School-based mindfulness programs

Perhaps teenagers are too cynical to benefit from mindfulness, say authors of latest school trial

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In the UK, more and more children are learning mindfulness at school. The Mindfulness in Schools project claims that over 4000 of our teachers are now trained in the practice. However, some experts are concerned that the roll-out of mindfulness has raced ahead of the evidence base, which paints a mixed picture.

A research team led by Catherine Johnson at Flinders University has now reported in Behaviour Research and Therapy the results of their latest school trial, which included new features in the mindfulness intervention, such as parental involvement and better designed homework materials, intended to maximise the programme’s effectiveness. However, once again the mindfulness programme led to no observable benefits.

Full story via The British Psychological Society

Link to Journal abstract: Johnson, C et al.  A randomized controlled evaluation of a secondary school mindfulness program for early adolescents: Do we have the recipe right yet?  Behaviour Research and Therapy | Volume 99, December 2017 |  Pages 37-46

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How Is Stress Reduced by a Workplace Mindfulness Intervention?

Mindfulness-based interventions are effective as curative and preventative approaches to psychological health. However, the mechanisms by which outcomes are secured from such interventions when delivered in the workplace, and to a stressed workforce, are not well understood | Mindfulness

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Image source: ringo.coco – Flickr // CC BY-NC-ND 2.0

The aim of the present study was to elicit and analyse accounts from past participants of a workplace mindfulness intervention in order to generate a preliminary model of how positive benefits appear to be secured.

In-depth, semi-structured interviews were completed with 21 employees of a higher education institution who had completed an eight-week intervention based on Mindfulness-Based Stress Reduction, adapted for the workplace. Interviews invited participants to recount their experiences of the intervention and its impact, if any, on their work life. Aspects of the interview data that pertained to intervention experience and positive benefits were analysed using a version of grounded theory, leading to the generation of a provisional model of how positive change occurred.

The model suggests that discrete, temporal experiences build on each other to generate multiple, positive benefits. As anticipated in mindfulness-based interventions, enhanced attentional capacity was important, but our provisional model also suggests that resonance, self-care, detection of stress markers, perceiving choice, recovering self-agency and upward spiralling may be central mechanisms that lead to positive outcomes. Understanding mechanisms of change may help support participant engagement and trust in work-based mindfulness programmes, and enhance participants’ ability to apply mindfulness in their work life.

Full reference: Hugh-Jones, S. et al. (2017) How Is Stress Reduced by a Workplace Mindfulness Intervention? A Qualitative Study Conceptualising Experiences of Change. Mindfulness. Published Online: 2 September 2017

The Role of Practitioner Resilience and Mindfulness in Effective Practice

A growing body of literature attests to the existence of therapist effects with little explanation of this phenomenon. This study therefore investigated the role of resilience and mindfulness as factors related to practitioner wellbeing and associated effective practice | Administration and Policy in Mental Health and Mental Health Services Research

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Data comprised practitioners (n = 37) and their patient outcome data (n = 4980) conducted within a stepped care model of service delivery. Analyses employed benchmarking and multilevel modeling to identify more and less effective practitioners via yoking of therapist factors and nested patient outcomes. A therapist effect of 6.7 % was identified based on patient depression (PHQ-9) outcome scores.

More effective practitioners compared to less effective practitioners displayed significantly higher levels of mindfulness as well as resilience and mindfulness combined. Implications for policy, research and practice are discussed.

Full reference: Pereira, J-A et al. (2017) The Role of Practitioner Resilience and Mindfulness in Effective Practice: A Practice-Based Feasibility Study. Administration and Policy in Mental Health and Mental Health Services Research. Vol. 44 (Issue 5) pp. 691–704

New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy

The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life | Revista Española de Enfermedades Digestivas

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Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life.

According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome).

A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.

Full reference: Sánchez, B.S. et al. (2017) New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy (ACT). Revista Española de Enfermedades Digestivas. Vol. 109 (No. 9) pp. 648-657

Mindfulness in schools: what next?

Mindfulness holds great promise, but can it really improve children’s thinking and wellbeing? And if so, does that help children to behave well in class and do better in school? | by Jennifer Hanratty for The Mental Elf Blog

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Maynard and colleagues (2017) carefully reviewed the evidence for MBIs for children in schools. They did a very thorough search of databases, relevant websites and conference records and contacted experts. They found 65 relevant studies of MBIs. Out of all the evidence found, 44 studies were well designed; in that the researchers assigned children or whole classes to either get MBI or not. Those who didn’t get MBI were put on a waiting list or just continued with their normal school activities. This means that the two groups (“got MBI”, “didn’t get MBI”) can be compared to see what effect MBIs have independent of any changes that would happen anyway without MBI. This is especially important for children because they will naturally develop thinking skills and social skills as they get older and also learn and practice these skills at school.

The author’s conclusions are slightly different to my own. They conclude that:

There is some indication that MBIs can improve cognitive and socio-emotional outcomes, but no support for improvement in behavior or academic achievement.

My interpretation of the evidence presented is that, as the authors say, there is a small effect of MBIs on helping children to feel good and improve their thinking skills. However, based on the forest plots it seems, to me at least, that there may well be a small positive effect on behaviour and academics too, but these results were not statistically significant and studies were of low quality. Without more and better quality studies we can’t say for sure whether or not MBIs might help children behave better or do better in school tests.

Mindfulness Meditation Can Improve Safety in Your Practice

Mindfulness meditation is a popular topic in the media now. Research has already demonstrated the clinical benefits of mindfulness-based stress reduction for patients with chronic pain or anxiety disorders | ONS Voice

Although there’s been limited research about the benefits of mindfulness stress reduction for oncology nurses and their patients, some evidence suggests that engaging in mindfulness exercises could lead to a safer environment.

Understanding human behaviors as they relate to attention and awareness is important. So much of our human behavior is automated. Consider how often you may switch into auto-pilot as you go through your day. Have you arrived at your house after a long shift and realized you don’t remember driving through that tunnel or over that bridge you cross every day? These are examples of mindless behaviors—something psychologists recognize as the antithesis of mindfulness and attention.

Read the full blog post here

Can mindfulness-based interventions influence cognitive functioning in older adults?

An increased need exists to examine factors that protect against age-related cognitive decline. There is preliminary evidence that meditation can improve cognitive function | Aging & Mental Health 

However, most studies are cross-sectional and examine a wide variety of meditation techniques. This review focuses on the standard eight-week mindfulness-based interventions (MBIs) such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).

We conclude that eight-week MBI for older adults are feasible, but results on cognitive improvement are inconclusive due a limited number of studies, small sample sizes, and a high risk of bias. Rather than a narrow focus on cognitive training per se, future research may productively shift to investigate MBI as a tool to alleviate suffering in older adults, and to prevent cognitive problems in later life already in younger target populations.

Full reference: Berk, L. et al. (2017) Can mindfulness-based interventions influence cognitive functioning in older adults? A review and considerations for future research. Aging & Mental Health. Vol. 21 (Issue 11) pp. 1113-1120