Embracing the Now! How Mindfulness can Build Resilience in Students and Educators Summer Institute 2013: Promoting Mental Health in BC Schools Vancouver, BC August 21, 2014 Dzung X. Vo, MD Clinical Assistant Professor Adolescent Medicine Ly M. Hoang, MA Senior School Counsellor Declaration of Disclosure Dzung Vo, MD, will be publishing a book entitled The Mindful Teen (New Harbinger Publications, April 205) We have no other actual or potential conflict of interest in relation to this program. We also assume responsibility for ensuring the scientific validity, objectivity, and completeness of the content of our presentation. Dzung Vo, MD Ly Hoang, MA Acknowledgments Jake Locke, MD Nimi Singh, MD Kelty Mental Health Resource Centre York House School Presentation Objectives 1) Define mindfulness 2) Share the benefits of mindfulness 3) Share mindfulness practices 4) Opportunity for asking questions 5) Share resources for further inquiry Invitation to You Experiences of Mindfulness Let go of expectations Beginner s Mind 1
Guided Practice: Mindfulness of Breathing Case: 16y Female 16y Female, Grade 11 Reputation: Anxious, perfectionist, high-strung On IEP: Gifted with learning disability Meltdowns before & after exams Referred to Counsellor s office by multiple staff: Came to office in tears Calligraphy by Thich Nhat Hanh Mindfulness: Personal Experience Ly Hoang and Dzung Vo on Mindfulness Retreat (Plum Village, 2010) Mindfulness in Youth: Potential Benefits Improve mental health? Promote development of emotional regulation and stress management? Provide lifelong skills? Improve School Functioning? Improve School Performance? Help Teachers? What is Mindfulness? Mindfulness Calligraphy by Thich Nhat Hanh 2
What is Mindfulness? Paying Attention in a particular way: On Purpose in the Present Moment and Non-Judgmentally Autopilot Awareness - Jon Kabat-Zinn Kabat-Zinn J: Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. 1994. p.4. Past/Future Here and Now Judgment Compassion Reacting Responding Ruminating Letting Go 3
Mindfulness Myths Having a blank or empty mind Seeking bliss Escaping pain Relaxation exercises Zoning out, Navel Gazing Panacea for everything Substitute for advocacy and social change Is Mindfulness a Religion? Present in ALL Wisdom Traditions Formal Mindfulness Moving Meditation Sitting Meditation Body Scan Walking Meditation Mindful Movements Informal Mindfulness Not taking specific time just for mindfulness Walking Eating Listening and speaking Becoming mindful in all moments of daily life Mindfulness-Based Stress Reduction (MBSR) Centuries: Eastern meditation traditions 1979: Stress Reduction Clinic, University of Massachusetts Medical School 8-week Program 2009: Over 240 hospitals and clinics 4
Mindfulness: Clinical Interventions MBSR: Mindfulness-Based Stress Reduction (Kabat-Zinn) MBCT: Mindfulness-Based Cognitive Therapy (Segal, Williams, & Teasdale) DBT: Dialectical-Behavioral Therapy (Linehan) MBRP: Mindfulness-Based Relapse Prevention (Bowen, Chawla, & Marlatt) MB-EAT: Mindfulness-Based Eating Awareness Training (Kristeller et al) MBCP: Mindfulness-Based Childbirth & Parenting (Bardacke) MBSR-T (Teens) (Biegel) MARS-A: Mindful Awareness and Resilience Skills for Adolescents (Vo & Locke) Mindfulness in Adults: Meta-Analysis Moderate evidence benefits: Anxiety Depression Pain Low evidence: Stress/distress, mental-health-related Quality of Life Conclusion: Small to moderate reductions of stress-related sx s Goyal. JAMA Intern Med. 2014;174(3):357-68 MBSR, Stress, Amygdala Mindfulness: Youth Voices Video Holzel BK. Soc Cogn Affect Neurosci. 2010; 5: 11-17 http://keltymentalhealth.ca/healthy-living/mindfulness Adapting Mindfulness Teaching for Youth Cognitive Development: Concrete language Attention: Shorter Practices Examples: Relevant Social environment: Teen-friendly Settings: Clinical; Educational; Community BC Children s Hospital: MARS-A Mindful Awareness and Resilience Skills for Adolescents Adapted from MBSR (Kabat-Zinn), MBCT (Segal et al), MBSR-T (Biegel) Adolescents age 15-19y with psychological distress With or without chronic illness, chronic pain Kabat-Zinn J. Full Catastrophe Living. New York: Bantam Dell, 2005 Segal, Williams & Teasdale. Mindfulness-Based Cognitive Therapy for Depression (2 nd Ed). New York: Guilford Press, 2012 Biegel G et al. J. Consulting and Clinical Psychology. 2009; 77(5): 855. 5
