Mindfulness interventions in outpatient cognitive behavior therapy for trainee therapists: A randomized controlled trial

正念起源于2500多年前的东方佛教传统。它可以被概念化为一种特殊形式的注意力，它是非评判的，有目的的，专注于当下。在过去的几十年里，正念已经成为新开发的心理治疗方法的核心组成部分。目前，在群体环境中进行的特定的手动形式的正念方法，如正念减压（MBSR），已经很好地建立起来，而它们的有效性可以在荟萃分析中得到证明。然而，在个体心理治疗中，患者和治疗师的正念体验对治疗过程和结果的影响的研究已经被要求。在这种情况下，特别强调的是，在有效性条件下，应该对实习治疗师进行简短的、引入正念元素的干预措施的研究；这可以阐明改善临床培训的机会。因此，本研究的主要目的是确定在治疗开始时进行的正念元素练习是否有助于改善治疗过程。更具体地说，我们将研究在有效条件下，由门诊和实习治疗师在治疗开始时练习的正念元素的简短干预对治疗变化过程和治疗结果的影响。因此，在治疗开始之前，150名门诊患者在经过五次诊断后被随机分配到正念干预组（MIG），对照组（CG）练习短形式的渐进式肌肉放松（PMR）或常规治疗组（TAU）。一个重要的结果变量将是心理治疗中一般变化机制的多视角评估量表（SACiP），我们开发、验证了它，并在几个过程-结果研究中证明了它的临床实用性。这项研究的结果不仅将解决科学文献中的主要研究空白，而且可能具有重要的实际意义，因为我们对正念元素的干预可能会为如何改善门诊培训中心心理治疗师的形成提供新的思路。

Mindfulness has its origins in a more than 2,500-year-old Eastern-Buddhist tradition. It can be conceptualized as a specific form of attention that is non-judgmental, purposeful, and focused on the present moment. In the past several decades, mindfulness has become a central component of newly developed approaches in psychotherapy. Currently, specific manualized forms of mindfulness-based approaches that are carried out in group settings, such as mindfulness-based stress reduction (MBSR), are well established while their efficacy could be demonstrated in meta-analyses. However, studies investigating the effects of mindfulness experiences of both patients and therapists on therapeutic processes and outcome in individual psychotherapy have been requested. In this context, it has been specifically highlighted that brief, session introducing interventions with mindfulness elements should be investigated in trainee therapists under effectiveness conditions; this could elucidate opportunities to improve clinical training. Consequently, the main purpose of this study is to identify whether exercises with mindfulness elements carried out at the beginning of therapy sessions help to improve the therapeutic process. More specifically, we will examine the effects of a brief intervention with mindfulness elements, as practiced by both the outpatient and trainee therapist at the beginning of therapy sessions, on processes of therapeutic change and treatment outcome under effectiveness conditions. Thereby, before the start of the therapeutic treatment, 150 outpatients are randomized after five sessions of diagnostics either to a mindfulness intervention group (MIG), a control group (CG) practicing a short form of progressive muscle relaxation (PMR), or a treatment as usual (TAU) group. One important outcome variable will be the Scale for the Multiperspective Assessment of General Change Mechanisms in Psychotherapy (SACiP), which we developed, validated and for which we demonstrated the clinical utility in several process-outcome studies. Results of this study will not only address major research gaps in the scientific literature but also could have important practical implications, as our intervention with mindfulness elements might inform new ideas of how to improve the formation of psychotherapists in outpatient training centers.