Transcript Developing an integrated community *based

Developing an
integrated
community–based
mindful parenting
programme
Skills for Life
Eluned Gold & Sophie Pratt
Acknowledgements
Staff at Corun I Sawdl – for support , encouragement and
creative ideas.
Davina Plum
Sian Davies
Sue Hughes
Sarah Jones
All staff at Centre for Mindfulness Research and Practice
esp.
Catrin Eames for help with research measures
Sarah Silverton
This presentation will include
• Introduction to the project
• Why we chose to develop the programme
• The Communities we have been working with
• The developing of this programme
• Some experiential exercises from the programme
• The programme so far
• Early learnings and - ?results?
• Lessons learnt and wider outcomes from the project
• Future developments
Introduction to the programme
• Experienced MBSR teacher taught a mindful parenting course
to young or multiply stressed mothers in this community
setting for 2 years alongside the community team. During that
time the basic MBSR course has been adapted to be more
accessible and meaningful to the client group.
• Staff from the community team took the first course alongside
clients
• One staff member - and later- a second – is undertaking
training in teaching MBSR
• The community team have continued to develop the
programme and now offer the programme in other areas.
• Staff teaching this programme continue to have supervision
and mentoring from an experienced MBSR teacher
Why
• Underserved rural community that needed a new programme.
• Integration with existing programme
• Opportunity for collaboration between NHS – Bangor
University
• Mindfulness known to be helpful.
(Bögels; Duncan; Kabat-Zinn; Singh)
Some background
The area in question is a ’Sure Start’ and ‘Flying Start’ area:
• Government funded initiative for early years – areas identified
are at high risk of early childhood behaviour problems • with all the risk categories Parenting Skills are a potential
mitigating factor.
So in this community:
• Unemployment –24% benefit claimants ( number of adults of
working age lower than rest of county)
• Educational attainment – 43% have no qualifications
• Single parents- 4.5% of working population single parents
• 81 % speak Welsh
• Geographically isolated
• Historically there are high proportion of extended families
• Greatest deprivation in county for income, health and housing
Issues identified in the client
group
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Multiple stressors
Low self esteem
Poor literacy skills
Intergenerational habits/schemas
Mental health issues e.g. post-natal depression, chronic
anxiety.
• Lack of Parenting skills
• Existing programme identified as not effective
Why mindfulness?
Evidence from other programmes indicate mindfulness:
• Reduces stress
• Improves executive function - Emotion regulation.
• Can decrease the cycle of intergenerational habits
• Develops self nourishing & compassion
• Improves relationships
etc
Why not mindfulness?
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Counter cultural – 81 % Welsh speakers
Middle class and inaccessible
Untried
Lack of Staff skills
Not initially chosen by clients
Too demanding – costly?
Early Lessons
• We quickly learned that:• Counter cultural for staff too! (NHS staff solve problems!!).
• The approach needs to be relevant and accessible – language and
cultural issues
• The facilitator needs to know the client group
• The participants need to be informed and ‘opt in’
• Home practice can be problematic
• It needs to be integrated into the existing programme
Nevertheless
Even from the early classes there were some encouraging
results:• Measures taken in the first couple of classes showed that the
participants with the most need benefited the most.
And there were some interesting individual cases.
Some solutions
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Flexibility of programme
MP3s rather than CDs
Handouts rather than hand book
Shorter practices
Art and creative activities in sessions
Integration into existing programme - mindful exercise and
mindful cooking.
• Make the Home practice very low key and………..
• Teach out of home practice
• Participants developed their own course work book
Pre course
• Referrals are received from community nurses/health visitors
• Assessment visit - includes assessment and an introduction to
to the programme - and level of support offered.
E.g. An important aspect of the programme is telephone contact
between sessions
Programme
Session 1 – There’s more right
with you than wrong with you
Orientation
• Community building
• What’s it all for – glitter
balls
• Practicalities
• Integrated programme
• Intro to practices – 3SBS
• Discussion of Home
Practice
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Group building
We’re all in this together
3SBS
Body scan 30mins.
Cloudy mind/clear mind
Sharing experiences
Listen to Body Scan track
Write/draw/stick
something you noticed
Programme
Session 2-Perception/Raising
awareness
Session 3-Body as Anchor
• Show and tell HP books
• Perception pictures/
video
• Body Scan
• 3 SBS
• Cloudy mind/ Clear mind
• Show and Tell HP Books
• HP what gets in the way –
enquiry?
