11 Oct 2026
International Panel of Acknowledgment
)
The International Panel of Acknowledgement recognised MIFM as an Emergent Mindfulness-Based Programme, highlighting its integration of mindfulness, occupational therapy and fatigue management. The review commended accessibility, compassion and trauma-sensitive delivery, while recommending clearer clinical governance, a formal theory of change and continued evaluation to strengthen its promising, early-stage evidence base.
INTERNATIONAL PANEL OF ACKNOWLEDGEMENT (IPA)
PROGRAMME REVIEW RESPONSE TEMPLATE
Programme Information
Programme Name: Mindfulness-Informed Fatigue Management (MIFM)
Lead Applicant: Charles Talbot
Target Population and Context: Adults experiencing persistent fatigue associated with acquired brain
injury, neurological conditions, long-term health conditions, burnout and stress-related exhaustion.
Reviewer: Dr Sophie Sansom
Review Date: 30.06.2026
Overall Outcome
☐ Acknowledged as an Established Programme
☑ Acknowledged as an Emergent Programme
☐ Invited to Provide Additional Information
☐ Invited to Undertake Further Development Before Reapplication
Summary Evaluation
Mindfulness-Informed Fatigue Management (MIFM) is a thoughtfully developed, trauma-sensitive,
co-produced mindfulness-based programme designed to support individuals experiencing persistent
fatigue across a range of health conditions. The programme demonstrates strong alignment with
established mindfulness-based approaches whilst introducing clinically relevant adaptations that
respond to the unique challenges associated with fatigue, including fluctuating energy levels,
cognitive fatigue, emotional exhaustion, sensory overload, and difficulties maintaining engagement
in mindfulness practice.
The programme is theoretically coherent, grounded in established mindfulness-based mechanisms of
change, occupational therapy principles, nervous system regulation, self-management and
behavioural science. The curriculum demonstrates clear developmental progression and maintains
mindfulness as the central mechanism of change.
MIFM currently possesses a promising but early-stage evidence base. Initial pilot data, qualitative
findings, real-world outcomes and ongoing programme evaluation support acknowledgement as an
Emergent Programme whilst further evidence accumulates.
DOMAIN 1: MINDFULNESS-BASED PROGRAMME INTEGRITY
Strengths
• Mindfulness is clearly positioned as the central mechanism of change.
• The programme draws appropriately upon established mindfulness-based approaches
including MBSR and MBCT.
• Sustained mindfulness practice, inquiry and experiential learning are embedded throughout
the programme.
• The programme explicitly cultivates awareness, acceptance, self-regulation, compassion and
behavioural flexibility.
• Contemporary understanding of attention, feeling tone (vedanā), self-regulation and
behavioural choice are integrated effectively.
Areas for Development
• Further articulation of the programme's explicit model of human suffering and flourishing
may strengthen theoretical coherence.
• Greater description of the inquiry process and teacher competencies would strengthen
fidelity guidance.
• Future work could clarify which elements constitute the essential "warp" and adaptable
"weft" of the programme.
Reviewer Commentary
MIFM demonstrates strong mindfulness-based programme integrity. Mindfulness is not used as an
adjunctive therapeutic technique but rather functions as the central organising principle
underpinning awareness, acceptance, self-regulation and behavioural change. The programme
explicitly cultivates present-moment awareness, decentring, compassion and non-reactivity, whilst
integrating these processes within the lived experience of fatigue.
The workbook demonstrates substantial use of formal and informal mindfulness practices, including
body scan, breath awareness, mindful movement, mindful eating, grounding practices and daily
home practice. Inquiry and experiential learning appear to be embedded throughout the curriculum.
The incorporation of feeling tone (vedanā) as a mechanism underpinning attentional deployment,
emotional regulation and energy conservation represents a particularly innovative and theoretically
coherent contribution.
Reviewer Rating
☑ Fully Meets Criterion (4)
☐ Meets Criterion with Minor Clarifications Required (3)
☐ Partially Meets Criterion (2)
☐ Does Not Yet Meet Criterion (1)
DOMAIN 2: ADAPTATION AND DEVELOPMENT
Strengths
• Clear rationale for programme development based upon unmet clinical need.
• Strong integration of occupational therapy, fatigue management and mindfulness-based
approaches.
• Co-produced and practice-informed development process.
• Adaptations preserve core mindfulness mechanisms whilst responding to fatigue-specific
needs.
• Strong attention to accessibility, pacing and energy management.
Areas for Development
• Explicit mapping against established adaptation frameworks (e.g., MRC, RE-AIM, Loucks et
al.) would strengthen the evidence trail.
• Greater detail regarding co-production methodology would be helpful.
• Clarification of which adaptations are essential versus optional would strengthen
replicability.
Reviewer Commentary
The adaptations underpinning MIFM appear highly appropriate and clinically justified. The
programme responds to a clearly articulated gap in the mindfulness field: the absence of a
mindfulness-based programme specifically designed for individuals experiencing persistent fatigue
across diagnostic groups.
The adaptation process demonstrates strong clinical grounding and reflects sustained engagement
with participants' lived experience. Fatigue-specific adaptations—including shorter practices, pacing
principles, fatigue psychoeducation, fatigue buckets, early warning systems and nervous system
regulation—appear coherent with the underlying mechanisms of mindfulness-based approaches.
