nurturing mindfulnessi

7/28/2019 Nurturing Mindfulnessi

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NurturingMindfulness

in

CaregiversandChildren:

APromising

Approach

for

Stress

Reduction

ACF March2012

MarkGreenberg

[email protected]

ThePennsylvaniaStateUniversity


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GoodAfternoon!


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3

WhatisMindfulness?

Mindfulnessis:payingattention, inaparticularway,onpurpose,inthepresentmoment,

non

judgmentally.

Kabat

Zinn,1990 Anawarenessofonesconductandthequalityof

onesrelationships,inwardlyandoutwardly,interms

of

their

potential

to

cause

harm,

are

intrinsic

elementsofthecultivationofmindfulness.

Mindfulnessineverydaylifeisthe

ultimate

challenge

and

practice.KabatZinn 2011


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MindfulnessQualities

to

Nurture

in

Children

andAdults!

Calmness

Kindness/Compassion (Conceptof

Interdependenceof

all

things)

Clarity/Insight(Awareness/Reflectivity

ability

to

Decenter)


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Researchon

Effects

of

Mindfulness

Symptoms(pain,reportedstress)

Depression(Teasdale)

Anxiety(Miller)

Chronicpain

Behavior

SubstanceUse

Suicide(Williams)

Aggression


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Researchon

Effects

of

Mindfulness

BrainActivityandExecutiveFunction

fMRI andEEGfindings(Davidson,Posner,Tang,Jha.

Lazar,etc)

Workingmemory

Inhibitorycontrol

Attentional Control(Lutz,

Jha)

Psychophysiology

Cortisol (Carlson,2007;)

Telomereactivity

(Epel,

ucdavis)

Immunefunction(Davidson)


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Peer-reviewed Research on

Contemplative Practices 2000-2011


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Mindfulness

is

Everywhere


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PEACE

PromotingEmpathy

Awareness

and

CompassioninEducation

Mindfulness andTeaching - CARE

Mindfulness Programs

for Children and Youth

Mindfulness and

Parenting


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11


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Mindfulnessand

Familybased

Prevention

ExtendingMindfulnesstoParentingand

Family/Parenting

Interventions Stress

Extrafamilial(Parentslives)

Family/Parentingstress

Relationship

changes

and

tensions

with

adolescents

InterruptingAutomaticnegativerelationshippatterns

AttentiontoParentwellbeing

FocusonCompassionforSelfandYouth

Applicationofskillsinchallengingsituations

NotestsofMindfulParentinginterventions


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MindfulParenting

Mindfulness contextualizedforparentingsituations

Intrapersonal

and

Interpersonal 5Coreelements

ListeningwithFullAttention Presentcenteredattention

Emotional

Awareness

of

Self

and

Child

NonjudgmentalAcceptanceofchildandself

Selfregulationinparenting

Compassionfor

Self

and

Child

Duncan,L.G.,Coatsworth,J.D.,&Greenberg,M.T.(2009).Amodelofmindful

parenting:Implicationsforparentchildrelationshipsandpreventionresearch.

ClinicalChildandFamilyPsychologyReview,12, 255270.

14


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Parent AdolescentDynamics

ChangingDynamicInteractionsMAY

contributeto

cyclical

patterns

of

negativity.

15

Youth

Response/Negativity

ParentNegativity

Increasein

HOSTILE/

CONTROLLING

parenting

Disengageor

Withdrawal

(GivingUp?)


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Study:Small

RCT

65FamiliesRecruited+Assigned+Assessed

atBaseline

SFP:1014(N=23)

MSFP

(N=25)

DelayedInterventionControl(N=17)

Assessed

immediate

Pre

and

Post

intervention

16


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Results

Changesinmindfulparentingassociated

withchanges

in:

AngerManagement

Mothers

positive

affect/behavior

(m)

Mothersnegativeaffect/behavior(m)

Youthspositiveaffect/behavior(m&y)

Youthsnegativeaffect/behavior(m&y)

