Hjeltnes 2015
Hjeltnes 2015
Hjeltnes 2015
and Well-being
Aslak Hjeltnes , Per-Einar Binder , Christian Moltu PhD & Ingrid Dundas
To cite this article: Aslak Hjeltnes , Per-Einar Binder , Christian Moltu PhD & Ingrid Dundas
(2015) Facing the fear of failure: An explorative qualitative study of client experiences in a
mindfulness-based stress reduction program for university students with academic evaluation
anxiety, International Journal of Qualitative Studies on Health and Well-being, 10:1, 27990, DOI:
10.3402/qhw.v10.27990
EMPIRICAL STUDY
Abstract
The aim of this qualitative study was to investigate the subjective experiences of 29 university students who participated in an
8-week mindfulness-based stress reduction (MBSR) program for academic evaluation anxiety. Participants who self-referred
to the Student Counseling Service underwent individual semi-structured interviews about how they experienced the per-
sonal relevance and practical usefulness of taking the MBSR program. Interviews were transcribed and analyzed through a
team-based explorativereflective thematic approach based on a hermeneutic-phenomenological epistemology. Five salient
patterns of meaning (themes) were found: (1) finding an inner source of calm, (2) sharing a human struggle, (3) staying
focused in learning situations, (4) moving from fear to curiosity in academic learning, and (5) feeling more self-acceptance
when facing difficult situations. We contextualize these findings in relation to existing research, discuss our own process of
reflexivity, highlight important limitations of this study, and suggest possible implications for future research.
Key words: Mindfulness-based stress reduction, university students, college students, test anxiety, performance anxiety,
evaluation anxiety, qualitative research, reflexivity, thematic analysis, phenomenology, hermeneutics
Responsible Editor: Soly Erlandsson, University West, Sweden.
(Accepted: 21 July 2015; Published: 20 August 2015)
University students report a high prevalence of mental achievement and high performance on exams may
health problems, and research indicates a general appear imminently important for their future life.
increase in symptoms of mental disorders among How do university students experience the usefulness
students in higher education (Bayram & Bilgel, 2008; of participating in an 8-week mindfulness-based train-
Eisenberg, Gollust, Golberstein, & Hefner, 2007; ing program for severe academic evaluation anxiety?
Storrie, Ahern, & Tuckett, 2010). Academic stress The present study aimed to explore the subjective
represents an important psychosocial challenge for experiences of 29 university students who partici-
both undergraduate and graduate students (Misra pated in an 8-week mindfulness-based stress reduction
& McKean, 2000; Robotham & Julian, 2006). The (MBSR) program for academic evaluation anxiety.
high prevalence of mental health problems among The terms evaluation anxiety, academic perfor-
university students highlights a need for accessible mance anxiety, test anxiety, and exam anxiety refer
interventions that can address the specific psychosocial to an anxiety in academic situations that may have
challenges of this population (Regehr, Glancy, & Pitts, severe consequences for well-being and academic
2013). Mindfulness-based interventions emphasize learning. Performance anxiety is defined by DSM-V
awareness, non-striving, and acceptance of present- as a subtype of social anxiety disorder (SAD) (APA,
moment experience, which may seem paradoxical for 2013). Powell (2004) describes performance anxi-
young people in a stressful academic situation, where ety as ‘‘strong but delimited fears that severely
Correspondence: A. Hjeltnes, Department of Clinical Psychology, University of Bergen, Christiesgate 12, NO-5020 Bergen, Norway. E-mail:
[email protected]
# 2015 A. Hjeltnes et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http:// 1
creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and
build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Citation: Int J Qualitative Stud Health Well-being 2015, 10: 27990 - http://dx.doi.org/10.3402/qhw.v10.27990
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A. Hjeltnes et al.
compromise an individual’s capacity to execute a task the effectiveness of MBSR for university students
at a level that can be reasonably expected, which is with academic evaluation anxiety, finding redu-
crucial to that person’s normal adjustment’’ (p. 804). ced academic evaluation anxiety and improved self-
The prevalence of academic evaluation anxiety has confidence after the intervention. In the current
been estimated to be as high as 35% among college article, the aim is to explore the subjective experi-
students, and has been shown to be associated with ences of the participants before, during, and after the
lower actual academic performance (Cassady & intervention.
