3/29/2018. Mindfulness: A treatment approach for individuals with Autism Spectrum Disorder and their families. Presentation Outline

Transcription

1 Mindfulness: A treatment approach for individuals with Autism Spectrum Disorder and their families. Kristen Red-Horse, MOT, OTR/L Michele Iemolo, PsyD., BCBA Presentation Outline I. What is Mindfulness? II. What does Mindfulness look like every day? III. Why Mindfulness for families of children with ADS? IV. Why Mindfulness for children and adolescences with Autism Spectrum Disorder (ASD)? V. Next steps Presentation Objectives 1. Participants will demonstrate an increased understanding of Mindfulness. 2. Participants will be able to identify 3-5 benefits of Mindfulness based interventions for individuals with ASD. 3. Practice mindfulness based activities. 4. Practice strategies in session. 1

2 Effects of Stress: Your Response Body (internal event) Headache Muscle tension Chest pain Fatigue Change in sex drive Stomach upset Sleep problems Mood (internal event) Anxiety Restlessness Irritability or anger Sadness or depression Behavior (external event) Overeating or under-eating Angry outbursts Drug or alcohol abuse Tobacco use Social withdrawal Consequence Decrease productivity Arguments Accidents Weight gain or loss Health problems Introduction to Mindful Breathing What is mindfulness exactly? 2

3 Mindfulness is a different way to work with stress. Paying attention in a particular way, on purpose, in the present moment, and non-judgmentally - Jon Kabat-Zinn A way of paying attention that is: On purpose In the present moment Non-judgmental Simple but not easy, a practice Mindfulness is not. A religion Clearing your mind Only being relaxed Positive thinking Getting rid of negative feelings One method or technique A cure-all Who uses mindfulness? Parents, children & teens Over 720 medical centers and clinics nationwide and abroad One quarter of U.S. Medical Schools have academic mindfulness centers and 49% have mindfulness related research - Barnes et al 2016 Schools: preschool to higher education. Administrators, Teachers & students CEOs and business leaders, judges & lawyers, clergy Corporations (e.g., Google, Intel, Twitter, Aetna, Nike, Apple) US Marines Olympic athletes and professional sports teams (e.g., Seattle Seahawks) Individuals/Programs to address numerous physical and psychologically related alignments and disorders Vanderbilt TRIAD 3

4 Mindfulness-based training programs at a glance General Mindfulness Based Programs MBSR Mindfulness based stress reduction MT Mindfulness Training MBPT mindfulness based parent training MBPBS Mindfulness-based positive behavior support MBCT Mindfulness-based cognitive therapy MMOV - Mindful movement MBPEP Mindfulness-Based-Psycho-Educational Programs MM Mindful meditation SMART-in-Education Stress management and relaxation Techniques MECL Mindful eating, conscious living MSC Mindful self-compassion Mindfulness based programs designed or modified for individuals with ASD MyMind: Mindfulness Training for Youngsters with ASD SoF: Meditation on the Soles of your Feet Parent-mediated Mindfulness for Children with ASD home based What does Mindfulness look like in everyday life? Everyday Mindfulness 1.Incorporating into every day 2.Practical 3.Simple alternatives to familiar, everyday activities (Informal mindfulness options) 4.Tangible goals 5.Realistic time demands 4

5 Informal vs Formal Mindfulness Practice Informal = what you re already doing Mindfulness opportunities Formal = setting aside time Starting with a realistic goal in mind A mindful minute Example: electronics What does a mindful moment look like? It is not: Clearing your mind Only being relaxed Positive thinking A cure-all It is: A practice Simple but not easy Paying attention to what s happening around us and in us. Vanderbilt TRIAD Awareness: What s happening around me? Using the senses Let s Practice: The Senses Benefits of Awareness: Being present in each moment Savoring Increasing curiosity and wonder 5

6 Awareness: What s happening in me? What s True for me in this very moment? The Breath Let s Practice: Breathing Exercise (Guided exercise) Mindful Thinking Our minds are very active thinking, wandering, jumping, past & future Thoughts can be helpful and unhelpful Let s Practice: Thought Snapshot Mindfully noticing our thoughts: Identify automatic thinking habits that aren t helpful to you Remind yourself thoughts are just thoughts or you don t have to believe everything you think Practice a realistic, helpful thought 6

