“These days there are apps for learning mindfulness. There are mindfulness programs that are just a couple of hours long. I see and hear of teachers who are doing things that are a very long way from what I would recognize as a mindfulness-based stress reduction program,” says Susan Woods, who helped develop and set up the Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy certification training curriculum for the Mindfulness-Based Professional Training Institute at the University of California, San Diego. The challenge, many leaders agree, is to set standards for teaching teachers that maintain the highest quality of mindfulness instruction.  To do just that, Winston, Dawa Phillips, and a small group of experienced teachers recently launched the International Mindfulness Teachers Association (IMTA). At first glance, its mission sounds fairly uncontroversial—“to oversee national and international mindfulness teacher education and training standards to ensure teaching and education programs continue to meet a level of depth and rigor needed to serve students and clients at the highest level and standardize the mindfulness teaching profession.” But almost as soon as its website went live last year, the fledgling association sparked a furor within the normally calm and collegial mindfulness community. Instead of bringing clarity to the field, Lynette Monteiro, a cofounder of the Ottawa Mindfulness Clinic in Canada, charged in an opinion piece in the magazine Tricycle, “IMTA has muddied the waters of existing professional certification processes.”  In an open letter to the IMTA signed by 10 leading experts from around the world, members of the International Integrity Network worried that the new association “will lead to added confusion in the field.” The writers accused the IMTA of ignoring the efforts of many other groups around the world, already well underway, to establish standards for mindfulness teachers. They also faulted the association for preemptively declaring itself to be an international association even when almost all of its members were US-based mindfulness practitioners. The worries go deeper. In an effort to regulate mindfulness teacher training, some critics have said, the movement is in danger of ignoring the essential quality of a good teacher—wisdom—in favor of a set number of prerequisites and course hours. In an article in The Huffington Post not directly addressing the IMTA but rather the larger issues facing the mindfulness community, Ron Purser, a Zen teacher and professor of business at San Francisco State University, wrote: “This amounts to the professionalization of the role of the mindfulness teacher in conjunction with the student-as-consumer… Students are no longer learners seeking knowledge for knowledge’s sake, but have taken on the identity of the customer. Similarly, the professionalization of the role of mindfulness teachers has colonized not only the teacher–student relationship, but it introduces market logic with its demands for competition, savvy marketing, and entrepreneurialism.” The intensity of the criticisms took the founders of the IMTA by surprise. “It was a shock at first,” Winston says. “We saw this as an altruistic effort, something that would help everyone in the field and everyone interested in learning to practice mindfulness.” But perhaps it shouldn’t have been so surprising. In many ways, the uproar has exposed rifts in the mindfulness community that have been around for years—among them, the challenge inherent in creating a formal teacher training program for a practice that proponents agree is available to anyone. Of course, any field growing as rapidly as mindfulness is today will experience growing pains. Still, many leaders see this as a pivotal moment. How the debate over international standards and formal credentialing for mindfulness teachers plays out, they say, will shape the future of mindfulness as a practice and a profession.