Johnson, 2002; Naveh-Benjamin, McKeachie, Lin, What do clients with anxiety disorders actually ex-
& Lavi, 1997). The potential negative consequences perience when they participate in mindfulness-based
of academic performance anxiety during the college group interventions, and how do they describe their
or graduate years indicate a need for accessible psy- personal experiences of suffering and therapeutic
chological interventions that may address the con- change? Elliott (2010) argues for the importance of
cerns of university students who experience these explorative qualitative research in building direct
academic and emotional difficulties. knowledge of the processes of therapeutic change.
Mindfulness has been defined as a process of This argument is parallel to the broader recognition
‘‘paying attention, on purpose, in the present moment, in the field of psychosocial intervention research
and nonjudgmentally to the unfolding of experience that well-performed qualitative studies are needed
moment by moment’’ (Kabat-Zinn, 2003, p. 145). to enhance the clinical usefulness, conceptual robust-
The MBSR program is an 8-week course for groups ness, and ecological validity of the knowledge base
who meet weekly for 23 h for instruction and prac- (Castonguay & Beutler, 2006; Malterud, 2001;
tice in mindfulness meditation (Baer, 2003; Kabat- McLeod, 2013). Qualitative studies of how psycho-
Zinn, 1990; Santorelli, 1999). The program involves logical treatments are experienced by clients, and
systematic training in mindfulness exercises, Hatha what clients themselves experience as the helpful or
yoga, group discussions, and homework between
not helpful aspects of these interventions, could gen-
classes. The psycho-educational components empha-
erate hypotheses for future research (Elliott, 2010;
size management of stress reactions and difficult situ-
Mace, 2008). Specifically, because the majority of con-
ations through awareness and acceptance of physical
temporary mindfulness research has been conducted
or psychological experience. MBSR is reported to be
within quantitative and neurobiological research para-
an effective intervention strategy for a broad spec-
digms, a continued examination of the first-person
trum of physical and psychological symptoms (Baer,
perspective and potential process variables is needed
2003; De Vibe, Bjørndal, Tipton, Hammerstrøm, &
to understand how mindfulness-based interventions
Kowalski, 2012; Hofmann, Sawyer, Witt, & Oh,
work for clients in specific contexts (Baer, 2010b;
2010). Randomized controlled trials (RCTs) have
Kuyken et al., 2010; Shapiro, Carlson, Astin, &
demonstrated the effectiveness of MBSR for people
with different anxiety disorders (Kabat-Zinn et al., Freedman, 2006; Wyatt, Harper, & Weatherhead,
1992; Vollestad, Nielsen, & Nielsen, 2012; Vollestad, 2014). Mace (2008) argues that there is a need for
Sivertsen, & Nielsen, 2011) and there are two recent more qualitative studies in the emerging scientific
RCTs that have reported MBSR as an effective literature on mindfulness, and that systematic quali-
intervention for SAD (Jazaieri, Goldin, Werner, Ziv, & tative methods may be used to ‘‘understand the needs
Gross, 2012; Koszycki, Benger, Shlik, & Bradwejn, of, and likely impacts on, specific client groups when
2007). There is less empirical research on the im- undertaking interventions like the MBSR program’’
pact of mindfulness-based interventions on indivi- (p. 38). Two meta-syntheses conducted by Malpass
dual performance, and although three recent studies et al. (2012) and Wyatt et al. (2014) have examined
indicate that mindfulness may facilitate improved the existing qualitative research on mindfulness-
performance in academic contexts (Beauchemin, based interventions, and indicate an absence of prior
Hutchins, & Patterson, 2008; Howell & Buro, 2011; qualitative studies of client experiences in MBSR
Shao & Skarlicki, 2009), there is a need for empirical for anxiety disorders. To our knowledge, this is the
studies to examine the mindfulness-based interven- first qualitative study of client experiences in mind-
tions for university students with academic evaluation fulness-based interventions for anxiety disorders. The
anxiety. present article attempts to address these gaps in the
The present article is based on data from a larger scientific literature by addressing the following ex-
clinical study of MBSR for university students with ploratory research question: How do university stu-
academic evaluation anxiety (which was conducted dents describe their experiences of taking the MBSR
at University of Bergen, Norway). In a prior article program to find ways of working with academic evalu-
(Dundas, Thorsheim, Hjeltnes, & Binder, 2015), we ation anxiety and other challenges in their everyday
described the results of a naturalistic pilot study of life?
