1. Introduction
I. Theoretical and Research Background
2. The Origins of Despair: An Evolutionary Perspective
3. Why the Idea of Suicide Won't Let Go
4. How Could Mindfulness Help?: Doing and Being
II. MBCT for Those at Risk of Suicide
5. Assessing Vulnerability to Depression and Suicidality
6. Developing the Preclass Interview: Encouraging Vulnerable
Participants to Engage in and Persist with Mindfulness
Meditation
7. Session 1: Awareness and Automatic Pilot
8. Session 2: Living in Our Heads
9. Session 3: Gathering the Scattered Mind
10. Session 4: Recognizing Aversion
11. Session 5: Allowing/Letting Be
12. Session 6: Thoughts Are Not Facts
13. Session 7: How Can I Best Take Care of Myself?
14. Session 8: Maintaining and Extending New Learning
15. How Does MBCT Enable Transformation?: Jane's Story
III. Training Teachers and Defining Competence
16. MBCT Teaching Integrity: Assessing Mindfulness-Based Teaching
Skills
17. The Experience of Being an MBCT Teacher
IV. MBCT--The Results
18. Mindfulness on Trial: Does MBCT Help People at Risk of
Suicide?
Further Reading and Resources
References
Mark Williams, DPhil, is Emeritus Professor of Clinical
Psychology at the University of Oxford, having been Wellcome
Principal Research Fellow at Oxford from 2003 to 2012 and at Bangor
University from 1991 to 2002. He collaborated with John Teasdale
and Zindel Segal in developing mindfulness-based cognitive therapy
(MBCT) to prevent relapse and recurrence in major depression;
together, they coauthored Mindfulness-Based Cognitive Therapy for
Depression, Second Edition (for mental health professionals), as
well as the self-help guides The Mindful Way Workbook and (with Jon
Kabat-Zinn) The Mindful Way through Depression. Dr. Williams is
also coauthor of Mindfulness-Based Cognitive Therapy with People at
Risk of Suicide (for mental health professionals). He is a Fellow
of the British Psychological Society, the Academy of Medical
Sciences and the British Academy. Now retired, he continues to live
near Oxford, to teach mindfulness to teachers-in-training across
the world, and to explore, with colleagues, how mindfulness might
be used in evidence-based public policy.
Melanie Fennell, PhD, is a Founding Fellow of the Oxford Cognitive
Therapy Centre, where she is now an Associate Trainer. She is also
an Associate Trainer at the Oxford Mindfulness Centre. As a
research clinician in the University of Oxford Department of
Psychiatry, she contributed to the development of evidence-based
treatments for depression and anxiety disorders, including MBCT.
She developed and led the Oxford Diploma in Cognitive Therapy, the
Oxford Diploma/MSc in Advanced Cognitive Therapy Studies, and (with
Mark Williams) the Oxford Master of Studies program in
Mindfulness-Based Cognitive Therapy. Dr. Fennell is an Honorary
Fellow of the British Association of Behavioural and Cognitive
Psychotherapies (BABCP) and was voted “Most Influential Female UK
Cognitive Therapist” by the BABCP's membership in 2002.
Thorsten Barnhofer, PhD, is Professor of Clinical Psychology at the
University of Surrey, United Kingdom, where he conducts research
into the use of mindfulness-based interventions for the prevention
and treatment of mental disorders. He has a particular interest in
the mechanisms by which mindfulness meditation benefits
psychological and neural functioning. Previously, he worked in Mark
Williams’s group at the Oxford Department of Psychiatry, where he
was involved in research on MBCT for suicidal and chronic
depression. A cognitive-behavioral therapist and yoga teacher, Dr.
Barnhofer regularly teaches MBCT training workshops and retreats
for mental health professionals.
Rebecca Crane, PhD, MA, DipCot, is Director of the Centre for
Mindfulness Research and Practice at Bangor University in Wales,
and has led the development of its training programs since 2001.
She previously worked in the mental health field as an occupational
therapist and an integrative counselor. Dr. Crane teaches and
trains internationally in both MBCT and mindfulness-based stress
reduction (MBSR), and is a certified MBSR teacher with the Center
for Mindfulness at the University of Massachusetts Medical School.
She is the author of Mindfulness-Based Cognitive Therapy:
Distinctive Features.
Sarah Silverton, DipCot, MEd, teaches at the Centre for Mindfulness
Research and Practice at Bangor University, Wales. She has
extensive experience as an occupational therapist, counselor, and
mindfulness teacher and trainer. She is the author of The
Mindfulness Breakthrough.
