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Timothy Stewart, PsyD, is a 2026 graduate of the PsyD program in Clinical Psychology at Antioch University, Seattle.
Dissertation Committee:
Jude Bergkamp, PsyD, Committee Chair
Liang Tien, PhD, PsyD, ABPP, Committee Member
Loppon Jamyang Tsultrim, Committee Member
Keywords
qualitative, narrative analysis, textual analysis, mindfulness, mindfulness-based treatment, mindfulness-based intervention, MBSR, MBCT, DBT, MBTs, ESTs, empirically supported treatments, clinical psychology, Buddhism, Theravāda Buddhism, Buddhist epistemology
Document Type
Dissertation
Publication Date
2026
Abstract
After gaining popularity in the United States of America (USA) in the 1960s and 1970s, Buddhist mindfulness was introduced to clinical psychology and investigated for its potential psychological healing effects. In the years since, mindfulness has been widely used in empirically supported treatments (ESTs) in clinical psychology in the USA to treat a wide variety of psychological conditions and disorders. This dissertation examines and compares conceptualizations and implicit understandings of mindfulness in early (Theravāda) Buddhism and in ESTs in clinical psychology in the USA. Through textual narrative analysis of two Buddhist sutta and 10 clinical psychology journal articles, this study investigates the theoretical, epistemological, and cultural contexts and assumptions surrounding mindfulness in early Buddhism and in ESTs in clinical psychology in the USA. Findings indicate that mindfulness has been transformed through quantitative empirical validation, simultaneously narrowing and broadening it into an amorphous concept lacking a consistent, agreed-upon theoretical framework. This destruction and reconstruction of mindfulness occurred not only through Western scientific epistemologies but also through neoliberal and individualistic cultural values, as well as capitalist and market-driven forces. As a result, mindfulness in ESTs has been fundamentally altered to align with dominant USA values and to become a tool that further reinforces USA understandings of suffering and its cessation. The study concludes that continued use of mindfulness in ESTs risks reinforcing an individualistic cultural narrative and contributing to cultural erasure. Buddhist mindfulness cannot be incorporated into ESTs in clinical psychology in the USA without fundamental conceptual alteration due to the epistemic dominance inherent in the empirical validation process. This raises questions about whether mindfulness should continue to be developed and used as an intervention or if a distinct clinical construct should be developed. Greater epistemic pluralism and engagement with Buddhist ways of knowing are recommended to enhance conceptual clarity, ethical integrity, and cultural responsiveness in clinical psychology. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/.
Recommended Citation
Stewart, T. (2026). The Use of Mindfulness in Empirically Supported Treatments in Psychology. https://aura.antioch.edu/etds/1259
Included in
Buddhist Studies Commons, Clinical Psychology Commons, Epistemology Commons, Psychoanalysis and Psychotherapy Commons
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Timothy Stewart, PsyD, 2026
ORCID iD 0009-0007-2281-2463
Tim Stewart is passionate about culturally informed and relational approaches to healing. As a practitioner of Zen Buddhism, he has conducted research on mindfulness and Buddhism in clinical psychology, coloniality, and religious and spiritual perspectives on human existence and suffering. His work reflects a sustained commitment to exploring how diverse traditions and perspectives inform the understanding and alleviation of suffering.