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Facing the fear of academic failure
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A. Hjeltnes et al.
and not helpful aspects of taking the MBSR pro- (Binder, Holgersen, & Moltu, 2012). A pattern is said
gram in as much concrete detail as possible. The to emerge when there is a high degree of convergence
interviews were conducted by the second, third, and between the experiences of different participants
fourth authors and a colleague at the Student Welfare within a certain area, and at the same time a moderate
Center. In no instances were interviews conducted degree of divergence between them that makes the
by the instructor of the specific MBSR course that pattern thematically rich. The meaning patterns were
the student had attended. The interviews were conceptualized by formulating themes, and providing
recorded and transcribed verbatim for analysis. quotes from the material to exemplify the content of
these themes and enhance the transparency of this
interpretive approach (Binder, Holgersen, & Moltu,
Data analysis 2012). The interviews with the participants differed
The data analyses of the transcribed interviews were considerably in terms of the level of detail and thick-
conducted using a team-based explorativereflective ness of descriptions. This was addressed by analyzing
thematic analysis (Binder, Holgersen, & Moltu, 2012) the entire data set, but selecting quotes from six
and Nvivo 10 software (QSR, 2012). By comparing participants with especially rich descriptions to illus-
the individual accounts, we sought to identify pat- trate the overall themes and meaning patterns that in
terns of meaning in how the university students themselves were formulated on the basis of all in-
experienced the MBSR program and the process of terviews in the sample. The examples in these six
finding ways to master academic evaluation anxiety. interviews were found to be representative of the
Analysis proceeded through eight stages detailed in thematic content of the 29 interviews analyzed in
Table I. this study.
A ‘‘meaning pattern’’ can be defined as a con-
densed summary of the units of relevance for a par- Ethics
ticular research topic that may be identified when The study was approved by the Regional Com-
comparing the experiences of several participants mittee for Medical and Health Research Ethics
Table I. Stages in the explorativereflective thematic analysis.
1. Noting initial impressions: The interviewers wrote down their immediate impressions after their dialogs with the
participants. They discussed these observations to establish a basic sense of the
participants’ experiences, and to promote reflexive awareness of interpersonal processes in
the interview situation.
2. Familiarization with the data: All researchers read the transcribed material to obtain a basic sense of the experiences
described by the participants.
3. Searching for patterns of Examining those parts of the text relevant to the research questions, the first and second
meaning: author identified separable content units that represented different aspects of the
participants’ experiences. We would here look at how the university students described
their experiences of taking the mindfulness-based stress reduction (MBSR) program in
relation to mastering academic evaluation anxiety and other challenges in their everyday
life.
4. Coding themes: The first and second author developed ‘‘meaning codes’’ for those units, which are
concepts or keywords attached to a text segment in order to permit its later retrieval. The
first author then edited the text in accordance with those codes into coded groups of text
with the technical assistance of Nvivo 10 software. For example, the participants’
descriptions of being friendlier with themselves or tolerating their anxiety were given the
code ‘‘Acceptance.’’
5. Reviewing and summarizing The first and second author interpreted and summarized the meaning within each of the
themes: coded groups of text fragments into conceptions and overall descriptions of meaning
patterns and themes reflecting what, according to their understanding, emerged as the
most important aspects of the participants’ experiences.
6. Team-based revision of All four authors turned back to the overall text to check whether voices and points of view
themes: needed to be added, or whether the conceptions and descriptions of themes could be
developed further.
7. Critical auditing: The third author, who was not a part of the team of teachers in the MBSR groups, had a
leading role in critically auditing the identification of meaning patterns (themes).
8. Forming a consensus on The themes were finally formulated, revised and agreed upon by all four authors.
themes:
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Facing the fear of academic failure
(REK VEST, project number: 021.04) and the the course from being an extra burden to becoming a
Norwegian Data Protection Authority (reg. code: welcome relief in their everyday life:
87478942). Care was taken to provide adequate infor-
mation about the study, and written informed consent In the beginning it was kind of something
was obtained from all students prior to participation you had to do before you could relax. But then
in the study. The participants were prescreened for towards the end of the exercise it felt good, it
potential clinical risk using the exclusion criteria. could be a positive thing rather than something
Students were informed that they could contact you had to do before you could go to sleep, like
teachers during the MBSR program if they experi- it was in the beginning. At first I did not really
enced emotional distress. understand what I was doing, I just said to
myself: ‘‘I just have go through this somehow.’’