17


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18

OverallMindful

Parenting

-0.75

-0.5

-0.25

2E-15

0.25

0.5

0.75

1

Pre-test Post-test

MSFP SFP Control


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MaternalWell

being

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

Mother Symptoms Global Mental Health

MSFP v.C MSFP v SFP


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ObserveThoughtsasThoughts

Notas

Reality

Onefather,DT,said:

[since

participating]

Ifind

that

the

more

Ican

remove

theangerthatImfeelingfromthesituation,themoreproductivethesolutionbecomes,andIcanstopandthinkandfeelandexpressnotonlyhowIamfeeling,

butit

gives

her[my

daughter]

achance

to

express

how

shesfeelingandgivesmetime,thatstheimportantthing,givesmesometimetounderstandhowshesfeelingandrememberhowoldsheisandthatnomatter

what

it

is,

its

not

the

end

of

the

world.

Usually

itsaprettyminorthing,inthebigschemeofthings.


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Yoga ForKids GoogleSearch 21,300,000hits

Feb2nd

2010


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PromotingMindfulnesswithYoga:

APilot

Study

in

Urban

America

Tamar

MendelsonMarkGreenberg

AliSmith

AtmanSmith

AndresGonzalez


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Question:CanYogaandMindfulnesssupportthe

developmentofchildrentoimprovetheir

copingand

attention?

Method:

Conductapilotrandomizedcontrolledtrialontheeffectivenessofamindfulnessbased

yogaprogram

for

low

income,

urban

youth

inBaltimore


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Background Youthinlowincome,urbancommunitiesareoften

exposedto

considerable

stress,

but

many

have

not

developedskillsforeffectivecoping.

Mindfulnessbased

approaches,

such

as

yoga

and

meditation,mayofferuniqueadvantagesfor

enhancingresilienceandeffectivecopingand

improvingboth

stress

management

and

attentional

capacitiesamongatriskyouth.


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Design

4schools

inner

city

Baltimore

2randomizedtointervention

Grades:4

th

and5th

Recruitandmatch~40interventionand40

controls(20kidsperschool)


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InterventionModel

StudentsattendtheYoga/mindfulnessprogram

4days/wkfor16weeks.

Sessionswerescheduledduringtheschoolday,

andlasted~45minutes


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TheIntervention

Basedonaseriesofyogicexercisesthatendwithaperiodof

mindfulnesstraining.

Progressionfrom

simple

to

more

complex

yogic

postures

concludeswithaseriesofbreathingexercises

Themindfulnesstrainingisaguidedexperienceattheend

whenstudents

lie

on

their

mats

in

the

relaxation

pose

Studentsareinstructedtowithdrawtheirattentionfromthe

distractionsaroundthemtoafocalpointinsidethemselves.

Theyare

guided

in

how

to

keep

their

minds

focused

and

centered,strengtheningtheircapacitynottobedistractedby

thoughts,sensations,orimpulses.


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Youthfocus

group

data

TheprogramhashelpedmebecausenowIknowdifferentroutinesandexercisesthatIcandoathomethathelpsmelower

and

reduce

my

stress.

So

whenever

Iget

stressed

out

Ican

justdoaposeandsometimesIcanshowmymotherandmyfamily.

4th gradegirl

Mostimportant

thing

Ilearned

in

the

program

is

that

its

all

differentwaystodealwithyourstresslikeinsteadoflikefightingandstuff.

5th gradeboy

Ithelps

you

relieve

stress

when

you

really

feel

stressed

out

or

yourereallymadandfocusonwhatsinsideofyouandjustmakesurethatyoustaycalm.

5th gradegirl


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Changesin

Self

Regulation

Anindexofselfregulation;relevanttomindfulnesstechniquesintheintervention

Hasbeen

found

to

correlate

with

heart

rate

activity

Subscales:

Rumination WhenIhaveproblemswithotherkids,Icantstopthinking

aboutthem

Emotionalarousal WhenIhaveproblemswithotherkids,rightawayIfeelreally

angry,sad,scared,orworried

Intrusivethoughts

WhenIhaveproblemswithotherkids,IcantstopthinkingaboutthemwhenItrytosleeporIhavebaddreamsaboutthem


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AdjustedMean(StandardError)

