Integrating Mindfulness into Family Therapy with Adolescents

Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices | Family Process

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These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy.

This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated.

Full reference: Brody, J.L. et al. (2017) A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.  Family Process. Published online: 7 June 2017

School-Based Mindfulness Program and Depression in Adolescents

This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms.

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Based on theory and previous research, we identified the following potential moderators:

  1. severity of symptoms of depression at baseline
  2. gender
  3. age
  4. school track.

The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium.

We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.

Full reference: der Gucht, K.V. et al. (2017) Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents. Mindfulness. 8(797)

Mindfulness and attachment styles through mother and infant interaction

Recently, research has focused on mindfulness as a potential variable to interrupt the transmission of insecure attachment and disrupt its effect across generations. | Infant Mental Health Journal

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Thirty-six regnant female participants completed the Five Facets Mindfulness Questionnaire and Relationship Questionnaire-Clinical Version at 30 weeks’ gestation. Following the infant’s birth, mothers and their babies participated in a video-recorded feeding session at 7 to 10 weeks’ postpartum. It was predicted that a secure attachment style and higher levels of mindfulness measured prenatally would be associated with greater maternal responsiveness postpartum. The hypothesis was supported for both the secure and insecure (fearful and profoundly distrustful) attachment styles. Mindfulness did not mediate the relationship between attachment and maternal distress. The mindfulness subscale Non-Reacting was significantly associated with maternal response to distress. These findings support the role of prenatal mindfulness skills and attachment security for later postnatal maternal sensitivity to baby.

Full reference: Pickard, J.A. et al. (2017) Observing the influence of mindfulness and attachment styles through mother and infant interaction: A longitudinal study Infant Mental Health Journal. DOI: 10.1002/imhj.21645

Mindfulness-based interventions with youth

Klingbeil et al (2017) present a meta-analysis of 76 explicitly mindfulness-focused youth interventions published up to December 2015

Abstract:

The treatment effects of Mindfulness-Based Interventions (MBIs) with youth were synthesized from 76 studies involving 6121 participants. A total of 885 effect sizes were aggregated using meta-regression with robust variance estimation.

Overall, MBIs were associated with small treatment effects in studies using pre-post (g = 0.305, SE = 0.039) and controlled designs (g = 0.322, SE = 0.040). Treatment effects were measured after a follow-up period in 24 studies (n = 1963).

Results demonstrated that treatment effects were larger at follow-up than post-treatment in pre-post (g = 0.462, SE = 0.118) and controlled designs (g = 0.402, SE = 0.081). Moderator analyses indicated that intervention setting and intervention dosage were not meaningfully related to outcomes after controlling for study design quality. With that said, the between-study heterogeneity in the intercept-only models was consistently small, thus limiting the amount of variance for the moderators to explain. A series of exploratory analyses were used to investigate the differential effectiveness of MBIs across four therapeutic process domains and seven therapeutic outcome domains.

Small, positive results were generally observed across the process and outcome domains. Notably, MBIs were associated with moderate effects on the process variable of mindfulness in controlled studies (n = 1108, g = 0.510). Limitations and directions for future research and practice are discussed.

Full reference: Klingbeil DA, et. al.   Mindfulness-based interventions with youth: A comprehensive meta-analysis of group-design studies. Journal of School Psychology Vol 63,  August 2017 p77-103.

Related: Mindfulness for young people: to meta-analyse or not to meta-analyse?

Mindfulness Meditation for Pediatric Chronic Pain

Waelde, L.C. et al (2017) Children. 4, 32.

Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years.

Mindfulness meditation shows promise as a feasible and acceptable intervention for youth with chronic pain. Future research should optimize intervention components and determine treatment efficacy

The full article is available to download here

Mindfulness and asthma symptoms

Shi, L. et al. Journal of Asthma | Published online: 1 May 2017

Introduction: Given the known link between asthma and stress as well as the link between mindfulness and stress, we explore the possible association between trait mindfulness and asthma-related diagnosis and symptoms with a cross-sectional study.

Discussion: This is the first study to suggest a link between trait mindfulness and asthma. Our finding provides evidence that people with higher level of mindfulness are less likely to have had an asthma diagnosis and less likely to have the symptoms of persistent dry cough and wheezing.

Read the full abstract here

Prospective Associations Between Peer Victimization and Dispositional Mindfulness in Early Adolescence

Riggs, N.R. & Brown, S.M. (2017) Preventative Science. 18(4) 481-489

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Peer victimization is associated with several mental health and behavioral problems during childhood and adolescence. Identifying prospective associations between victimization and factors known to protect against these problems may ultimately contribute to more precise developmental models for victimization’s role in behavioral and mental health.

This study tested prospective associations between peer victimization and dispositional mindfulness, defined by non-judgmental and accepting awareness of the constant stream of lived experience, during early adolescence.

As hypothesized, baseline victimization predicted significantly lower levels of mindfulness at 4-month posttest. Baseline mindfulness did not predict victimization. Results may reflect victimized youths’ mindful awareness being recurrently diverted away from the present moment due to thoughts of prior and/or impending victimization. Study implications may include implementing mindful awareness practices as an intervention strategy for victimized youth to enhance and/or restore this promotive factor.

Read the abstract here