But then you notice: I slept better after I started
Results doing the exercises. I slept much calmer, and
felt calmer generally as well. Then I found out
Participants’ descriptions of their experiences when
that it had an effect, and it became much easier
taking the MBSR program clustered around five
to do the exercises. (Female A, 24 years)
main themes: (1) finding an inner source of calm,
(2) sharing a human struggle, (3) staying focused in The practice of intentionally focusing awareness on
learning situations, (4) moving from fear to curio- their breathing and bodily sensations was experienced
sity in academic learning, and (5) feeling more self- by most of the participants as a helpful way to regulate
acceptance when facing difficult situations (Fig. 1). negative mind states such as ruminative thoughts
or feelings of fear, frustration, and shame. They
described using these meditation practices as useful
Finding an inner source of calm practical techniques to ‘‘step back’’ from these experi-
An initial theme in our analysis was the participants’ ences, and focus on their breathing as they noticed
experiences of finding an inner source of calm bodily sensations, emotions, thoughts, and their
through the mindfulness meditation exercises. In immediate surroundings. Some used this as a techni-
the pre-course screening interviews, the participants que in specific anxiety-provoking situations, whereas
disclosed feeling overwhelmed by worries, physical others began to practice these exercises regularly and
arousal, and negative feelings before academic dead- described feeling a greater sense of calm and emo-
lines, often to a degree that impaired their ability to tional balance in their everyday life. Some partici-
study and engage fully in their everyday life. Parti- pants described this learning experience as finding
cipants had often struggled with performance anxi- ‘‘a source of inner calm’’ where mindful awareness of
ety for years, with an accumulated sense of futility, breathing had helped them to regulate the intensity
frustration, and fear of failure. of emotional distress and relate to negative feelings
Most of the participants encountered initial diffi- from a different perspective. The experience of having
culties with the meditation practice. They described practical ways to access feelings of calm provided
restlessness, frustration, fatigue, sleepiness, and con- the participants with a growing sense of agency within
centration difficulties during the mindfulness exer- the storm and stress of their everyday lives:
cises. However, they noted that the daily homework
assignments gradually shifted during the 8 weeks of And I feel a different relationship to stress.
When it begins, when it starts to get too much
. . . too much to focus on, and I feel that stress is
Finding an inner starting to build up, I have the exercises as a
source of calm
kind of refuge. So I have a way to bring myself
back down to earth and just tell myself that:
Feeling more self- ‘‘It’s no big deal, now I can just go and do the
Sharing a human acceptance when
facing difficult
exercises, and then it will be fine afterwards.’’ So
struggle
situations I know that it can really change how I feel inside
when I do the exercises. (Female B, 47 years)
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A. Hjeltnes et al.
long-term struggle with self-criticism and emo- After recognizing their shared struggles with aca-
tional isolation due to their academic difficulties. demic evaluation anxiety, the participants described
For example, in the beginning of the program, they being more open to talking about their vulnerable
expressed doubts if they were ‘‘doing it right’’ feelings within the group and engaging constructively
or thinking that ‘‘there must be something wrong with their own difficulties between the classes. The
with me’’ when they were unable to feel relaxed or participants described this as making them feel more
focused during the exercises. Hearing how other normal and enabling them to recognize anxiety as a
students struggled with the same challenges during natural and workable human struggle.
the mindfulness exercises normalized these experi-
ences for the participants. One participant described
how the process of understanding anxiety reactions Staying focused in learning situations
as shared existential challenges made it easier for her
The participants described that they began exploring
to continue with her own meditation practice:
ways of using mindfulness when they were distrac-
It was good to hear that there were several others ted by anxious feelings in academic performance
who had the same problems as me when it came situations. The experience of learning to allow anxi-
to exams. And at times, when I felt restless or ous thoughts and feelings in the mindfulness exercises
discovered that I had slept through half the body provided a model for many participants in terms of
scan exercise, there were others who had done how they could approach similar distractions in
the same. It was not just me who faced those academic learning situations. Some students actively
challenges there. And at the same time it felt used the mindfulness practices to prepare for exams
good to hear when they got it right, because it and reduce their general stress levels, whereas others
sort of told me that if I just kept going*when used these exercises in moments of ‘‘acute’’ perfor-
I was feeling stuck, and the others*someone mance anxiety in exam situations:
described that they had a great experience the
day before . . . then I thought: ‘‘If I just keep I have been very troubled by losing my focus
going, it can change.’’ So in that sense it helped during exams, that I can’t concentrate on the
me to continue. (Female C, 23 years) task and what I do. And it just becomes a
snowball rolling downhill and just growing
Many participants felt ashamed about their per- bigger . . . Finally I get very stressed. But now I
formance anxiety, and described relief in realizing use the breath, and focus on my breathing as
that they were not alone in their suffering. The group soon as I enter the room. So when the exam
discussions provided opportunities to talk openly questions are handed out, I’m already quite
about potentially embarrassing experiences asso- calm and focused, and don’t have the tendency
ciated with academic evaluation anxiety: to look up right away to see what is happening
around me, or what the others are writing.