• Movement – body scan
• 3SBS
• Mindful T break
• Mindfulness of breath
 Body Scan
 Draw write or Stick in
books
 Noticing
Movement Informal Practice
3SBS
Body Scan at bed time
Draw write or Stick in books
Programme
Session 4-Finding out about meStaying with it
• Show and tell HP books
• Body Jigsaw
• Identify Stress in the body
• 3 Affect circles – behaviours
(Gilbert)
• 3SBS
• Mindfulness body & breath
• What’s working – support in
the group
 Draw/Write/Stick noticing stress
in the body
 3 circles –what’s my typical
behaviour?
 Mindful activity with the children
 Texting one another
Session 5-Let it be – Hanging out
with the difficult
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Show and tell HP books
Movement
Vicious flower
Revisiting three circles – what
could be helpful?
• 3 SBS coping – ( salt analogy)
• Collage or drawing of
difficulty – staying with it
• Story – Sun and wind
 Nurturing activity for you and
children
 Write draw stick difficulty
 Sitting practice
 3 SBS
Programme
Session 6-AutomaticThoughts/behaviours
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Show and tell HP books
Raisin
Monkey mind – thoughts
Brain power –
approach/Avoid
• Own warning signs of stress
• Movement ---Sitting
 Write draw stick your own
monkey chain
 Record your warning signs
 Mindful eating with children
 3SBS
 10 min sit
Session 7-Mindfulness in
Relationships
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Show and tell HP books
Mindful listening
Hand aikido
Sitting Practice
Movement
Mindful listening with
children
Write draw stick patterns
in relationships
Nurturing activity – self
/children
Programme
Session 8 -
Coming to our senses
Group walk
Silent periods
Listening
seeing
Smelling
Mindful walking
Programme
Session 9 Moving on to Community Bringing it all together
• Show and tell HP books
• Make sitting cushion
• Eating together
• Celebration
• Movement – body Scan –
Sitting
Session 10- Follow up
Some findings from 2 groups
Warwick-Edinburgh Mental Well-being Scale (WEMWBS)
Tennant, R., Stewart –Brown, S. et al 2007
64
54
44
pre course
post course
34
24
14
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Observations - What they said
From parents
• I’m noticing more • I’m using breathing space to help in managing children making a noticeable difference in children’s behaviour
• I have shared with families & friends
• I can talk better with my partner about how I’m feeling
• It has built my confidence and helped me with coping
From Staff
• Noticed an increase in self esteem
Spin offs
• Further ways to integrate mindfulness, e.g. Mindful baby
massage
• Interest shown within larger staff group within the NHS -e.g.
other Health visitors/Nurses/Managers
• Genesis – skills for return to work programme
• Spreading out geographically – offering the programme from
other centres
• Other community organisations are interested. E.g. Women's
Aid Centre, Communities First
Summary of key findings
• The approach can be delivered in an acceptable way.
• Early results indicate that the programme appears to lead to
an increase in well-being in multiply stressed mothers.
• The programme needs to be delivered in a flexible way
• Staff development is an important ingredient
• This project has initiated interest in other community groups
and there is potential to develop more
What next?
• Training more staff in order to extend the programme
• Training welsh speaking teachers
• Further and more detailed research into aspects of the
programme
• Extending the programme beyond the immediate
geographical area
• ? Mindful community - a collaboration of a number of
organisations within one community
References
• Bögels, S., et al. 2010, Mindful Parenting in Mental Health Care, Mindfulness 1,2
• Duncan, L., et al., 2009.. A Model of Mindful Parenting: Implications for Parent–Child
Relationships and Prevention Research. Clin Child Fam Psychol Rev.
• Garrison Institute Report September 2010 Mindful Parenting: Conceptualization and
Measurement A Symposium of the Garrison Institute’s Initiative on Contemplation and
Education
• Gilbert, P., et al. 2009, Compassion Focused Therapy Mind Therapy. Workshop handbook .
• Kabat-Zinn, J., Kabat-Zinn, M., 19??? Everyday Blessings, Piatkus NY
• Singh, Nirbhay N. et al. 2006. Mindful parenting decreases aggression, noncompliance, and
self-injury in children with autism. Journal of Emotional and Behavioural Disorders
• Singh, Nirbhay N. et. al. 2010 Training in Mindful Caregiving Transfers to Parent–Child
Interactions. Journal of Child and Family Studies
• Tennant, R., Stewart –Brown, S. et al 2007, Warwick-Edinburgh Mental Well-being Scale.