Mothers Matter – Self-Compassion, Reflective Functioning & Parental Burnout »
Statement of the Problem: Parenting and in particular motherhood requires a significant investment of time, energy, and emotional resources. Parental burnout was already a problem prior to the COVID-19 pandemic and the expectations, fears, and requirements associated with it have only exacerbated an already serious problem. Mothers are at a greater vulnerability for developing parental burnout as they spend more time with children and complete less rewarding parental tasks such as shuttling children to appointments and preparing meals. Methodology & Theoretical Orientation: An online, research study was utilized to identify the relationship between parental self-compassion, reflective functioning, and parental burnout. Findings: Mothers who endorsed lower self-compassion were more likely to believe their children’s misbehaviors were deliberately directed at them (pre-mentalizing) and in turn, endorsed higher levels of parental burnout. Mothers who reported greater self-compassion were less likely to engage in pre-mentalizing thoughts, which, in turn, served as protective factors to parental burnout. Conclusion & Significance: Mothers who can show compassion to themselves in times of stress are able to stay present and recognize their children’s own distress as a separate entity from themselves. This research found a lack of self-compassion and the pre-mentalizing thought pattern leads to parental burnout which is characterized by feelings of exhaustion, distancing, and loss of parental accomplishment. Recommendations are made for mothers to develop skills in self-compassion so they can serve as a steady presence during times of familial stress without over analyzing the situation, ultimately allowing them to feel engaged and connected to their children.
Presenting author: Courtney Katzenberg, M.Ed, Towson University
Co-author(s): Jonathan Mattanah, Ph.D.
Self-Compassion for Family Caregivers »
The presentation will include results from a research-based “Self-Compassion for Family Caregivers” 6-week pilot series at the University of NE-Lincoln. There are 55 million family caregivers in the United States alone, and caregiving is becoming more recognized as a public health issue due to the influx of global research on the burdens and demands associated with the role. Data from the series will be shared reflecting the consistencies of the literature on the adverse effects of caregiving upon individuals, such a poorer health outcomes, increased anxiety/stress, and decreased connection with the self. Self-compassion practices have been empirically shown to help mitigates the burdens associated with family caregiving. Data from the pilot study regarding improvements of caregiver well-being due to self-compassion practices will be shared. Results and recommendations on how the self-compassion intervention can be integrated into clinical and community settings such as nursing homes, rehabilitation centers, hospitals, clinics and community networks in effort to support, maintain and increase the well-being family caregivers. The presentation will also emphasize the social implications regarding one’s access and barriers to self-compassion practices and how it affects overall well-being. The presented solution contributes to the new and innovate practices because family caregivers and providers need support in two ways: they need to be able to support themselves and their own well-being during stressful times, and they need support navigating and coping with the social structures and systems that impede their well-being due to high demands and lack of resources. Self-compassion can act as an innovative practice because it helps a person regulate their nervous system, accept what is in the moment with mindful practices, and providing clarity for one to move forward with action no matter what come their way.
Presenting author: Sarah Rasby, MA, Ph.D. student scholar and research assistant, University of Nebraska-Lincoln
Co-author(s): Dr. Holly Hatten-Bowers, Ph.D.
Self-compassion in Action for HealthCare Communities »
Self-Compassion in Action for HealthCare Communities
Project objective/background: Professional dissatisfaction and burnout among health care communities have reached alarming levels nationwide and have been exacerbated by the Covid-19 pandemic. Healthcare organizations are responding by placing an increased emphasis on programs for clinician well-being. Negative associations of clinician dissatisfaction and burnout include lower patient satisfaction and worse clinical outcomes. In feasibility studies, improved well-being and reduced burnout have been shown for participants of the Self Compassion for HealthCare Communities Program
Methods/approach: Physicians from diverse specialties who worked for a large healthcare system were invited to participate in a synchronous online CME-accredited self-compassion in healthcare (SCHC) training program consisting of six one-hour sessions emphasizing mindfulness and self-compassion practice strategies in clinical settings.