Time2Measure Intervention Control ES

RSQInvoluntaryEngagement 0.75(0.05) 1.05(0.05) 0.83***

Rumination 0.76(0.08) 1.15(0.08) 0.70**

Intrusive

Thoughts0.68(0.07) 0.95(0.08) 0.51*

EmotionalArousal 0.65(0.07) 1.00(0.08) 0.64**

ImpulsiveAction 0.99(0.09) 1.23(0.09) 0.38

PhysiologicArousal 0.70

(0.07) 0.91

(0.07) 0.39

Interventioneffectsonselfregulation

*p


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0

0.2

0.4

0.6

0.8

1

1.2

Pre Post

InterventionControl

Pre andPostInterventionInvoluntaryEngagement

ScoresbyStudyCondition


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Mindfulnessin

Teaching

CARE

CultivatingAwareness

and

ResilienceinEducation


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CultivatingAwarenessandResiliencein

Education(CARE)

Integratesemotionskillstrainingandmindfulnessbasedapproachestoemotionregulation

AppliesmindfulnesstotheWAYteachers

Teach Relatetostudents

Manageclassrooms

Modelprosocial behavior

Yearly

Facilitator

Training

at

The

Garrison

Institute

(NewYorkState)

ResearchProjectsinanumberofUSlocations


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CARE

InterventionAims

ImproveTeachersWellbeing

Increase

Mindfulness

Positiveaffect

Efficacy

Decrease

BurnoutNegativeaffect


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The

Prosocial Classroom:

AModelofTeacherSocialandEmotionalCompetenceandClassroomandChildOutcomes

Healthy

Teacher/Student

Relationships

Healthy

Classroom

Climate

EffectiveSEL

implementation

TeachersSocial&

Emotional

Competence

Student

Social,emotional&

academic

outcomes

Effective

classroom

managementskills

School/CommunityContextFactors

Jennings&Greenberg,2009


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CAREProgram

ProgramModel

2days

1day(2weekslater)

1day(2weekslater)

1daybooster

Phonecoaching

Onlinesupport

Sustainabilityplan


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ResultsofIESGoal2PilotRCTTeacher

Self

Reports

CovarianceAdjustedPostTreatmentMeans

Measures Intervention X

N=23

ControlX

N=27

Significance/ES

ClassroomEfficacy 7.2 6.7 **/.51

TimeUrgency Sense ofHurry 3.6 3.38 */ .41

DailyPhysical Symptoms 20.6 14.1 **/.54

EmotionRegulation(ERQ)

Reappraisal 5.25 4.54 **/.72

Emotion Regulation(ERQ)Suppression 2.8 3.35 .08/.43

Maslach Burnout PersonalAccompl. 4.79 4.51 * /.40

PANAS PositiveAffect 3.46 3.36 NS/.20

PANAS NegativeAffect 1.99 2.33 NS/.36

CESDepression 12.6 15.6 NS/.29


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AwarenessImbeingmoreawareofthekids,more

opportunitiesto

talk

with

them,

just

more

aware

ingeneral,ofmyself,whatImfeeling,whatIm

eating,whatImdoing,whereImgoingmy

awarenesshas

just

been

heightened.

And

if

Ican

justkeepremindingmyselfofthat,justtobe

aware,awareofotherpeople,awareofmyown

stuff,thats

ahuge

thing

for

me

in

life.

TeacherafterCARE


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Self

Regulation/De

centeringImmuchmorecalm.EvenwhenImathome,

drinking

coffee,

my

minds

not

racing

in

a

thousanddifferentplaces,Imjustlikingmycoffee. Ivelearnedhowtojusttakethingsforwhattheyareandnotkeepeverythingonmy

shouldersall

the

time.

And

because

Im

not

doing

thatanymore,thatallowsmetotreatmykidsbetterandaddresstheirneedsbetterandtryand

teachthem

to

be

that

way

through

my

example.