There was one student who asked why she (Female C, 23 years)
constantly had to go to the bathroom when she
had exams. And it’s one of those questions that One participant discovered that accepting these
you usually don’t dare to ask, such as: Why distractions would paradoxically improve her capa-
does my stomach turn inside out? It’s not that city for concentration, stating that ‘‘if distractions
you actually just get the medical explanation happen, I know that it’s not my fault; I just go back
for why it’s like that, but that you can actually and keep coming back again, and again, and again’’
talk about it with others. And I think we (Female A, 24 years). The students described turning
discussed blood pressure and other things you their attention to their breathing or bodily sensations
usually don’t see as being related to stress, and when encountering negative thoughts and feelings as
it was interesting to hear that there were many they were attempting to concentrate on their studies.
common symptoms, even if it doesn’t show on Participants described using awareness of their breath-
the outside. So it was reassuring to know that
ing when reading academic material, writing a paper
I’m not the only one who has to run to the
at home or writing an essay in an actual exam
bathroom when it’s like that (laughs). So you
situation, performing in a musical recital, or when
don’t feel so alone, you feel more normal.
doing presentations in front of others. The mind-
(Female D, 23 years)
fulness exercises helped them to be more present
The quote above illustrates how the partici- when they were studying or taking difficult exams:
pants could discuss their fears of being different ‘‘Those situations that could previously be stressful
and finding resonance in the experiences of others. were now more . . . I was able to concentrate and
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Facing the fear of academic failure
focus on exactly where I was, and what I was doing’’ The same participant described that she concen-
(Female D, 23 years). trated more on understanding the ‘‘bigger picture’’
and the unifying ‘‘threads’’ of the academic subject:
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A. Hjeltnes et al.
That’s not my fault. And just feel more self- The themes identified in our analysis indicate
acceptance, of some sort. (Female E, 24 years) something of the range and complexity of the parti-
cipants’ subjective experiences during the 8-week
The experience of feeling self-acceptance in these MBSR course. When taken together, the themes
situations was rarely described as a linear process, developed from our analysis indicate that the group-
or a global and permanent achievement. Sometimes based mindfulness intervention seemed to offer the
the participants described falling back into familiar participants more than just help with their specific
patterns of self-condemnation, doubt and insecurity, presenting problem of academic evaluation anxiety.
but that they were gradually able to be kinder toward The participants described experiencing meaningful
themselves in difficult situations. Several partici- forms of change in different domains of their every-
pants described that they could still feel anxiety after day life, and we will discuss and contextualize these
the program, but that they had learned to accept findings in terms of three dimensions: (1) The pro-
these reactions and relate to them in a new way: cess of developing capacities for inner calm and self-
acceptance, (2) the experienced impact of group
I may perhaps have the same nervousness, yet I
processes in promoting self-acceptance, and (3) the
can relate to it in a different way. It’s still there,
experience of learning mindfulness to master diffi-
but I don’t get so caught up or paralyzed, I can
culties in academic contexts.