Demographic differences between “completers” (i.e., individuals who completed at least one session and the post-survey) and “non-completers” were analyzed as were baseline levels of self-compassion (Self Compassion Scale, SCS), quality of life (ProQOL), and resiliency (Resilience Activation Scale, RAS). Pre-post changes were assessed using the Student’s t test. The number of responders in the training intervention were calculated using the ProQOL “Burnout” subscale’s severity thresholds. The Benjamini-Hochberg test was applied to correct for multiple tests.
Results: A total of 131 physicians completed baseline assessments of which 45 (34%) completed post assessments. Among completers, most were females (83%), more than 40 years old (80%), with greater than 5 years of healthcare experience.
Compared to non-completers, completers were significantly older (p = .04) and presented higher baseline levels of compassion satisfaction (p = .03), as measured by the ProQOL subscale.
Completers showed significant improvement after the SCHC program in every subscale of the SCS, the ProQOL, and the RAS (all p values < .04), except for the “resilience activation” subscale. After applying the multiple test correction, most effects remained statistically significant.
Among those who participated in this SCHC program, 17% reduced the severity of their burnout.
Conclusion: We found that it is feasible to offer a Self-Compassion training to busy clinicians via a Live online CME program. Significant improvement in burnout, resilience and self-compassion were shown among physicians who completed the program. These findings can guide redesign of a health care system that can promote the well-being of clinicians, patients and their families.
Presenting author: Elizabeth H. B. Lin MD, MPH, U of Washington School of Medicine, Seattle, WA
Co-author(s): Paula Gardiner MD, MPH, Adrian Aranda PhD, Natalie Bell PT, Dawn Clark MD
Designing and Refining a Mindfulness Questionnaire for Black Youth: The Process of Capturing Cross-Cultural Differences in Trait Mindfulness »
The field of mindfulness has gained increasing attention in Western science, with mindfulness-based interventions (MBIs) being used to bolster well-being and provide alternative therapies for various clinical conditions. Increasing evidence points to the benefits of MBIs for young populations, with several studies indicating the effectiveness of MBIs in improving adolescents’ physical and psychological well-being. Consequently, a rising focus has been on incorporating children and adolescents into mindfulness research. Unfortunately, research has shown that the growing body of evidence has primarily focused on middle and upper-class White youth, leaving marginalized communities, including Black youth, excluded from the benefits of MBIs. Black youth are less likely to have access to traditional forms of treatment and have a higher prevalence of mental health distress due to structural forms of oppression, interpersonal discrimination, and racism. In response, researchers have begun to intentionally adapt mindfulness interventions to be culturally responsive to the growing needs of Black youth. However, as the number of culturally adapted mindfulness programs for Black adolescents rises, so does the need for culturally sensitive validated instruments to assess mindfulness in these communities.
There is currently a dearth of validated measures explicitly designed to assess mindfulness in diverse adolescent populations. This gap in mindfulness research is deeply troubling, as it assumes that mindfulness is acultural and is experienced similarly across different cultural contexts. Therefore, it is essential to develop adequate measures that reflect the expression of cross-cultural differences in mindfulness. Without these tools, researchers will continue to use measures designed mainly by and for White youth when working with diverse adolescents. By doing so, scientists contribute to the erasure of mindfulness in these communities.
To address this gap, our team sought to design a mindfulness survey for a group of Black adolescents (ages 12 to 19) in Hartford, Connecticut, in a systematic, two-phase process. In phase one, we developed the Black Youth Mindfulness Questionnaire (BYMQ) by adapting pre-existing items and constructing entirely new items, all of which were informed by an extensive literature review and focus group data. Our qualitative data revealed distinct differences in perceptions of mindfulness and language used to describe these conceptualizations among Black youth. These differences were woven into the creation of the first iteration of the BYMQ through a series of steps, including (1) focus groups, (2) a literature review, (3) synthesis of data, and (4) item development. In phase two, we refined the BYMQ through expert validation and cognitive interviews with potential respondents to create a more culturally relevant survey reflecting trait mindfulness among Black youth. The finalized BYMQ was then pilot tested in a larger sample of Black youth from Hartford, and the results are currently being analyzed. In embarking on this process, we are underscoring that the experiences of mindfulness are unique for Black youth and that these experiences are worth capturing.