TeacherafterCARE


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WaystoFacilitateMindfulnessin

InterpersonalContexts:

ATaxonomy


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IntrapersonalActivitiesFormsofSittingMeditation

WalkingMeditation

FormsofYoga

FormsofPrayer

InterpersonalActivitiesDeepListening

StoryTelling

ContemplativeDialogue/Discourse

CouncilProceduresinGroups

EmpathyTraining

FormsofMartialArts

FormsofServiceLearning

ContemplativeArtandMusic

ContemplatingtheNaturalWorld

AwarenessDuringDailyActivities

TypesofMindfulPractices TypesofOutcomes

IntrapersonalOutcomesBrainActivity

Symptoms(pain,distress)

Self

Reports

of

Intrapersonal

Mindfulness

InterpersonalOutcomesImprovedInterpersonalRelations

SelfAwarenessinEveryday

Interactions

SelfRegulationinEveryday

Interactions

Self ReportofInterpersonal

Mindfulness

CompassionforSelf

CompassionforOthers

?

?

?

ExplicitCombinations

of

Both


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AreMindfulnessandPracticesthe

SameThing?

Mindfulness/

Awareness

Practices

Meditation

Yoga

Cultivationof

Positive

Affect

MartialArts

ServiceLearning


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Being

IntentionalIthinkwhathelpsmeiswhenIgetfrustrated

onmy

way

to

school,

Ijust

stop

myself

and

set

anintention. WhatdoIreallywanttodo

today? WhatsreallyimportantthatIdo

today.

Itsmore

freeing

than

setting

agoal

or

atodolist.

TeacherafterCARE


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Insight/Attributional ShiftIlikeattitudeadjustment.Ithinkthatsagoodway(todescribeCARE).Becauseitreallyisyourwhole,

the

way

you

look

at

lots

of

different

thingsitsalmostlikeyougivepeopleacushion,andIvegivenmykidsacushion,andIvegiven

myself

a

cushion,

and

allowed

myself

to

realize

whyIreactcertainwaystocertainthingsandthathelpsmetomaybejustnotputitonotherpeopleanymore. Ithinkaboutmyselfdifferently,

andIthink

about

my

students

differently

now.

Ithinkattitudeadjustmentisagoodwaytoput

it,notthatyouhadabadonebefore,butyoulookateverythingdifferently.

Questions to Ask When


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QuestionstoAskWhen

ExaminingaPractice

WhataretheGoals/Outcomes?

WhatCanBeMeasuredandHow?

WhatPracticesorActivitiesIncrease

Mindfulness? HowdotheGoals/Outcomes,

Measurements,andPractices/Activities

changewith

age and

context

?


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Skillsand

Competencies

MentalSkills

SelfRegulatory

Skills

Attention

Emotion (Calmness)

CognitiveSkills

Cognition (Clarity/Awareness)

AbilitytoDecenter

Attributional Shifts

Socialemotional

behavioral

Competencies

Empathy/Compassion (Kindness)

CommunicationSkills(deeplistening,thoughtfuldialogue)

W N d Cl D i ti f


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WeNeedClearDescriptionof

Interventions

Richdescriptionofintervention

Specificinstructions

Whatisthesource(s)ofintervention?

Hasitbeenmodifiedtobeageappropriate?

Whoisinstructor? Whatistheirtraining?

Whatisthedosing frequency?

Arethere

out

of

session

assignments?


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What

Can

Mindful

Practices

Do MayHaveQuiteDifferentOutcomes

Dependingon

the

Practices

(Breathing,

Yoga,

CompassionFocus,AttentionFocus)

MayDependonthePopulation

Havingacleartheoryofchangeiscriticaland

thisneedstobecontextualized


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Mindfulness

Projects

Mindfulness and Teaching CARE

Mindfulness and Parenting

Mindfulness Programs for Children and

Youth


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Partners:Garrison

Institute

Contemplation&EducationLeadershipCouncilHolisticLifeFoundation:TravellingYogisJohnsHopkins SchoolofPublicHealthNumerous

Public

School

Districts

PennState PreventionResearchCenter

Funders:GarrisonInstituteMindandLifeInstituteAttias FamilyFund

JohnsHopkins

Ctr on

Violence

PreventionPSUCenter

U.S.DepartmentofEducationNationalInstituteofDrugAbuse


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