The programme succeeds in preserving essential mindfulness-based processes whilst adapting
structure and content to accommodate the realities of fatigue.
Reviewer Rating
☑ Fully Meets Criterion (4)
☐ Meets Criterion with Minor Clarifications Required (3)
☐ Partially Meets Criterion (2)
☐ Does Not Yet Meet Criterion (1)
DOMAIN 3: SAFETY AND GOVERNANCE
Strengths
• Strong emphasis on trauma-sensitive delivery.
• Explicit participant safety planning procedures included.
• Clear boundaries regarding therapeutic and educational roles.
• Attention to participant pacing and physical safety.
• Programme developed and delivered by a BAMBA-registered mindfulness teacher and
specialist occupational therapist.
Areas for Development
• More formal articulation of screening and exclusion procedures.
• Greater specification of adverse event reporting procedures.
• Further development of governance and quality assurance documentation would strengthen
future applications.
Reviewer Commentary
Participant safety appears to have been carefully considered throughout the design and delivery of
MIFM. The workbook includes explicit guidance regarding participant support, safeguarding, crisis
support and appropriate boundaries between educational and therapeutic interventions.
The trauma-sensitive orientation of the programme is particularly appropriate given the vulnerability
of many participants experiencing persistent fatigue and acquired brain injury. The emphasis on selfcompassion, pacing, autonomy and participant choice further supports psychological safety.
Whilst overall safety appears robust, future development would benefit from more formalised
governance procedures and explicit reporting frameworks.
Reviewer Rating
☑ Meets Criterion with Minor Clarifications Required (3)
☐ Fully Meets Criterion (4)
☐ Partially Meets Criterion (2)
☐ Does Not Yet Meet Criterion (1)
DOMAIN 4: EVIDENCE AND IMPACT
Strengths
• Pilot study completed using validated outcome measures.
• Rich qualitative data demonstrating participant benefit.
• Evidence of meaningful real-world outcomes.
• Ongoing evaluation with additional cohorts.
• External professional recognition through CPCAB accreditation and national conference
presentation.
Areas for Development
• Larger sample sizes are required.
• Independent evaluation would strengthen the evidence base.
• Further quantitative outcome evaluation is recommended.
• Evaluation across multiple populations and settings is desirable.
Reviewer Commentary
MIFM currently possesses a promising but emerging evidence base. The initial pilot study
demonstrated positive trends across fatigue, stress, resilience and psychological flexibility, although
statistical significance was not achieved due to limited sample size.
Qualitative findings were particularly compelling, identifying themes of safety, learning and
gratitude, together with reports of increased self-awareness, reduced emotional reactivity and
improved participation in valued activities.
Importantly, the programme has already demonstrated meaningful real-world impact through
improvements in employment, social participation, healthcare engagement and quality of life.
The current evidence base is appropriately characterised as emergent and supports
acknowledgement at this stage whilst further evaluation proceeds.
Reviewer Rating
☑ Meets Criterion with Minor Clarifications Required (3)
☐ Fully Meets Criterion (4)
☐ Partially Meets Criterion (2)
☐ Does Not Yet Meet Criterion (1)
Evidence Pathway Determination
☐ Foundational
☑ Emergent
☐ Established
Rationale
MIFM has progressed beyond pilot development and demonstrates evidence consistent with an
emergent programme. The programme has completed initial feasibility evaluation, has generated
both quantitative and qualitative outcome data, and is currently undergoing further implementation
and evaluation through additional cohorts. External professional recognition and dissemination
activities further support its developmental maturity. However, independent evaluation, larger
cohorts and replication across settings remain necessary before consideration as an established
programme.
Scoring Summary
Domain Score
Mindfulness-Based Programme Integrity 4
Adaptation and Development 4
Safety and Governance 3
Evidence and Impact 3
Total Score: 14 / 16
Final Decision Rationale
The review panel concludes that Mindfulness-Informed Fatigue Management demonstrates strong
mindfulness-based programme integrity, a coherent and justified adaptation process, appropriate
attention to participant safety, and a promising emerging evidence base. The programme addresses a
clearly articulated gap within existing mindfulness-based approaches and presents a thoughtful
integration of mindfulness, occupational therapy, fatigue management and contemporary
understandings of self-regulation and behaviour change.
The panel particularly recognises the programme's strong commitment to participant experience,
accessibility, compassion and trauma sensitivity. The adaptation of mindfulness principles to support
individuals experiencing persistent fatigue appears theoretically coherent, clinically justified and
responsive to an important area of unmet need.
Whilst further evaluation is required before consideration as an Established Programme, sufficient
evidence currently exists to support acknowledgement as an Emergent Programme.
Priority Recommendations (Next 12 Months)
1. Develop a formal logic model and theory of change.
2. Formalise governance, screening and adverse event procedures.
3. Continue collecting quantitative and qualitative outcome data across additional cohorts.
Future Development Opportunities (Established Programme Criteria)
1. Undertake independent evaluation.
2. Explore implementation across multiple clinical and community settings.
3. Develop teacher training and fidelity guidance materials.
Reviewer Name: Dr Sophie Sansom
Date: 30.06.2026
