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NurturingMindfulness
in
CaregiversandChildren:
APromising
Approach
for
Stress
Reduction
ACF March2012
MarkGreenberg
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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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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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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