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Towards a second generation of mindfulness-based interventions

Australian & New Zealand Journal of Psychiatry, 49(7) In addition to featuring in the practice guidelines of the American Psychiatric Association and the United Kingdom’s National Institute for Health and Care Excellence for the treatment of recurrent depression in adults, emerging evidence suggests that mindfulnessbased interventions (MBIs) have applications for treating diverse psychopathologies and disorders including addictive behaviours (e.g. pathological gambling, workaholism), post-traumatic stress disorder (PTSD), anger dysregulation, attention deficit hyperactivity disorder, pain disorders (e.g. fibromyalgia), sexual dysfunction and psychotic disorders (Shonin et al., 2014). Mindfulness is also recommended by the Royal Australian and New Zealand College of Psychiatrists as a non-first-line treatment for binge eating disorder in adults. However, commensurate with growing interest into the clinical (and non-clinical) applications of MBIs, there are growing concerns over the rapidity at which mindfulness has been extracted from its traditional Buddhist setting and introduced into psychiatric treatment domains (Van Gordon et al., 2015). Specifically, these concerns centre on the alleged absence within the first-generation MBIs (FG-MBIs) of the factors that, according to the 2500-year-old system of Buddhist meditative practice, are deemed to maximise the efficacy of mindfulness. Simply put, some researchers, clinicians and Buddhist scholars have suggested that mindfulness in MBIs has been altered from its traditional Buddhist construction to such an extent that it is inaccurate and/or misleading to refer the resultant technique as ‘mindfulness’. To address these concerns, a number of second-generation MBIs (SG-MBIs) have recently been formulated and empirically investigated. Thus, we explicate the key differences between FG-MBIs and SG-MBIs, appraise key empirical findings and issues relating to SG-MBIs and discuss the implications of the trend towards a second generation of MBIs for psychiatrists and service users.