"The book is the culmination of an ambitious decade-long effort to
develop and refine an effective treatment for the subgroup of
depressed patients who are most susceptible to suicidal
behavior--those with histories of early maltreatment, an early
onset, recurrent episodes, and incomplete recovery. The authors
comprehensively present their adaptation of MBCT, provide
guidelines for training and supervision, and summarize the results
of a recent clinical trial. This is useful and fascinating material
for clinicians treating this highly challenging group of
patients."--Daniel N. Klein, PhD, Department of Psychology, Stony
Brook University
"MBCT has established an admirable track record for preventing
relapse into depression. But can a program based on mindfulness
meditation be safely applied to people suffering from vulnerability
to suicide? The authors take us on a scholarly and compassionate
journey that lasted over a decade, pointing out the specific
adaptations they made to the MBCT program and why. This book
represents an important advance for mindfulness-based
psychotherapy, an impressive model for how to develop an
evidence-based treatment, and a rich resource for anyone who wishes
to understand and treat the dilemma of suicide."--Christopher
Germer, PhD, private practice, Arlington, Massachusetts
"This book examines despair and suicidality with a keen eye. It is
a beautiful illustration of how to bring astute observation to an
important clinical problem and develop and test a theory-based
intervention. The authors present an innovative adaptation of MBCT
that helps individuals uncouple suicidality from depressed mood,
decrease cognitive reactivity and suicidal thinking, and increase
awareness and self-compassion. Importantly, their research
demonstrates the particular effectiveness of this approach for the
most vulnerable, those who experienced childhood trauma."--Stuart
J. Eisendrath, MD, Director, UCSF Depression Center, University of
California, San Francisco
"Taking up a sensitive and painful topic, this book lays out a
comprehensive course for helping suicidal patients using MBCT.
Williams et al. explain suicidality through evolutionary logic and
grapple directly with the most treacherous aspects of working with
this population. The authors argue that MBCT helps to make
autobiographical memories more specific, thus addressing a crucial
vulnerability factor in suicidality. The volume covers a lot of
ground. It provides multiple mindfulness and movement exercises
aimed to reduce suicidal thoughts and restore patients on a path of
well-being."--Elliot Jurist, Professor of Psychology and
Philosophy, The Graduate Center and the City College of New York,
City University of New York
“Extremely accessible, informative, and engaging, this outstanding
book is a 'must read' for anyone with an interest in understanding
suicidal despair and its treatment. It is unusual in a single
volume to find such a comprehensive description of the science of
suicide risk as well as a detailed overview of how to adapt and
implement MBCT. The inclusion of the case studies, such as 'Jane's
story,' is really helpful."--Rory C. O’Connor, PhD, Director,
Suicidal Behaviour Research Laboratory, University of Glasgow,
United Kingdom "The authors describe their work with clients who
need the best help possible, but who are often excluded from
research trials and treatment programs. They discuss how they
sensitively adapted the MBCT program to address such problems as
the originally high dropout rate of people at the highest risk of
suicide. The reward is clear: those who are most vulnerable do best
with this adapted version of MBCT, compared to treatment as usual
and psychoeducation. I truly hope this program becomes available to
all who need it."--Susan Bögels, PhD, Department of Medical,
Clinical, and Experimental Psychology, University of Amsterdam, The
Netherlands-This book is a very helpful addition to the literature
on treatment of patients experiencing suicidal ideation and
depression. The authors present a wealth of clinical, teaching, and
research information to appeal to clinicians and train them to
incorporate mindfulness and cognitive restructuring--within a
positive, compassionate stance--to assist clients with significant
depression. The informative and easygoing writing style makes the
material easy to digest. The rich description of what to do, with
examples, makes this book easy to read and absorb so that
clinicians can incorporate the techniques in their work with
clients.--Mindfulness, 6/26/2017ƒƒThroughout the book there are
helpful summary boxes of key points and examples of dialogue to
illustrate examples--this helped immensely to make this book very
reader friendly….This book would be helpful for any clinician
working with clients who present with these difficulties and offers
a new, innovative way to effectively work with people who
experience acute distress and suffering.--The Psychologist,
6/1/2016ƒƒ_x000D_Teachers of mindfulness-based interventions, both
those who are interested in using MBCT with individuals at risk for
suicidal thinking and behavior and those who are less inclined to
work with such individuals, will benefit from reading this
engaging, informative, and accessible book. For the general
teacher, the book offers practical, clearly articulated material to
increase competency….For the teacher interested in using this
adapted version of MBCT to treat individuals at risk of suicidal
depression, the book provides a clear and comprehensive review of
the protocol changes that were made to tailor the treatment for
this population. Moreover, the detailed description of the authors'
theoretically and empirically based conceptualization of suicidal
behavior clarifies the purposes of and rationale for the various
techniques of adapted MBCT.--PsycCRITIQUES, 12/21/2015
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