Applying Participatory Research in the Development of Clinical Practice Recommendations for Incorporating Mindfulness into Mental Health Treatment with Youth at Risk for Psychosis

Abstract

Mindfulness is a promising adjunct strategy that clinicians can use with individuals at risk for psychosis to help manage their distressing symptoms and difficulties with daily functioning. This article explores how mental health clinicians can support young people to safely engage with mindfulness practices as part of their overall recovery through the development of specific guidance for the implementation of mindfulness programs within routine clinical care. A collaborative approach was taken to the development of the recommendations through the adoption of participatory research principles across three phases. The first two phases were published elsewhere. In Phase 3, initial recommendations were formulated, in consideration of the findings of Phases 1 (evidence mapping) and 2 (qualitative analysis of the perspectives of practitioners with experience working with young people at risk for psychosis, and youth at risk for psychosis, regarding the use of mindfulness as an adjunct to usual treatment) and existing mindfulness intervention protocols for psychosis. Initial recommendations were fed back to the practitioner group used in Phase 2 in a validation cycle to ensure recommendations matched their views and for final endorsement. Eight key recommendation areas with corresponding clinical practice points were endorsed, highlighting the practical utility of the recommendations. Recommendations included the benefit of youth-relevant mindfulness content and adapting mindfulness to young people’s needs, the importance of trauma-informed principles, the utility of compassion-based practices, and key ways to address barriers to mindfulness uptake for youth at risk for psychosis. It is anticipated that through the implementation of these recommendations, safe and effective implementation of mindfulness interventions within early intervention practice will improve outcomes for young people experiencing attenuated psychotic symptoms and associated morbidity.