MINDFULNESS SKILLS GROUP FOR PEOPLE WITH DISABILITIES

KELLY BECK

SCHOOL OF HEALTH AND REHABILITATION SCIENCES, REHABILITATION COUNSELING

ACKNOWLEDGEMENTS

Support and Collaboration by:

University of Pittsburgh, Cognitive Skills Enhancement ProgramHiram G. Andrews CenterThe Albert Schweitzer Fellowship, PittsburghThe Children’s Institute Three Rivers Center for Independent Living

BACKGROUN

D

MINDFULNESS

“Paying attention on purpose in the present moment, without judgment or reaction to

whatever appears in the field of your experience”

(Kabat-Zinn, 1985)

• Originally a Buddhist principle

• Developed into non-religious therapeutic interventions by Jon Kabat-Zinn

• Holistic wellness & preventative care

• Assisting people in coping with everyday lives and obstacles

MINDFULNESS BASED INTERVENTIONS

8-12 weeks group program, 1-3 hours formal per week

• Self Reflection• Self-motivated • Non-judgmental, non-reactive• Suspend believing in judgments as being true. • Inherent acceptance of pain and suffering

Activities Mind-Body Relaxation• Meditation• Gentle Yoga • Breathing Exercises

APPLIC

ATIO

NS OF

MINDFU

LNESS F

OR

PEOPL

E WIT

H

DISABILI

TIES

DISABILITIES & MINDFULNESS

B A R R I E R S O F D I S A B I L I T I E S

More likely to experience….