Protecting the integrity of research-backed mindfulness practice

Almost everyone agrees that there’s a need for formal and widely accepted standards for teachers. “At the moment, the field is very much in flux, which is indicative of the nascent stage we’re in,” says Lynn Koerbel, director of mindfulness-based stress reduction teacher education and curriculum development at the University of Massachusetts Medical School’s Center for Mindfulness in Medicine. “The field of mindfulness has broadened and deepened, and the question is, now what?” Rebecca Crane, who directs the Centre for Mindfulness Research and Practice at the School of Psychology at Bangor University in Wales, agrees. “The field is moving along quite swiftly now,” she wrote in an email. “There is a strong recognition that in order to protect the integrity of this work, there needs to be transparent systems for the general public to discriminate between those who have undertaken in-depth training and those who have not.” The same goes for educational institutions, medical centers, corporations, and other establishments that want to launch in-house mindfulness programs. “The problem at the moment is that it’s less and less clear who the qualified teachers are,” says Phillips, who is serving as the IMTA’s executive director. “Institutions should be able to feel confident that they are hiring the best mindfulness teachers, and that’s very difficult today.” With an internationally accepted standard for credentialing mindfulness teachers in place, experts say, there’s better likelihood that health insurers will be persuaded to provide coverage for mindfulness as an intervention in health care. “Because there has been so much evidence showing the efficacy of mindfulness, if we can establish rigor around the teaching, then it might get coverage by insurance companies down the road,” says Winston. That would benefit patients and mindfulness practitioners alike. A formal certification process for teachers would also be helpful to support the advance of research into the benefits of mindfulness. To conduct any carefully controlled study, researchers need to make sure every participant receives the same treatment. In the case of an experimental drug, that’s easy. But when the treatment is mindfulness training, it’s much more difficult. For now, there is no way to measure mindfulness as a state. Instead, researchers try to make sure that study participants receive essentially the same mindfulness training—and that the training is generally accepted as the right approach by others in the field. “Certainly in terms of research, having a consistent standard is paramount,” says Koerbel. “It’s critically important that the delivery of all those classes be at the same level.” Finally, an agreed-upon set of professional standards for training mindfulness teachers would benefit people who want to become teachers, by clearly indicating what will be expected of them, and the core competencies that need to be mastered. “If we create standards and requirements that everyone agrees on, mindfulness teachers will have more depth for themselves, and serve their clients better,” says Winston. The fact is, efforts to establish teaching standards have been under way for almost a decade. UMass’s Center for Mindfulness in Medicine, for instance, has created its own curriculum, which includes very specific criteria to assess the competence of teachers of mindfulness. In 2013, Susan Woods helped create a similar curriculum for UC San Diego’s Mindfulness-Based Professional Training Institute.  In the UK, meanwhile, experts in mindfulness have created their own standards for certification. The development process started around 2009, says Crane, “when Bangor University, Oxford University, and Exeter University, all of which were interested in assessing teaching as part of their respective master’s and research programs, came together to collaborate by pooling expertise and experience.” Trainers from the three universities painstakingly refined the standards and created what they called the Mindfulness-Based Interventions Teaching Assessment Criteria, or MBI:TAC. “The MBI:TAC provides an agreed national benchmark for teaching competence—students graduating from these programs have all been assessed against the same criteria and judged to be competent or above,” according to Crane. Today MBI:TAC is widely used by many teaching programs in the UK, the US, and other parts of the world. “Between the criteria we’ve been using, and the MBI:TAC, we feel pretty clear that this process is rigorous and deep and affords the teacher and us a moment in time that says, yes, you’ve done this training, you’ve done this work, we see competence, we see a conveyance of the essence of the program,” Koerbel says. In order to help consumers connect with qualified instructors, several online registries of vetted mindfulness teachers and mindfulness programs have been launched. The UK Network for Mindfulness-Based Teachers, for example, a collaboration between 23 training organizations, offers a listing of teachers who meet good practice guidelines. A website called “Your Guide To Mindfulness-Based Cognitive Therapy,” at mbct.com—created by Zindel Segal, Mark Williams, and John Teasdale—provides a variety of resources for people interested in MBCT, including qualified programs and teachers. 

The real hurdle to creating mindfulness certification standards

Why, if most experts agree on the need for widely accepted standards for teachers and many groups are already drafting them, did the launch of the IMTA met such fierce criticism? Part of the answer is that there are so many individuals and organizations already doing the hard work of testing requirements for teachers. Woods, one of the experts who signed the open letter criticizing the IMTA, explains, “The field of mindfulness-based interventions has been looking and struggling with how to come to an understanding about standardization for years. The IMTA didn’t take time to talk to people who were actively involved in mindfulness-based programs. They reached out to some people, but then they didn’t actively involve many of them. That was a mistake. They didn’t acknowledge that the field of MBI programs was already deeply involved in conversation about standardizing the field.”  To make matters worse, critics say, the IMTA’s mission and mandate were unclear, at least at the beginning, creating confusion rather than clarifying the issues of credentialing teachers and accrediting mindfulness programs. “Were they setting themselves up as a training body, or a clearinghouse, or an adjudicating body?” says Monteiro. “It wasn’t at all clear, and those three roles are very different.”  In their defense, the founders of the IMTA acknowledge that the organization is evolving to meet the needs of the profession. “Obviously, this is a work in progress,” says Phillips. “It’s collaborative. We recognize that there are different credentialing programs out there based on specific curriculums or specific institutions. We want to go beyond that, to create an independent and collaborative organization that can provide standards that aren’t based on a single curriculum or institution. We’re still learning a lot. But I’m convinced that the IMTA can act as an aggregator of the knowledge, because we’re not committed to a particular curriculum or institution.” As the uproar over the IMTA reveals, the effort to craft universally accepted standards and a single certification for mindfulness teacher training is likely to take time, hard work, and considerable cooperation. Interviews with leaders from around the world highlighted some of the most pressing challenges that lie ahead: 

