Training Teachers to Deliver Mindfulness-Based Stress Reduction

Principles and Standards

Jon Kabat-Zinn, PhD and Saki F. Santorelli, EdD, MA
with Melissa Blacker, MA, Jeffrey Brantley, MD, Florence-Meleo-Meyer, MS, MA, Paul Grossman, PhD, Ulrike Kesper-Grossman, MA, Diane Reibel, PhD, Robert Stahl, PhD

The training of teachers to deliver MBSR is a complex undertaking.
This is in part because MBSR spans a confluence of epistemologies and practices from two very distinct and until recently, divergent lineages, both committed to empirical investigation, albeit utilizing very different methodologies: that of science, medicine, and psychology, on the one hand, and that of Buddhist meditative traditions and their teachings and practices, known collectively as the Dharma, on the other. One reason MBSR proved viable in mainstream clinical settings is that the Dharma is in essence universal. Mindfulness, often being spoken of as "the heart of Buddhist meditation," and being primarily about the systematic training and refinement of attention and awareness, compassion and wisdom, is a manifestation of its universal applicability. In the present context, to recognize the universal character of the dharma, we use the term with a small "d."

Because people with many different backgrounds are interested in becoming MBSR teachers, programs for the training of MBSR instructors of necessity include a range of different characteristics to expose potential trainees to a spectrum of experiences, perspectives, and practices with which they may have limited familiarity, and then nurture their development and build increasing competency over time.

Certain principles are important for effective teaching of the MBSR curriculum and for adhering to its professional standards of practice. A non-exclusive list of essential elements of training programs to develop MBSR teachers would include:

  1. The teacher of MBSR teachers him or herself needs to have a longstanding grounding in meditative practices and be a committed student of the dharma, as it is expressed both within the Buddhist meditation traditions and in more mainstream and universal contexts exemplified by MBSR. This has nothing to do with being or not being a Buddhist.
  2. MBSR is a vehicle for embodying and transmitting the dharma in a wholly secular and universal idiom. It is a recontextualizing of dharma, not a decontextualizing of it.
  3. MBSR instructors need to have their own personal meditation practice and attend retreats in the spirit of "continuing education" and the on going deepening of their practice and understanding.
  4. MBSR instructors follow the principle that we never ask more of program participants than we do of ourselves on a daily basis in terms of both formal and informal mindfulness practices. This needs to be the case for teachers of MBSR teachers as well.
  5. The teaching of mindfulness is never a matter of merely teaching or operationalizing techniques. Mindfulness is a way of being in a wiser relationship to one's experience, not one particular mental state to be pursued and attained. Thus, the non-instrumental dimensionality of the work and of the practice of mindfulness is the foundation of effective practice and teaching.
  6. Teaching MBSR is an opportunity for right livelihood. Thus, it is important to develop fair and non-exploitative pricing structure for both MBSR and for the training of teachers of MBSR.

Standards of Practice for Trainers of MBSR Instructors

These Standards of Practice reflect three decades of professional education and training at the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School. They are not sacrosanct and do not represent an invariant path to becoming an MBSR teacher. Other well-established MBSR training programs and institutes exist around the world. Wherever possible, the expressed intention of the Center for Mindfulness is to align with MBSR professionals conducting these training programs in order to establish program equivalency and reciprocity when possible. We look forward to collaborating with colleagues around the world in the development of a well-informed international body of professionals capable of establishing broadly agreed-upon principles and standards of practice for both teachers of MBSR and for those teaching others to teach MBSR. Until such an organization is established and standards agreed upon, we have elected to use the current Center for Mindfulness/Oasis Institute education and training model as a well-established criteria for Standards of Practice for MBSR teacher training programs.

The standards enumerated below set a high bar – one we consider to be reasonable and appropriate for the magnitude and potential depth of this work. They are the minimal standards to which we hold ourselves. Not all health professionals or educators will be able to meet these standards when they begin to undertake teaching MBSR to patients/clients/participants. They can be "grown into" over time, according to each individual's background, training, motivation, and life circumstances. However, in our view, they serve as an appropriate benchmark for individuals who are involved in the training of professionals to teach MBSR.

  1. Participation in and completion of the MBSR in Mind-Body Medicine: A 7 Day Residential Training/Retreat taught by Center for Mindfulness (CFM) teacher trainers.
  2. Participation in and completion of the 8-week or 9-day Practicum in Mindfulness-Based Stress Reduction, taught by CFM teacher trainers (or their equivalent as recognized by the CFM).
  3. Participation in and completion of the 8-day Teacher Development Intensive, taught by CFM teacher trainers.
  4. Full teaching responsibility for a minimum of fifteen 8-week MBSR program cycles over a minimum of three years.
  5. Engagement in Supervision in MBSR (one or two 8-week cycles) with a certified CFM teacher trainer (or a CFM recognized MBSR supervisor/mentor).
  6. Teacher Certification in MBSR granted by the CFM (teacher certification process complete or in process), or partnering organizations.
  7. On-going participation in the MBSR Teacher Trainer Consultation program provided by a certified CFM teacher trainer), or equivalent.
  8. Regular attendance at teacher-led silent meditation retreats of 7 to 10 days in duration, with at least two being of ten days duration or more. We strongly recommend that all aspiring and engaged MBSR teachers and teacher trainers attend retreats in the Western Vipassana tradition, because this tradition closely reflects and serves as a foundation for the spirit, practice and attitudes of MBSR. We also recognize that wisdom is expressed and reflected in a range of meditation traditions and consciousness disciplines, and that retreats in other traditions may serve in profound and important ways to expand, enrich, supplement, and strengthen this basic foundation.
  9. A sustained and on-going personal mindfulness practice that includes sitting meditation and mindful Hatha yoga reinforced by on-going study with teachers.
  10. Well-developed learner-centered teaching skills in working with classes and with groups; a capacity for deep listening, regard, and compassion for all participants; languaging sensibilities in relationship to guiding meditative practices and navigating class dynamics, skill in large and small group dialogue and the process of inquiring together; and skill in creating and maintaining a safe container for learning and exploration in the face of stress, pain, illness, and suffering.

