Introduction. Description of Mindfulness. Mindfulness. Description of CCS. Mindfulness and Music in the Crisis Stabilization

Transcription

1 Mindfulness and in the Crisis Stabilization Setting Michael O Connor, PMHNP BC Mindfulness This speaker has no conflict of interest to disclose 1 4 Introduction The goal of this presentation is to provide an introduction to the basics of mindfulness, music for mindfulness, use of community/peer participants in group, and discuss the confluence of these forces. Description of Mindfulness Mindfulness has been used for thousands of years for spiritually centering practices,e.g. Buddhism, catholic centering prayer. Medically useful for psoriasis (Kabat-Zinn, 1998) HTN, pain, high cholesterol (Harvard Health Publications 2011) Used for emotional well being with the following target symptoms: Anxiety Depressive symptoms Relapse thoughts. 2 5 Description of CCS Mindfulness CCS services include: crisis stabilization initial and continuing bio-psychosocial assessment case management (benefits, insurance, and varied community-based supports) psychiatric evaluation and medication management Psychiatric interventions aligned with recovery-focused principles (peerto-peer support) mobilization of natural supports and community resources. Goal The goal is to introduce clients to a technique, which they may be able to incorporate as coping mechanism upon their discharge. Short-term, providing 24-hour observation and supervision, and continual reevaluation length of stay 3-4 days Home-like, consumer-friendly, and comfortable environment conducive to recovery Admissions and discharges occur 24/7/ O'Connor 1

2 Group structure Mindfulness breathing Body scan (long) Mindfulness music Eating mindfully A Mindful Walk (cigarettes always interfere) Benefits Increased relaxation (immediate) Increase ability to notice thoughts ( I am not my thoughts ht, automatic ti thoughts, ht depressive, anxiety,or relapse thoughts. Cognitive distortions, automatic thoughts. Increased ability to practice acceptance. Serenity Prayer familiar and useful in this exercise Tips for mindfulness in CCS setting -Keep it short, begin with 5 minutes of breathing exercises -demystify the process, instead of empty the mind (which is too hard or impossible) frame it as assigning a task to the brain to pay attention to the breath. -The concept of non-judgmental is probably the hardest to get, use acceptance,or gently returning the attention back to the breath and It is what it is. -focus on present, rather than a walk through the woods etc (guided imagery) 8 11 Space This can be a big limitation, CCS unit, in shelter, and in prison clinic. Requires a calm and quiet space ideally, but being practical, accepting good rather than perfect (and removing barriers when possible) In this group, music is played (on CD or with live musician) after mindfulness breathing for comparison O'Connor 2

3 Tips for music on mindful groups Use music without lyrics ( I was thinking about my family when I listened to that song ) Avoid even instrumental music with strong associations (e.g. film) Live music has benefit of being more present Not to be judgmental, but some instruments (flute, guitar) better than others (trombone) Group of consumers/peers who are musicians Tunefoolery One clinician, but run by consumers almost entirely It was very calm and relaxing Hearing the music after doing the mindfulness breathing made me appreciate it more Weekly meeting with performances, recording, and a monthly coffeehouse which is open to patients in the SCF building, but goal is gigs and members play up to 130 paid performances yearly. Serendipity of this program being in same building, agreed to trial, first one day a week, now 3 days a week O'Connor 3

4 Something further happens when the connection of the mindfulness practice and the music. Limitations Not for everyone, generally 20% walk out. Very difficult for the most in need, anxiety, BPD. I can t my mind is racing too much, Go to the bathroom or suddenly need a prn. Not sustainable; So far no other staff to lead, so it does not happen when I am not there ian: I was a client here and I think about that every time I come up to play, I remember where I was during that time and I m grateful that I m now in this better space, able to come and give back by playing my music, I try to bring something positive, I don t know if I do or not Client: I am really grateful that (the musician) came here today to play his music, it was beautiful. ian: I usually have a hard time breathing when I get nervous and play in front of people, the breathing exercise helps Client: I used to always like to listen to music, you reminded me Literature Mindfulness for Beginners by Jon Kabat-Zinn The Non-Runner s Marathon Trainer discusses mindfulness technique for long distance running. by David Whitsett Effortless Mastery - offers mindfulness techniques to musicians, letting go of judging, analyzing and critiquing every note.- by Kenny Werther A Mindfulness-Based Stress Reduction Workbook- by Goldstein, Stahl, Santorelli and Kabat-Zinn Eating Mindfully - by Susan Albers Why Zebras Don t Get Ulcers discusses stress and worried mindby Robert Sapolsky Client: I was going to go to a program, now I want to get my backpack and travel (ian: I think you should go to the program ) One Tunefoolery member leads a Breathing mediation with Singing Bowl and flute music (on CD) but he was late today. One musician wrote music just for the group. He was inspired by the participants who are in turn inspired by the performance O'Connor 4

5 25 I woke up this morning, Smiled at the rising sun, Three little birds, Sat on my doorstep, Singing sweet songs 26 I woke up this morning, Smiled at the rising sun, Three little birds, Sat on my doorstep, Singing sweet songs -Bob Marley "Three Little Birds" 27 O'Connor 5