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Integrating Buddhist Practices and Principles Into Mental Health Settings Integrating Buddhist Practices and Principles into Mental Health Settings: A Mixed Method Investigation Venerable Edo Shonin, PgCert, MSc Psychology Division, Nottingham Trent University, Nottinghamshire, UK, NG1 4BU A thesis submitted in partial fulfilment of the requirements of Nottingham Trent University for the degree of Doctorate of Psychology December 2015 1 © Edo Shonin, 2015 This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed to the owner of the Intellectual Property Rights. Recommended citation: Shonin, E. (2015). Integrating Buddhist Practices and Principles into Mental Health Settings: A Mixed Methods Investigation [PhD Thesis]. Nottingham: Nottingham Trent University. Keywords: Mindfulness, Meditation, Meditation Awareness Training, Buddhist-Derived Interventions, Mindfulness-based Interventions, Second-Generation Mindfulness-based Interventions, Emptiness, Buddhism, Loving-Kindness Meditation, Compassion Mediation, Psychopathology, Stress, Anxiety, Problem Gambling, Pathological Gambling, Schizophrenia, Psychosis, Reoffending, Work Addiction, Work-related Stress Aspects of this doctoral project were supported by: Awake to Wisdom Centre for Meditation and Mindfulness Research Bodhayati School of Buddhism 2 Table of Contents Declarations 6 List of Publications 8 List of Tables and Figures 16 General Abstract 17 Chapter 1: General Introduction 19 SECTION A. CONTRIBUTION TO THEORY Chapter 2: The Emerging Role of Buddhism in Clinical Psychology: 27 Toward Effective Integration Chapter 3: Buddhist-derived Loving-kindness and Compassion Meditation 64 for the Treatment of Psychopathology: A Systematic Review Chapter 4: Mindfulness and Wellbeing: Towards a Unified Operational Approach 110 SECTION B. CONTRIBUTION TO RESEARCH SECTION B: PART 1 Chapter 5: Do Mindfulness-Based Therapies have a Role in the Treatment of Psychosis? 133 Chapter 6: Cognitive Behavioural Therapy (CBT) and Meditation Awareness Training 144 (MAT) for the Treatment of Co-occurring Schizophrenia and Pathological Gambling: A Case Study SECTION B: PART 2 Chapter 7: Meditation Awareness Training (MAT) for Work-Related Wellbeing and Job 171 Performance: A Randomised Controlled Trial Chapter 8: Managers’ Experiences of Meditation Awareness Training 200 SECTION B: PART 3 Chapter 9: Mindfulness and other Buddhist-Derived Interventions in 227 Correctional Settings: A Systematic Review SECTION B: PART 4 Chapter 10: Buddhist Philosophy for the Treatment of Problem Gambling 253 3 Chapter 11: Mindfulness and the Social Media 275 Chapter 12: The Treatment of Workaholism with Meditation Awareness Training: 285 A Case Study SECTION C: CONTRIBUTION TO PRACTICE Chapter 13: Practical Tips for using Mindfulness in General Practice 295 Chapter 14: Mindfulness of Emptiness and the Emptiness of Mindfulness 302 Chapter 15: General Conclusion 335 References 343 4 To Professor Mark Griffiths for his ongoing mentorship To the simple monk, Venerable William Van Gordon 5 Declaration of Originality I hereby declare that this submission is my own work and that, to the best of my knowledge and belief, it contains no material which has been accepted for the award of any other degree or diploma of a university or other institute of higher learning. Signed: (Edo Shonin) Date: 18th December 2015 Statement of Ethical Compliance All of the studies conducted as part of this doctoral thesis were subject to an in-depth assessment of their ethical implications. Ethical approval for all studies was provided by the Nottingham Trent University College of Business, Law, and Social Sciences Research Ethics Committee. I declare that I have not deviated from the terms of the ethical approval issued by this Committee. Signed: (Edo Shonin) Date: 18th December 2015 6 Author Contribution Statement I confirm that I am responsible for the conception, design, and writing of all chapters included in this thesis. I conducted the literature reviews, designed the research, collected and analysed the data, and prepared the first-draft of each chapter. Some of the empirical and theoretical findings from this thesis have been published in peer-reviewed journals. In such instances, I confirm that I was the primary and corresponding author, and was responsible for responding to reviewers and making any revisions to the paper. Professor Mark Griffiths was the Director of Studies for this research programme and his role as co-author on papers