Understanding the Impact of Meditative Homework on Thought Processes in the Context of Mindfulness Based Cognitive Therapy (MBCT)

Mindftilness based cognitive therapy (MBCT) is a group psycho-educational treatment
designed to reduce the risk of recurrent depression by integrating mindfulness based
meditation practices with cognitive therapy techniques. Existing studies have focused
on the effectiveness or acceptability of MBCT as an intervention, yet have failed to
discretely examine the experience of meditative homework assignments. Given the
prominence of this aspect of the MBCT programme, the aim of the present study was to
explore subjective accounts of the meaning of carrying out meditative homework
assignments in the context of a MBCT programme within the National Health Service.
The research questions focused on the impact of meditative homework on thought
processes as well as an exploration of barriers and facilitating factors from a
participant's perspective.
Individual in-depth interviews were conducted with six adult participants, all of whom
had completed an eight-week MBCT programme. The Interpretive Phenomenological
Analysis methodology was adopted to analyse interview transcripts. Data analysis
began with a detailed examination of one case until a thorough analysis was completed
after which subsequent cases were analysed. Finally a cross case analysis was carried
out where individual themes were interrogated for similarities and differences (Smith, et
al., 2009).
Two master themes emerged from the analysis: 'The relationship of meditative
homework to metacognitive experience' and 'motivating and discouraging factors for
engagement in meditative practice'. Participants' accounts of completing the meditative
homework component of the MBCT programme revealed a transformation in
metacognitive processes as a result of undertaking meditative homework. Participants'
experiences of metacognitive processes are examined in the context of existing psychological theories of metacognition, including the ICS (Teasdale, 1999a, 1999b)
and the S-REF (Wells, 2000). A model for the perceived facilitating factors and
difficulties experienced in carrying out meditative homework is constructed based on
the Integrated Theoretical Foundations Model for CBT homework assignment
(Kazantzis et al., 2005). This model explores participants' motivation in three stages of
the homework process: during assignment of the homework task; in completing the
planned task; and in carrying out a review of the task. The theoretical and clinical
implications of the present study are discussed in relation to psychological literature,
homework assignment and the practise of MBCT.

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