Examining the Role of MBSR in Enhancing Resilience among Chinese College Students with Identified Psychological Concerns
Xue Piao1*, Syed Mohamad Syed Abdullah1
1 School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
*Corresponding Author: [email protected]
Received: 15 May 2023 | Accepted: 10 July 2023 | Published: 30 July 2023
DOI:https://doi.org/10.55057/ijares.2023.5.2.15
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Abstract: This study explores the potential role of Mindfulness-Based Stress Reduction (MBSR) in enhancing resilience among Chinese college students at Xi’an Mingde Institute of Technology in China dealing with psychological concerns. Rising mental health issues among college students globally, especially in China, signify an urgent need for effective interventions.
While MBSR has demonstrated a wide range of psychological benefits, its specific impact on resilience still needs to be explored. This research addresses this gap using a phenomenological qualitative approach, seeking to understand participants' lived experiences with MBSR. The study recruited 20 college students identified with psychological issues from a university counseling center. In-depth, semi-structured interviews were conducted at three points, capturing experiences pre, post, and three months after the MBSR program. The findings suggest that MBSR enhanced the participants' resilience and coping abilities.
However, students with more severe psychological concerns indicated the need for additional therapeutic support, highlighting individual differences in MBSR's impact on resilience. This study contributes to our understanding of MBSR's role in fostering resilience among Chinese college students with psychological issues, providing insights for future research and therapeutic practices.
Keywords: MBSR, Psychology, Education, College students
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1. Introduction
The increasing prevalence of psychological issues among college students has become a matter of pressing concern globally, with the high-pressure academic environment in China being of particular note (Liu et al., 2020). Such issues encompass stress, anxiety, depression, and other mental health conditions and substantially threaten students' academic achievements, social relationships, and overall quality of life (Auerbach et al., 2018).
Resilience, characterized as the capacity to bounce back from adversity while maintaining mental health, is instrumental in ensuring student well-being (Masten, 2014). Enhancing resilience can equip students with the tools to manage their mental health issues more effectively, cope with academic stress, and improve their overall psychological quality (Lee et al., 2017).
One strategy demonstrating potential in this regard is Mindfulness-Based Stress Reduction (MBSR). Developed by Jon Kabat-Zinn, MBSR is an evidence-based intervention with various psychological benefits, including stress reduction and mood improvement (Khoury et al., 2015). Utilizing techniques such as meditation, body awareness, and yoga, MBSR seeks to help individuals focus on the present moment non-judgmentally, thereby enhancing their self- awareness (Kabat-Zinn, 2013).
In China, a cultural context significantly different from where MBSR originated, this method has gained increasing recognition over the past few years (Keng, 2020). Despite its roots in the West, MBSR has shown promise as an intervention strategy for various psychological issues prevalent among the Chinese population, including anxiety and depression (Keng, 2020).
While the positive effects of MBSR on general psychological distress have been well established, a significant gap exists in our understanding of its specific influence on resilience, particularly among Chinese college students in Xi’an Mingde Institute of Technology; this is also the object of our research. These students face substantial academic pressure and other psychosocial stressors, potentially leading to psychological issues (Zhang et al., 2019). Thus, an investigation into the specific role of MBSR in bolstering resilience in this demographic is of considerable importance.
The existing literature primarily focuses on the general population or other specific groups, leaving a significant gap in our understanding of the possible benefits of MBSR for Chinese college students grappling with identified psychological concerns (Zhang et al., 2019).
Addressing this knowledge gap is critical to developing effective, resilience-enhancing interventions tailored to the unique needs of this student population.
The present study aims to bridge this gap by scrutinizing the role of MBSR in fostering resilience among Chinese college students dealing with psychological challenges. We employ a qualitative approach to understand the impacts of MBSR on resilience within this group.
Through this research endeavor, we aspire to illuminate effective intervention strategies for resilience enhancement and contribute to the broader discourse on the positive psychological development of college students in China.
