Efficacy of a mindfulness and compassion-based intervention in psychotherapists and their patients: Empathy, symptomatology, and mechanisms of change in a randomized controlled trial.

In recent years, mindfulness and compassion-based interventions (MCBI) have been found to beneficially influence the acquisition of essential skills in psychotherapy and are a promising way to improve relationships with patients. In this regard, new studies are needed to evaluate the effects of MCBI on psychotherapists and their patients and to analyze the influence of these effects on the processes and outcomes of psychotherapy. In this randomized controlled trial, we evaluate the efficacy of an MCBI in psychotherapists' mindfulness skills and self-reported empathy, as well as its indirect effect on patients (patient-reported psychotherapists' empathy, therapeutic bond, and symptomatology). Finally, we present a multilevel structural equation model (MSEM) to analyze the relationship between these variables in psychotherapists and their patients. A group of psychotherapists (N = 63) were randomized to an MCBI or an active control group (empathy diary). We assessed psychotherapists and their patients (N = 121) before and after the MCBI and at follow-up evaluation. Psychotherapists' results showed an increase in psychotherapeutic mindfulness skills (PMS) after the MCBI and at follow-up, whereas self-reported empathy improved at follow-up. Patients' results showed an improvement in perceived empathy, therapeutic bond, and symptomatology after the MCBI. The improvements in symptomatology were maintained for somatization and anxiety at follow-up. According to the MSEM, the increase in PMS is related to an increase in patient-reported psychotherapists' empathy, which produces an improvement in therapeutic bond and their symptomatology. These results support the benefits of introducing MCBI in psychotherapists' training to improve the psychotherapy outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effectiveness of mindfulness-based interventions on psychotherapy processes: A systematic review.

In the field of psychotherapy, scientific research has highlighted the importance of empathy and therapeutic alliance in regard to the effectiveness and better results of psychological treatments. In recent years, mindfulness-based interventions (MBIs) have shown to be effective at increasing empathy and therapeutic alliance and how this could affect the patients' symptomatology. In this study, we conducted a systematic review of the effectiveness of MBIs applied to psychotherapists to improve their empathy, the therapeutic alliance and the patients' symptomatology. Sixteen studies evaluating the impact of an MBI on some of these variables were identified, of which six included measures evaluated by the patients whose psychotherapists received the MBI. The risk of bias of the included studies was analysed following the methodological standards. We found very different designs and methodologies in the studies included in this review, with few of them including a control group. The results show a limited increase in empathy, measured by the psychotherapist, after an MBI. However, the results in therapeutic alliance are not conclusive, as well as the improvements in the perception of patients about their symptomatology. It is concluded that MBIs can have a beneficial effect on the psychotherapeutic practice, through the development of psychotherapists' empathy. Future research would require new studies with a higher methodological quality, and in which the effects of MBIs on empathy, therapeutic alliance and patients' symptomatology and the relationships between them are analyzed.