Table 2.
The Bangor, Exeter and Oxford guiding principles for MBCT implementation (Kuyken et al. 2012)
| Guiding principles | How this relates to MBCT |
|---|---|
| Research needs to be translated | - Make local decisions about target populations/inclusion/exclusion criteria |
| - Base decisions on definitive and emerging MBCT evidence for MBCT and on local service priorities | |
| - Research needs to be accessible to services. Typically, this involves tailoring the research and consensus development at a local level | - Consider and map out how new MBCT service will sit alongside existing care pathways |
| Ownership is critical | - Engage key stakeholders in service planning and commissioning |
| - Ownership of the research or of the implementation process is likely to positively affect uptake | - Offer taster sessions/intern places for stakeholders to communicate MBCT's aims and intentions |
| - System based, top-down approaches that “force” research use in organisation can negatively affect uptake | - Support grassroots interest through experiential opportunities to take mindfulness classes |
| - Develop local networks for interested clinicians and stakeholders | |
| Enthusiasts are key | - Identify one or more “champion(s)” with adequate knowledge and access to key networks |
| - People who are enthusiastic about the issue/topic/practice can act as champions and promote new ideas | - Champions are needed both within the organisation and external to the organisation |
| - Former participants in MBCT classes can be compelling advocates | |
| Conduct an analysis of context | - Analyse local context to identify implementation barriers and facilitators |
| - An analysis of the context of implementation prior to designing the strategy can facilitate a particularised approach through the targeting of local barriers and facilitators | - Set up an implementation steering group to systematically address local barriers and facilitators in the range of challenge areas and to develop and oversee the new service until it is fully embedded |
| Ensure credibility | - Ensure that key evidence and national guidance on MBCT is clearly conveyed to staff by a credible champion |
| - Research use is enhanced by credible evidence, credible champions/opinion leaders and a commitment to process | - Set up appropriate and realistic service evaluation |
| - Ensure evaluation data are routinely collected and reported to key stakeholders | |
| Provide leadership | - An overall MBCT service lead is required who can provide clear leadership |
| - Strong and facilitative leaders at project and organisational level can lend strategic support and authority to the process | - Leadership is needed on a strategic and a clinical level |
| - Strategic leaders within the organisation's management should ideally have experiential understanding of MBCT | |
| - Clinical leaders need in-depth training in MBCT, so they can teach the course and support other staff in developing their skills through supervision and mentoring | |
| - Leadership on good practice governance is needed using national guidance and contextualising it locally | |
| Provide adequate support/resources | - Identify appropriate and adequately trained staff to run MBCT classes who at minimum meet the UK good practice recommendations (UK Network 2011) |
| - Implementation needs adequate resources and support including financial, human (dedicated project leaders) and appropriate equipment | - Using epidemiological data, it is estimated that a population of 200,000 would need 2 full-time MBCT teachers to provide a service (Patten and Meadows 2009). If the service is being offered to a broader client group that is recommended by NICE, then more teachers will be required |
| - Support and cultivate competent MBCT teachers | |
| - Support and cultivate (though the classes and reunions) former MBCT participants | |
| - Secure staff time to prepare and run classes | |
| - Secure staff time for screening, assessment and orientation of participants | |
| - Secure staff time for providing some individual participant support between sessions in person or via phone, text or email | |
| - Put in place required training, supervision for ongoing development and adherence to good practice standards | |
| - Ensure that a fit for purpose room is available | |
| Ensure that an ongoing supply of meditation recordings and participant handouts is available | |
| - Secure administrative support for setting up classes and preparing class handouts | |
| - Ensure that equipment for sessions is available | |
| Develop opportunities for integration | - Integrate MBCT implementation strategy with local and national strategies for increasing access to psychological therapies |
| - Activities, changes and new practices need to be integrated into the organisation's systems and processes to enhance their sustainability. Initiatives that fit with strategic priorities are more likely to be given/allocated adequate resources and support | - Identify appropriate imperatives for MBCT, such as the NICE depression guidance, health economic data or local strategic initiatives |
| - Establish a service pathway from referral through to discharge and communicate this effectively to all stakeholders | |
| - Cultivate relationships with referrers | |
| - Enhance service sustainability by promoting it and integrate it with other strategic priorities | |