Presenting author: Zoie Carter, MPH Candidate, Brown University
Co-author(s): Caitlin Elsaesser, Ph.D., Jeffrey Proulx, Ph.D.
Identifying Adaptations for a Self-compassion Intervention for Spanish-speaking Mothers of Children with Disabilities or Health Conditions »
Objectives: Culturally relevant mindfulness- and self-compassion-based interventions for Spanish-speaking mothers of children with disabilities or health conditions are lacking despite growing evidence of their benefits for English-speaking mothers. To address this need, we offered a mindfulness- and self-compassion-based intervention to this population in Spanish. We aimed to explore how contextual factors influenced participant experiences and outcomes with the goal of informing future cultural adaptations.
Methods: Sixteen mothers participated in a 6-week intervention and completed semi-structured interviews that were professionally transcribed and translated for qualitative analysis. Using a realist evaluation framework, we examined 1) participants’ context, 2) the intervention’s mechanisms, and 3) outcomes that participants identified. We conducted a thematic analysis in which we identified themes, mapped them to this context-mechanisms-outcomes framework, and explored relationships between them. In alignment with community-based participatory research principles, peer facilitators who are mothers of children with health conditions or disabilities participated in planning, translation into Spanish, intervention delivery, analysis, and development of recommendations for future adaptations.
Results: Our thematic analysis found that four contextual elements – faith, self-concept as a woman and mother, trauma, and level of social support – influenced how participants experienced the mechanisms. Faith supported engagement, with participants describing how they integrated intervention practices with their faith-based practices. Past trauma was linked to difficulties with a few practices that involved self-kindness and self-touch. Self-concept as a woman and mother – evidenced by participants’ tendency to prioritize their family’s needs over their own self-care – was a barrier to engagement for some participants. Although participants with a low level of pre-existing social support reported making fewer comments during the intervention, they reported having positive experiences and valued listening to others. When describing their experiences, participants linked the mechanisms of (1) having positive experiences with practices and (2) engaging in self-reflection to three outcomes: emotion regulation, empowerment to practice self-care, and savoring daily life experiences. Participants frequently described the mechanism of self-reflection as a means of overcoming barriers to engagement. They connected a third mechanism – sharing life experiences and learning in community – to the outcome of common humanity.
Conclusions: Based on our findings, we propose that the impact of the intervention could be increased by inviting participants to explore how the intervention content aligns with their faith-based values and practices. Opportunities for self-reflection could increase motivation to use practices and address barriers to engagement. We also found that the realist evaluation framework proved useful when adapting a mindfulness-based intervention to a new context because it facilitated an exploration of how the context interacted with the mechanisms of the intervention and influenced attainment of outcomes that participants valued.
Presenting author: Kimberly C. Arthur, MPH, Kaiser Permanente Washington Health Research Institute
Co-author(s): Araceli Mendez Sanchez, MPH; Angie Tamayo Montero, MA; Patricia Delgado; Ofelia Rosas Ramos; Felice Orlich, PhD; Arti D. Desai, MD, MSPH
Operationalizing Mindful Teaching for Secondary Educators in the Be CALM Program »
Teachers’ social-emotional competence and wellbeing are theorized to promote student-teacher relationships, effective classroom management, and implementation of social-emotional learning (SEL) programs, which in turn support a healthy classroom climate, that contributes to student SEL (Jennings & Greenberg, 2009; Jones & Doolittle, 2017). In the last decade, evidence has grown that shows mindfulness promotes teacher SEL through insight and practice change as well as reducing teaching stress and increasing self-awareness, empathy, and emotion regulation (Jennings et al., 2011, 2015; Roeser et al., 2013). However, there is little empirical guidance for how specific teacher practices, or “mindful teaching” might be enacted in interactions with students to optimize youth outcomes.