submitted for publication involved: (i) making suggestions on the presentation and refinement of the material included in the paper, (ii) providing suggestions for some additional content of the paper (which may or may not be included in the chapters that comprise this doctoral thesis), (iii) providing advice on responding to comments from the journal reviewers and editor, and (iv) providing advice on the selection of a suitable journal to target for publication. The role of any other individual included as a co-author on a published paper that was based on findings from this doctoral thesis was limited to providing editorial input and commenting on drafts. Two exceptions to this are Thomas Dunn who provided statistical support for the randomised controlled trial and William Van Gordon who conducted an independent audit of findings from the systematic reviews as well as on outcomes from specific empirical analytical components. Signed: Signed: Edo Shonin Mark Griffiths (Director of Studies) Date: 18th December 2015 Date: 18th December 2015 7 List of Publications As referred to in the Author Contribution Statement, this PhD thesis resulted in a number of peer-reviewed journal outputs. In the following list of publications, a ‘*’ denotes published works that are largely based on the content (whether in full or in part) of specific chapters included in this PhD thesis. In the case of all published papers designated with a ‘*’, I am the first author. The final published versions of these papers are unlikely to exactly replicate the contents of the chapter in this thesis upon which they were originally based. I acknowledge that the copyright of the final version of any published works arising from this doctoral thesis resides with the copyright holder(s) of those works. All other papers shown below (i.e., those not marked with a ‘*’) have been published since the start of this doctoral project, but are more loosely based on some of the theoretical and/or empirical findings of the thesis. Consequently, in the list of publications that follows, I may or may not be the first author of papers that are not designated with a ‘*’. 8 List of Publications *Shonin, E., Van Gordon, W., Compare, A., Zangeneh, M., & Griffiths, M. D. (2015). Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review. Mindfulness, 6, 1161-1180. *Shonin, E., & Van Gordon, W. (2015). Managers’ experiences of Meditation Awareness Training. Mindfulness, 4, 899-909. *Shonin, E., Van Gordon, W., Dunn, T., Singh, N. N., & Griffiths, M. D. (2014). Meditation Awareness Training for work-related wellbeing and job performance: A randomised controlled trial. International Journal of Mental Health and Addiction, 12, 806-823. *Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). Mindfulness and the social media. Journal of Mass Communication and Journalism, 2014, 4: 5, DOI: 10.4172/2165- 7912.1000194. *Shonin, E., Van Gordon W., & Griffiths, M. D. (2014). Practical tips for using mindfulness in general practice. British Journal of General Practice, 64, 368-369. *Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). Cognitive Behavioural Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196. *Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). The emerging role of Buddhism in clinical psychology: Toward effective integration. Psychology of Religion and Spirituality, 6, 123- 137. *Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). Do mindfulness-based therapies have a role in the treatment of psychosis? Australia and New Zealand Journal of Psychiatry, 48, 124-127. 9 *Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). The treatment of workaholism with Meditation Awareness Training: A Case Study. Explore: The Journal of Science and Healing, 10, 193-195. *Shonin, E., Van Gordon, W., Slade, K., & Griffiths, M. D. (2013). Mindfulness and other Buddhist-derived interventions in correctional settings: A systematic review. Aggression and Violent Behaviour, 18, 365-372. *Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addictions, 2, 63-71. *Shonin, E., & Van Gordon, W., & Griffiths, M. D. (2015). Mindfulness and Wellbeing: Towards a Unified Operational Approach. In: T. Lomas & I. Ivtzan (Eds). Mindfulness in Positive Psychology: The Science of Meditation and Wellbeing. Oxford: Routledge. [In Press] *Shonin, E., Van Gordon, W., Singh, N. N., & Griffiths, M. D. (2015). Mindfulness of Emptiness and the Emptiness of Mindfulness. In: E. Shonin, W. Van Gordon, & N. N. Singh (Eds).
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