Table 1.

Summary of the initial¹ Mindful Awareness Practices (MAPs) for ADHD Program

Session Theme	Topics Discussed 2	In-Session Mindfulness Meditation Exercises	At-Home Assignments
1. Introduction to ADHD and Mindfulness. Re-framing of ADHD	- ADHD psychoeducation - Defining mindfulness - Discussion of individual experiences with ADHD - How purposefully changing one’s awareness can change the quality of their experience - Directions on the basics of sitting meditation (e.g., posture)	- Mindful Eating - Mindfulness of Breath	- Formal: Daily 5 minute Mindfulness of Breath exercise - Informal: Mindful awareness of a routine daily activity (e.g., eating or brushing teeth) - Informal: Telephone Breath exercise (involves taking a breath every time the phone rings) to improve awareness of breath in daily life
2. Mindful Awareness of ADHD Patterns	- Discussion of common difficulties in practicing formal meditation and overlap with ADHD symptoms, particularly inattention, restlessness, and boredom. - Discussion of the acceptance-change dialectic - Experientially noticing any problems that arise during mindfulness of breath meditation in session - Discussion of helpful modifications to the formal practice such as counting, imagery, and walking - Mindfulness of movement	- Mindfulness of Breath/Counting Breaths - Mindful Walking - Brief Loving-Kindness	- Formal: Daily 5 minute Mindfulness of Breath exercise (a Mindful Walking exercise can be substituted). Note any difficulties that arise while meditating - Informal: Mindful awareness of ADHD symptoms with curiosity (e.g., “What is my ADHD like?)”
3. Mindful Awareness of Breath, Body & Sound	- Noticing shifts in attention and awareness of breath, body, and sound - Using the breath as an “anchor” to return to while distracted and to bring awareness back into the present moment (can be applied to ADHD experience of phenomena such as daydreaming) - Attentional check-in	- Three Minute Breath Space - Mindfulness of Music - Mindfulness of Sound - Mindfulness of Movement - Mindfulness of Breath, Body, and Sound - Brief Loving-Kindness	- Formal: Daily 10 minute Mindfulness of Breath, Body, and Sound exercise - Informal: Mindfulness of daily life with an emphasis on sound and walking - Informal: Practice attention check-ins (e.g., “Where is my attention/awareness right now?”)
4. Mindful Awareness of Body Sensations	- Being fully present with one’s body - How does body movement correspond with ADHD and related characteristics (e.g., physical restlessness, clumsiness, body tension in response to stress) - Coping with physical pain and how it differs from suffering amplified by reactions to pain - Contrast between ADHD behaviors and being on “automatic pilot,” and mindful awareness of daily activities	- Mindfulness of Breath - Body Scan - Mindfulness of Physical Pain - Mindfulness of Putting on Shoes - Brief Loving-Kindness	- Formal: Daily 10 minute Mindfulness of Breath, Body, and Sound, or Body Scan - Informal: Putting on Shoes (as an alternative, choosing a problematic activity such as placement of items that are typically lost)
5. Mindful Awareness of Thoughts	- Mind like a sky and thoughts like clouds metaphor - Noticing thoughts with openness and awareness - ADHD and self-esteem: Working with judgmental thoughts	- Mindfulness of Breath - Mindfulness of Thoughts/Mind Like a Sky - Mindful Walking - Brief Loving-Kindness	- Formal: Daily 10 minute Mindfulness of Thoughts - Informal: Counting the frequency of judgmental thoughts in one day
6. Mindful Awareness of Emotions	- Awareness of emotions (i.e., psychoeducation on emotions and emotional functioning in ADHD) - Introduction to RAIN mnemonic to manage difficult emotional situations - Cultivating positive emotions	- Mindfulness of Breath - Mindfulness of Emotions using RAIN - Mindful Walking - Loving-Kindness - Mindful Presence - Brief Loving-Kindness	- Formal: Daily 15 minute Mindful Presence - Informal: RAIN mnemonic to manage difficult emotional situations, practicing loving-kindness with self and others
7. Mindful Awareness of Interactions	- Open awareness and observing of different facets of attention in daily life - Interpersonal interactions and common difficulties that arise for individuals diagnosed with ADHD (e.g., interrupting, not listening, and talking too much) - Introduction to mindful communication	- Mindfulness of Breath - Mindful Presence - Mindful Walking - Mindfulness in Pairs: Deep Listening - Brief Loving-Kindness	- Formal: Daily 15 minute Mindful Presence - Informal: Mindful speaking and listening with a spouse or friend
8. Review and Wrap-up	- Making mindfulness part of daily life and how it takes practice to establish new mindfulness practice routines - Ways to keep practicing (e.g., setting alarms) - Beyond MAPs: Future mindfulness training - ADHD and mindfulness resources	- Mindfulness of Breath - Mindful Presence - Mindful Walking - Brief Loving-Kindness

Note.

¹This table reflects the initial MAPs for ADHD Program tested by Mitchell et al. (in press) and Zylowska et al. (2008); see Zylowska (2012) for content additions and modifications to the eight-week training sequence.

²Topics for each session involve a review of the previous session content and experience with at-home assignments. For formal at-home mindfulness meditation practices, patients are encouraged to vary exercises and are allowed to pick a different exercise than the one “assigned” in session to foster curiosity in developing an individualized mindfulness meditation routine.