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Mindfulness at work: What works, why, for whom, under what cirumstances, and in what respects?

This blog is about the research I am currently undertaking as part of my DPhil in Evidence-Based Health Care at the University of Oxford. In order to be able to design more effective and sustainable workplace mindfulness programs we need a better understanding of what works, why, for whom, an under what circumstances. My research seeks to tackle these bunring questions. I will (hopefully) post regularily on certain aspects of my work. Some blogs might be more technical others more personal. I welcome any comments, observations, experiences, examples, and questions that help me test and refine my research!

The project

How did I end up with this vast research question?
Stress, anxiety, and burnout have become one of the leading causes for absenteeism from work and early retirement in industrialized countries. This has far-reaching consequences not only for employees and organizations but for economies and societies as a whole. The World Health Organization reports that work-related stress affects more than 40 million individuals in the European Union, costing an estimated €20 billion a year in lost time and health bills. 

Many organizations see a need to address that problem and invest in health programs for their workforce. Among these programs, mindfulness training is gaining popularity. It is seen to have the potential to provide individuals with a capability that helps them deal in a resourceful way with the challenges of today's world of work. The efficacy of standardized mindfulness courses such as MBSR and MBCT in reducing stress, anxiety, and depression in clinical populations has been well demonstrated (Khoury et al., 2013; Kuyken et al., 2016). Yet research on workplace mindfulness-based programs (MBPs) is still in its infancy. Existing evidence suggests that mindfulness training at work might indeed be beneficial ( Lomas et al., 2017). However, that evidence is based on a great heterogeneity of intervention types, target groups, and outcome measures, making generalizations difficult. We do not know yet what works, why, for whom and in what contexts.

A realist approach

Workplace interventions are complex. They involve a series of actors for implementation; they are embedded in organizational structures and cultures, run different periods of time, consist of multiple components, and involve human agency. More concretely, individuals have to show up for classes and integrate mindfulness practices into their packed daily routine; they have to learn to switch from a mode of 'doing' and 'problem-solving' to 'being' and 'acceptance', they are invited to open up to their vulnerability in a professional context that might promote strength, and they learn to cultivate compassion in an often highly competitive work environment. 

So while current available evidence indicates workplace mindfulness training can work, more research on why and under what circumstances it works is needed in order to implement MBPs successfully on a larger scale in different settings for different people. 

In order to tackle the overarching research questions of what works, why, under what circumstances, for whom and in what respects, a realist approach, underpinned by a realist philosophy of science and causality (Pawson 2006; Wong, Westhorp, et al., 2013), will be taken. A realist inquiry is based on the underlying realist assumption that it is not the program that causes change but what individuals make of it. It aims at developing theories that help explain how particular conditions trigger mechanisms that generate certain outcomes. 

An increased understanding of the causal mechanisms in workplace MBPs will help to design more effective and sustainable health programs. No prior realist review and realist evaluation have been conducted on this topic.

What will be the output?

The main output of this research project will be a refined programme theory that provides decision-makers and practitioners with a better understanding of how and in which contexts workplace MBPs contribute to the health and wellbeing of their staff and employees.

My supervisors are Dr. Geoff Wong, clinical research fellow and internationally recognised expert in realist synthesis and evaluation of complex health and social interventions and Dr. Jeremy Howick, director of the Oxford Empathy Programme, expert in evidence-based medicine and in the implementation of yoga into mainstream practice.

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Saturday, 04 July 2020

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