MINDFULNESS, SHAME, AND ATTRITION IN A DIALECTICAL BEHAVIOR THERAPY OUTPATIENT SAMPLE

Abstract

Mindfulness, shame, attrition, and suicidality were examined to better understand the presenting concerns and symptoms of clients seeking mental health treatment in a Dialectical Behavior Therapy (DBT) intensive outpatient (IOP) program at a community mental health center. Specifically, this study explored how clients initially presented in terms of mindfulness and shame, as well as what competencies clients gained as a result of attending the IOP program in terms of mindfulness and reduction of shame. As attrition and suicidality are important concerns in therapy, the relationship between mindfulness and client attrition was also explored, as well as mindfulness and previous suicide attempts. The results of the study indicated that mindfulness scores (measured using the Five Facet Mindfulness Questionnaire; Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006) did not predict attrition for participants pre-treatment. Graduates of the DBT IOP program showed significant gains in the observe mindfulness subscale when comparing pre-test and post-test FFMQ scores, while no significant differences were found for the other four FFMQ subscales. Further, scores of shame (using the State Shame and Guilt Survey; Marschall, Sanftner, & Tangney, 1994) were not significantly different from pre- to post-test for graduates of the program. Lastly, there was a significant difference in pre-test mindfulness scores on the describe mindfulness subscale when comparing FFMQ scores of participants reporting a past suicide attempt and those reporting no past suicide attempt, while no significant differences were found on the other four FFMQ subscales. Implications for researchers and clinicians are discussed.