or disposition (Brown et al., 2007; Kabat-Zinn, 1990), and skill. Additionally, we note its commodification and concurrently utilize a critical family ecological framework to consider how mindfulness occurs within families (Walsh, 2016; Wilson, 2016).
The origin of the term mindfulness derives from the Pali word Sati meaning “to remember.” When referenced in Buddhism, “as a mental factor it signifies presence of mind, attentiveness to the present” (Bodhi, 2000, p. 86). While it derives from Eastern religion, philosophy, and practices, it is also a component of Western Buddhism(s), Buddhist psychology, integrative health, education, business (and more) practices and programs. We refer to its Eastern roots as an ethical decision to honor the Central, East, and Southeast Asian peoples and cultures where mindfulness arose. Reviewing all types of meditation and the various instructions associated with particular types of meditation is beyond the scope of this chapter. This chapter is about mindfulness meditation although meditation generally is practiced among religious folks, atheists, and agnostics. The 2014 religious landscape research study (Pew Research Center, 2014) found the highest percentage of persons who meditate daily in the United States are Jehovah Witnesses (77%) and Buddhists (66%). Many other groups (historically Black Protestant, Evangelical Protestant, Catholic, mainline Protestant, Muslim, Hindu, Jewish, agnostic, atheist, and those identifying “nothing in particular”) report meditating as well.
While mindfulness as a construct is based on Buddhism (Kabat-Zinn, 2003) many people in Western contexts learn about mindfulness as a component of a health-related program, experiential learning in P–16 education, or community education programs. Mindfulness as a robust academic theme and emerging discipline surfaced in the late 1970s with a few publications in the 1980s, incremental increases starting around 2010 and exponentially expanding through today (American Mindfulness Research Association, 2019). Mindfulness-based stress reduction (MBSR) is the prominent model emerging early in this trajectory. As the first and most researched of these evidence based programs, the creator of MBSR, Jon Kabat-Zinn, describes mindfulness as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally” (1994). Bishop and colleagues are attentive to the quality of one’s experience describing mindfulness as “a process of regulating attention in order to bring a quality of non-elaborative awareness to current experience and a quality of relating to one’s experience within an orientation of curiosity, experiential openness, and acceptance” (Bishop et al., 2004, p. 234).
Criticism of the empirical evidence for mindfulness includes poor methodology, lack of attention to potential adverse effects, and lack of information about teacher training (Van Dam et al., 2018). Facilitators with extensive mindfulness practice are more equipped to support quality program delivery (Segal et al., 2002). In this chapter, the mindfulness practices referenced in case examples were facilitated by a highly trained facilitator with extensive and ongoing practice history over 20 years. We utilize peer and systematically reviewed research citations when possible to support our claims that promote using mindfulness as a tool for managing stress in families.
Family Pathways to Mindfulness
Families learn about and experience mindfulness in many ways including intensive practice-based programs such as MBSR and intensive skill-based programs such as dialectical behavior therapy (DBT). Families also become aware of mindfulness through family-focused interventions often based on MBSR and DBT models, family therapy, as well as various exercises, practices, and programs adjusted to meet the developmental, topical, or contextual needs of a particular individual, family, group, or community. In this section, we tune into MBSR and DBT as core Western approaches, with Mindful Schools (mindfulschools.org; www.mindfulschools.org) as a developmentally appropriate program, and referencing Langer’s (1989) cognitive approach. There is purposeful attention to the (in)accessibility of mindfulness and family-based mindfulness programs to families currently and historically marginalized or oppressed. We provide two corresponding family cases connecting individual family member experiences to real and potential family impacts via the ABC-X and AaBbCc-Xx models in spaces where vulnerable and oppressed families converge.
Mindfulness-Based Stress Reduction (MBSR)
The contemporary secular mindfulness movement harkens back to the late 1970s. MBSR (Kabat-Zinn, 2011) emerged at that time and is the most empirically supported mindfulness program to date and serves as a model for multiple other mindfulness-based interventions (MBIs) and programs including mindfulness-based cognitive therapy (Segal, 2002). Jon Kabat-Zinn utilized various mindfulness practices recruiting hospital patients considered to be non-responding or who would “fall through the cracks” of a health-care or “disease care” setting (Kabat-Zinn, 2011). During the MBSR 8-week program folks are guided in formal practices (e.g., sitting meditation, walking, body scan, gentle mindful movement) weekly with experiential exercises about the impact of stress on the body and mind, and opportunities to express practice experiences. Participants are given materials to practice formally on their own between weeks (home practice) and practice informally as they interact in the world.
The MBSR program is helpful with nonclinical and clinical health challenges (Grossman, Niemann, Schmidt & Wallach, 2004). It improves mental health (Fjorback, Arendt, Ørnbøl, Fink, & Walach, 2011), showing moderate effectiveness with depression, anxiety, distress, and stress (Khoury, Sharma, Rush, & Fournier, 2015), and when adapted, MBSR improves psychological functioning among youth vulnerable to community trauma (Sibinga, Webb, Ghazarian, & Ellen, 2016), with particular improvements in interpersonal relationships, physical health, school achievement, and hostility (Sibinga, Kerrigan, Steward, Johnson, Magyari, & Ellen, 2011). Health-care professionals participating in MBSR see increased quality of life and reduced stress (Shapiro, Astin, Bishop, & Cordova, 2005). Increasing the amount of mindfulness practice time in MBSR leads to significantly more positive intervention outcomes (Parsons, Crane, Parsons, Fjorback, & Kuyken, 2017). Lloyd, White, Eames, and Crane (2018) make a call for more research attention to “home practice” as this is a large component of MBSR with limited research connecting it to outcomes. We also wonder how home practice impacts families, particularly as it relates to well-being and stress management.
MBSR and DBT were designed to address physical pain and emotional suffering. Dialectical cognitive therapy (DBT) is a skill-based program originally designed for people experiencing suicidal ideation, parasuicidal behavior, relationship difficulties, and symptoms often related to borderline personality disorder (BPD; Linehan, 1993, 2020). Clients categorized as BPD are often doubly stigmatized both socially due to mental health stigma and medically by helpers or clinicians who, while often well meaning, are frustrated with or do not want to work with BPD clients.
Dialectical Behavior Therapy (DBT)
Research in DBT is relatively new and even more sparse as it relates to adolescents (James, Taylor, Winmill, & Alfoadari, 2008). Quite promising though is the research on adult clients diagnosed with BPD showing effectiveness in controlling and stabilizing self-destructive behavior and violence and decreasing the frequency of use of psychiatric crisis services (DeCou et al., 2019). DBT is adjusted to meet the needs of couples and to address intimate partner violence (Rathus, Cavuoto, & Passarelli, 2006). Dialectical behavior therapy for adolescents (DBT-A; Miller, Rathus & Linehan, 2007) was developed with adolescents in mind and utilizes a biosocial model (Linehan, 2015) recognizing challenges with emotional dysregulation due to the interaction of an environment that is invalidating and some sort of biological predisposition. There is a small to medium effect size for depression, self-injury, anxiety, and suicide risk for DBT-A therapy participants (Hunnicutt Hollenbaugh & Lenz, 2018).
DBT utilizes mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance as skills. There are now multiple workbooks outlining particular DBT skill-development exercises for multiple purposes and
