Objectives

Evidence-based mindfulness programs have well-established benefits, but the potential for harmful effects is understudied. We explored the frequency and severity of unpleasant experiences and harm in two nonclinical samples participating in an adaptation of mindfulness-based cognitive therapy (MBCT) for the general population.

Methods

Study 1 included 84 schoolteachers; study 2 included 74 university students. Both studies were uncontrolled. Participants completed self-report questionnaires about psychological symptoms before and after the 8-week mindfulness course. After the course, they responded to a survey designed for this study that included Likert ratings and free-text questions about unpleasant experiences and harm. All data were collected online.

Results

In both samples, about two-thirds of participants reported unpleasant experiences associated with mindfulness practice during the course. Most participants (85–92%) rated these experiences as not at all or somewhat upsetting; some indicated that difficult experiences led to important learning or were beneficial in some way. The proportion of participants reporting harm from the mindfulness course ranged from 3 to 7%. The proportion showing reliable deterioration on symptom questionnaires ranged from 2 to 7%. Those reporting harm and those showing reliable deterioration on questionnaires were largely separate subgroups; only one participant fell in both.

Conclusions

Findings highlight the need for mindfulness teachers to manage expectations about benefits and difficulties that may occur in mindfulness-based programs and to work skilfully with participants experiencing difficulties. Experiences of harm may not be captured by symptom questionnaires and should be explicitly assessed in other ways.

中文翻译：

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两个一般人群样本中基于正念的计划中自我报告的不愉快事件和伤害的频率

目标

基于证据的正念计划具有明确的好处，但潜在的有害影响尚未得到充分研究。我们探索了两个非临床样本中不愉快经历和伤害的频率和严重程度，这些样本参与了针对普通人群的基于正念的认知疗法（MBCT）的调整。

方法

研究 1 包括 84 名学校教师；研究 2 包括 74 名大学生。这两项研究都是不受控制的。参与者在为期 8 周的正念课程前后填写了有关心理症状的自我报告问卷。课程结束后，他们回答了为本研究设计的一项调查，其中包括李克特评分以及有关不愉快经历和伤害的自由文本问题。所有数据均在线收集。

结果

在这两个样本中，大约三分之二的参与者报告了课程期间与正念练习相关的不愉快经历。大多数参与者（85-92%）认为这些经历根本不令人不安或有些令人不安；一些人表示，困难的经历带来了重要的学习或在某种程度上是有益的。报告正念课程造成伤害的参与者比例为 3% 至 7%。症状问卷显示可靠恶化的比例为 2% 至 7%。那些报告伤害的人和那些在问卷中显示出可靠恶化的人基本上是不同的亚组；只有一名参与者同时落败。

结论

研究结果强调，正念教师需要管理对正念项目中可能出现的好处和困难的期望，并与遇到困难的参与者巧妙地合作。症状调查问卷可能无法捕获伤害经历，应以其他方式明确评估。