2. Literature review
2.1 Mindfulness-Based Stress Reduction (MBSR)
Mindfulness-Based Stress Reduction (MBSR) is a structured group program that uses mindfulness meditation to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders (Kabat-Zinn, 2003). Mindfulness, rooted in ancient Buddhist philosophies, involves intentional, non-judgmental awareness of one's thoughts, feelings, and bodily sensations in the present moment (Kabat-Zinn, 2013).
MBSR typically involves an eight-week program, as shown in Figure 1, comprising weekly group meetings, a day-long retreat, and daily at-home practices (Kabat-Zinn, 2003). It includes a variety of mindfulness practices such as seated meditation, body scan, and gentle Hatha yoga, all designed to cultivate greater awareness of the unfolding of experience moment by moment (Grossman et al., 2004).
Figure 1: Curriculum at a Glance
(Source: MBSR Training: 8-Week Course in Mindfulness-Based Stress Reduction, https://www.mindfulleader.org/mbsr-training)
Over the past few decades, MBSR has garnered widespread recognition for its potential for stress reduction and overall psychological improvement. A meta-analysis by Khoury et al.
(2015) found that MBSR showed moderate effect sizes in improving mental health, reducing symptoms of stress, anxiety, and depression among both clinical and non-clinical populations.
Furthermore, MBSR has been effective in diverse settings, from healthcare to education, and for various issues ranging from chronic pain to emotional burnout (Grossman et al., 2004;
Kabat-Zinn, 2003).
While MBSR's therapeutic efficacy has been recognized globally, its use and acceptance vary across cultural contexts. This is especially pertinent when considering its application in non- Western societies, such as China, where sociocultural factors might influence its reception and outcomes (Cheng, 2019).
2.2 MBSR and Chinese College Students
The application of MBSR in the Chinese context, particularly among college students, is an emerging research area. While Eastern philosophies have significantly influenced the principles of mindfulness, the standardized format of MBSR is a Western innovation.
Therefore, it is crucial to assess its effectiveness within China's unique cultural and societal dynamics (Yin & Zhang, 2012).
Chinese college students face immense academic pressure, often linked with future employment and societal status. This high-pressure environment often leads to various psychological issues, including anxiety, depression, and sub-threshold depression (SD), a state associated with impairments in adolescent health and an increased rate of major depression (Zhang et al., 2022). Traditional Chinese perspectives on mental health and the stigma associated with mental disorders often create barriers to seeking psychological help, emphasizing the need for practical, culturally appropriate interventions like MBSR (Hwang, 2009).
Emerging studies suggest that MBSR can be beneficial for Chinese college students. For instance, a study by Li and Qin (2021) explored MBSR's impact on fear of emotions among Chinese university students, a crucial aspect of emotional disturbance. The results showed that MBSR led to increased mindfulness and decentering (a cognitive process linked to mindful awareness) and decreased rumination, emotion regulation difficulties, and various aspects of fear of emotions. Notably, it was found that students in Chinese culture tended to have a more moderate experience of positive emotions.
In another study, Zhang et al. (2022) investigated the impact of a tailored MBSR program on psychological health among adolescents with sub-threshold depression. They found significant improvements in the MBSR group compared to the control group, including a decreased depression level, reduced rumination, and increased mindfulness level. These improvements were maintained for three months after the intervention, suggesting the lasting impact of MBSR. Further, studies by Hou et al. (2014) and Deng et al. (2019) also found significant improvements in psychological well-being and reduced depression symptoms following MBSR interventions among Chinese college students.
Despite these promising findings, more research is needed to fully establish the efficacy of MBSR among Chinese college students, particularly regarding different psychological aspects such as resilience.
2.3 The Role of Resilience in Psychological Health
Resilience represents a critical aspect of psychological health and well-being. It is generally defined as the process of effectively adapting in the face of adversity, trauma, tragedy, threats, or significant sources of stress (Southwick et al., 2014). It is not merely the absence of psychological distress but also dynamic, positive adaptation processes that promote personal growth and development (Windle, 2011).
