is composed of people with diverse experiences (see also Ethical Practices at link above). Any licensed healthcare practitioner (or those in training) with a formal mindfulness practice who agrees to the group guidelines and mission of the Mindful Therapists will be invited to join this now co-facilitated group after attending this workshop. It is also hoped this will support greater networking in the service of self and other care within the PBTA community.
CE Learning Objectives
Following this presentation, participants will be able to:
- Describe the steps and process of Interpersonal Mindfulness Practice (IMP), a practice that is often an adaptation designed to support clients with insecure attachment histories and distressing emotions in eventually developing silent intra-personal mindfulness and compassion practices.
- Practice a mindfulness approach to peer consultation, Compassionate Case Consultation (CCC), that integrates IMP with positive and practical / applied ethics and deliberate practice to support ethical responding when treating highly distressed and often challenging clients at risk for difficulties with Mindfulness- and Compassion Based Programs (MCBPs) such as MBSR, MBCT, MSC, CBCT. etc.
- Describe common difficulties that can occur trans-diagnostically in disorders of trauma / stress, anxiety, obsessive-compulsive and mood that can interfere with response to and adherence to MCBPs if not responded to with adaptations on the part of the MCBP teacher / therapist.
- Describe trans-therapeutic adaptations to MCBPs that support learning in MCBPs when, and even because, such difficulties arise in response to traditional MCBP elements.
- Practice Compassionate Case Consultation (CCC) with peers to support ethical clinical decision making and responding when implementing Mindfulness- and Compassion-based Programs (MCBPs) with personally challenging cases.
About Dr. Molnar
Chris Molnar, Ph.D., obtained her Ph.D. degree in Clinical Psychology and Psychophysiology from The Pennsylvania State University. Her post-doctoral fellowship training was in traumatic stress and functional neuroscience at the Medical University of South Carolina. She teaches Mindfulness-based-Cognitive Therapy (MBCT) and Stress Reduction (MBSR) for MBCT International Registry and details about teacher qualifications] and adaptations of Mindfulness and Compassion Based Programs (MCBPs) She has adapted MBSR and MBCT for implementation with people with trauma, anxiety, and mood disorders marked by extreme fear, panic, suicidality, intrusive cognition, and reactive behavior. Adaptations in the META program she has investigated and refined since 2007 include integration of interpersonal mindfulness to address attachment-related trauma; behaviorally-based deliberative practice strategies and functional emotion and neuroscience findings to support learning of evidence-based MBP practices. She is President of the Mindful Exposure Therapy for Anxiety and Psychological Wellness Center, Inc. (META Center: www.meta4stress.com). At META Center, she integrates Cognitive-Behavior Therapy (CBT) with other forms of psychotherapy. Her work is guided by ongoing developments in functional neuroscience, emotion and motivation, and other areas of inquiry into how humans learn optimally to maintain and apply healthy habits during states of threat and challenge. Before founding META Center in 2007, Dr. Molnar worked as a clinical investigator supported by grants from the National Institute of Health (NIH) and other funding agencies. For a full list of credentials, scientific contributions, popular press articles, and select professional presentations visit www.meta4stress.com Resources tab.
Target Audience
This presentation is intended for mental health professionals, researchers, and graduate students. The instructional level of this presentation is intermediate.
Note: This workshop does not require attendees to have a formal mindfulness practice but some experience with a personal mindfulness practice will be useful. Attendees will be guided in practicing formal IMP and CCC at this workshop. For distressed clients with insecure attachment histories, IMP is sometimes the foundation for a silent intra-personal mindfulness and compassion practice. Those who want support adapting MCBPs to challenging clients and willing to role play such clients are encouraged to attend.
Continuing Education
- Philadelphia Behavior Therapy Association is approved by the American Psychological Association to sponsor continuing education for psychologists. Philadelphia Behavior Therapy Association maintains responsibility for this program and its content.
- This program provides seven (7) hours of CE credits. This workshop qualifies for three (3) contact hours for the ethics requirement and one (1) contact hour for the suicide prevention requirement as mandated by the Pennsylvania State Board of Psychology.
- PBTA is also an authorized provider for CE credits for Professional Counselors, Marriage and Family Therapists, and Clinical Social Workers licensed in the state of Pennsylvania.
- Full attendance is required to obtain CE credits for this program. APA guidelines do not permit PBTA to issue partial CE credits. No refunds are provided for CE programs. No exceptions allowed.