sort of allow to let it be. I remember we talked in
the course about letting things be the way they
are, instead of constantly trying to escape things
Understanding the process of developing capacities for
that are uncomfortable. So I do feel I have
inner calm and self-acceptance
learned something, it’s easier for me to relate to
my own nervousness. (Female F, 48 years) The themes of ‘‘finding an inner source of calm’’ and
‘‘feeling more self-acceptance when facing difficult
Having learned practical strategies such as aware- situations’’ are different, but at the same time closely
ness of breathing as a way to accept and be present related experiences that describe the broader process
with anxious feelings, participants described that they of exploring new ways to face emotional distress and
could allow their anxiety to be there and still study or personal suffering. The experience of being able to
perform in exams. Participants experienced being more calm oneself (theme 1) seemed to offer new possibi-
supportive of themselves or even laughing quietly to lities for both agency and acceptance in the face
themselves about their reactions in difficult situa- of anxiety. The sense of practical mastery or coping
tions. Some participants described being less afraid of ability that the exercises offered the participants
their own feelings and more attentive to feelings and appeared to promote an increased sense of agency
the need for self-care during stressful exam periods. when encountering stress and anxiety in everyday
One participant described that this experience of life. The participants’ descriptions of using the mind-
being less afraid of anxious feelings made it easier for fulness exercises as practical techniques to regulate
her to face challenging performance situations: negative feelings (theme 1) may resonate with re-
search which indicates that mindfulness may en-
I think I look a little more positively at things hance capacities for emotional regulation (Chambers,
now. A bit like this: ‘‘Well, I am nervous, ok, Gullone, & Allen, 2009). Robins, Keng, Ekblad, &
yes, interesting, yes, fine, fine.’’ Then I go on, Brantley (2012) found that the MBSR program
rather than making it into an obstacle. And might have a beneficial impact on clinically relevant
before the exam, I feel it helps to just sit down emotion regulation processes. Our findings do not
for ten minutes, to get some perspective, get provide causal explanations for the experiences des-
some sort of overview, I think it makes me a bit cribed by the participants, but may possibly offer a
calmer and in control, and . . . feeling that the phenomenological or first-person description of these
nervousness is there, but I can breathe at the forms of emotional and attentional regulation ex-
same time. It may still be here, but you don’t perienced and felt at the level of the participants’
drown in the nervousness. (Female A, 24 years) subjective experience. The program also appeared to
have an impact on how the participants experienced
and acted toward themselves in difficult situations.
Discussion
The participants’ experience of finding self-acceptance
We have presented our analyses of the experiences of in difficult situations (theme 5) seems to resonate
the 29 participants, focusing on five themes identified with theoretical formulations of an accepting or
in the accounts offered by the participants in our compassionate stance toward the self as an impor-
study. Figure 1 provides a visual summary of our tant dimension of change in psychotherapy (Gilbert,
themes. 2010; Rogers, 1995; Williams & Lynn, 2010).
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Facing the fear of academic failure
Neff and McGehee (2010, p. 226) describe self- experience itself appeared to reduce feelings of iso-
compassion as ‘‘the ability to hold one’s feelings of lation among the participants indicates the poten-
suffering with a sense of warmth, connection, and tial role of group processes and common factors
concern’’ and argues that this attitude of acceptance in mindfulness-based interventions. The psycho-
when facing pain or failure represents an important educational components and group structure of the
pathway to mental health. Increased self-acceptance MBSR program emphasize suffering as a normal
and a greater capacity for emotional regulation (inner and universal feature of the human condition. Imel,
calm) have been reported as recurrent findings in Baldwin, Bonus, and MacCoon (2008) examined
qualitative studies on client experiences in mindfulness- results from 59 MBSR groups and reported group
based interventions (Malpass et al., 2012; Wyatt membership as accounting for 7% of the global vari-
et al., 2014). For example, Allen, Bromley, Kuyken, ability in psychological outcomes, which indicates the
and Sonnenberg (2009) conducted a qualitative study potential significance of group dynamics in MBSR.
of mindfulness-based cognitive therapy for recurrent The experience of a supportive group environment
depression and identified ‘‘acceptance’’ as an im- has been reported in prior qualitative studies as
portant theme in the clients’ descriptions of their an important factor that may enhance or facilitate
experience. They described the theme of acceptance change in mindfulness-based interventions (Malpass
as involving both a new way to understand the self et al., 2012; Wyatt et al., 2014). MacKenzie, Carlson,
(destigmatization) and a new way of relating to de- Munoz, and Speca (2007) conducted a qualitative
pressive thoughts and feelings (depression objectified). study of MBSR for cancer patients and described the
The possibility of cultivating a compassionate stance significance of ‘‘shared experiences’’ and a supportive
toward the self through meditative practice has group environment as an important theme in the
been a central concern in the mindfulness literature narratives of the patients in their study. The impor-
(Germer, 2012; Gilbert, 2010), and studies indicates tance of group cohesiveness and social support have
that group-based mindfulness-based interventions been described as important psychological processes
may promote increased levels of self-compassion in the group therapy literature (Yalom & Leszcz,
(Baer, 2010a; Kuyken et al., 2010; Neff & Germer, 2005), but have not yet become a major focus in empi-
2013; Shapiro, Astin, Bishop, & Cordova, 2005). rical research on change processes in mindfulness-
A potential benefit from our study is the first-person based group interventions (McCown, Reibel, &
perspective on how participants in a mindfulness- Micozzi, 2010).
