mindfulness day outline sept 17th...

Mind Full or Mindful? Mindfulness for medical schools -‐ what do we

and our students need?

17th September 2014

Mindfulness for medical schools: what do we and our students need? #mindfulmed 1

Table of Contents

Foreword from the organising committee ................................................................................... 2

Venue Map ................................................................................................................................. 3

Date, Time & Venue .................................................................................................................... 4

Aims............................................................................................................................................ 4

Learning Objectives..................................................................................................................... 4

Session Timetable ....................................................................................................................... 4

Speakers – Morning Sessions....................................................................................................... 5

Speakers – Afternoon Sessions.................................................................................................... 8

Useful Resources....................................................................................................................... 11

Notes Pages .............................................................................................................................. 13


Foreword from the organising committee

A warm welcome to all our delegates to this, the first pan-‐London medical school conference on Mindfulness. In the current climate of structural changes, targets, financial uncertainty and reduced job security, the need to be resilient is ever more important. Mindfulness allows us to reconnect with our bodies, our senses and our awareness of the present moment. Today we will explore the importance of being mindful, how mindfulness leads to resilience and how mindfulness can be integrated into our home and working lives.

We are delighted to present a programme offering both local and international perspectives on mindfulness, delivered by local educators and clinicians with expertise in mindfulness and our keynote presenter, Dr Patricia Dobkin, a leading international authority on the subject. Whether you are already involved in implementing mindful practices in your education or work environment; use mindful techniques for your own wellbeing; or are simply an interested novice; we hope that you will find the presentations, exercises and discussions interesting and useful.

This programme also contains a list of resources we think are useful, but do please recommend others that you are aware of. At lunchtime, we will have a display of some of the books listed, with the opportunity to purchase two of the titles: The Mindful Manifesto and Mindful London.

We will be using the Twitter hash tag #mindfulmed during the day, so for any Tweeters in the audience, please feel free to join our conversation.


Venue Map


Date, Time & Venue 17th September 2014 9.30am-‐4.30pm Room G8, Chantler SaIL Centre, Shepherd’s House, Guy’s Campus,

Aims To introduce clinical teachers to a variety of mindfulness ideas; with the aim of developing their resilience, consulting and teaching skills.

Learning Objectives To facilitate participant understanding of

• What “mindfulness” means • Where mindfulness originated and how its is being used for well being and therapeutics in the 21st

century • Mindfulness-‐based practices currently happening in medical schools and potential for future

initiatives • How mindfulness can help us as individuals

Session Timetable Time Activity Speaker 9.30am Registration 10.00am Introduction to the day Ruth Sugden 10.10am Keynote – Mindfulness in Medicine: Promoting

Resilience in Patients, Physicians and Allied Health Care Professionals

Patricia Dobkin

11.00am Coffee Break 11.15am Mindfulness : how can it help us and our patients? Katie Amiel 11.45am Mindfulness: what is it and how can we use it? Jonty Heaversedge 12.15pm Lunch 1.15pm Student Lightning Talks (10 slides, 20 seconds per

slide, panel Q&A after all talks) Siobhan Lynch & students

1.45pm Play dough mindfulness exercise Siobhan Lynch 2.00pm Mindfulness based CA-‐CBT programme to work with

anxiety, depression in traumatised clients: lessons learned for working with students going through difficult experiences

Meera Bahu

2.30pm Life as a mindful clinician Rachael Orr 2.45pm Brief mindfulness-‐based stress reduction in medical

schools Amy Spatz

3.15pm Tea break 3.30pm “Wordle café” (small groups working on world café

style questions – put into wordles)

4.10pm Panel Q&A All 4.25pm Closing summary Ruth Sugden/Kerry Boardman


Speakers – Morning Sessions Keynote Presentation Patricia Dobkin –Mindfulness in Medicine: Promoting Resilience in Patients, Physicians, and Allied Health Care Professionals Patricia is an Associate Professor in the Faculty of Medicine and has been a faculty member in the Department of Medicine at McGill University for the past 20 years. She is affiliated with McGill Programs in Whole Person Care and teaches undergraduate and medical students. Patricia obtained her PhD in Clinical Psychology in the United States, interned at Rochester (New York) Medical Center and completed her post-‐doctoral training at McGill University. Her specialty is Mind-‐Body Medicine. She has published >100 articles and book chapters in medical and psychological journals and has presented her work internationally in various conference venues.