Signatories

Jon Kabat-Zinn, PhD is Professor of Medicine emeritus at the University of Massachusetts Medical School, where he founded MBSR (in 1979) and the Center for Mindfulness in Medicine, Health Care, and Society (in 1995).

Saki F. Santorelli, EdD, MA is Associate Professor of Medicine, Director of the Stress Reduction Clinic/MBSR program and Executive Director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.

Melissa Blacker, MA is a Senior Teacher and Associate Director of the Stress Reduction Program/MBSR program and Director of Oasis Institute for Mindfulness-Based Education and Innovation at the Center for Mindfulness in Medicine, Health Care and Society at University of Massachusetts Medical School.

Jeffrey Brantley, MD, DFAPA is Board Certified in psychiatry (in 1984) and was elected as a "Distinguished Fellow of the American Psychiatric Association" (in 2008). He is a Consulting Associate in the Department of Psychiatry and Behavioral Sciences at Duke Medical Center. Dr. Brantley was trained in mindfulness as a resident in psychiatry at the University of California at Irvine Medical Center, and has been practicing mindfulness for 30 years. He began teaching mindfulness meditation to health professionals and others in 1990. He is one of the founding faculty members of Duke Integrative Medicine, where he started the Mindfulness-Based Stress Reduction program in 1998. He is also a member of the Community of Scholars of the Center for Spirituality, Theology, and Health at Duke University.

Florence Meleo-Meyer, MS, MA, LMFT is a Senior Teacher in the Stress Reduction Program/MBSR program, Director, Oasis Institute for Mindfulness-Based Education and Innovation and Director of the Mindfulness in Education Project at the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School.

Paul Grossman, PhD., is Director of Research, Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Switzerland. He has published extensively on mindfulness and has been principal investigator of several investigations of mindfulness-based intervention for long-lasting medical conditions (including multiple sclerosis, fibromyalgia and sequelae of bone marrow transplantation). He also studies various aspects of relations between psychology, and respiratory and cardiovascular physiology. Dr. Grossman is Associate Editor of the journal Mindfulness, a 'Science and Contemplative Affiliate' of the Mind and Life Institute, teaches Mindfulness and Buddhist Psychology at the Psychological Institute of the University of Freiburg, Germany, and completed the MBSR Internship at the UMass Medical School, Center for Mindfulness in 1998.

Ulrike Kesper-Grossman, MA holds a Masters degree in education and is a trained Rogerian Psychotherapist and Yoga teacher, certified by the German/European Yoga Association. In 1994, she completed the MBSR internship (Practicum) at the Center for Mindfulness at the University of Massachusetts Medical Center, USA and also taught MBSR in one of the special projects there for several years. Since then, she has been teaching MBSR courses for a wide range of people and conducted seminars for healthcare professionals. She has participated as teacher and clinical supervisor in several clinical research projects on mindfulness interventions for patients suffering from chronic illness (e.g. multiple sclerosis, fibromyalgia and cancer survivors) at the Freiburg Institute for Mindfulness Research and the University Hospital Basel, Switzerland. A major focus of her work for the last five years has been to develop and direct a 1.5-year professional training program for MBSR-teachers, designed primarily for healthcare professionals, at the MBSR Institute, Freiburg, Germany.

Diane Reibel, Ph.D. is the Director of the Mindfulness Institute at the Jefferson-Myrna Brind Center of Integrative Medicine and Research Associate Professor in the Department of Emergency Medicine at Jefferson Medical College. She has been teaching mindfulness –based stress reduction (MBSR) for over 18 years to patients, medical students, college students and healthcare professionals. Dr. Reibel is a certified MBSR teacher through the Center for Mindfulness at UMMC. In addition to her passion for teaching mindfulness she studies the physiologic effects and health outcomes of mindfulness training and her research is published and widely cited in both scientific journals and the popular press. Dr. Reibel is coauthor of the book Teaching Mindfulness: A Practical Guide for Clinicians and Educators.

Bob Stahl, PhD., founded and directs MBSR programs in three medical centers in the San Francisco Bay area. Bob serves as an Adjunct Senior Teacher for Oasis Institute at the Center for Mindfulness at University of Massachusetts Medical School. He is a co-author of "A Mindfulness-Based Stress Reduction Workbook" and "Living With Your Heart Wide Open." He also teaches at Vipassana Santa Cruz and is a visiting teacher at the Spirit Rock Meditation Center and the Insight Meditation Society.