• Unemployment

• Poverty

• Inadequate healthcare

• Socializing barriers

• Less satisfaction with life

• More stress

…..Than people without disabilities

M I N D F U L N E S S B E N E F I T S

Increased life satisfaction

Increased quality of life

Acceptance of disability

Increased autonomy

Less anxiety

Strategies for stress management

CHRONIC PAIN & MINDFULNESS

C H R O N I C P A I N

Low levels life satisfaction

Increased stress

Decreased activity

Lack of community participation

Helplessness

Pharmacological side effects

R E S E A R C H E D M I N D F U L N E S S

B E N E F I T S

Increased life satisfaction

Increased autonomy & activity

Increased community participation

Acceptance of pain

Pain management techniques

Non-pharmacological strategies

COGNITIVE DISABILITIES & MINDFULNESS

C O G N I T I V E D I S A B I L I T I E S

Autism Spectrum Disorder

Traumatic Brain Injury

Stroke

Attention Deficit Hyperactivity Disorder

Learning Disability

Developmental Delay

Cerebral Palsy

Spina Bifida

R E S E A R C H E D M I N D F U L N E S S

B E N E F I T S

Decrease aggressive behaviors

Regulation of thoughts, emotions, & behaviors

Improved attention control

Decrease anxiety

Improved life satisfaction

Improved awareness

PROTO

COLS

3 Populat

ions

GROUP DIFFERENCES

15 people, Ages 18-2480% Caucasian, Male

Cognitive Disabilities

15 people, Ages 35+90% African American, Female

Significant Disabilities

Ages 11-1790% Caucasian

RND Pain Disorders

Enrolled in cognitive rehabilitation program

Post Secondary Education

Attendance Required

TRCIL Consumers

Dependent on ACCESS

Voluntary

High IQ, Athletic

Outpatient

Voluntary, Parental consent

PURPOSE & GOALS

1. Attention Control

2. Awareness of Self

3. Awareness of Present

1. Life Satisfaction

2. Make life more fulfilling

3. Stress Management

1. Life Satisfaction2. Regulation of

Emotions3. Diaphragmatic

Breathing

4. Regulation of Emotions

5. Regulation of thoughts

6. Decrease Anxiety

4. Socialization5. Increase

Participation 6. Decreased Stress

Levels

4. Pain Management5. Expression of Pain6. Loving Kindness of

Pain

CONTENT

• Education of attention types

• Develop Attention Skills

• Present Moment Awareness

• Non-judgmental Awareness

• Minding your pain• Expression of pain• Diaphragmatic

breathing

• Mindfulness Awareness

• Mindfulness Meditation

• Meditation• Adaptive Yoga• Stress Reduction

Strategies • Socialization

• Meditation• Stress Management• Non-judgmental

loving kindness

MEASURES

Mindfulness Awareness Attention Scale

Satisfaction with Life Scale

Satisfaction with Life Scale

Perceived Stress Scale

Mindfulness Awareness Attention Scale

Satisfaction with Life Scale

State Trait Anxiety Scale

Consumer Report and Feedback

Perceived Stress Scale

Pain Scales

RESEARCH

DESIGN

CSEP RESEARCH DESIGN

• Pre, Post Measures

• 12 Week curriculum

• Weekly, forty-five minute sessions

• Consistent Group Leaders

• Weekly homework

• Embedded within larger cognitive rehabilitation program

• Statistical analyses

RESULTS

PRELIMINARY RESULTS CSEP

• Statistical analyses and results are pending.

• 2 term thesis project.

• First term data collected

TRCIL

• 4/12 group sessions completed

• “Does wonders for helping me to learn to be more aware of my body”

• “Relieves tension in my body and allowed me to focus on my ‘safe place’-which is my breathing’

• “I nearly slept, which is virtually impossible”

The Children’s Institute

• Group begins in January, results analyzed by May

DISCUSSIO

N

MINDFULNESS AND DISABILITY

• Mindfulness effective and desired across disabilities

• Empowerment, advocacy, and preventative health

• Embracing disability, mind, body

• Health and group socialization benefits

FUTURE RESEARCH

• Stress and disability

• Both environmental stress and disability negatively impact function

• Environmental barriers increase stress for those with disabilities

• Stress management interventions across disabilities

• Funding/Policy changes for environmental stress and disability

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based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis. Journal of Psychosomatic Research, 68, 539-544.

Dorjee, D. (2010). Kinds and dimensions of mindfulness: Why it is important to distinguish them. Mindfulness, 1, 152-160.

Hwang, Y. and Kearney, P., (2013). A systematic review of mindfulness intervention for individuals with developmental disabilities: Long-term practice and long

lasting effects. Research in Developmental Disabilities, 34, 314-325.

Haydicky, J., Wiener, J., Badali, P., Milligan, K., Ducharme, J. M., et al. (2012). Evaluation of a mindfulness-based intervention for adolescents with learning disabilities and co- occuring ADHD and anxiety. Mindfulness 3, 151-164.

Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MSBR). Constructivism in the Human Sciences, 8:2, 73-83.

Kabat-Zinn, J., Lipworth, L., Burney, R. (1985). The clinican use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8:2, 163-189.

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therapy, and zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice, 18:4, 233-252.

McCown, D., Reibel, D., Micozzi, M. S. (2010). Teaching Mindfulness: A practical guide for clinicians and educators. New York: Springer. (Introduction Information)

McMillan, T., Robertson, I. H., Brock, D., Chorlton, L., et al. (2002). Brief mindfulness training for attentional problems after traumatic brain injury: A randomized control

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Miller, J. J., Fletcher, K., Kabat-Zinn, J. (1995). Three year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192-200.

Paulik, G., Simcocks, A., Weiss, L., Albert, S. (2010). Benefits of a 12-week mindfulness group program for mental health consumers in an outpatient setting. Mindfulness, 1, 215-226.

Robertson, B. L. (2011). The adaptation and application of mindfulness-based psychotherapeutic practices for individuals with intellectual disabilities. Fletcher, R., J. (Ed), Psychotherapy for individuals with intellectual disability (pp. 91-106). New York: NADD.

Singh, N., Lancioni, G., Manikam, R., Winton, A., Singh, A., Singh, J., Singh, A. D., (2011). A mindfulness-based strategy for self-management of aggressive behavior in

adolescents with autism. Research in Autism Spectrum Disorders, 5, 1153-1158.

Zylowska, L., Ackerman, D., Yang, M., Futrell, J., Horton, N., Sigi Hale, T., Pataki, C., Smalley, S. (2008). Journal of Attention Disorders, 11, 737-746.