title: Are We Speaking the Same Language? Finding Theoretical Coherence and Precision in "Mindfulness-Based Mechanisms" in Chronic Pain.
abstract: OBJECTIVE
  Over the past 50 years, the field of chronic pain has witnessed an evolution of psychological approaches with some notable success. Some of this evolution has included "mindfulness-based interventions" (MBIs), now regarded as having encouraging partial support for their effectiveness. However, several theoretical challenges remain that may inhibit the progress of MBIs. These challenges include a lack of clarity surrounding the mindfulness construct itself, the proliferation of purported underlying mechanisms arising from different theories, and limited evidence for the mechanisms through which MBIs work. The current conceptual review provides a critique of existing theoretical models of mindfulness that have been applied to understanding and treating chronic pain.
  
  
  METHODS
  A conceptual narrative review was conducted.
  
  
  METHODS
  Treatment programs for people with chronic pain.
  
  
  METHODS
  Individuals with any type of chronic pain.
  
  
  METHODS
  MBIs for chronic pain.
  
  
  METHODS
  Mindfulness-based mechanisms explored in relation to several domains of functioning.
  
  
  CONCLUSIONS
  Based on this assessment, a summary of available evidence for a particular contextual behavioral theory of "mindfulness"-psychological flexibility-is outlined. Findings show the need for further integration of existing mindfulness constructs to better guide development and evaluation of mindfulness-based treatment methods in the future.
authors.affiliation: Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Harrison
authors.affiliation: Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom.
authors.forename: Whitney
authors.initials: W
authors.lastname: Scott
authors.affiliation: Department of Psychiatry, University of Oxford, United Kingdom.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Johns
authors.affiliation: School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
authors.forename: Eric M J
authors.initials: EMJ
authors.lastname: Morris
authors.affiliation: Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom.
authors.forename: Lance M
authors.initials: LM
authors.lastname: McCracken
mesh_terms: D001288:Attention / Q000502:physiology*; D001519:Behavior / Q000502:physiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D032882:Comprehension; D006801:Humans; D064866:Mindfulness / Q000379:methods; D008962:Models, Theoretical
keywords: Acceptance and Commitment Therapy; Chronic Pain; Mindfulness; Review; Theory