Mindfulness in Youth: Meta-Analysis 20 articles met inclusion criteria Mostly school-based MBI beneficial for range of outcomes Small-moderate effect sizes No iatrogenic harm Greatest Benefits: Psychological Symptoms Clinical Populations Zoogman S. Mindfulness. Jan 2014. Mindfulness in Education: Canada BC: MindUP Toronto: Mindful Ambassador Council Schonert-Reichl K. Mindfulness. 2010; 1(3): 137. http://mindfulnesswithoutborders.org/youth MindUP: Video http://thehawnfoundation.org/ http://vimeo.com/86520490 (6 min) MindUP: Research Grade 4 7 Acceptable and feasible for teachers Improved Optimism Improved prosocial classrooms behaviors Less depression, aggression Improved stress regulation Schonert-Reichl K. Mindfulness. 2010; 1(3): 137. Lawlor MS. New Directions for Youth Development. 2014;142:83 Mindfulness in Education Related to SEL: Social-Emotional Learning Cognitive, Executive Functioning Social skills, Emotional regulation Teachers: Self-efficacy, Classroom Management Caution: Research still in infancy Mindfulness Case Study: York House School Individual counselling Assemblies Before test and exams School play Mindfulness club Supporting staff Mindful culture Meiklejohn J. Mindfulness. 2012; 3(4):291 Frank. Research in Human Development. 2013; 10(3):205. Greenberg MT. Child Dev Perspectives. 2011; 0(0):1 6
Back to the Case: 16y Female Introduced mindfulness as a stress management strategy Practiced together Guided practice before test and exams Dramatic change in coping noticed by staff and the student herself Mindfulness for Teachers Teaching Mindfulness Take my advice, I m not using it Why Mindfulness for Teachers? Teaching is socially and emotionally demanding Teachers are expected to: Support students emotionally Model healthy emotional regulation Create positive classroom environment Jennings, P. A. (2011). Promoting teachers social and emotional competencies to support performance and reduce burnout. In A. Cohan & A. Honigsfeld (Eds.), Breaking the mold of pre-service and inservice teacher education: Innovative and successful practices for the 21st century (pp. 133 143). New York: Rowman & Littlefield. SMART in Education Stress Management and Relaxation Techniques (SMART) in Education Professional Development for K-12 Teachers and administrators 8-week program, Modeled on MBSR Currently piloted in Colorado & Vancouver http://smart-in-education.org Jenning and Greenberg. (2009). Review of Educational Research. 79, 491. 7
SMART in Education I have never experienced this in all my years of teaching. The kids are really calm I am getting a lot more than I bargained for I am softer and kinder to the world I now approach my day with greater confidence http://smart-in-education.org CARE: Cultivating Awareness and Resilience in Education Teachers pre-k-12. Goals: Improve overall well-being & effectiveness Improve teacher-child relationships and classroom environment Increase students prosocial behaviors Various formats: Intensives, retreats Preliminary Research: Promising www.garrisoninstitute.org Jennings PA. Journal of Classroom Interaction. 2011; 46(1):37. I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. Object Meditation -- Maya Angelou Image courtesy of SOMMAI / FreeDigitalPhotos.net Mindfulness in Education: More Programs and Resources MindUP (BC) http://thehawnfoundation.org/mindup/ Mindful Schools (California) http://www.mindfulschools.org/.be ( dot-be ) (UK) http://mindfulnessinschools.org/ Mindfulness for Schools: Goodwill Teaching Guide (UK) http://www.mindfulnessforschools.com Mindfulness in Education: More Resources Broderick P., Learning to BREATHE. (2013) http://learning2breathe.org Saltzman A., A Still Quiet Place. (2014) www.stillquietplace.com MindUP Curriculum (Scholastic) Srinivasan M., Teach, Breathe, Learn. (2014) htttp://teachbreathelearn.com McHenry & Brady, eds. Tuning In: Mindfulness in Teaching and Learning. (2009) 8
Mindfulness in Education: More Programs and Resources MBSRBC.ca Dalai Lama Center for Peace and Education http://dalailamacenter.org/ Mindfulness in Education Network www.mindfuled.org Association for Mindfulness in Education www.mindfuleducation.org Collaborative for Academic, Social, and Emotional Learning (CASEL) www.casel.org Further Resources Stahl & Goldstein. A Mindfulness-Based Stress Reduction Workbook. (2010) Biegel G. The Stress Reduction Workbook for Teens. (2009) Willlard C. Mindfulness for Teen Anxiety. (2014) Greenland SK. The Mindful Child. (2010) Himmelstein, S. A Mindfulness-Based Approach to Working with High-Risk Adolescents (2013) Willard C. Child s Mind (2010) Late 2014 or early 2015: Dzung Vo, The Mindful Teen (New Harbinger Publications) www.newharbinger.com Twitter: @TheMindfulTeen Questions? STOP Meditation Briefly step into present moment S T O P Stop Take 3 Breaths (or more) Observe (body, feelings, thoughts) Proceed Dzung X. Vo, MD dvo@cw.bc.ca Twitter: @DzungXVo, @TheMindfulTeen Ly M. Hoang, MA lhoang@yorkhouse.ca Whenever you hear a bell i.e., door closing, phone rings, car honking etc Whenever you feel stress arise Keeping Quiet, Pablo Neruda 9