SPECIAL SERIES
Using Mindfulness- and Acceptance-Based Treatments With Clients From Nondominant Cultural and/or Marginalized Backgrounds: Clinical Considerations, Meta-Analysis Findings, and Introduction to the Special Series: Clinical Considerations in using Acceptance- and Mindfulness-based Treatments With Diverse Populations

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Abstract

A growing body of research suggests that mindfulness- and acceptance-based principles can increase efforts aimed at reducing human suffering and increasing quality of life. A critical step in the development and evaluation of these new approaches to treatment is to determine the acceptability and efficacy of these treatments for clients from nondominant cultural and/or marginalized backgrounds. This special series brings together the wisdom of clinicians and researchers who are currently engaged in clinical practice and treatment research with populations who are historically underrepresented in the treatment literature. As an introduction to the series, this paper presents a theoretical background and research context for the papers in the series, highlights the elements of mindfulness- and acceptance-based treatments that may be congruent with culturally responsive treatment, and briefly outlines the general principles of cultural competence and responsive treatment. Additionally, the results of a meta-analysis of mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds are presented. Our search yielded 32 studies totaling 2,198 clients. Results suggest small (Hedges' g = .38, 95% CI = .11 – .64) to large (Hedges' g = 1.32, 95% CI = .61 – 2.02) effect sizes for mindfulness- and acceptance-based treatments, which varied by study design.

Section snippets

Acceptance-Based Behavioral Therapies

It has been suggested that Western/dominant cultural values are inherent in many current evidence-based treatments (Benish, Quintana, & Wampold, 2011). In particular, the emphasis placed in cognitive behavioral therapy (CBT) on individualism, present functioning, assertiveness, rationality, and behavior change reflects values that may not be shared by all clients, particularly those from non-Western/nondominant cultural backgrounds (Hays, 2009). In contrast, recent evolutions in CBT highlight

ABBTs and Underserved Populations

There are several ways that ABBTs may be particularly relevant to people from marginalized and/or underserved backgrounds. The therapeutic stance in many ABBTs is that the client's experience is influenced by sociopolitical and historical factors that affect the way that distress is experienced and expressed (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). Emotional distress is viewed as a universal human experience that is inevitable and natural. Thus, a focus of these treatments is generally to

Culturally Competent and Responsive Mental Health Care

Although ABBTs may lend themselves to culturally responsive mental health care in many ways, therapists must also explicitly consider culture and culturally competent care when working with each client. We provide a brief overview of elements of culturally responsive therapy (see Hays, 2008, Lee et al., 2009, Sue and Sue, 2003, for more in-depth discussions of these important issues).

“Culture” has been defined broadly as a person's worldview, which is shaped by life experiences and affects the

Meta-Analysis of Acceptance- and Mindfulness-Based Behavioral Treatments With Underserved Populations

As noted previously, the literature base on the use of acceptance and mindfulness-based treatments with underserved populations is steadily growing. As a result, we conducted a meta-analytic review of the published and unpublished empirical studies to date that have used mindfulness- and acceptance-based treatments with individuals from nondominant cultural and/or marginalized backgrounds; more specifically individuals who are not traditionally the focus of psychological treatment outcome

Overview of the Special Series

In the articles that follow, researchers and clinicians present specific suggestions of how acceptance- and mindfulness-based behavioral treatments might be used with clients from nondominant cultural and/or marginalized backgrounds to optimize relevance and engagement. We invited submissions from clinicians and researchers working with a range of underserved populations to provide their clinical recommendations regarding the use of acceptance- and mindfulness-based treatments with the specific

Acknowledgements

We would like to express our gratitude to the members of the ACT and Mindfulness communities for responding to our solicitations to share their work and resources with us for inclusion in this review. Although not all contributions solicited were included in this paper, we would like to thank Sarah Bowen, Helen Coelho, Devon Hinton, Brjánn Ljótsson, Jonathan Kanter, Marco Kleen, Nancy Kocovski, David Neale-Lorello, and Katherine Rimes for responding to our requests.

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  • Cited by (0)

    Cara Fuchs is now at the Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior and Jonathan K. Lee is now at the Family Institute at Northwestern University.

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    References included the meta-analysis are noted by an asterisk.

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