Original Article Feasibility of mindfulness-based therapy in patients recovering from a first psychotic episode: a pilot study Renate van der Valk, 1 Susanna van de Waerdt, 1 Carin J. Meijer, 1 Ingrid van den Hout 2 and Lieuwe de Haan 1 1 Department Early Psychosis, Academic Medical Centre, University of Amsterdam, and 2 Private Practice, Amsterdam, the Netherlands Corresponding author: Mrs Renate van der Valk, Department Early Psychosis, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands. Email: r.vandervalk@amc.uva.nl Received 10 May 2011; accepted 26 January 2012 Abstract Aim: Recently, a mindfulness therapy for people with psychotic disorders was developed. However, clinicians and researchers are cautious given case reports in which extensive medi- tation provoked psychotic symptoms in people with a psychotic disorder. The purpose of this study was to examine the feasibility, adverse effects and possible favourable effects of mindfulness-based therapy (MBT) in people recently recovering from a first episode of psychosis. Method: A nonrandomized, non- controlled prospective follow-up study. Patients were offered an MBT that consisted of eight 1-hour ses- sions within a 4-week time span. Positive and Negative Syndrome Scale, Symptoms Checklist 90 and the Southampton Mindfulness Question- naire were assessed before and after the therapy. Results: Of the 16 persons who started MBT, 13 completed (81.5%) the therapy. No significant increase in psychotic symptoms was found. Between two meetings, one partici- pant initially misunderstood the mindfulness instructions, which led to an increase in distress. No increased awareness of intrusive thoughts or visual or auditory halluci- nations was reported by participants. We found a decrease in agoraphobic symptoms (p < 0.028) and in psycho- neuroticism (P < 0.025). Conclusion: The MBT had no signifi- cant adverse effect on psychotic symptoms in patients in this small pilot study, neither did it raise the level of mindfulness in the partici- pants. A decrease in psychological symptoms was found, although one patient experienced an increase in symptoms of distress. Our study demonstrates that therapists should be cautious that therapy and practice instructions are understood properly. Future studies are feasible and needed, in larger samples with an RCT design, in order to draw conclu- sions regarding the effects of the MBT. Key words: early psychosis, group therapy, meditation, mindfulness. INTRODUCTION In the last decennia the interest for psychological interventions for treating psychosis has increased considerably. Cognitive behavioural therapy (CBT), for example, is now considered an evidence-based treatment for people with a psychotic disorder. 1 Where the focus of CBT was initially on treating psy- chotic symptoms like hallucinations and delusions, later this was complemented by, for example, person-based cognitive therapy for distressing psychosis, which aims to alleviate the distress associated with psychotic symptoms. 2 Recently the interest for interventions focusing on distress has extended to other psychological interventions such as acceptance and commitment therapy (ACT) and mindfulness-based therapy (MBT), in which mindfulness exercise is an important ingredient. 3 Mindfulness is defined as ‘paying attention to rele- vant aspects of experiences in a non-judgmental Early Intervention in Psychiatry 2012; ••: ••–•• doi:10.1111/j.1751-7893.2012.00356.x First Impact Factor released in June 2010 and now listed in MEDLINE! © 2012 Blackwell Publishing Asia Pty Ltd 1