Table 1.

Treatment Protocol of Mindfulness-Based Psychoeducation Programme (MBPP)

Session	Theme	Component and Goals of Each Session	Contents
1	Orientation & engagement	Introduction Establishment of mutual trust and respect Identify the goals, objectives, clients role and responsibility in the program Identify the basic concepts of mindfulness	Introduction of facilitators, participants. Give participants an Overview of the program Group discussion about role and responsibility Contracting for later on sessions (e.g. attendance, respect for others, silent when practicing). The importance of regular practice, and set realistic expectations. Introduce participants with the basic concepts of mindfulness Body scan and mindful eating Reflections on the mindfulness exercise. Homework: Body scan and mindful eating
2	Awareness & Acceptance	Awareness on auto-pilot, breathing, bodily sensation Focused attention on body sensation with acceptance attitude	Body scan & Mindful-walking Reflection, discussion and inquires: Noticing sensation, Describing bare sensation and thoughts Recognized recurring experience, allowing, awareness and accepting attitude towards experience How to manage schizophrenia: the basic information Sharing on Cause, signs and symptoms, stage of illness, importance of management Homework: Body scan and Mindful-walking
3	Non-judgement	Explore present moment experience Focused attention on breathing with acceptance and non-judgmental attitude Understand the basic information of schizophrenia	Mindful-stretching Reflection, discussion and inquires: Noticing sensation, feelings and thoughts (auto-pilots) Observe from moment to moment with non-judgmental How to manage schizophrenia Sharing and discussion on Medication and drug compliance Homework: Mindful- stretching and drug compliance sheet
4	Stay present & Let go	Mindful attitude: stay present and let go Increase acceptance and compliance of medication	Mindful sitting (with breathing) Reflection, discussion and inquires: Sustained focus to observe body sensation, feelings and thoughts Observe experience with stay present attitude and letting go attitude How to manage schizophrenia Expand Social networking & social skill Homework: Mindful sitting (with breathing) & mindful stretching
5	Response without reacting	A Mindful Difference: Respond vs React Recognising recurring thoughts and standing back from them, without questioning them Advocate social networking	Three-minute breathing space & Mindful sitting (with difficulties) Reflection, discussion and inquires: Difference between react and response Alternative options and response for negative thoughts/sensation: mindful, response without react How to manage schizophrenia Stigma Homework: Three-minute breathing space & mindful walking
6	Our thoughts are not real	Thoughts are not facts – alternative perspectives of seeing your thoughts and sensations Integrate mindfulness in managing stress and daily difficulties	Mindful walking & Three-minute breathing space (expand) Reflection, discussion and inquires: Alternative perspectives of seeing your thoughts and sensations Recognising recurring thoughts and standing back from them, without questioning them How to manage schizophrenia Discussion on stress management Homework: Mindful walking & Three-minute breathing space (expand)
7	Empowerment of self-control	Advocate problem-solving and communication with mindful attitude	Mindful stretching & Three-minute breathing space (expand) Reflection, discussion and inquires: Integration of mindfulness in daily living How to manage schizophrenia Discussion on daily difficulties Discussion and role play on problem-solving skill with mindful attitude Homework: Mindful stretching & Three-minute breathing space (expand), communication worksheet
8	Relapse prevention and Care in community	Identify strategies for relapse prevention Consolidation and develop future plan on disease management with the use of mindfulness	Body scan and Mindful sitting Reflection and discussion: Compare the difference How to manage schizophrenia: Relapse prevention Identifying signs of relapse and associated factors Checking each person’s community support resources/mechanisms Identify strategies to prevent and handle relapse Planning continuing mindfulness practice and other meaningful daily activities in the future Invitation to outcome assessment