Mindfulness- & Compassion-Based CBT: A Relational Practice integrated with CBT

Those with high levels of distress, stress, and / or insecure attachment histories can encounter challenges with the traditional 8-week MBPs as a starting point. The longer silent practices and inquiry periods  of MBPs may result in inpatience, disconnection, and self-criticism in participants that can interfere with beneficial outcomes. Similar to how MBCT creators anticipated such challenges (i.e., presence of suicidality & ruminative brooding), Molnar (2014, 2018) has integrated parallel adaptations for those with high levels of anxiety, OCD, and trauma-aftermath.  Mindfulness- and Compassion-based CBT (MC-CBT) integrates tools from several areas of inquiry to adapt longer MBPs to the needs of those with high levels of anxiety, fear, perseverative cognition, physiology that reaches panic attack levels, and occurs in transdiagnostic conditions. Principles and practices derived from CBT, functional neuroscience, Interpersonal Emotional Processing (IEP), Buddhist and Social Psychology are adapted with traditional but briefer practices of MBCT and MBSR to support health of mind, body, and behaviors in MC-CBT (see EBP article by Molnar & Molnar, 2014: META for GAD).

In MC-CBT participants practice deconstructing unpleasant emotion states into elements consistent with a CBT model of emotion and being in friendly and assertive relationship with experience.  Specifically, mental, physical, and behavioral impulse elements serve as cues for covert and overt compassionate responding. Such responding, with practice, supports automatic adaptive responding or "unconscious competence" (Eubanks & Goldfried, 2019) . Relational (i.e., interpersonal) Mindfulness Practices (RMP) supplement behavioral principles in each module of MC-CBT to support an increase in mindfulness and compassion and a decrease in maladaptive symptoms of distress (Molnar, 2014). A transtherapeutic intervention, MC-CBT, enhances emotional processing of corrective information during exposure therapy and other high stress situations to strengthen intentional responding within and between training meetings.

Schedule

Foundational meeting (7/7/25): Orientation to the four modules, imaginal rehearsal integrated with mental contrasting and implementation intentions; SMART goals; brief formal guided practices. The "3 'B"s that compose emotion.

Module 1 (7/14): Attuning to non-conceptual sensations with Beginner's Mind. The "B" of Body. The divine abode of appreciative joy.

Module 2 (7/21): Meta-Cognitive awareness of mental events, befriending, and letting go. The "B" of Beliefs about self, others, and world. The divine abode of loving-kindness.

Module 3 (7/28): Cultivating internal and external resources to meet stress and negative emotions with a challenge rather than threat mind-set. Interpersonal Emotional Processing (IEP) with compassion, friendliness, joy, and equanimity. Emotions & the "3 B"s - reprise. The divine abode of equanimity.

No meeting 8/4/25

Module 4 (8/11): Motivating and sustaining behavior change compassionately with deliberate practice; MCII and SMART goals reprise; and patience. The "B" of Behaviors. The divine abode of compassion.

https://www.meta4stress.com/mccbt.

Continuing Education

Following this presentation, participants will be able to:

1. Describe and implement the four modules of an  adapted Mindfulness- and Compassion based Program designed as a foundational training for those initially challenged by high distress and stress levels that may interfere with completion of MBCT, MBSR and related longer training programs.

2. Implement and describe the four steps of Mental Contrasting and Implementation Intentions into a foundational Mindfulness- and Compassion- Based Program integrated with Cognitive-Behavior Therapy (CBT)

3. Implement and describe the four steps of Self-Controlled Coping Desensitization and Cued Mindfulness and Compassion for adaptive emotion management.

4. Describe and implement meditation guidelines for formal Relational Mindfulness Practices (RMP).

5. List three important adaptations needed for RMP with high distress and stress levels.

6. Observe and directly experience, as a participant-observer, the delivery and curriculum elements of MC-CBT

About the Presenters

Chris Molnar, Ph.D., obtained her Ph.D. degree in Clinical Psychology and Psychophysiology from The Pennsylvania State University. Her post-doctoral fellowship training was in traumatic stress and functional neuroscience at the Medical University of South Carolina. She is President of the Mindful Exposure Therapy for Anxiety and Psychological Wellness Center, Inc. (META Center). At META Center, she integrates Cognitive-Behavior Therapy (CBT) with other forms of psychotherapy. Her work is guided by ongoing developments in functional neuroscience, emotion and motivation, and other areas of inquiry into how humans learn optimally to maintain and apply healthy habits during states of threat and challenge. Before founding META Center in 2007, Dr. Molnar worked as a clinical investigator supported by grants from the National Institute of Health (NIH) and other funding agencies. For a full list of credentials, scientific contributions, popular press articles, and select professional presentations visit www.meta4stress.com Resources tab.

