Table 1.

Modifications to the MBSR protocol to address trauma secondary to IPV. Note – not every session was modified from the original MBSR protocol. Additionally, it should be noted that no content was removed from the original MBSR protocol.

Modification	Aim	Source
Session 1 – Introduction to neurophysiology of trauma	Provide a framework with which to understand trauma related symptomology, as well as a rationale for using mindfulness skills to cope with symptoms stemming from survival of past traumatic experience	(Allen, 1995; Foa & Kozak, 1986; Pearlman & Saakvitne, 1995; Rosthchild, 2000; Siegel, 2003, van der Kolk, McFalane, & Weisaeth, 2007)
Session 2 – Discussion of reactivity as related to survival of trauma and symptoms as adaptations.	Provide a framework for understanding coping behaviors from a strengths-based perspective; identify coping behaviors and the underlying anxieties resulting in such behaviors	(Pearlman & Saakvitne, 1995; Follette, Palm, & Rasmussen Hall, 2004; van der Kolk, McFalane, & Weisaeth, 2007; Herman, 1997)
Session 2 – Social Brain vs. Survival Brain	Discuss the relationship between higher-order more cognitive and relational aspects of thinking and more survival (primitive) aspects of thinking, and how these higher-order and primitive forms of cognition relate to the fight, flight, or freeze response	(Siegel, 2003)
Session 2 - Trauma survivors and Perceptions	Discuss the perceptions exercise from the perspective of being a trauma survivor; foster the recognition that the individual made attempts to cope with anxiety or other symptoms stemming from the initial overwhelming traumatic experience	(Foa & Kozak, 1986; Follette, Palm, & Rasmussen Hall, 2004; Garland, Gaylord, & Fredrickson, 2011; van der Kolk, McFalane, & Weisaeth, 2007)
Session 2 – Brief introduction to physiological processing	Recognize the physiological symptoms of trauma reactivity in the body	(Ogden, 2006; Rothschild, 2000)
Session 3 – Introduction to meditation of physiological experience	Notice bodily reactions to particular triggers; learn to regulate physiological arousal through mindful breathing, paced breathing, grounding (coming into the present moment and into the body using mindfulness of physical sensations), and resourcing (remembering healthy coping resources to aid in present-moment awareness, e.g., remembering the face of a family member important to the participant)	(Rothschild, 2000; Siegel, 2003)
Session 3 – Observation of Suppression, Repression, Avoidance, and Denial	Discuss the adverse consequences of suppressing thoughts and/or emotions; gain awareness of thought suppression through meditation	(Follette, Palm, & Rasmussen Hall, 2004; Freud, 1936)
Session 4 – Seeing Our Patterns	Introduce the idea of patterns of relating with others; develop insight into how one’s current emotional attachments are based on past relationships and psychological adaptations developed following previous traumatic experiences	(Allen, 2005; Benjamin, 2004; Follette, Palm, & Rasmussen Hall, 2004; Pearlman & Saakvitne, 1995)
Session 4 – The Trauma Triangle	Introduce the idea of the victim/victimizer/bystander relationship with a discussion of the different roles/dynamics that participants recognize themselves taking in their relationships	(Herman, 1997; Miller, 1994; Staub, 2002)
Session 5 – Review of patterns of relating and the trauma triangle, integrating reacting vs. responding	Review of materials from classes 2 & 4	(Benjamin, 2004; Follette, Palm, & Rasmussen Hall, 2004; Herman, 1997; Pearlman & Saakvitne, 1995; Staub, 2002; van der Kolk, McFalane, & Weisaeth, 2007)
Session 7 – Mindful/Present Parenting	Discuss mindfulness as it applies to parenting; provide psychoeducation on how meditation practices might be integrated into everyday experiences with one’s children	(Kabat-Zinn & Kabat-Zinn, 1997; Saakvitne K. W., 2005)