Developing an integrated community–based mindful parenting programme

Skills for LifeEluned Gold & Sophie Pratt

Acknowledgements

Staff at Corun I Sawdl – for support , encouragement and creative ideas.

Davina PlumSian DaviesSue HughesSarah Jones All staff at Centre for Mindfulness Research and Practice esp.Catrin Eames for help with research measuresSarah Silverton

This presentation will include• Introduction to the project

• Why we chose to develop the programme

• The Communities we have been working with

• The developing of this programme

• Some experiential exercises from the programme

• The programme so far

• Early learnings and - ?results?

• Lessons learnt and wider outcomes from the project

• Future developments

Introduction to the programme• Experienced MBSR teacher taught a mindful parenting course to

young or multiply stressed mothers in this community setting for 2 years alongside the community team. During that time the basic MBSR course has been adapted to be more accessible and meaningful to the client group.

• Staff from the community team took the first course alongside clients

• One staff member - and later- a second – is undertaking training in teaching MBSR

• The community team have continued to develop the programme and now offer the programme in other areas.

• Staff teaching this programme continue to have supervision and mentoring from an experienced MBSR teacher

Why• Underserved rural community that needed a new programme.

• Integration with existing programme• Opportunity for collaboration between NHS – Bangor

University• Mindfulness known to be helpful. (Bögels; Duncan; Kabat-Zinn; Singh)

Some background

The area in question is a ’Sure Start’ and ‘Flying Start’ area: • Government funded initiative for early years – areas identified

are at high risk of early childhood behaviour problems -

• with all the risk categories Parenting Skills are a potential mitigating factor.

So in this community:

• Unemployment –24% benefit claimants ( number of adults of

working age lower than rest of county) • Educational attainment – 43% have no qualifications• Single parents- 4.5% of working population single parents• 81 % speak Welsh• Geographically isolated• Historically there are high proportion of extended families• Greatest deprivation in county for income, health and housing

Issues identified in the client group

• Multiple stressors• Low self esteem• Poor literacy skills • Intergenerational habits/schemas • Mental health issues e.g. post-natal depression, chronic

anxiety.• Lack of Parenting skills• Existing programme identified as not effective

Why mindfulness?

Evidence from other programmes indicate mindfulness:• Reduces stress• Improves executive function - Emotion regulation.• Can decrease the cycle of intergenerational habits• Develops self nourishing & compassion• Improves relationshipsetc

Why not mindfulness?• Counter cultural – 81 % Welsh speakers • Middle class and inaccessible• Untried• Lack of Staff skills • Not initially chosen by clients • Too demanding – costly?

Early Lessons• We quickly learned that:-• Counter cultural for staff too! (NHS staff solve problems!!).• The approach needs to be relevant and accessible – language and

cultural issues• The facilitator needs to know the client group• The participants need to be informed and ‘opt in’ • Home practice can be problematic• It needs to be integrated into the existing programme

Nevertheless

Even from the early classes there were some encouraging results:-• Measures taken in the first couple of classes showed that the

participants with the most need benefited the most.

And there were some interesting individual cases.

Some solutions• Flexibility of programme • MP3s rather than CDs• Handouts rather than hand book• Shorter practices• Art and creative activities in sessions• Integration into existing programme - mindful exercise and

mindful cooking.• Make the Home practice very low key and……….. • Teach out of home practice• Participants developed their own course work book

Pre course • Referrals are received from community nurses/health visitors

• Assessment visit - includes assessment and an introduction to to the programme - and level of support offered.

E.g. An important aspect of the programme is telephone contact between sessions

Programme

Orientation

• Community building• What’s it all for – glitter

balls• Practicalities• Integrated programme• Intro to practices – 3SBS• Discussion of Home

Practice

Session 1 – There’s more right with you than wrong with you

• Group building• We’re all in this together• 3SBS• Body scan 30mins.• Cloudy mind/clear mind• Sharing experiences

Listen to Body Scan trackWrite/draw/stick

something you noticed

ProgrammeSession 2-Perception/Raising

awareness

• Show and tell HP books• Perception pictures/ video• Body Scan• 3 SBS• Cloudy mind/ Clear mind

Body Scan Draw write or Stick in booksNoticing

Session 3-Body as Anchor• Show and Tell HP Books• HP what gets in the way –

enquiry?• Movement – body scan • 3SBS• Mindful T break• Mindfulness of breath

Movement - Informal Practice3SBSBody Scan at bed timeDraw write or Stick in books