The Be CALM Program utilizes a “co-regulation” framework (Murray et al., 2019) to define and teach key elements for promoting youth’s developmental skills and capabilities through interactions with caring adults, including: 1) creating safe, supportive classroom environments, 2) building strong teacher-student relationships, and 3) promoting application of social-emotional skills in day-to-day interactions. Over 100 middle and high school educators have been trained in a blended learning approach including self-study, live virtual, and in-person workshops. Foundational training teaches what mindfulness is and how it is relevant both personally and professionally through education and experiential practice. Mindful teaching is operationalized through core principles and key phrases. Strategies for student interactions are taught using active learning methods like self-reflection, role plays, and video modeling. Equity is promoted by 1) using mindfulness to promote teachers’ awareness of their cultural lenses and biases, 2) supporting student voice and choice to promote a sense of agency, and 3) building a learning environment where all students feel valued and a sense of belonging.
Two intervention development studies demonstrate the initial benefit of this approach for teachers. In a small randomized controlled trial (RCT) conducted in five middle schools, trained health/PE teachers (n = 5) reported less emotional burnout (η = .27) and greater mindfulness (η = .39) than comparison teachers (n = 4) and were observed to more frequently support students’ social-emotional skills (t = -4.277, p = .00). In a pre-post pilot study with 11 ninth grade teachers in 2021-2022, an observational measure was developed to assess Mindful Teaching, Student Connections, Safe Supportive Learning Environments, and Support for Students’ Skill Application (Roudebush, under review), with 6 items demonstrating internal consistency (Cronbach’s alpha – .80). Scores on this measure improved over time for teachers and were modestly associated with student engagement in the program (r(19) = .402, p = .088).
Overall, the Be CALM Program’s approach is well-grounded theoretically, measurable, and appears to have value for training secondary educators in making mindfulness actionable in interactions with students. This has been further validated by promising impact on students as well.
Presenting author: Macy Lawrence Ratliff, MS, University of North Carolina Chapel Hill
Co-author(s): Desiree W. Murray, PhD
Does Being Self-Compassionate When Stressed Build Resilience?: A Four-Year Longitudinal Study »
This study investigated the dynamic relationship between stress, self-compassion, and resilience in university students over a 4-year period. Drawing from stress theories, this study examined whether self-compassion operates as an attribute that can strengthen resilience over time. Results indicated that higher trait self-compassion was associated with lower stress and greater resilience. Furthermore, an increase in stress was associated with a corresponding increase in self-compassion at the subsequent time point, and an increase in stress coupled with an increase in self-compassion was associated with increased resilience. These findings highlight the benefits of self-compassion and suggest that avoiding stress may deprive people of the opportunity to build resilience. This study provides a nuanced understanding of the dynamic relationship between stress, self-compassion, and resilience and emphasizes the importance of developing self-compassion skills prior to encountering stress.
Presenting author: Jinyoung Park, M.A., Duke University/ Department of Psychology and Neuroscience
Co-author(s): Karen Bluth, PhD, Christine Lathren, MD, MSPH
Identifying Core Program Components and Core Instructor Competencies of Mindfulness‑Based Programming for Youth »
The implementation of mindfulness-based programming/interventions (MBP) for youth, and corresponding research, has proliferated in recent years. Although preliminary evidence is promising, one pressing concern is that the heterogeneity of MBP for youth makes it difficult to infer the essential constituent program elements that may be driving specified outcomes (i.e., core program components (CPCs)). A second concern is that there are no current consensus recommendations for core competencies for youth MBP instructors, leading to highly heterogeneous training backgrounds and competency standards. This flash talk will present recent research that employed the Delphi method to survey expert MBP scientists and instructors to identify consensus of CPCs and instructor competencies of MBP for youth. Delphi Round 1 surveyed scientists (n = 19) to name and define potential CPCs and instructor competencies of MBP for youth; responses were qualitatively analyzed yielding categorical codes. Delphi Round 2 recruited MBP instructors (n = 21) identified by scientist participants and peer instructor nomination. In Rounds 2 and 3, the full participant sample (scientists and instructors) were asked to consider the preceding Round’s results and whether each of the identified codes were an essential CPC or core instructor competency of MBPs for youth. Final Round 3 results indicated consensus (≥ 75% endorsement) of 9 CPCs and 11 core instructor competencies. These findings are the first to report expert consensus of identified CPCs and core instructor competencies of MBP for youth. These findings have significant implications for future youth MBP evaluation, implementation, and curriculum development. Attendees will learn more about essential constituent components of MBP for youth, and about core competencies for an effective youth MBP instructor. Question and answer will discuss future directions for research, implementation, program development, and instructor training.