Resilience plays a pivotal role in mitigating the impact of psychological distress and fostering recovery in individuals facing various psychological concerns. This capacity for positive adaptation enables individuals to maintain or quickly regain mental health following challenges (Kalisch et al., 2015). It has been linked to a range of positive mental health outcomes, including reduced symptoms of anxiety, depression, and stress (Campbell-Sills et al., 2006).
In the context of Chinese college students, who often face high levels of academic stress and societal pressures, resilience can serve as a critical protective factor. Studies indicate that higher levels of resilience are associated with better mental health outcomes in this population (Wu et al., 2020).
However, enhancing resilience is not a straightforward process, and many interventions do not target resilience directly but aim to build skills or traits, such as mindfulness, that can contribute to resilience (Reivich & Shatté, 2002). Thus, examining how interventions like MBSR can foster resilience is crucial, especially in populations with identified psychological concerns, is crucial.
2.4 MBSR and Resilience
The potential of MBSR to cultivate resilience is a growing area of exploration. By fostering greater awareness and acceptance of present-moment experiences, MBSR may enhance an individual's capacity to adapt to stressors and recover more quickly from psychological distress (Kabat-Zinn, 1990).
The enhancement of resilience through MBSR can be understood through several mechanisms.
Firstly, mindfulness, a key component of MBSR, encourages a non-judgmental and accepting attitude toward one's experiences, fostering emotional regulation and cognitive flexibility (Davis & Hayes, 2011). These traits are crucial to resilience, enabling individuals to adapt to stressors and maintain psychological well-being. Moreover, MBSR promotes a shift from automatic, habitual reactions to more conscious responses. This shift can help individuals manage adversity more effectively, mitigating the impact of stressors and reducing the likelihood of mental health issues such as depression and anxiety (Shapiro et al., 2007).
A few empirical studies have begun to explore the relationship between MBSR and resilience.
For instance, a study by Pipe, Bortz, Dueck, Pendergast, Buchda, & Summers (2009) found that MBSR participants reported increased resilience, decreased stress levels, and improved quality of life. Another study by Schure, Christopher, and Christopher (2008) suggested that MBSR could significantly increase self-reported resilience measures among healthcare professionals.
However, understanding how MBSR influences resilience, particularly among Chinese college students with identified psychological concerns, still needs to be improved, necessitating further research.
2.5 Identified Gap
While a growing body of research underscores the potential benefits of MBSR and its role in cultivating resilience, a distinct gap exists in understanding its effects among Chinese college students with identified psychological concerns.
Several studies have begun to highlight the value of MBSR in managing psychological distress and fostering resilience among diverse populations (Pipe et al., 2009; Schure et al., 2008).
However, these studies involve adults in Western contexts, with relatively few focusing on young adults in an educational setting, particularly in China.
Furthermore, studies that have examined the impact of MBSR on Chinese college students have mainly centered on its role in reducing specific forms of psychological distress, such as fear of emotions (Li & Qin, 2021), or on broader measures of psychological health (Zhang et
al., 2022). While these findings are promising, they do not explicitly address the role of MBSR in fostering resilience among this population.
Hence, although MBSR has been widely researched for its benefits in various populations and settings, there needs to be a significant gap in understanding its role in enhancing resilience among Chinese college students with identified psychological concerns. There is a need for studies that explicitly explore this relationship, using robust research designs and outcome measures specific to resilience. Research would contribute to understanding MBSR's potential as a resilience-building intervention for this demographic.
3. Methodology
Given the complex nature of human experiences, a qualitative research approach is an ideal fit for this study. This methodological choice allows for an in-depth understanding of the participant's experiences and their interpretations of these experiences, aligning precisely with the study's objectives. Therefore, this research utilized a phenomenological approach to investigate the lived experiences of Chinese college students participating in MBSR training and the subsequent impact on their resilience. This longitudinal perspective enables a dynamic capture of participants' experiences in the MBSR program and the following weeks and months. Such an approach affords a nuanced comprehension of the potential contribution of MBSR to resilience enhancement over time.
