Mindful medical practice and the therapeutic alliance
Main Article Content
This review article focuses on how the therapeutic relationship is central to clinician-client/patient relationships in psychiatry as well as other medical and psychotherapeutic encounters. Crucial to this relationship is the alliance formed between the caregiver and the person who seeks their care. The threats to the therapeutic alliance in psychiatry are discussed as is the importance of facing them. How mindfulness enables clinicians to build such bonds and foster well-being in themselves and in those they treat is examined in the context of quantitative and qualitative studies.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Creative Comons 4.0 CC-BY
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
Gillitt T. The Mindful Therapist: an interpretive phenomenological analysis of mindfulness meditation and the therapeutic alliance [thesis]. Grahamstown, South Africa: Rhodes University; 2011.
Priebe S, Mccabe R. Therapeutic relationships in psychiatry: the basis of therapy or therapy in itself? Internat Rev Psych. 2008;20(6):521–6.
Siegel D. The Mindful Brain: reflection and attunement in the cultivation of well-being. New York: Mind Your Brain, Inc.; 2007.
Bowlby J. A secure base: parent-child attachment and healthy human development. London: Routledge; 1988.
Butler Center for Research. Therapeutic alliance: improving treatment outcome. Research Update [Internet]. 2006 [cited 2014 Nov 17]). Available from: https://www.hazelden.org/web/public/researchupdates.page.
Smith B. Inappropriate prescribing. APA [Internet]. 2012 [cited 2014 Nov 17]; 43(6). Available from: http://www.apa.org/monitor/2012/06/prescribing.aspx.
Carlat D. Unhinged: the trouble with psychiatry - a doctor's revelations about a profession in crisis. New York: Free Press; 2010.
Grohol J. Psychiatry doesn’t do psychotherapy anymore. World of Psychology [Internet]. 2011 [cited 2014 Nov 17]. Available from: http://psychcentral.com/blog/archives/2011/03/06/psychiatry-doesnt-do-psychotherapy-anymore/.
Eisenberg L. Past, present, and future of psychiatry: personal reflections. Can J Psych. 1997;42:705–13.
Frances A. Saving Normal. New York: Harper Collins Publishers; 2013.
Programa mínimo para residência médica em psiquiatria. Associação Brasileira de Psiquiatria. [Internet]. [cited 2014 Nov 17]. Available from: http://portal.mec.gov.br/.
Coêlho B, Zanetti M, Lotufo F. Residência em psiquiatria no Brasil: Análise Crítica. Rev Psiquiatr RS. 2005;27(1):13-22.
Zanetti M, Coêlho B, Lotufo F. Residência em Psiquiatria no Brasil: uma contribuição para o debate (Editorial). Rev Bras Psiquiatr. 2005;27(1):9-10.
Sadock B, Sadock V. Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 10th Edition; Washington, D.C.: Lippincott Williams & Wilkins; 2007. p 1-11.
Lucena R, Lesage A. Family Physicians and Psychiatrists: Qualitative Study of Physicians’ Views on Collaboration. Can Fam Phys. 2002;48:923-9.
Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009 Sep 23;302(12):1284-93.
Marr L. No agenda. J Pall Med. 2013;16(11):1482-3.
Dobkin, D. I am my brother’s keeper. In: Dobkin PL, editor. Mindful Medical Practice: Clinical Narratives and Therapeutic Insights. New York: Springer; 2015.
Boyce B, Kabat-Zinn J, Siegel D, Hanh TN, Kornfield J. The Mindfulness Revolution: Leading psychologists, scientists, artists, and meditation teachers on the power of Mindfulness in daily life. Boston, MA: Shambhala Publications; 2011.
Dass R. Remember, Be Here Now. San Cristobal: Lama Foundation; 1971.
Kornfield J. A Path with Heart: A Guide through the Perils and Promises of Spiritual Life. New York: Bantam; 1993.
Epstein RM. Mindful practice. JAMA. 1999 Sep 1;282(9):833-9.
