Thursday, Oct. 27
14:30 – 16:30 (2 hrs)
Meeting Room: Sheraton Hall E (Lower Concourse)
Andrea Grabovac*, MD, FRCPC

CanMEDS Roles:

1. Medical Expert
2. Health Advocate
3. Scholar

At the end of this session, participants will be able to: 1) Apply the 30-second mindfulness interoceptive exposure task (MIET) with patients for immediate distress reduction; 2) Explain the transdiagnostic efficacy of mindfulness-integrated cognitive-behavioural therapy (MiCBT), using the co-emergent model of reinforcement; and 3) Understand how to use mindfulness meditation to neutralize operant conditioning and improve therapeutic efficacy.

Mindfulness-integrated cognitive-behavioural therapy (MiCBT) is a novel, evidence-based integration of traditional CBT and mindfulness meditation into a four-stage framework that addresses a wide range of acute and chronic psychiatric conditions. It is based on the co-emergent model of reinforcement (CMR), a psychological model that integrates operant conditioning, information processing theory, and Buddhist psychology and highlights the role of attachment and aversion to pleasant and unpleasant sensations in maintaining reactivity.

The four clinical stages of MiCBT will be reviewed, with a focus on the development of interoceptive awareness and equanimity (Stage 1), mindfulness-based exposure using SUDS (Stage 2), improving interpersonal skills through assertiveness with equanimity (Stage 3), and compassion as a relapse prevention strategy (Stage 4). The 10 session structure of MiCBT will be introduced, and strategies for applying mindfulness skills outside of regular daily meditation practise will be emphasized.

Participants will be taught to self-implement the mindfulness-based interoceptive exposure task (MIET), a 30-second applied mindfulness practise that teaches patients to face unpleasant sensations without avoidance or anxiety, resulting in a rapid reduction in distress. It is the foundation for the applied mindfulness interventions in all four stages of MiCBT and a practical tool for applying equanimity and decreasing reactivity in daily life.

References:

1. Cayoun BA, Frances SE, Shires AG. The Clinical Handbook of Mindfulness-Integrated Cognitive Behaviour Therapy. Hoboken (NJ): Wiley-Blackwell; 2019.
2. Cayoun BA. The Co-Emergence Model of Reinforcement: A Rationale for Mindfulness Integration. Hoboken (NJ): Wiley-Blackwell; 2011.