Context sensitive mindfulness: lessons from graduates of a professional training in South Africa.

Objective: The study aimed to evaluate the implementation of mindfulness based interventions, in different community settings in South Africa, by graduates of a two-year mindfulness training course, and to explore the challenges involved in adapting to the local context.

Methods: This was a descriptive exploratory qualitative study using semi-structured interviews. Ten graduates of a two-year training in mindfulness-based interventions (MBIs) were identified using purposeful criterion-based sampling based on their implementation of adapted MBIs in communities that represented the systemic social, economic and health challenges affecting a majority of South Africans.

Results: Previous and ongoing trauma is pervasive in South Africa which significantly affects the quality of lived experience for many individuals and families. Teachers who offered mindfulness-based approaches within these communities needed to hold a high level of sensitivity to pre-existing and ongoing trauma and signs of traumatic abreaction to effectively and skilfully deliver these interventions. Context sensitive adaptations needed to be implemented to programme structure, such as length of sessions, prioritisation of curricular elements and duration of mindfulness practices, along with in-the-moment flexible responsiveness such as ending a formal practice ealier than planned, or responding to the emotional needs of an individual. This was supported by the creation of a robust and compassionate holding environment, a safe and secure space in which attuned relationality supported co- and self-regulation and the internalisation of mindfulness skills.

Conclusion: Mindfulness can be a valuable practice in diverse settings in South Africa, including communities affected by previous and current trauma, and the training curriculum in this context requires high levels of sensitivity to these conditions and must prioritise a safe and compassionate environment in which to learn.