Implementation Support

Implementation support can be provided primarily by the NHS Scotland Mindfulness Network (supported by NHS Education for Scotland). This is led by two coordinators (Neil Rothwell and Charlotte Procter) who oversee the Scotland wide network and Mindfulness Leads in each Health Board area (Scottish NHS Mindfulness Network, https://learn.nes.nhs.scot/40297/scottish-nhs-mindfulness-network, many of whom will be experienced at delivering training and supervision.

In addition, there are national organisations that guide the practice, teaching and development of mindfulness-based approaches and set standards around training and supervision.  These include BAMBA (British Association of Mindfulness Based Approaches) and The Mindfulness network, who offer supervision, professional development and training. There are a number of additional training organisations (University, private or charity based) that can offer training, supervision and continuing professional development (many of which will be affiliated training organisations within BAMBA).

Implementation support for the delivery of on-line interventions should also include access to a suitable, secure platform which has been approved by the local Health Board. The platform should ideally have the option of break-out rooms.

Start-up Costs

Training in MBCT is provided at no cost if available through local NHS Health Board areas.  This is dependent upon the availability of trainers (mindfulness therapists who have been trained to deliver a training) and their capacity to be made available to conduct training. Health Board areas may share resources / expertise to deliver training jointly.  NHS staff will be able to complete the 8 week MBCT course at no cost if there are staff places available in patient focussed groups.

Costs will apply for training by private providers if there is no availability of local training within the NHS Boards and if a Health Board / service area is starting or restarting a mindfulness service.

Start-up costs include costs of basic training, optional membership of BAMBA (this is not a requirement of mindfulness therapists in Scotland as there is use of an alternative listing procedure), supervision fees. Additional costs apply including books / training materials / ongoing CPD events including mindfulness based retreats / intensive training.

1. Staff attendance at an 8 week mindfulness based course (free if locally provided) or available at a number of locations (locally, on-line, staff based course run by NES) at a cost of between £200 - £300 (may be less if delivered on-line).
2. Therapist training course (free if locally provided) or available through a variety of training organisations (University, private or charity organisations), usually in the form of a 12 month programme of training at costs ranging from £1, 350 - £1, 500 and University based courses ranging from £4000 to £5000. The courses differ in that some provide teacher training alone, some are competency assessed and others offer a Masters qualification.
3. Supervision costs (free if offered locally with supervisors who have attended generic supervision training plus the additional training for mindfulness supervision) or privately at a variable cost (around £60 / hour). Expectation is for three half hour sessions of supervision (minimum for the delivery of a 8 week course) as a newly qualified therapist (over at least two 8 week courses) and ongoing monthly supervision (which can often be provided in a peer group setting).
4. Fee for joining the BAMBA register of mindfulness therapists (optional for NHS Scotland therapists, but recommended if delivering privately), £90 for initial application and £37.50 for annual renewal.
5.  CPD costs (recommended two to seven days of annual training which may include CPD training days and intensive training in the form of practice “retreats”). £60 - £150 per day (costs vary). The NHS Scotland Mindfulness Network offers two CPD days per year (which are free to mindfulness therapists).
6. Additional costs in the form of key texts / course books (around £25 - £100).

Building Staff Competency

Qualifications Required

MBCT is delivered in the NHS by professionals with a variety of backgrounds in health and social care (e.g. clinical psychology, psychiatry, occupational health, nursing, physiotherapy, OT, social work), who have professional training and experience in working with the population (in physical and mental health) to whom the intervention will be offered. MBCT draws upon cognitive theory, but is not cognitive behavioural therapy (CBT), and practitioners do not need to have pre-requisite training in CBT to deliver MBCT in an enhanced psychological practice framework.

Personal interest in mindfulness / meditation practice and a willingness to develop and sustain a personal practice is vital, as the intervention is delivered from the in-depth experience and embodiment of the practice. Those who already have a personal mindfulness practice (including a mindful movement practice such as yoga, T’ai Chi) will probably have a shorter training journey as they already have an established practice.

Training Requirements

Training comprises a 1-2 year journey starting with attending an 8 week mindfulness based course (MBCT /MBSR) as participant and to develop / sustain their own mindfulness practice over the course of around 12 months as a pre-requisite to therapist training.

The next step is to attend a therapist development course (4-7 training days along with an apprenticeship training in their local health board) or a 12-month MBCT Therapist Training course (delivered by a training organisation in the University, private or charity sector) which can be delivered face-to-face or remotely. 

It is expected that trainees will deliver their first two courses under supervision / and as part of an apprenticeship model with a more experienced therapist prior to delivering courses independently. 

There is no formal accreditation as part of the training courses, but local leads in Health Board areas will approve trainees as suitable for joining the NHS listing of therapists once they have completed training / apprenticeship and these will be listed on the NHS Mindfulness website.

Following training, therapists may choose to join the UK based register of mindfulness teachers with BAMBA who use a formal registration and re-registration process for an annual fee.  This is not a formal requirement for professionals who are trained to deliver mindfulness interventions in NHS Scotland. Ongoing mindfulness practice and CPD is a requirement for the delivery of MBCT. 

Supervision Requirements

It is recommended practice in Scotland that this psychological intervention is conducted under regular supervision with a practitioner who has expertise in MBCT / mindfulness based approaches, the clinical area in which it is being delivered  and has completed training in supervision of psychological therapies and interventions (further information: https://www.nes.scot.nhs.uk/our-work/supervision-of-psychological-therapies-and-intervention/) including the Mindfulness Specialist Supervision Training component.

One to one supervision is particularly helpful for newly qualified therapists and MBCT group supervision is useful (as an alternative to ongoing one to one supervision) for more experienced MBCT therapists.