Ethical considerations

The proposal for this research was granted full ethical approval by the Metanoia Ethical Committee. Additionally the research was conducted within the ethical codes of the British Psychological Society (BPS,-2011) and the Metanoia Institute. I took a process approach to ethics (Parnis-et-al 2005,-in Liamputtong,-2007), viewing it as an ongoing negotiated process and ensured participants had an opportunity to voice any concerns and voice any queries throughout both the training and research processes. Interested participants were provided with a ‘Participant Information Sheet’ (Appendix 2) and a ‘Mindfulness and Training Information Sheet’ which outlined what mindfulness is and the format of the training element (Appendix 3). Those who remained interested in participating were sent a ‘Research Consent Form’ (Appendix 4) and a ‘Mindfulness Training Registration’ (Appendix 5). The consent form reiterated their right to withdraw at any time etc and informed consent was negotiated in an ongoing process (Kemmis-

and-McTaggart,-1981). The ‘Mindfulness Training Registration’ contained standard

questions used for an MBSR training as a form of ‘due diligence’ to screen out unsuitable participants together with a ‘Research Study Criteria Checklist’ (Appendix 5) to be signed to ensure participants met the research criteria.

Precautions were taken to ensure confidentiality with audio-files and transcripts kept in secure computer files and anonymised to protect the identity of the participants and their training institutions, with paper forms secured in a filing-cabinet. The report aims to ensure quotes are non-attributable to participants.

I did not anticipate any risk of physical or mental harm to participants from the research process, given they had spent two months discussing their experience of mindfulness with me on a weekly basis. However, I aimed to avoid any potential for harm from the mindfulness training itself as the process may be quite intense or revelatory for some. There were several factors to mitigate risk: making personal therapy and supervision inclusion criteria to ensure adequate participant support, pre-training screening for suitability, monitoring participant well-being in the training sessions, and regular supervision of my training by a leading mindfulness trainer / psychotherapy supervisor. Following the research and training interventions I have remained available to participants for discussion and support. Participants were offered a debrief on the research findings in the form of a half day workshop.

was not expected that the research process itself would have such a potential impact. Thus the potential for participant change was a critical ethical issue to consider and plan for in this research. From my own experience and the literature review it is clear that mindfulness training can lead to a range of positive changes for practitioners at emotional, bodily and cognitive levels, from increased empathy and presence to being better able to be with the difficult - both personally and professionally. In contrast, the literature reviewed did not highlight any specific contraindications for mindfulness training. However, I was strongly aware of the powerful potential for change that mindfulness has and worked to ensure participants were fully informed of this and the training and research processes, through the Participant Information Sheet (Appendix 2) and information on mindfulness itself (Appendix 3 Mindfulness Information for participants) and in an ongoing process during the training sessions.

Reflecting carefully on this I implemented a range of steps to minimize risk and support participants. Mindfulness teacher training organizations emphasise that teachers assess participants for suitability and readiness e.g. that participants are not currently experiencing any significant mental health or emotional issues. The Mindfulness Training Participant Registration Form (Appendix 6), together follow-up telephone calls / e-mail where I decided I needed further clarification, were used to assess readiness and suitability for the mindfulness training. Given this potential for change I wanted to ensure participants were fully supported by being in both regular personal therapy and clinical supervision. Additionally I monitored participants well-being throughout the mindfulness training, with one or more inquiry or debrief processes in each session. I was also available after sessions and by phone in between should participants have needed this , though this offer was not taken up. In summary, I recognized that there were some potential risks associated with participation in both the programme and the research, but I took appropriate steps throughout the project to address such risks in order to minimize the chance of them occurring.

A particular dilemma in this research was balancing participants’ identity protection with how much to disclose of their personal characteristics and experience. In the end the only identifying personal information I provided was that in Appendix 15 ‘Participant Characteristics’. In an earlier version of this I had included participants training organisation but in discussion with peers and supervision considered that this, in conjunction with their stated year of study could lead to individuals being identified

(e.g. where there might be 12 students in a particular year in a training institution it would not be difficult to identify who had done the mindfulness training, especially as this my arise in the context of primary supervision). Additionally I reflected that I also needed to extend the confidentiality of the research to participants’ research institutions.

It was also necessary to review the Analysis & Findings section and ensure that any identifying information of participants and training institutions was removed / disguised, especially where participants criticized their training organizations and employers / placement organizations. An example would be where one participant in an IAPT service explicitly criticized how they struggled with certain policies and procedures as well as supervisory style when they moved away from set protocols. I hadn’t anticipated how the mindfulness training might impact the relationship between trainees and their training institution / employer and address this further in Section 5.4.