Epstein RM. Thoughts Without a Thinker: psychotherapy from a Buddhist perspective. New York: Basic Books; 2004.
Goldstein J. One Dharma: The Emerging Western Buddhism. San Francisco: Harper One; 2003.
Benson H, Stark M. Timeless Healing. New York: Scribner; 1997.
Davidson RJ, Kabat-Zinn J, Schumacher J, Rosenkranz M, Muller D, Santorelli SF, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med 2003 Jul;65(4):564-70.
Kabat-Zinn J. Full Catastrophe Living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte Press; 1990.
Fulton PR. Mindfulness in clinical training. In: Germer CK, Siegel RD, Fulton PR, editors. Mindfulness and Psychotherapy. NY: Guilford Press; 2005.
Escuriex BF, Labbé EE. Health care providers' mindfulness and treatment outcomes: A critical review of the research literature. Mindfulness 2011;2(4):242-53.
Irving JA, Dobkin PL, Park J. Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR). Complement Ther Clin Pract. 2009 May;15(2):61-6.
Beckman HB, Wendland M, Mooney C, Krasner MS, Quill TE, Suchman AL, et al. The impact of a program in mindful communication on primary care physicians. Acad Med. 2012 Jun;87(6):815-9.
Irving J, Park J, Fitzpatrick M, Dobkin PL, Chen A, Hutchinson T. Experiences of health care professionals enrolled in Mindfulness-Based Medical Practice: a grounded theory model. Mindfulness 2014;5(1):60-71.
Moody K, Kramer D, Santizo RO, Magro L, Wyshogrod D, Ambrosio J, et al. Helping the helpers: mindfulness training for burnout in pediatric oncology-a pilot program. J Pediatr Oncol Nurs. 2013 Sep;30(5):275-84.
Fatter DM, Hayes JA. What facilitates counter-transference management? The roles of therapist meditation, mindfulness, and self-determination. Psychother Res. 2013;23(5):502-13.
Dobkin PL. Fostering healing through mindfulness in the context of medical practice. Curr Oncol. 2009 Mar;16(2):4-6.
Dobkin PL. Mindfulness and Whole Person Care. In: Hutchinson TA, editor. Whole Person Care: A New Paradigm for the 21st Century. New York, NY: Springer Science + Business Media, LLC; 2011.
Dobkin PL, editor. Mindful Medical Practice: Clinical Narratives and Therapeutic Insights. Switzerland: Springer International Publishing; 2015.
Grepmair L, Mitterlehner F, Loew T, Bachler E, Rother W, Nickel M. Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study. Psychother Psychosom 2007;76(6):332-8.
Horst K, Newsom K, Stith S. Client and therapist initial experience of using mindfulness in therapy. Psychother Res 2013;23(4):369-80.
Padilla A. Mindfulness in therapeutic presence: How mindfulness of the therapist impacts treatment outcome [PhD thesis]. New York: New School University; 2010.
Beach MC, Roter D, Korthuis PT, Epstein RM, Sharp V, Ratanawongsa N, et al. A multicenter study of physician mindfulness and health care quality. Ann Fam Med 2013 Sep;11(5):421-8.
Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003 Apr;84(4):822-48.
Carlson LE, Brown KW. Validation of the mindful attention awareness scale in a cancer population. J Psychosom Res. 2005 Jan;58(1):29-33.
Grossman P. On measuring mindfulness in psychosomatic and psychological research. J Psychosom Res. 2008 Apr;64(4):405-8.
Ryan A, Safran JD, Doran JM, Muran JC. Therapist mindfulness, alliance, and treatment outcome. Psychother Research. 2012:22(3):289-97.
Keane A. The Influence of therapist mindfulness practice on psychotherapeutic work: a mixed-methods study. Mindfulness 2013;1-15.
Dobkin PL, Bernardi NF, Bagnis CI. Enhancing clinician well-being and patient-centered care through mindfulness. JCEHP. 2015 (submitted).