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Table 1 Summary of the content of the MBI manual for P

From: Distant delivery of a mindfulness-based intervention for people with Parkinson’s disease: the study protocol of a randomised pilot trial

Week Theme Agenda
Week 1:
Automatic pilot
Mindfulness starts when we recognise the tendency to be on automatic pilot and make a commitment to learning how best to step out of it to become aware of each moment. Body scan practice trains the mind in putting attention and awareness in different places at will. The aim of this week is to enhance awareness. Establish the orientation of the group
• Set ground rules regarding confidentiality and privacy
• Ask participants to introduce themselves in the group
• Raising exercise
• Discussion of raising exercise
• Body scan meditation
Homework: body scan meditation (6 out of 7 days), mindfulness of a routine activity, eat one meal mindfully.
Week 2:
Mindfulness of the breath
Further focus on the body begins to show more clearly the chatter of the mind and how it tends to control our reaction to everyday events. The aim of this week is to enhance awareness. • Body scan meditation
• Homework review
• Cultivating curiosity about body sensations
• Hearing meditation
Homework: body scan (6 out of 7 days), pleasant events calendar, and mindfulness of a routine activity.
Week 3:
Staying present
Greater awareness of how the mind can get hooked in judgements and unhelpful thoughts leads to awareness of the impact of those thoughts and emotions on the body. In this week, decentering is introduced. • Mindfulness movement meditation
• Homework review
• Explain low mood/anxiety cycle and the role of automatic thoughts
• 3-min breathing space
Homework: body scan or mindful movement meditation for 6 days out of 7, unpleasant events calendar, 3-min breathing space.
Week 4:
Dealing with barriers
The mind is most scattered when it tries to cling to some things and avoid/escape other things. Mindfulness offers a way of staying present by giving another place from which to view things: to help take a wider perspective and relate differently to experience. In this week, decentering is further explored and acceptance is introduced. • Sitting meditation
• Homework review
• Explain acceptance versus avoidance/fusion concepts and explore unhelpful coping strategies linked to avoidance or fusion.
• 3-min breathing space-coping
Homework: sitting meditation (6 out of 7 days), 3-min breathing space, early warning signs and action plan exercise.
Week 5:
Using mindfulness to respond instead of react
Relating differently involves bringing to experience a sense of ‘allowing’ it to be, just as it is, without judging it or trying to make it different. Such an attitude of acceptance is a major part of taking care of oneself and seeing more clearly what, if anything, needs to change. Acceptance is further explored, and self-compassion is introduced. • Sitting meditation
• Homework review
• Responding vs. reacting
• 3-min breathing space-dealing with difficulties
Homework: sitting meditation (6 out of 7 days), 3-min breathing space.
Week 6:
Thoughts are not facts
Negative moods and the thoughts that accompany them restrict our ability to relate differently to experience. It is liberating to realise that our thoughts are merely thoughts, even the ones that say they are not. This week brings together the concepts of decentering, acceptance, and self-compassion. • Sitting meditation
• Homework review
• Thoughts and feeling exercise (‘walking down the street’)
• Discuss how decentering and accepting can lead to being kinder towards oneself
• 3-min breathing space
Homework: practise with a selection of meditations, 3-min breathing space.
Week 7:
How can I best take care of myself?
There are some specific things that can be done when distressed. Taking a breathing space will come first and then deciding what action, if any, to take. Each person has his or her unique warning signs of distress, but participants can help each other in making plans of how best to respond to the signs. This week brings together the concepts of decentering, acceptance and self-compassion. • Sitting meditation
• Homework review
• Generate list of pleasure and mastery activities
• Plan how best to schedule such activities
• 3-min breathing space as the first step before choosing whether to take mindful action
Homework: Select from all different forms of practice, a pattern you intend to use on a regular basis, 3-min breathing space.
Week 8:
Planning for the future
Maintaining a balance in life is helped by regular mindfulness practice. Good intentions can be strengthened by linking such intentions to a positive reason for taking care of oneself • Body scan meditation
• Homework review
• Review whole course: what has been learned
• Discuss how best to keep up momentum and discipline developed over the past 7 weeks in both formal and informal practice
• Concluding meditation