The Mind-Body Team: Mindfulness in College Health
American College Health Association
June 2, 2010Robin Boudette, Ph.D.Shefalika Gandhi, LCSWDeanna Nobleza, MDVictoria Rosenfeld, RD, CSSDLaura Rubinstein, Health Educator
Today’s Objectives
Introduction to mindfulnessOverview of mindfulness based
interventionsMindfulness in college health, why?Evolution the Mind-Body Team at PrincetonCase StudyApplications for college counseling centersBest practices in bringing mindfulness to
college health settings
Definitions
Introduction to mindfulnessOverview of mindfulness based
interventionsMindfulness in college health, why?Evolution the Mind-Body Team at PrincetonCase StudyApplications for college counseling centersBest practices in bringing mindfulness to
college health settings
Mindfulness Based InterventionsDialectical Behavior TherapyAcceptance and Commitment TherapyIntegrating mindfulness in individual
therapyMindfulness-Based Stress Reduction
▫MBCT▫MBRP▫MB-EAT▫MBRE▫MBAT
MBSR: John Kabat-Zinn
Developed in 1979 at U MassMost researched mindfulness interventionInvolves 8 week psycho-education programParticipants learn and practice mindfulness
meditation and mindfulness in a variety of activities
Suggested practice: meditation 40 minutes 6 times per week
Program appropriate for all stress-related conditions
Positive Clinical Outcomes with MBSR
Chronic Pain: Kabat-Zinn, 1985 Anxiety: Kabat-Zinn, 1992Fibromyalgia: Goldenberg, 1994 Psoriasis: Kabat-Zinn, 1998Binge Eating: Kristeller, 1999Depression: Teasdale, 2000Cancer: Speca, 2002Immune Function: Davidson, 2003
Studies Funded by National Institutes of Health
Does Mindfulness Change the Brain:Findings in Neuroscience
The Impact of Mindfulness: Domains of Possibility
PhysicalCognitivePsychologicalBehavioralSocialSpiritual
Mindfulness in College Health: Why?
Chronic stress in college students is implicated in:▫Physical Illness: sleep disturbance, colds,
headaches▫Psychological disorders: anxiety and
depression▫Unhealthy behaviors: substance use, suicidal
ideation▫Declining academic performance
National College Health Association Survey: Students reported the following factors affected their academic performance
National results
Princeton results2006N=543
2008N=752
2009N=641
Stress 29.3% 31.1% 29.5%
Sleep 21.6% 22% 20%
Cold & Flu 26% 31.1% 16.7%
2006N=94,806
2008N=80,121
2009N=87,105
Stress 32.0% 33.9% 27.8%
Sleep 23.9% 25.6% 20.o%
Cold & Flu 26.0% 28.8% 19.0%
Mindfulness in College Health: Research
Shapiro, et al. (1998) RWLC Medical students reported decreased levels of stress and depression with reductions maintained during exams; findings replicated with WL group.
Rosenzweig et al. (2003) Medical students reported significant reduction in negative mood and increased ability to cope with stress.
Jain et al. (2007) RWLC Pre-med undergrads students reported significant reduction in psychological distress and increased empathy.
Integrated Approach at UHS
Comprehensive Health Service▫Medical Services▫Counseling and Psychological Services▫Employee Health Services▫Health Promotion and Wellness Services▫Inpatient Service
Multidisciplinary Team Approach▫Eating Disorders Team▫Alcohol and Other Drugs Team▫Mind/Body Health Team▫Integrative Case Conference
Evolution of the Mind Body Team
UHS Mind Body Team: Mission
Create a culture that supports use of mind/body interventions in the treatment of stress related problems.
Give treatment providers the education, skills and materials to inform students about the effectiveness of mind/body interventions and resources available on campus.
Develop a multidisciplinary team within UHS that specializes in behavioral medicine and provides medical, psychological and nutritional services to students with stress-related problems.
Liaison with campus groups that provide mind/body services to create a network of resources for students beyond UHS.
Mind Body Interventions
Psycho-education on mind body connectionRelaxation ResponseMindfulnessAttuned EatingHealthy ExerciseMental ImageryCognitive Behavioral Therapy
Mind Body Team: Clinical
Take a holistic approach to treating physical illness and psychological disorders.
Educate staff and students about the mind/body connection and the effectiveness of mind/body interventions in healing physical and psychological concerns.
Use mind/body interventions such as meditation and relaxation to address psychological and physical concerns.
Refer staff and students to campus activities for mind/body health.
Provide prevention services for staff and students.
Support the Peer Health Educators.
