Mindfulness takes practice

Mindfulness meditation practice is set at 45 minutes a day at home, as well as weekly group sessions with the teacher. And the 45 minutes is every day, six days a week for the eight weeks that the course lasts.

These are the guidelines for students taking part in the standard Mindfulness-Based Cognitive Therapy (MBCT) or Mindfulness-Based Stress Reduction (MBSR) courses. Not all students practice for 45 minutes a day. An average course student practices 30 minutes daily at home, but the good news is that nevertheless, this practice is related to positive benefit. This can be measured as reduced stress, pain, better well-being and so on.

These are the main findings of the study "Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: a systematic review and meta-analysis of participants' mindfulness practice and its associations with outcomes," an international collaboration between the Universities of Aarhus, Oxford and Bristol. The study has recently been published in the journal Behavior Research and Therapy, and according to associate professor Christine Parsons from the Interacting Mind Center at the Department of Clinical Medicine at Aarhus University, it is new and important knowledge:

"This is the clearest evidence we have that mindfulness-home practice can make a difference. This is a big source of debate because there are many components at play in a MBSR or MBCT course. The support of a teacher might bring about benefit, practicing mindfulness on the actual course, or being in a group with similar other people," Christine Parsons says.

According to the study, the effect of doing home practice is small, but statistically significant in the 28 scientific studies included in the analysis. In all studies, the MBCT or MBSR courses were eight weeks long, and the participants kept diaries of their practice at home. The diaries were used by researchers to examine the benefits of practice. Unfortunately, there is always uncertainty linked to a self-report diary, which Christine Parsons is trying to minimize.

Can we rely on students to tell their own teacher about their home practice? Do student fill in their diaries faithfully? We know that people have difficulty reporting on their food or alcohol consumption or even physical activity. Should mindfulness practice be any different?

Similarly, Christine Parsons is concerned about the difference between quantity of mindfulness practice and the of practice. Anyone who has tried to meditate knows that practice can be difficult. For example, it is easy to spend time thinking about a conflict at work or writing a long mental shopping list. Mindfulness practice is about cultivating awareness of the present moment, without judging or evaluating, not just spending time on a yoga mat.

"We need to understand how people truly engage with their home practice. There are many problems with self-report as our only assessment method. I have therefore received money from Trygfonden to develop and test a number of other measurement methods that will clarify how mindfulness students behave outside the classroom. How they practice and what works -- and how it works," Christine Parsons says.

She worked at Oxford University for the past six years, but she has moved her research to the Interacting Minds Center at Aarhus, where she will remain as long as the grant of 2.3 millioner kroner pays for her stay.

Christine Parsons in collaboration with engineers from Aarhus University, led by associate professor Kasper Løvborg Jensen and the Danish Center for Mindfulness, is developing an app that records how long participants listen to the guided meditations, which are part of the home practice in MBCT or MBSR.

The information will be sent via the mobile phone app to a server that registers and compares the incoming data with information from a 'fitness' wristband. This enables the research team to see what happens to, for example, the student's heartbeat when he or she is practicing mindfulness.

"It's all little pieces of the big jigsaw puzzle -- how students actually behave outside the classroom. How they practice, what it means, and what actually works," says Christine Parsons, without wanting to undermine the importance of the recently published result.

"This study forms the basis of our new work, and now we know, that practicing at home has an impact. The question is whether we can use new technology to measure and support participants doing their home practice. And can we support behavior changes in the long run? For example, if you receive a smartphone reminder to practice," Christine Parsons says before she -- again -- praises the unique opportunities for interdisciplinary research at the Interacting Minds Center.

"It's invaluable to sit down with an engineer who poses completely different questions than I can imagine with my psychology background. It opens for a lot of new opportunities. Bringing together mindfulness teachers, engineers and designers allows us to really think about what we can do to best support our students," says Christine Parsons.