During the past 8 years Patricia has provided and studied psychosocial programs entitled, Mindfulness-‐Based Stress Reduction and Mindfulness-‐Based Medical Practice. While most research pertaining to these programs show positive mental and physical health outcomes, relatively few have examined the processes underlying these benefits. Moreover, there is a paucity of research with regard to how MBSR impacts health professionals’ well-‐being. She, along with her students and colleagues, is filling this gap. In the context of the Physicianship 4 course for the 4th year medical students Patricia leads an elective entitled, Mindful Medical Practice, each year. How, where, and why Mindful Medical Practice is being taught and practiced in medical schools will be highlighted Patricia’s keynote address. Data from patients, physicians, medical students, and residents taught Mindfulness-‐Based Stress Reduction courses will be presented. An exercise in being a mindful clinician will give participants a taste of the practice.

Dobkin, P. L. (2009). Fostering healing through mindfulness in the context of medical practice [Guest Editorial]. Current Oncology, 16(2), 4-‐6.

Hutchinson, T.A., & Dobkin, P.L. (2009). Mindful medical practice: just another fad? Canadian Family Physician, 55(8), 778-‐779.

Dobkin, P.L., & Hutchinson, T.A. (2010). Primary prevention for future doctors: promoting well-‐being in trainees. Medical Education, 44(3):224-‐226.

Dobkin, P.L. (2011). Mindfulness and Whole Person Care. In: Hutchinson, T.A. (Ed.). Whole Person Care: A New Paradigm for the 21st Century. 1st ed. p. 69-‐82.

Dobkin, P.L., Irving, J. A., & Amar, S. (2012) For whom may participation in a Mindfulness-‐Based Stress Reduction program be contraindicated? Mindfulness. 3(1):44-‐50.

Irving, J., Park, J., Fitzpatrick, M., Dobkin, P. L., Chen, A., Hutchinson, T. (2012) Experiences of Health Care Professionals Enrolled in Mindfulness-‐Based Medical Practice: A Grounded Theory Model. Mindfulness

Dobkin, P.L. (Ed.) Mindful Medical Practice: Clinical Narratives and Therapeutic Insights (Springer Press, 2015)


Ruth Sugden – Introduction Ruth is the King’s College London Phase 5 Community Teaching Lead and Deputy Year Lead, as well as being a Practice Nurse in Surrey. She has a keen interest in mindfulness and completed her first MBSR course in 2012 now practising daily and is working to increase the prominence of the concept within the medical school at King’s. Ruth runs weekly 'mindful half hour' sessions for staff at King's and has recently started the Foundation Course at the Oxford Mindfulness Centre she then plans to roll out a programme of courses for medical students and staff at King's with the intention of making King's School of Medical Education a more mindful place for students, staff and patients.

Ruth will start off our day with a brief introduction to mindfulness and what to expect from the day.

Katie Amiel – Mindfulness: How can it help us and our patients? Katie is a GP working in Hackney. She combines this with looking after her two young children and teaching mindfulness to doctors. She trained to teach mindfulness with Professor Mark Williams at Oxford University who developed Mindfulness Based Cognitive Therapy (MBCT). With his support, and the support of the Oxford Mindfulness Centre, she developed a programme for teaching mindfulness to doctors based on a version of MBCT developed for non-‐clinical populations.

In addition to running mindfulness courses for GPs, she has recently started work with the Practitioner Health Programme (PHP) to offer mindfulness training to doctors with mental and physical health concerns. She also runs workshops on their ‘Time to Think’ programme – an initiative for doctors who are finding that everyday workplace pressures are preventing them from performing at their best. Katie’s talk will cover some of the background to the development of mindfulness based health approaches and the evidence for their use. Personal experiences of doctors who have done mindfulness training will also be shared.