Mind Body Services Flyer
Team Members
CounselingMedicalPsychiatryNutritionHealth EducationAthletic Trainer
Team Members: Counseling
Mindfulness-Based Therapy o Acceptanceo Patience and Compassiono Mindfulness Meditation
Practice
Applicationso Stress, Management o Depression and anxietyo Interpersonal issueso Medical issues
Psycho-education/ Interpretationo Triangle of Awareness o Reacting vs. Responding to
Stress o Mind’s Conditioningo Holding on vs. Letting go
Therapeutic Effectso Present Moment
Awarenesso Tolerance of Rumination/
Worryo Ability to Disengage o Shift Perspectiveo Cultivate Positive Emotions
Mindfulness Trainingo Mindfulness and
Psychotherapy conferenceso MBSRo MBCTo MB EATo MBRP
Mindfulness Groups
Clinical▫ Mindfulness Skills Training for Graduate Students▫ Mindfulness for Undergraduates ▫ Mindfulness for Health and Healing▫ Mindfulness-Based Performance Enhancement for
Athletes▫ Mindfulness- Based Graduate Women’s Therapy group
Outreach▫ Lunch Time Stress Management▫ Mindful Food Group▫ Meditation for Staff▫ Monthly Series at the Graduate School
Mindful Time Management Mindful Interpersonal Skills Mindfulness Skills for Job Search Mindfulness and Happiness
Groups Flyer
Mindfulness Skills Training for Graduate Students: Outcomes42 participants over 6 semestersFormal mindfulness practice
▫71% of students found it “very helpful”▫64% would continue to practice
Mindful activities▫57% of students found it “very helpful”▫62% would continue to practice
Weekly group▫86% of students found it “very helpful”▫75% of students expressed an interest in
participating in another group in the future
Mindfulness Skills Training Group: Student Feedback“My stress level went down. My awareness of my
moods went up. I learned to be more accepting of myself.”
“I feel happier somehow. I use the methods to ground myself when I run away from problems.”
“Thoughts are not facts”“I’m more attentive to thoughts, feelings, at least
some of the time. I meditate more regularly.”“Group participants made me realize that I am not
alone with feeling anxieties about graduate school, my work, etc.”
“Helped me very much with dealing with my depression.”
Team Members: Psychiatry
Evaluations with an ear to…o Medical comorbiditieso Somatic symptomatologyo Openness (or not) to
psychotropic medications o Self care
Psychoeducationo Exerciseo Mind/Body Interventionso Sleep Hygieneo Light therapyo Herbals/Supplements
Referralso Individualo Groupso Nutritiono Massage Therapyo Medicalo Herbalist/CAM specialist
Mindfulness Trainingo Nutritional and
Complementary Approaches to Mental Health Disorders
o Herbal Medications in Psychiatry
o Orthomolecular Psychiatry
Team Members: Medicine
Evaluations with an ear to… Illnesses that have a
Med/Psych and/or Stress Componento Chronic paino IBSo Headacheso Insomnia
Role of stress and lack of self-care on presenting problem(s)
Psychoeducationo Studentso Medical Staff
Referralso Mind/Body Interventionso Mind/Body Teamo Nutritiono Counseling
Mindfulness Trainingo UHS Wide trainingo Mindfulness Based Stress
Reduction for HealthCare Providers
Team Members: Nutrition
Nutrition assessment including:o Spiritual practiceo Current or past use of mind
body modalities- meditation, guided imagery, yogao Stress o Sleepo Coping skills
Presenting problemso BEDo IBSo Ulcerative Colitiso Weight worriedo HTN
Approach:o Integrate M/B practices into
treatment plano Mindful eating/Intuitive eatingo Mindful awarenesso Correct sleep and stress
management early in processo Refer to other team members,
groups, written and online resources
Mindfulness Trainingo UHS Wide trainingo Mindfulness Based Stress
Reduction for HealthCare Providers
Future directions:o Additional trainingo Intuitive eating groupso Integration of structured
HAES/Intuitive eating process
Team Members: Health Promotion and Wellness
Outreacho Team Marketingo Mindfulness Workshopso Eating Mindfully at the holidayso Graduate Mindfulness Series
Peer Advisor Trainingo Healthy Mindso Eating Concerns Advisorso Student Athlete Wellness
Leaders
Infusing into “Traditional” Contento Smoking Cessationo “Healthy Eating”o Eating Disorderso Depressiono Stresso Order in’s
Educational Resources:o Online informationo Audio Downloadso Books and DVDs at the
UHS lending library
Case Study
EG
Mindfulness Initiatives in University Settings Mindfulness Centers:
▫Teach mindfulness through programs, courses, workshops
▫Engage in research that furthers the understanding of mindfulness and its benefits
▫Serve campus community through special events, publications, and other activities
Groups and online resources:▫Mindfulness Programs for students, staff and
faculty▫For credit MBSR classes▫Extensive educational materials, audio
downloads
Mindfulness At Other UniversitiesTraining in mindfulness for post-doctoral
cliniciansCampus-wide initiatives:
▫Centers, departments and groups partner to support and offer education and training in mindfulness
Mind-Body Lab:▫Self-paced environment designed to help students
explore various resources for improving their emotional and physical health
▫Features self-directed audio and video instructions on mind-body practices, biofeedback equipment and other interactive tools
Integrated health services- Medical and counseling within one service department
Mindfulness in College Health
Benefits ChallengesHolistic approach to
healthcareEvidenced-based, short-term
clinical interventionsEffectively and efficiently
offered in large group settingsAttracts diverse student
groups to servicesAppropriate for prevention
and treatmentEncourages participants to
take and active role in healthcare
Fosters health of campus community
Competing clinical demands within health services
Barriers to engaging students in stress management
Motivating students for groups and home practices
Competing interests for students’ time
Future Directions
What ideas or experience do you have in bringing mindfulness into college health?
What are some “best practices” in bringing mindfulness into college health?
Best Practices for Mindfulness in College HealthProfessional training for designated staff
members in the Health Services DepartmentAn integrative, multi-disciplinary team
approachIn-service trainings across disciplinesDiversity of services for students
Clinical interventionsOutreach activities
Monitor outcomesPartner with student groups Partner with other student life departmentsOpportunities for staff and faculty to learn
and practice