For participant selection, this study recruited 20 college students in Xi’an Mingde Institute of Technology, identified as grappling with psychological issues. Opting for a smaller sample size is a common and appropriate practice in qualitative research as it facilitates an exhaustive exploration of each participant's unique experiences. The specific inclusion criteria would be established with the counseling center to ensure the sample's representativeness.
Data collection was undertaken through semi-structured, in-depth interviews conducted at three critical junctures: before beginning the MBSR program, immediately after the program's conclusion, and three months post-completion. These interviews aim to explore the participants' experiences with the MBSR program, their perception of its impact on their psychological well-being, and any observable shifts in their resilience.
Data analysis followed a phenomenological approach informed by the framework proposed by Moustakas (1994). The initial stage will involve 'epoche,' or bracketing of the researcher's personal experiences, enabling immersion into the participants' experiences. Following this, 'phenomenological reduction' would be employed to highlight specific statements or phrases that provide insight into how the participants encountered the phenomenon under study.
Through 'imaginative variation,' the study would aim to understand the context and consequences of the experience. The final stage of data analysis involves synthesizing meanings and essences. Here, a composite description was developed from individual experiences, encapsulating the core 'essence' of the shared experience for the entire group.
Qualitative data analysis software will be utilized to code and analyze transcripts, facilitating the identification of themes and patterns within the data.
4. Result
The findings from the semi-structured interviews with Chinese college students participating in the Mindfulness-Based Stress Reduction (MBSR) program revealed several key themes.
Below, Table 1 summarizes the key themes that emerged, along with the frequency of mentions and illustrative quotes.
Table 1: Summary of Interview
Themes Frequency Illustrative Quotes
Experiences with the MBSR
Program None None
Positive experiences 15 out of 20
"MBSR has taught me to be more attentive to my thoughts and feelings. Instead of being swept away by them, I now
observe them from a distance."
Initial engagement
challenges 10 out of 20
"At first, it was difficult to let go of my thoughts and focus on the present moment. However, with practice, I gradually got
better at it."
Impact on Coping Abilities None None
Increased ability to cope
with stress 18 out of 20
"When stress arises, I now have a toolkit that I can use. I take a moment to breathe, to observe my thoughts without
judgment, and to respond rather than react."
Changes in Resilience None None
Enhanced sense of resilience 17 out of 20 "I feel stronger, more capable of dealing with setbacks. Even when things get tough, I trust myself to cope."
Individual Differences None None
Additional therapeutic
support needed 5 out of 20
"While MBSR was helpful, I also needed more specific therapeutic support to cope with my severe psychological
concerns."
Our research encapsulates interviews with 20 participants, with findings suggesting diverse experiences concerning the MBSR program. Positive experiences were reported by 15 participants, with their engagements with MBSR providing an improved state of mindfulness and resilience. These experiences were shared, however, as 10 participants noted initial challenges with engagement. This group referenced various factors that contributed to these challenges, such as preconceptions about mindfulness, cultural beliefs, or the inherent difficulty of the exercises.
Regarding coping abilities, most participants (18 out of 20) reported increased capacity to manage stress and adversity following the MBSR program. This improvement was attributed to various factors, including a deeper understanding of their thoughts and emotions, developing and applying mindfulness skills, and the opportunity to apply these skills in their daily lives.
On the topic of resilience, 17 out of the 20 participants felt an enhanced sense of resilience since the inception of the MBSR program. This suggests that most students find value in MBSR as a tool to boost their psychological resilience.
However, it is essential to acknowledge that the impacts of MBSR are not uniform across all individuals. Five participants expressed that while MBSR was beneficial, they required additional therapeutic support due to the severity of their psychological concerns. This hints at the need for a more personalized approach, considering individual differences in addressing psychological issues among students.