based group intervention experience the process of
developing self-acceptance or a compassionate stance
toward the self. Our findings did not suggest an Learning mindfulness as a way to master academic
immediate transformation in the global self-concept problems
of the participants we interviewed, but seemed to indi- The themes of ‘‘staying focused in learning situa-
cate gradual changes in their experience of being more tions’’ and ‘‘moving from fear to curiosity in academic
accepting toward themselves in specific contexts. learning’’ might represent experiences specific to stu-
dents in academic contexts, or may describe more
general processes involving a movement from being
The role of group processes in mindfulness-based driven by avoidance to developing mastery in rela-
interventions tion to anxiety symptoms and problems in life.
The experience of ‘‘sharing a human struggle’’ Although there are no prior empirical studies that
(theme 2) is also a theme that strongly relates to have examined mindfulness-based interventions for
the experience of increased self-acceptance, and performance anxiety in university contexts, the parti-
that seems most closely tied to more generic group cipants’ descriptions of their experiences of learning
processes within the MBSR program. Acknowledging mindfulness as a way to master academic problems
anxiety as a part of the human condition could be an have points of convergence with research in cognitive
important way to counteract the isolation and shame psychology, neuroscience, and academic learning.
experienced by the participants in their struggles The participants’ experiences of being more able to
with performance anxiety. An important question in stay focused in learning situations (theme 3) may
understanding these findings is to what extent these have important parallels with cognitive models of test
experiences are specifically related to the mindfulness anxiety and neuroscientific research on mindfulness.
interventions in the MBSR program, and to what Attentional control theory (Derakshan & Eysenck,
extent they represent processes and principles found 2009) postulates that anxiety interferes with the cogni-
in other psychotherapeutic approaches. The medita- tive resources available to process complex tasks in
tion practices may represent a specific factor in performance situations. Neuroimaging studies indi-
the MBSR program, but the finding that the group cate that systematic training in mindfulness meditation
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might produce improved concentration and atten- course provided them with more help than for their
tional processes (Chiesa, Calati, & Serretti, 2011). presenting problem of academic evaluation anxiety.
Farb et al. (2007) conducted a neuroimaging study of The qualitative meta-syntheses conducted by Mal-
participants in an MBSR course, and found evidence pass et al. (2012) and Wyatt et al. (2014) indicate a
of neural dissociation between two different forms similar multidimensionality of the experiences and
of self-awareness: ‘‘narrative focus,’’ which involves change processes described by clients participating
monitoring of self-referential traits, and ‘‘experiential in other studies of mindfulness-based interventions.
focus,’’ which entails broadly attending moment- The MBSR program emphasizes the interplay of
by-moment experiences. These two forms of self- formal mindfulness practices (the body scan, sitting,
awareness seem to involve distinct neurobiological standing, and walking meditation exercises) and
systems. Farb et al. (2007) argue that the MBSR pro- informal mindfulness practice in ordinary everyday
gram may decrease rumination and self-referential situations, with the assumption that the effects of
processes by developing capacities for focused atten- these formal exercises might generalize into other
tion to the present. The participants’ exploration of domains of daily life. Many participants described
new approaches to academic learning may provide an that the program would not only have an impact on
experiential perspective on processes described in their experience of performance anxiety in academic
prior research on motivational processes in learning. contexts, but would influence how they felt about
The participants’ descriptions of moving from fear to themselves and engaged with difficulties in other
curiosity in their academic learning (theme 4) can be situations in their everyday life. The wide range and
seen as resonating with Dweck’s (1986) descriptions complexity in the client experiences identified in this
of learning versus performance goals, and Elliot’s particular study suggest that a qualitative investiga-
(1999) distinction between approach and avoi- tion of the subjective experience of participants may
dance motivation in understanding achievement be important to understand the contextual factors
goals. Dweck (1986) differentiates between perfor- and multiple dimensions of change in mindfulness-
mance goals, where individuals attempt to gain based interventions.
