Mindfulness in Clinical Training: A Mixed Methods Study of Mindfulness Training with MSW Students

Purpose: Numerous studies have demonstrated that mindfulness training is effective in helping clients alleviate stress, regulate affect and reduce both physical and psychological distress (Baer, 2003). Mindfulness training has also been linked to gains in skills that are key to therapeutic effectiveness such as attention, empathy and compassion (Shapiro & Walsh, 2006). In a recent randomized trial, Grossman and colleagues (2007) demonstrated that the clients of trainees who were exposed to meditation, a primary form of mindfulness training, reported better treatment outcomes. These findings have led to an interest in applying mindfulness to foster clinical skill development among trainees in the helping professions. Advocates argue that mindfulness training provides a means of adding affective and attitudinal components to current cognitive and behavioral training strategies, potentially strengthening students’ ability to integrate basic clinical skills and transfer them to the field (Lambert & Simon, 2008).  In order to investigate this hypothesis we asked: Does mindfulness training foster clinical learning and skill development among incoming MSW students?

Method: In keeping with recent presentations at SSWR, we used a mixed methods design to begin to explore the potential effects of this novel training strategy. Students in two of seven sections of a first year interviewing skills class [n = 39] received 15 minutes of mindfulness training per class, while the remaining five classes served as a cohort control group [n = 97]. Students completed pre, post, and follow-up surveys that used standardized scales to measure change in variables related to counseling skills acquisition, as well as responding to open-ended questions designed to explore their experience of the training. Data analysis included descriptive statistics, between group t-tests, regression analyses and thematic analysis.

Results: The mindfulness training group showed greater increases in helping skills, session management, and overall counseling self-efficacy at posttest and again after students had transitioned to working with clients in the field at 3-month follow-up. The results were statistically significant and represented a medium-sized effect overall (.58). Students who had experience in mindfulness practice at program entry had larger gains in counseling self-efficacy at follow-up. Qualitative findings matched and extended the quantitative findings with all 36 students who responded to the open-ended questions describing at least one benefit they received from the training. Students reported that the training helped them to manage anxiety and distractions, develop emotional self-awareness and contain negative reactions, and remain flexible and responsive to their clients in the field.

Implications: The results of this study indicate that mindfulness training may have some promise as a strategy for enhancing clinical social work education. The training appeared to facilitate the development of counseling self-efficacy in particular, which is a key early indicator of clinical skills acquisition. In addition, the effect appeared to be dose-dependent, as students with prior exposure made more significant gains.Qualitative findings provided new directions in identifying potential benefits of the training that can be measured in subsequent studies.