Our research findings serve to bridge the identified gap in the existing literature. The role of MBSR in bolstering resilience among Chinese college students with psychological concerns is apparent. However, as the theme of individual differences suggests, MBSR may be more effective when supplemented with other therapeutic supports for students grappling with significant psychological concerns.
Hence, the results of our study not only contribute to the current understanding of MBSR's potential impacts on Chinese college students' psychological well-being and provide insights to guide future research and practice in this field, especially concerning enhancing resilience.
5. Discussion
The present study explored the role of Mindfulness-Based Stress Reduction (MBSR) in enhancing resilience among Chinese college students with identified psychological concerns.
Based on the results of our semi-structured interviews, we can discuss several key findings and their implications.
Firstly, the overwhelmingly positive experiences and improved coping abilities reported by most participants signify the potential benefits of MBSR in this context. These findings align with the extant literature on the positive impacts of MBSR on mental health and stress management (Kabat-Zinn, 2013). However, it is crucial to note the initial engagement challenges a subset of participants faces. This emphasizes the need to address cultural beliefs and preconceptions about mindfulness during the introduction of MBSR programs, ensuring its accessibility and acceptance among Chinese college students. These findings resonate with previous studies highlighting the importance of cultural adaptation in mindfulness interventions (Ho et al., 2019).
Secondly, the enhanced sense of resilience noted by most participants reinforces the potential of MBSR in bolstering resilience among Chinese college students. This adds to the growing body of evidence suggesting the positive impact of mindfulness on resilience (Regehr et al., 2013). However, the need for additional therapeutic support for students with severe psychological concerns indicates that MBSR may not be a standalone solution for all students.
This underscores the importance of a comprehensive, multi-faceted approach to mental health support on college campuses, echoing recommendations in existing literature (Eisenberg et al., 2012).
In addressing the identified gap, this study affirms the value of MBSR in enhancing resilience among Chinese college students. However, as demonstrated by the theme of individual differences, MBSR may be most effective when complemented by other therapeutic interventions for students with more serious psychological issues.
Overall, this study offers insights into the role of MBSR in promoting resilience among Chinese college students with psychological concerns. It also highlights the importance of individualized mental health strategies incorporating MBSR as one of the multiple components. Future research could further explore the reasons behind individual differences in MBSR impacts and investigate how MBSR could be integrated with other interventions for more effective psychological support.
6. Conclusion
The study provides valuable insights into the potential of Mindfulness-Based Stress Reduction (MBSR) in enhancing resilience among Chinese college students with identified psychological concerns. Our findings indicate that MBSR can benefit this demographic, improving coping strategies and heightened resilience.
However, the outcomes also pointed to the necessity of acknowledging and catering to individual differences in dealing with psychological issues. Some students, particularly those with more severe concerns, may benefit from a multi-faceted approach integrating MBSR with other therapeutic interventions.
The initial engagement challenges observed in some participants highlight the importance of adapting mindfulness interventions to align with cultural beliefs and preconceptions, a vital consideration in the Chinese context. This underscores the necessity of making cultural adaptation a core element in the planning and implementing of mindfulness programs in such contexts.
This research contributes to the literature by addressing the previously identified gap regarding the specific impact of MBSR on resilience, particularly among Chinese college students with psychological concerns. The outcomes offer valuable insights that can be used to inform future research and aid the development of more effective mental health resources for this demographic.
Ultimately, this study underscores the potential of MBSR as a powerful tool in the arsenal for enhancing the psychological well-being of Chinese college students. Nonetheless, our findings also emphasize the importance of personalized and culturally sensitive approaches alongside an integrated model that combines MBSR with other therapeutic strategies to support students with differing needs and psychological concerns optimally.
Acknowledgment
The authors thank the Universiti Sains Malaysia for supporting this study.
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