favorable evaluations and avoid negative judgments
of their competence, and learning goals, where indi-
viduals attempt to increase their competence to under- Reflexivity
stand and master new areas. Whereas performance Reflexivity involves continuously examining how the
goals involve demonstrating competence relative to subjectivity and preconceptions of the researcher
others, learning goals are driven by intrinsic motiva- or team of researchers may affect the understand-
tion and the individual’s development of mastery. ing and interpretation of the phenomena in the re-
Elliot (1999) describes avoidance motivation as be- search process (Alveson & Sköldberg, 2009; Binder,
havior directed toward a negative or aversive possibi- Holgersen, & Moltu, 2012; Finlay & Gough, 2003).
lity, whereas approach motivation is described as The contemporary popularity of mindfulness-based
behavior that is directed toward a positive event. interventions calls for a reflexive recognition that these
Neff, Hsieh, and Dejitterat (2005) found that self- interventions, like other psychotherapeutic approaches,
compassion among undergraduate students was po- may not work for everyone. Our primary interest
sitively associated with adaptive academic motivation when developing the interview guide for this study
patterns (learning goals) and negatively associated was to explore the perceived relevance and usefulness
with performance-avoidance goals, indicating that experienced by university students undergoing the
self-compassionate students might cope more adap- mindfulness-based intervention, and to understand
tively with the fear of academic failure. The partici- how participants with academic evaluation anxiety
pants’ descriptions of their performance anxiety and experience would integrate the 8-week program
prior efforts to avoid academic failure may illustrate into their everyday life. The fact that three of the
such maladaptive attempts to master the process of researchers in our team have practiced mindfulness
academic learning. The themes of staying focused and taken an MBSR program might offer both
when facing distractions (theme 3) and moving from advantages and disadvantages. Having a personal
fear to curiosity in academic learning (theme 4) may background as mindfulness practitioners gives the
illustrate how moving toward a growth and mastery- advantage of first-hand knowledge of possible client
oriented approach may be helpful for university experiences that could be explored in the research
students struggling with performance anxiety. interviews with the participants, but may also have
Most of the participants described that they constricted our openness for recognizing other im-
experienced the course as relevant and useful for portant processes among the participants in the MBSR
finding ways to master their academic evaluation program. Researchers without a personal mindful-
anxiety, however many also described that the 8-week ness background might identify different phenomena
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Facing the fear of academic failure
during the research process, and the presence of ‘‘rich quotes’’ to illustrate the findings were all female,
a ‘‘non-practicing’’ researcher in our research team which may represent an important question to the
represented an important part of the critical audit- present study. We cannot, from the findings in this
ing in our research process. For example, the critical study, assume that the MBSR program is equally
examiner in the research team highlighted important accessible and acceptable to both male and female
relationships between the five themes we identified university students.
in this particular MBSR study, and identified an
important ‘‘meta-theme’’ or narrative structure in
the themes we identified, where several of the indi- Implications for research
vidual themes described the participants’ experi- Qualitative research methods have the potential
ences as initially encountering a negative experience of systematically exploring user experiences and
(‘‘challenge’’) and then having a positive experience subjective processes of change in mindfulness-based
(‘‘mastery’’). The positive trend in this meta-theme interventions such as MBSR (Castonguay & Beutler,
may represent an accurate interpretation of the ex- 2006; Elliott, 2010; McLeod, 2011), and our findings
periences described by the participants in the quali- do indicate what clients may experience as useful and
tative interviews, but may also highlight the need relevant when participating in mindfulness-based
for discussing the limitations of this qualitative study. interventions for anxiety problems. It may be im-
Another important question that emerged in the portant to secure a balanced gender sample in future
reflexive process was the possibility of gender differ- studies to assess the impact and implications of possi-
ences in academic performance anxiety. The partici- ble gender differences among university students
pants who entered our study were predominately with academic performance anxiety. Further empiri-
female university students (86% women vs. 14% cal studies will be required to investigate the causal
men), and only 4 among the 29 students we inter- mechanisms of change in mindfulness-based inter-
viewed were male. The low participation of male ventions for academic evaluation anxiety. We recom-
students in this study may reflect gender differences mend that future studies investigate both levels of
in coping strategies when faced with academic stress performance anxiety, subsequent academic perfor-
and performance anxiety; or that male students were mance and general mental health as possible outcomes
more reluctant to seek professional help. of psychological interventions for this population.
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