Jonty Heaversedge – Mindfulness: What is it and how can we use it? Jonty is an inner city GP in a large practice in South London. He has a particular interest in mental wellbeing, as well as physical health problems, and co-‐authored ‘The Mindful Manifesto’ on the benefits of mindfulness and meditation for health. Jonty is a familiar face on the television, having presented 3 series of Street Doctor for BBC1, and a BAFTA nominated series for CBBC called The Smokehouse – working with children to help their parents quit smoking. He co-‐presented Lifegivers -‐ a BBC1 series on organ donation, and more recently has contributed to From The Heart -‐ ITV's campaign encouraging people to sign up to the donor register in the UK.

Most recently he took part in Long Live Britain -‐ BBC1's mass health screening event highlighting the importance of NHS Health Checks. He continues to contribute to a range of other TV and radio programmes and is a regular on the ITV This Morning sofa. Jonty has had a number of non-‐clinical roles within the NHS, including as a teacher, trainer and appraiser. He is currently the Chair of Southwark Clinical Commissioning Group (CCG) – responsible for planning, monitoring and paying for health services in Southwark. His session today will look at what we mean by mindfulness and some of the ways it can be used


Speakers – Afternoon Sessions

James Fish – Student Lightning Talk James is a medical student at King’s College London School of Medicine. He has a previous degree in Psychology and Philosophy from Leeds University. James’s lightning talk will present preliminary findings from a systematic review of technology-‐delivered mindfulness training.

Ananda Kumar – Student Lightning Talk Ananda is a final year medical student who has been interested in meditation for many years.

This led to a research project with Dr Siobhan Lynch, comprising a systematic review of mindfulness-‐based programs for students in higher education, looking at content, implementation and outcomes relating to academic performance, physical health and mental health.

James Brimson – Student Lightning Talk James is a Mental Health Studies MSc student. He will be presenting the findings from his master’s dissertation, which investigated the feasibility of employing an online, student tailored, mindfulness-‐based programme, ‘Mindfulness-‐based Coping with University Life’ (MBCUL).


Siobhan Lynch – Mindful play dough exercise Siobhan is a mindfulness trainer and researcher, currently working at Southampton University, having worked at King’s College London until August of this year. Siobhan’s main research interests are in learning and teaching mindfulness. Her PhD focused on how mindfulness can benefit university students. Siobhan supervised the student projects presented today in the Lightning Talks section of the programme.

Today, Siobhan will be guiding us through a mindful exercise with the aid of play dough!

Meera Bahu – Mindfulness based CA-‐CBT programme to work with anxiety, depression in traumatised clients: lessons learned for working with students going through difficult experiences Meera is a Cognitive Behavioural Psychotherapist and mindfulness teacher,working for St Georges Mental Health NHS Trust. She was involved in setting up mindfulness projects in the trust and she also runs MBCT and MBSR groups. She has a particular interest in trauma and traumatic stress and she developed a specialised programme for victims of torture in Wandsworth Psychological Therapies and Well-‐being service incorporating mindfulness.

The Mindfulness based CA-‐CBT Group Programme is a holistic, mind-‐body approach that trains people to be present to their experiences through meditation and breathing practices. It also addresses the client’s culture and the different ways of being. It involves paying attention to one’s environment and creating a safe space to witness one’s thoughts, feelings and body sensations to manage anxiety and depression. Traditional MBSR or MBCT meditation practices can be quite difficult for vulnerable people who face high levels of uncertainty. Therefore these practices are adapted to suit the needs of the clients so they can develop flexibility and adaptability in responding to difficult emotional experiences and create space for wise choices and actions. Lessons learned when teaching mindfulness in this population will be extrapolated for the benefit of educators working with students going through difficult experiences. The session will address

• Background to Mindfulness Based CA-‐CBT Group Programme • Adaptation of mindfulness practices to suit the needs of the clients • Results and implications for further research (What we can learn from this and wider clinical

implications)


Rachael Orr – Life as a mindful clinician Rachael Orr is a Cognitive Behaviour Therapist and Mindfulness Teacher for the NHS in Wandsworth. Along with her colleague Meera Bahu and with the support of her team, she has been setting up Mindfulness Courses for people with Anxiety and Depression in Primary Care and more recently for people with Diabetes. She also is involved in developing opportunities for NHS staff to learn about and practice Mindfulness.