Presenting author: Joshua C. Felver, PhD ABPP, Cornell University
Impact of Mindfulness Interventions on Human Flourishing: A Meta-analysis »
Background: Historically, researchers focused on mindfulness interventions to reduce negative situations such as depression and anxiety. Researchers had predominantly focused attention on individuals’ suffering exclusively, which is not a productive method for all individuals. Researchers have less often studied mindfulness interventions to promote the positive aspects of life that help individuals flourish.
Objective: The aim of this meta-analysis was to examine the effect of mindfulness interventions on flourishing. In addition, we examined the moderator effects of participant characteristics, methods, and intervention characteristics.
Methods: We searched CINAHL, PubMed, Scopus, Ovid PsycINFO, Ovid Medline, Web of Science, and unpublished dissertations without date restrictions to June 2022. Studies were eligible if researchers tested mindfulness interventions against comparison groups using randomized trial or quasi-experimental designs with adults ≥18 years, measured flourishing quantitatively, and reported their studies in English. We coded studies for 5 categories: source variables, methods which included quality indicators, intervention characteristics, participant characteristics, and outcomes. We used SPSS to describe the studies; we used comprehensive meta-analysis (CMA) to calculate effect size and examine moderator effects. Further, to understand if the effect of mindfulness interventions on flourishing reflected spontaneous improvement, we examined one-group pretest/posttest mean differences within the mindfulness groups and within the comparison groups. We conducted the analysis estimating no correlation (r=0.0) and reanalyzed estimating correlation (r=0.8). If comparison groups showed significant improvement in flourishing, we would suspect that the effects we see in the mindfulness groups simply reflected spontaneous improvement.
Results: Fifteen studies met inclusion criteria (S=15) providing 16 comparisons (K=16; one study provided two comparisons). Across studies (N=2,834), the effects of mindfulness interventions on flourishing among adults was 0.37 [(95% CI=0.15, 0.59) p=0.00] compared with comparison groups. Moreover, mindfulness group pre-post comparisons showed that flourishing increased by 0.32 (p<.000) when groups were uncorrelated (r=0.0) and 0.394 (p<.000) when groups were correlated (r=0.8). Control group pre-post comparisons showed non-significant change in effect size when groups were uncorrelated (0.05, p=0.495) or when correlated (0.04, p=0.419). Moderator analyses revealed that mindful yoga resulted in greater improvement in flourishing compared to mindful meditation (0.79 vs 0.16, respectively; p=0.000). Additionally, mindfulness interventions showed that for every increase in the number of females in a study, flourishing reduced by 0.002 (Slope=-0.002, T2 = 0.03, Qmodel = 5.60, P = 0.017). Only one quality indicator, the percentage of attrition rate, influenced effect size. Moderator analyses revealed that for every 1% increase in the percentage of attrition, flourishing decreased by (-0.01) of ES (Slope=-0.01, T2 = 0.03, Qmodel = 6.41, P= 0.011).
Conclusion: Overall, mindfulness interventions have a small to moderate effect on flourishing among adults. Mindful yoga interventions have a greater effect on improving flourishing than mindful meditation interventions. Additionally, attrition rate and percent of females were significant moderators that negatively influenced the effect of mindfulness interventions on human flourishing among adults. Our findings suggest that mindfulness interventions might be recommended as one approach that could potentially improve flourishing among adults.
Presenting author: Samah Hawsawi, Ph.D(c), RN, Saint Louis University
Co-author(s): Joanne Kraenzle Schneider, PhD, RN, Tanapa Rittiwong, PhD, RN
Parent and Teacher Assessment of a Mindful Eating Intervention for Preschoolers »
National nutrition data reveal that the diet quality of young American children is poor and that once unhealthy eating habits emerge, they are likely to persist over time and result in negative health outcomes. Thus, there is a critical need to cultivate healthy eating behaviors early in life when children’s eating patterns and their ability to self-regulate food intake are being developed. Nutrition research acknowledges that caregivers have the capacity to shape healthy eating among preschool age children via feeding practices that include sensory experiences, support satiety cues, and model healthy practices. Thus, there is also a need for programs that can be integrated into childcare centers that include simple practices to support children’s curiosity with food and promote healthy eating behaviors.
