For Whom May Participation in a Mindfulness-Based Stress Reduction Program be Contraindicated?

Mindfulness-Based Stress Reduction (MBSR) programs are offered worldwide. To date, there has been little discussion about for whom participation may not be appropriate. We reviewed the literature pertaining to attrition and adverse effects following participation in MBSR; relatively little was learned in this search. A few clinical trials from Mindfulness-Based Cognitive Therapy (MBCT) provide ideas concerning who may not benefit from this program and who is likely to drop out. There are some case studies of individuals who manifested various mental health issues following experiences with various forms of meditation, but often specifics are missing such that it is not known what type of meditation was practiced or if the individuals in question had previous psychiatric disorders or preexisting conditions that could predispose them to negative outcomes. While we could not provide an empirically based answer to our question, we open the discussion and offer recommendations, especially with regard to preprogram screening, to guide instructors when they form a new group for an MBSR course so that the risk of harm is reduced. We trust that this paper will prompt our colleagues to examine the issue of risk and report adverse events should they occur.