Alissa S. Yamasaki, Ph.D. is a licensed psychologist and the founder of Ayama Psychotherapy, located in Lemont, PA. Her practice has gained a positive local reputation for its mindful and collaborative business practices, psychotherapists who are especially effective in the area of health and mind-body conditions, and wellness events for health and wellness providers.

Dr. Yamasaki's clinical expertise focuses on the treatment of chronic and complex anxiety, as well as insomnia. Her earliest study of the mind-body connection was as an undergraduate in an exercise psychophysiology lab investigating the effects of physical activity on how people feel and think. Dr. Yamasaki earned her Ph.D. from Penn State University in 2006 and completed her internship at Albany Medical Consortium. Her current practices reflect her belief in the importance of being fully present while drawing from empirically-driven interventions. She utilizes a blend of CBT and relational approaches, including mindfulness-based interventions. Dr. Yamasaki attended the 5-day Mindfulness-Based teacher training retreat with Chris Molnar, Ph.D., in 2022, which sparked both the deepening of her mindfulness practices and greater effectiveness in the therapy room.

Target Audience

This presentation is intended for mental health professionals (MHPs) and select non-MHPs screened for suitability. The instructional level of this presentation is BEGINNER.

Note: This workshop does not require attendees to have a formal mindfulness practice. Attendees will be guided in practicing formal Relational Mindfulness (RM) and Mindfulness Out Loud (MOL).

Continuing Education

Suggested Reading

Benjamin, L. S. (2018). The Interpersonal Reconstructive Therapy treatment model. In L. S. Benjamin, Interpersonal reconstructive therapy for anger, anxiety, and depression: It's about broken hearts, not broken brains (pp. 103–132). American Psychological Association. https://doi.org/10.1037/0000090-005

Crane, R. S., Brewer, J., Feldman, C., Kabat-Zinn, J., Santorelli, S., Williams, J. M. G., & Kuyken, W. (2017). What defines mindfulness-based programs? The warp and the weft. Psychological medicine, 47(6), 990-999.

Erickson, T. M., Newman, M. G., & McGuire, A. (2014). Adding an interpersonal-experiential focus to cognitive behavioral therapy for generalized anxiety disorder. Working with emotion in cognitive behavioral therapy: Techniques for clinical practice, 356-380.

Eubanks, C. F., & Goldfried, M. R. (2019). A principle-based approach to psychotherapy integration. Handbook of psychotherapy integration, 88-104.

Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: exposure to corrective information. Psychological bulletin, 99(1), 20.

Goldfried, M. R. (2019). Obtaining consensus in psychotherapy: What holds us back?. American Psychologist, 74(4), 484.

Hayes, A. M., Beck, J. G., & Yasinski, C. (2012). A cognitive behavioral perspective on corrective experiences. In L. G. Castonguay & C. E. Hill (Eds.), Transformation in psychotherapy: Corrective experiences across cognitive behavioral, humanistic, and psychodynamic approaches (pp. 69–83). American Psychological Association. https://doi.org/10.1037/13747-005

Molnar, C. (September, 2017). Playing in the ocean of awareness: Innovations in mindfulness training The Pennsylvania Psychologist Quarterly, pages 16-17.

Newman, M. G., Castonguay, L. G., Jacobson, N. C., & Moore, G. A. (2015). Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive–behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy. Journal of Consulting and Clinical Psychology, 83(5), 915–925. https://doi.org/10.1037/a0039359

Newman, M. G., & Zainal, N. H. (2020). Interpersonal and Emotion‐Focused Therapy (I/EP) for Generalized Anxiety Disorder (GAD). Generalized anxiety disorder and worrying: A comprehensive handbook for clinicians and researchers, 231-244.