Transcript Document

Mindfulness Training in
Dane Hilton & Will Canu
Abstract
Mindfulness is a practice rooted in building awareness of self
and the environment that has been associated with
improvement in directed attention capacity and reduced stress,
among other positive outcomes (). The executive functioning
deficits that are central to As-U-R participants’ difficulties in
school and other life pursuits are theoretically amenable via
mindfulness. The current study highlights the process and pilot
outcomes from a mindfulness training curriculum employed in
As-U-R in the 2013-14 year.
Background Information
•Executive functions (EFs) are typically defined as the
related yet distinct cognitive abilities of inhibition, updating
of working memory, and set shifting (Baddeley, 1996), and
are understood to be important in many aspects of daily
human functioning.
•Deficits in EF are found in a number of common disorders
such as ADHD, Specific Learning Disorders, and Autism
Spectrum Disorder, in addition to being present in
individuals with no identifiable psychological disorder
(Seidman, 2006; Seidman et al., 2001; Ozonoff et al., 1994).
•Mindfulness meditation is a particular kind of meditative
approach that emphasizes observant and non-judgmental
awareness of an individual’s thoughts, emotions, and
physical state (Zylowska et al., 2008), and has recently
garnered attention as a mental training tool to regulate
attention and brain function (Bishop et al., 2004).
•The purpose of the current poster is to examine the effects
of an 8-week mindfulness meditation program on three
college students enrolled in the Appalachian State University
As-U-R program.
Participants
• 4 students receiving services through As-U-R (1 Fall 2013, 3
2014) participated in the piloting of mindfulness training as
a component of the As-U-R student seminar.
• Data presented herein is from 3 students (1 F, 2 M) who
completed the entire 8-session mindfulness protocol.
• Participants were of mixed diagnostic status but all had
established and current EF deficits.
Session
Table 1
Measures
1
2
• Barkley Deficits in Executive Functioning Scale (BDEFS;
Barkley, 2013): A self-report measure tapping several aspects of
executive functioning
3
4
• Depression, Anxiety, Stress Scale (DASS; Lovibond & Lovibond,
1995): A self-report survey tapping clinical symptoms of
depression, anxiety, and stress
5
6
7
• Wechsler Adult Intelligence Scale Digit Span (WAIS-IV-DS;
Wechsler, 2008): A standardized task tapping working memory, a
core executive cognitive ability.
8
Description
Pre-tx measures. Introduction to EF challenges (EFCs) and mindfulness.
Program rationale and basic mindfulness exercises introduced. Formal
at-home practice is assigned (guided mindfulness CD distributed)
Mindful awareness of EFC in daily life discussed; common difficulties in
practicing meditation identified. Emphasize mindfulness is not staying
with your breath but returning to it (breath exercise).
Mindful awareness of breath, body, and sound is introduced and
practiced. Students encouraged to become the “impartial observer” of
their experiences, told to ask “where is my attention right now?”
Mindful awareness of body sensations is fostered through gentle body
movements and mindfulness of pleasant, unpleasant, and neutral
sensations. Ways to work with pain is also discussed.
Mindful awareness of thoughts is introduced (sky with clouds metaphor).
Difference between judgment and discerning discussed; non-judgmental
awareness explained as it relates to discernment, choice, mindful action.
Mindful awareness of emotions is introduced using the mnemonic RAIN:
recognize, accept, investigate, and non-identify. Cultivating positive
emotions is practiced.
Mindful awareness of interactions introduced in the context of open
awareness of all present-moment experiences. Mindfulness of
interactions is practiced via deep listening and mindful speaking exercise.
Mindful awareness as a life journey is discussed; constant process of
checking in with one’s attention, renewing same in the present moment,
and applying the acceptance-change dialectic every day. Review of topics
and additional resources provided. Completion of post-tx measures.
• Adult ADHD Self-Report Scale (ASRS; WHO, 2002): A selfreport measure tapping core symptoms of ADHD.
Results and Discussion
• Satisfaction with Treatment Scale (Hilton, 2013): 5-item measure
tapping satisfaction with the intervention.
•Positive change in aspects of executive functioning and
adjustment were noted, yet the extent varied across participants
and could be described as modest in sum. See Table 2 for a
selected summary of quantitative data.
Procedure
• Participants completed pre-intervention measures 1 week prior to
session 1. All sessions were completed in the late afternoon
during scheduled seminar time, weekly (exceptions for school
holidays, instructor conflicts). See Table 1 for session content.
• Participant 1 (Fall 2013) completed the mindfulness intervention
in a 1:1 format; Participants 2 and 3 (Spring 2014) participated in
a group format with 4 other individuals.
• Training was led by a 2nd year clinical psychology graduate
student, supervised by a licensed psychologist (1st, 2nd authors).
•Participants uniformly endorsed high satisfaction with the
training. See Table 2 for satisfaction data and qualitative feedback
and trainer observations.
•Differences in training efficacy in addressing EF deficits may be
due to several factors, including diagnostic status, individual
versus group training formats, biological sex of participant, and
situational circumstances (e.g., timing of exams, major papers).
•Mindfulness training for the 2014-15 year will follow a similar
format to that described here. Data will continue to be collected
such that a better analysis of efficacy and factors therein can be
completed.
Table 2
Participant
1
Positive Indication of
Change
DASS symptom reduction
DKEFS subtest improvement
BDEFS score improvement
ADHD symptom reduction
2
Processing speed
improvement
Digit Span improvement
3
DKEFS Inhibition
improvement
Digit Span improvement
No Indication of
Change
No Digit Span change
No change on BDEFS:
Self-org/prob solve
Self-restraint, selfmot, self-reg. of
emotions
No change on BDEFS:
self-restraint, selfmotivation, self-reg.
of emotions, time
management
Qualitative Observations
Increased reports of mindfulness in
daily life reported across sessions.
Increase reports of stress tolerance.
High reported satisfaction with group.
Increased engagement in group
discussion across session. Reports of
using mindfulness in daily
interactions with others. High
reported satisfaction with group.
Marked increase in discussion across
sessions. Marked increase in formal
meditation practice at home. High
reported satisfaction with group.
For more information contact Dr. Canu at [email protected].