ProgrammeSession 4-Finding out about me-

Staying with it• Show and tell HP books• Body Jigsaw• Identify Stress in the body• 3 Affect circles – behaviours (Gilbert)

• 3SBS• Mindfulness body & breath• What’s working – support in the

group Draw/Write/Stick noticing stress in the

body 3 circles –what’s my typical

behaviour? Mindful activity with the children Texting one another

Session 5-Let it be – Hanging out with the difficult

• Show and tell HP books• Movement• Vicious flower• Revisiting three circles – what

could be helpful? • 3 SBS coping – ( salt analogy)• Collage or drawing of difficulty –

staying with it• Story – Sun and wind

Nurturing activity for you and childrenWrite draw stick difficulty Sitting practice3 SBS

Programme

Session 6-Automatic-Thoughts/behaviours

• Show and tell HP books• Raisin• Monkey mind – thoughts• Brain power – approach/Avoid• Own warning signs of stress• Movement ---Sitting

Write draw stick your own monkey chain

Record your warning signsMindful eating with children 3SBS10 min sit

Session 7-Mindfulness in Relationships

• Show and tell HP books• Mindful listening• Hand aikido• Sitting Practice• Movement

Mindful listening with children

Write draw stick patterns in relationships

Nurturing activity – self /children

Programme

Session 8 -

Coming to our senses Group walk

Silent periods Listening

seeing Smelling

Mindful walking

ProgrammeSession 9 Moving on to Community

- Bringing it all together

• Show and tell HP books• Make sitting cushion• Eating together

• Celebration• Movement – body Scan

– Sitting

Session 10- Follow up

Some findings from 2 groups Warwick-Edinburgh Mental Well-being Scale (WEMWBS) Tennant, R., Stewart –Brown, S. et al 2007

1 2 3 4 5 6 7 8 9 10 11 1214

24

34

44

54

64

pre coursepost course

Observations - What they said

From parents• I’m noticing more - • I’m using breathing space to help in managing children -

making a noticeable difference in children’s behaviour• I have shared with families & friends• I can talk better with my partner about how I’m feeling• It has built my confidence and helped me with copingFrom Staff• Noticed an increase in self esteem

Spin offs• Further ways to integrate mindfulness, e.g. Mindful baby

massage• Interest shown within larger staff group within the NHS -e.g.

other Health visitors/Nurses/Managers• Genesis – skills for return to work programme• Spreading out geographically – offering the programme from

other centres• Other community organisations are interested. E.g. Women's

Aid Centre, Communities First

Summary of key findings• The approach can be delivered in an acceptable way.• Early results indicate that the programme appears to lead to

an increase in well-being in multiply stressed mothers.• The programme needs to be delivered in a flexible way • Staff development is an important ingredient• This project has initiated interest in other community groups

and there is potential to develop more

What next?• Training more staff in order to extend the programme• Training welsh speaking teachers• Further and more detailed research into aspects of the

programme• Extending the programme beyond the immediate geographical

area• ? Mindful community - a collaboration of a number of

organisations within one community

References

• Bögels, S., et al. 2010, Mindful Parenting in Mental Health Care, Mindfulness 1,2• Duncan, L., et al., 2009.. A Model of Mindful Parenting: Implications for Parent–Child

Relationships and Prevention Research. Clin Child Fam Psychol Rev.• Garrison Institute Report September 2010 Mindful Parenting: Conceptualization and

Measurement A Symposium of the Garrison Institute’s Initiative on Contemplation and Education

• Gilbert, P., et al. 2009, Compassion Focused Therapy Mind Therapy. Workshop handbook .• Kabat-Zinn, J., Kabat-Zinn, M., 19??? Everyday Blessings, Piatkus NY • Singh, Nirbhay N. et al. 2006. Mindful parenting decreases aggression, noncompliance,

and self-injury in children with autism. Journal of Emotional and Behavioural Disorders• Singh, Nirbhay N. et. al. 2010 Training in Mindful Caregiving Transfers to Parent–Child

Interactions. Journal of Child and Family Studies• Tennant, R., Stewart –Brown, S. et al 2007, Warwick-Edinburgh Mental Well-being Scale.