Our interdisciplinary research team developed a holistic mindful eating curriculum, Mindfully Growing, that includes child, parent, and teacher components. The four key program elements include: 1) preschooler mindful eating – increasing self-regulation of appetite using mindful tasting and internal cues of hunger and fullness; 2) parent/teacher mindful eating – practicing mindful eating and improving awareness of internal hunger and fullness cues; 3) family/childcare center engagement – introducing concepts of mindful eating to parents and teachers; 4) family/teacher integration – infusing and sustaining mindful eating practices within the family and childcare settings.
This spring, parents of preschool children and preschool teachers are participating in focus groups to assess the feasibility and acceptability of the parent and teacher workshops. The purpose of these components are to enhance mindfulness and mindful eating within caregivers in order to better support these practices with children in their care. We are gathering data via semi-structured interviews in order to make needed modifications prior to pilot testing the intervention in the fall. We anticipate moderating four in-person group sessions (2 groups of 8 teachers and 2 groups of 8 parents). In this flash talk, we will present data collected via focus groups with parents and teachers and share themes around engagement strategies and integrating technology in ways that best meet the needs of families and childcare centers.
Presenting author: Rachel Razza, PhD, Syracuse University
Co-author(s): Lynn Brann, PhD
Mindfulness Facets as Pathways to Emotion Regulation for Adults in Mexico »
Objective: Mindfulness has become increasingly popular as research in this field suggests promising results in clinical and non-clinical populations, particularly in reducing stress and promoting well-being and mental health-related benefits (Goldberg et al., 2022). Grecucci et al. (2015) suggest that mindfulness has achieved these outcomes through its contribution to emotion regulation. Although the psychological benefits of mindfulness for emotion regulation are well-documented (Roemer et al., 2015), the precise mechanisms underlying these effects remain less clear. Therefore, this study completed in Mexico aimed to examine which facets of mindfulness are the best predictors of emotion regulation.
Methods: The Mexican version of the Mindfulness Inventory (Ibinarriaga Soltero et al., 2023) and the Emotion Regulation subscale of the Inventory of Socioemotional Competences for Adults (Mikulic, Crespi & Radusky, 2015) were completed in Spanish by N = 387 participants (Mage= 39.85; SD = 12.70) who registered for an online mindfulness seminar implemented at National Autonomous University of Mexico. While participants had diverse demographic characteristics, the sample was predominantly female (84.2%), psychologists (60.7%) who held a bachelor’s degree (63%) and lived in Mexico City (62.5%). A multiple linear regression analysis was performed to analyze the effect of contextual variables and the Mindfulness Inventory facets on emotion regulation.
Results show that the predictor variables together explain almost 50% of the variance of emotional regulation (adjusted R2 = .497, F = 42.26, p < 0.001). Particularly, the following Mindfulness Inventory facets were statistically significant predictors of emotional regulation: a) not judging internal experiences (β = .289, p < 0.001), b) observing the breathing (β = .092, p = .045), c) not acting on autopilot (β = .311, p < 0.001), d) paying attention to external stimuli (β = .127, p = .005), and e) not reacting to internal experiences (β = .195, p < 0.001 ). According to Cohen's rules, the effect size was small for ‘observing the breathing’ (d = .151) and ‘not judging internal experiences’ (d = .216); small to moderate for ‘paying attention to external stimuli’ (d = .270) and ‘not reacting to internal experiences’ (d = .402); and large for ‘not acting on autopilot’ (d = 1.031).
Conclusion: Findings from the current study suggest that for Mexican adults participating in a mindfulness seminar, mindfulness represents a pathway for emotional regulation, which involves awareness of inner and external experiences without judgment and reactivity.
Presenting author: Ximena Ibinarriaga Soltero, Ph.D. student, University of Wisconsin-Madison
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