3/06/2016 What is Mindfulness? ¨ A state of mind, a trait/disposition and a process MINDFUL SELF-REGULATION IN ¨ A secular approach ¨ Mindfulness is used in a range of therapeutic approaches for children and ADOLESCENTS adolescents ¤ Mindfulness-based groups n Mindfulness-based stress reduction for Children (MBSR-C) and Adolescents (MBSR-A) Freya Reynolds n Mindfulness Based Cognitive Therapy for Children (MBCT-C) Educational and Developmental Psychologist n Independently developed group programs (e.g., Learning to BREATHE, Mindful Schools) ¤ Mindfulness-informed interventions Association of Counsellors of Catholic Secondary Schools n Acceptance and Commitment Therapy (ACT) Queensland conference – 3 rd June 2016 n Dialectical Behaviour Therapy – Adolescents (DBT-A) n As one component of an individual intervention ¨ A multi-dimensional construct ¤ Many different models ¤ Consensus panel definition (Bishop et al., 2004): n Attention Between stimulus and response there is a space. In that space is our power to n Attitudes choose our response. In our response lies our growth and our freedom. Viktor Frankl Attitudes (IAA) IAA model (Shapiro et al., 2006) • Curiosity Being curious Deciding, choosing and remembering to be mindful (like an explorer or a scientist) • Openness Knowing why • Beginner's mind (an active stance of not knowing) on purpose, in the present moment, Being kind • Non-judging I ntention • To yourself • Patience • To your thoughts and feelings • Non-striving • To your wandering mind Being willing • Turning towards experience • Acceptance/willingness to feel • Allowing and not pushing away ‘negative’ A ttention A ttitudes emotions and distressing thoughts Paying attention in a particular way: and non-judgmentally. • Not trying to control inner experiences or content of thoughts Kabat-Zinn, 1994, p4 • Not trying to force internal experience to be ‘positive’ or ‘pleasant’ (not about being relaxed) • Letting go Process of Mindful Attention (IAA) What is self-regulation? ¨ Self-regulation is influenced by biological and social processes and generally Focus/re-focus attention on chosen area refers to an individual’s ability to control their emotional, cognitive, and motivational arousal in order to meet the demands of different situations, follow (e.g., breath, thoughts, sound etc) standards (e.g., rules, laws, social norms) or achieve certain goals, values or ideals ¤ Identification and acceptance of emotional experiences An internal (e.g., thought, Let go ¤ Management of distress and modulation of excitement feeling, sensation, urge) or ¤ Sustaining motivation Allowing the internal/external experience external (e.g., sensory) ¤ Prioritizing among competing goals to stay or go experience occurs ¤ Adaptive adjustment of behavioral responses (Broderick & Jennings, 2012; MacKenzie & Baumeister, 2015; Willis & Dinehart, 2014) ¨ Process of self-regulation: setting/identifying the standard, monitoring progress Defusion/Decentering/Reperceiving and acting (exerting effort) to achieve the standard Choice-point (MacKenzie & Baumeister, 2015) With mindful attitudes, notice and name the internal/external experience ¨ Self-regulation involves the application of executive functioning skills which collectively enable top-down, goal directed control over lower level impulses Brief labeling (“Thinking”, ”Planning/Remembering”, ”Feeling”, (Galla, Kaiser-Greenland & Black, 2016) “Worried”) or full sentences (“I notice that I am thinking/feeling…”) Freya Reynolds 1
3/06/2016 Potential mechanisms of mindful self-regulation Selected findings ¨ There is overlap in the theorised processes involved in self-regulation and Mindfulness: potential mechanisms of change in mindfulness interventions with Top-down (conscious control over ¤ Brings automatic processes under more conscious control, adolescents (which are still under investigation) fostering reflective decision making and reducing one’s attention and actions) impulsive reactions ¨ Research indicates that mindfulness interventions is associated with ¤ Increases metacognitive awareness of mental processes improvements in attention and executive function that contribute to emotion dysregulation ¤ Strengthens the executive skill of inhibition by intentionally n Total attention scores (Bogels et al., 2008; Semple et al. 2010) sustaining focused attention n Measures of attentional conflict and set shifting (Zylowska et al., 2008) n Behaviour regulation scale of the BRIEF (Van de Weijer-Bergsma et al., 2012) n Dispositional mindfulness has also been positively correlated with inhibitory control (Oberle et al., 2012) and EF (a combined measure of WM, cognitive flexibility and inhibitory control) ¤ Disrupts reactivity and automatic responses (increases the (Riggs et al., 2015) gap between impulse and action) by being attentive and ¨ Emotion regulation in adolescents following mindfulness intervention practicing a non-reactive attitude toward one’s impulses ¤ Increased awareness and recognition of types of emotion ¤ Strengthens tolerance for distress thorough the practice of Dampens bottom up reactivity ¤ Decreased difficulties in emotion regulation orienting to experience with curiosity, patience, and (automatic responses) nonjudgment ¤ Increased self-efficacy in affective regulation ¤ Increased access to regulation strategies (Lyons & DeLange, 2016) (Broderick & Jennings, 2012) n (Broderick & Metz, 2009; Metz et al., 2013) Meta-analyses of the Child and Adolescent Pathways to Regulation or Dysregulation Literature ¨ Meta-analysis of 20 articles ¨ Meta-analysis of mindfulness based (Zoogman et al., 2014) interventions in schools Less reactivity to Engage Mindfully (Zenner et al., 2014) stress triggers, ¤ Mindfulness interventions were helpful, Regulation Tolerance of positive greater distress with no iatrogenic harm identified ¤ 24 studies (13 published) of students and negative affect tolerance in Years 1-12 ¤ Effect size in the small to moderate range supporting the superiority of ¤ Overall effect sizes were Hedge’s mindfulness interventions over active g = 0.40 between groups and control comparison conditions (0.23) g = 0.41 within groups ( p < 0.0001). TRIGGER FOR STRESS ¤ No significant moderation associated ¤ Between group effect sizes for (emotional distress) with most aspects of study design or domains were: delivery system of mindfulness n Cognitive performance g = 0.80; ¤ Larger effect sizes were found for: n Stress g = 0.39 Disengage n Clinical (0.50) than non-clinical samples n Resilience g = 0.36, (all p < 0.05), (Push distress away, engage in (0.20) n NS behaviours to avoid distress n Outcomes measuring psychological Maladaptive n Emotional problems g = 0.19 e.g., substance use, aggression, symptoms (e.g., anxiety, depression, cognitions, behaviours n Third person ratings g = 0.25 self-harm) 0.37 than for other DVs (0.21) Dysregulation and intolerance for Over engage emotional distress is ¤ Mindfulness interventions were shown reinforced to improve measures of mindfulness (Try to reduce distress by and attention (0.28) hypervigilance, rumination and Small Medium Large other obsessive behaviours) 0.2 0.5 0.8 (Broderick & Jennings, 2012) The process of mindful self-regulation I have created space… what should I choose? Situation/Context What does the child need to be doing? Choice/Action ¨ What framework do you currently use in your clinical practice? External/ Observable SOMETHING or Internal HAPPENS ¨ ACT: using acceptance and mindfulness processes (contact with An event or interaction occurs present moment, defusion, self-as-context) to facilitate committed action in valued directions Letting go – Automatic Mindfully ¤ Values (versus goals) Reactions Slow Down, Creating Space n What is important/meaningful to me? Thoughts, feelings, body Notice & Name to Choose sensations, urges to act n Build on strengths n Highlight relational motivations for self-regulation ¨ Healthy/helpful coping strategies Being CURIOUS about what is ¨ Social problem solving models happening for you Being WILLING to feel ¤ Stop Think Do Being KIND to yourself & don’t ¤ POOCH (Problem, Options, Outcome, Choice, How did it go?) judge yourself for what you are experiencing ¤ Considering options and the effect of the choice or behaviours on self as well as others Freya Reynolds 2
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