What does having a personal Mindfulness practice do to your day-‐to-‐day work with patients? Rachael will reflect on some of the ways having her own Mindfulness practice has changed how she works with her patients and manages the stresses of a demanding job. Noticing reactions to ‘difficult’ patients, keeping your cool when someone is shouting in your face and managing a never-‐ending workload – just a few scenarios where responding in a Mindful way can transform the experience. This session will explore why we might want to develop Mindful clinicians in the first place and some of the ways it can lead to tangible benefits for doctors and patients.

Amy Spatz – Brief mindfulness based stress reduction in medical schools Amy is a lecturer in Clinical Communication at St George’s, University of London where she enjoys teaching large and small groups in equal measure. She is a highly experienced facilitator, specialising in experiential learning: working with role-‐plays and actors on a wide range of subjects including advanced clinical communication skills for consultants. She has developed novel teaching materials for improving clinical communication skills relating to empathy, chronic pain, and medically unexplained symptoms. She is committed to improving the experience of medical students, whilst facilitating their education to a high standard, thus hopefully improving the experience of patients as well!

Amy, together with Gary Coulton, both mindfulness practitioners, created a brief mindfulness based stress reduction course (BMBSR), and piloted the 3-‐week programme with student volunteers. The aim was to investigate the effectiveness and acceptability of a shorter, less time intensive, less costly model of mindfulness training for busy medical students. During this presentation, the rational as well as the basic course content will be outlined along with the comments of the students, some potential pros and cons to this approach and some thoughts for future evaluation.


Useful Resources

Books • The Mindful Manifesto. Jonty Heaversedge and Ed Halliwell (2012) Hay House. • Mindful London: How to Find Calm and Contentment in the Chaos of the City. Tessa Watt (2014)

Virgin Books. • Wherever you go – there you are. Jon Kabat-‐Zinn (2004) Piatkus. • Sane New World – Taming the Mind. Ruby Wax (2014) Hodder paperbacks. • Mindfulness: A Practical Guide to Finding Peace in a Frantic World. Mark Williams and Danny

Penman (2011) Piatkus. • The Compassionate Mind. Paul Gilbert (2009) Constable and Robinson • Intelligent Kindness. Reforming the Culture of Healthcare. John Ballatt & Penelope Campling

(2011). RCPsych Publications

Websites • http://www.mindfulexperience.org/evidence-‐base.php

o For the latest research and to keep up to date with new publications in the field: • www.bemindful.co.uk

o A good site to recommend to clients/patients, run by the Mental Health Foundation. It has information on mindfulness, patient videos, info on local courses and also a four-‐week online course (recently subject of pilot study in BMJ Open).

• www.oxfordmindfulness.org . o If you are interested in teacher training/ masterclasses/ retreats: They run great one-‐day

masterclasses e.g. Mindfulness Based Cognitive Therapy for Cancer -‐ Trish Bartley (also recommend her book 'MBCT for Cancer: turning towards gently'); Mindfulness in the NHS; Breathworks approach to Chronic Pain, Illness and Stress – Vidyalma Burch; Mindfulness Based Childbirth and Parenting.

• www.breathworks-‐mindfulness.org.uk o Mindfulness courses focused on chronic pain/ chronic illness. Includes online Mindfulness

for Health Course and links to local 8-‐week courses. (Book: Mindfulness for Health – Vidyamala Burch and Danny Penman. She also does masterclasses on this in Oxford – see above).

• www.headspace.com o links to free 10-‐day app with 10 minute guided meditations, and then you can subscribe to

various guided meditation courses. • www.breathingspacelondon.org.uk

o Runs various courses in MBCT, MBSR, Mindfulness Based Relapse Prevention, Kindness Behavioural Training etc. Some of these courses are free to Tower Hamlets/ Hackney residents.

• www.compassionatemind.co.uk o Prof Paul Gilbert’s website


Apps Headspace – iOS and Android versions, from the Headspace.com team

Mindfulness TS – iOS and Android versions

The Mindfulness App UK – iOS, Android and Windows Phone versions

Other http://www.mindful.org/mindful-‐magazine/doctor-‐burnout-‐and-‐mindfulness is an interesting online magazine article on burnout in medical professionals.

Journal Articles Many of today’s speakers have published extensively in the field of mindfulness. Do look out for their articles (too many to list individually here!)


Notes Pages

mindfulness day outline sept 17th...

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