  1. Accessibility One of the oft-cited criticisms of the professionalization of the field is elitism. Mindfulness, by its very nature, is available to everyone. Yet the programs that train teachers of mindfulness are expensive enough to be out of reach for many people. As an example, the eight-week course in fundamentals of mindfulness-based stress reduction at the Center for Mindfulness at UMass costs $2,100—and that’s just tuition, not living expenses or travel. The CFM’s practice teaching program costs an additional $2,750. Group and individual teaching supervision adds an additional $2,300 to the bill.  Add to that the cost of four silent retreats, also required for teacher certification, and the $1,275 cost of getting certified, and the tab is well over $10,000 in tuition alone to become a teacher. Scholarships and financial aid help defray some of those costs. But many experts say the field will have to do more to address concern about financial barriers.
  1. Cultural sensitivity The rise of mindfulness as a teaching profession has its roots in the first world and in privileged cultural settings. But the issues that face practitioners in developing parts of the world and in marginalized communities are often very different. Creating standards and requirements that are appropriate for very different countries, cultures, and communities will pose a major challenge. “Obviously, one size doesn’t fit all,” says Phillips. “We have to address that, and find ways to be culturally sensitive.” One approach, Susan Woods suggests, is to begin with agreement about the basic requirements, and allow for flexibility to allow them to be met in ways that recognize cultural and national differences.
  2. Existing degree and certification programs With the proliferation of mindfulness teaching programs around the world, thousands of people have already completed their training and in some cases received certificates and even degrees in the teaching of mindfulness. Many have been teaching for years. If the field adopts a single standard, administered by a single association, there will be a need to “grandfather” their credentials into the new standard. The IMTA has already acknowledged this issue. “In recognition of the fact that for many decades there have been rigorous alternative teacher training programs training qualified mindfulness teachers around the world,” the association acknowledges on its website, “the IMTA is committed to offering an alternate pathway for graduates of these in-depth programs to join the IMTA as we evolve, and receive provisional certification by meeting alternative eligibility requirements.” Ironing out the details, however, may not be easy.
  3. The rise of subspecialties The first professional programs for mindfulness teachers focused on mindfulness-based stress reduction and, later, mindfulness-based cognitive therapy. But a growing number of subspecialties have emerged, including mindfulness-based relapse prevention, mindfulness-based childbirth and parenting, mindful eating programs for weight control, mindfulness in education, and others. Should the same requirements for teachers apply to all these areas? Do people who are working in the field of addiction, for example, need additional focused training? The questions are particularly fraught in fields where mindfulness teachers work with vulnerable populations, such as those with mental illnesses. Should mindfulness teachers be required to have formal training in psychology or social work? “Obviously, these training programs will be very different,” says Woods, “and we’re just beginning to consider what those differences should be.”
  4. Continuing education While there’s general consensus about what a rigorous curriculum for teachers should include, less attention has been focused on the need for continuing education. Teaching mindfulness is a lifelong process, and there’s growing recognition that it’s important to build in a component of continuing education in order to ensure that teachers grow and learn and also that they don’t drift from the accepted approaches. What mechanisms should the field of mindfulness put in place to require teachers to renew their credentials from time to time? One proposal from the IMTA is to require mindfulness teachers to attend a five- or seven-day silent retreat at least once every two years in order to maintain their teaching credentials. But even such a seemingly modest proposal has sparked concerns.  “What about a mindfulness teacher with a small rural practice who can’t afford to travel for a week-long retreat? What about a mindfulness teacher with a family with small children who just can’t get away that long?” asks Monteiro in Ottawa. “I don’t want people who have invested in this, and who are doing good and essential work in the community, to think that what they’re doing is somehow not worthy.”
