This training protocol covers eight group sessions of 90 minutes’ duration, plus two follow-up sessions. Groups consist of 8 to 12 men and women between 18 and 65 years of age. While the composition of the group may vary, an attempt should be made to match participants. When a man signs up, for example, it would be appropriate to include another male in the group. Although this is not technically group therapy, we still subscribe to the “Noah’s Ark principle” of “two of every kind,” since validation, recognition, and learning capacity are enhanced when participants can identify with other group members. A particular group may contain impulsive individuals who quickly and regularly display emotions, as well as inhibited and detached subjects with blunted or flat affect. The underlying idea of a varied group is that, in a safe training environment, everyone can learn from each other.
The main feature setting a training protocol apart from a treatment protocol is that everything discussed in the group relates to the acquisition of skills. While there is some room for participants’ insights, these are ideally linked back to the training. Group dynamics, to the extent they are present, are utilized for illustrating the interactions between automatic pilot and schemas/modes. The trainer’s attitude is one of curiosity and openness to whatever participants bring to the table, through which they effectively model the desired mindfulness-based approach to experience. Additionally, trainers provide psychoeducation concerning schemas, modes, and schema coping.
Another distinction between this training protocol and those prescribed by, for example, Segal et al. (2002), is that trainers are expected to fulfill a more action-oriented and regulating function, entailing a greater degree of psychoeducation. This manner of training has been found to be indispensable when training individuals with more serious personality problems, making the trainers’ task all the more challenging; thus, trainers need to be mindfully action-oriented.
Instead of delving into participants’ personality problems at large, three of each group member’s most influential schemas and modes are identified, which then function as the object of attention over the course of the training. By concentrating the focus on these specific schemas and modes, awareness and understanding of schema processes are facilitated.
The first two sessions revolve around the description, explanation, and practice of basic mindfulness skills. Exercises include those described in mindfulness-based cognitive therapy for depression (Segal et al., 2002), among others. In the third session, participants practice mindful awareness of painful memories. From session 4 onwards, participants learn to consciously observe their schemas and modes in action. In sessions 5 and 6, participants are also asked to challenge their schemas on a cognitive level, practicing the mindfulness-based doing mode. Sessions 7 and 8 involve exercises that facilitate mindful awareness of the Healthy Adult and Happy Child modes. In conclusion, two follow-up sessions will be planned, offering the opportunity for participants to refresh their memories and learn additional mindfulness exercises in the context of schemas and modes.
Our descriptions of mindfulness exercises intentionally incorporate an explicit distinction between the attention-oriented aspect and the action-oriented aspect (doing mode) of an exercise. This division is not intended to create an artificial division between the two, but rather to help participants become aware of these as dual processes.
At the following website, http://www.mfvanvreeswijk.com, patients can buy mindfulness exercises (audio files), like the ones in this book. We consider these required listening, as experience has shown the training to be more effective when participants practice on their own, outside of the group meetings.
Pre- and post-measures of the training are obtained with the aid of questionnaires (YSQ and SMI-1), in which participants record their experiences. One of the questionnaires is administered multiple times over a number of sessions (Five Facet M Questionnaire, Baer, 2010). Results are returned to participants, providing them with additional insight into their experiences during the training. Note that the terms employed in these questionnaires reflect a focus on experience, rather than outcome effect. Any mention of effects will elicit the notion that training is expected to bring about some kind of change in symptoms, schemas, or modes. Although change may certainly occur, it is not the objective. The aim of the training is to learn to be mindful, without action-orientedness, and without preconceived goals.