7 The ABCs of Stress Triggers (Antecedents) Body, Mood & Behavior (Internal &external responses) Consequences Alarm clock going off notification Red light Altercation with partner Your child not listening Headaches Muscle tension Fatigue Anxiety Irritability Drug or alcohol abuse Tobacco use Social isolation Decreased productivity Arguments Accidents Weight gain or loss Health problems Why Mindfulness for families of children with ASD? Why Mindfulness for Families? Mindful parenting calls to wake-up to the possibilities, the benefits and the challenges of parenting with a new awareness and intentionality. Jon Kabat-Zinn 2010 Increased the quality of child-parent interactions Hwang et al 2015 Reciprocal relationships between parents and children Improved well-being Increased calmness 7

8 Why Mindfulness for Parents & Caregivers of Children with Autism? Unique challenges in caregiving Benn et al 2012 High rates of parental stress & continually elevated stress levels - Eisenhower et al 2005, Harper eta l 2013 Large body of research supporting Mindfulness-based training. Bi-directional effects Neece et al 2012 Parents and children are active participants in the development of the children Learn to slow down, be aware, stay clam, not to overreact and to accept themselves and their child - De Bruin et al 2015, Bögels et al 2010 What are researchers learning about Mindful Parenting for parents/caregivers of children with ASD? Enhanced parent-child interactions Improved: attention, executive functioning, executive functioning, sense of mindfulness, quality of life, process of parenting, marital functioning Decreased stress, anxiety & preoccupation Decreased reactivity to stressors Breaking cycles of dysfunctional schemes Increased self-nourishing attention Increased acceptance SMART-in-Education - Benn et al 2012 MyMind for teens and parallel MPT for parents - De Bruin et al 2014 MBPT or SBPT Ferraioli & Harris 2013 MT and Parent Mediated mindfulness training for children Hwang et al 2015 Mindful Parenting Bögels & Restifo 2014 Jones et al Why Mindfulness for Children and Adolescents with ASD? 8

9 Mindfulness for children and adolescents with ASD Opportunities Adapt to meet individual needs Mindfulness on the move Use visuals and experiences to illustrate concepts like body awareness and breath Potential Challenges Sitting still and lying down practices may be hard Abstract language and concepts Why mindfulness for children and adolescents with ASD? Higher perceived levels of stress & poorer ability to cope with stressors in children with ASD - Browning et al 2009 Adolescents with ASD experience greater levels of anxiety Cachia 2017 Children with ASD could benefit from support to increase their coping abilities and reduce their stress Ridderinkhof et al 2017 Cultivating mindful qualities may support improved executive functioning and reducing aggressive and problem behaviors Keenan- Mount et al 2016 Adolescents can learn to use mindfulness practices to self-regulate stress responses & enhance their well-being Singh et al 2011 Mindfulness may help development of self-awareness and empathy for others Outcomes of Mindfulness Based Interventions for children and Adolescents with ASD. Improved executive function Decreased aggression Decreased problem behaviors Tools to manage angst Learn to self-regulate stress responses Enhanced well-being Improved social responsiveness Decreased rumination Meditation on the Soles of the Feet SoF - Singh et al 2011 MyMind: Mindfulness training for Adolescents with ASD - de Bruin et al 2014 MyMind: Mindfulness training for younger children with ASD - Ridderinkhof et al

10 Next Steps Next Steps Recognizing limitations Much of the existing research reliant on self-report/self-assessment Small sample sizes Need for control groups With parent-child dyad plans to disentangle how each group informs the other Opportunities Further research Look at how mindfulness-based programs compliment and advance current EBP in ASD More specific programs for mindful parenting programs for young children Looking at age & developmental stages for developing specific programs for different aged individuals with ASD Bilingual resources Benefit cost analysis of providing programs for parents, caregivers and teachers of children with ASD Next Steps What you can start doing right now Using your breath Looking for on-line & app resources that might fit into your life Read some of the research literature if it interests you 10

11 Opportunities for a Mindful Moment Morning Greeting the day Getting ready Commute to work Arriving at work Work Day Starting your day at work Lunch/Planning periods During meetings Transitions and Ending the day Evening Heading home Winding down Thank you! Questions, Comments? Kristen Red-Horse kredhorse@salud.unm.edu Michele Iemolo s miemolo@salud.unm.edu 11