  5. Embodying the practice Unlike many professions, learning and teaching mindfulness is essentially experiential in nature, not knowledge-based. There will never be a written graduate exam for mindfulness instruction. Effective teachers are those who have experienced mindfulness for themselves and who are actively engaged in their own practice of mindful meditation. More than that, they must embody their practice. In ways that are difficult to define, let alone measure, they should convey compassion, nonjudgmental attentiveness, and other qualities we associate with mindfulness.  Defining how to teach those qualities is a challenge. But one key component, almost everyone agrees, is mentoring. “There’s something about teaching a program over and over again with mentoring or consultation, peer supervision, that’s really helpful in developing skills over time,” says Woods. But exactly what form mentoring should take, and what role it should play in continuing education, remains an open question.
  6. Outcomes-based evidence By far the most pressing question facing the field is also the most basic. What makes a good teacher of mindfulness—and do the qualities and experience most of us assume are important really make a difference to the people they are teaching? Surprisingly, no one knows, because very little solid research has been done. “We are still at an early stage in building our understanding about competence assessment in the context of mindfulness-based training,” says Crane. “The research on the reliability and validity of the MBI:TAC is promising but preliminary. So there is appropriate caution—but also considerable interest in proactively building out understanding.” In the one controlled study that has been published, Crane and colleagues Pauline Eva Ruijgrok-Lupton and Dusana Dorjee studied nine mindfulness-based stress reduction teachers with varying levels of experience and 31 people participating in their classes. The study, published in the journal Mindfulness in 2018, showed that well-being and reductions in perceived stress were significantly better for participants taught by teachers with an additional year of mindfulness-based teacher training and assessment. But no significant differences showed up in score increases for mindfulness, self-compassion, or other outcomes. A much larger study is now under way, sponsored by UMass Medical School, that should help shed more light on teacher competency and student outcomes.
  7. Taking a mindful perspective For all the contention that the IMTA initially provoked, however, most of the people involved in the effort to move the profession forward are upbeat about the future—buoyed by their belief in the benefits of mindfulness and the ability of its practitioners to collaborate constructively. “We all share the same values. We all wish the best for each other. How we enact that may be very different. There’s going to have to be some give and take. But I’m optimistic,” says Monteiro. “I think we’re on the path of consolidating what we mean by certification. What remains now is to see, is it working? Are our certified teachers doing what we are guaranteeing they will do?”   For his part, Dawa Phillips believes the current push-and-pull will ultimately help strengthen the movement. “When people criticize the developments in the mindfulness field, they are really criticizing some of the unhealthy aspects of modern-day capitalism that have found their way into our profession. That’s why collaboration is so important. By working together, we can all become better practitioners, and better teachers, and better teachers of teachers, and reach more people. If IMTA can contribute to this in some small way, then we will have accomplished something important.” Diana Winston agrees. “The mindfulness field is going to continue to grow, and more and more people will want to become teachers. They will see it as a lifelong process, where they continue to grow and learn as teachers. In five or 10 years, I hope, whatever happens, that mindfulness teachers will be perceived by the general public as professionals.” In the end, the hope is that the values that inform mindfulness itself will serve to guide leaders in the field as they navigate the path toward standards and credentials the public can trust. “We are all in process. None of us is done,” says Woods. “We all have a passion for bringing the practice and the benefits of mindfulness to more people. And I think all of us understand that it’s a world that’s increasingly reactive, where emotions are very strong—where the benefits of mindfulness are more important than ever. All of us, individually and collectively, are working toward the same goal, to maintain the highest quality of teaching and reach as many people as we can.”

Read more

Peter Jaret November 5, 2018