Using mindfulness to improve quality of life in caregivers of individuals with intellectual disabilities and autism spectrum disorder.

OBJECTIVES: Caring for individuals with intellectual disabilities (ID) or autism spectrum disorder (ASD) can be gratifying as well as stressful. Professional staff employed as caregivers often report compromised mental and physical wellbeing due to the stressful nature of working with clients who exhibit aggressive and destructive behaviors. Prolonged work-related stress results in diminished quality of life for the caregivers. The aim of the present study was to evaluate the comparative effects of three programs-mindfulness program, psychoeducational program, and inservice training-as-usual-on the quality of life of professional caregivers who provide services to adolescent and adult clients with ID and ASD. METHODS: Professional caregivers (N = 216) were randomized into three experimental conditions, and trained in mindfulness, psychoeducation, and inservice training-as-usual. The effects of the training on the caregivers' quality of life were assessed in terms of perceived stress, compassion satisfaction, compassion fatigue (i.e. burnout, secondary traumatic stress), and symptoms of depression at the end of 32 weeks of implementation. RESULTS: Perceived stress, burnout, and secondary traumatic stress decreased significantly in the mindfulness condition, followed by psychoeducation, but not in the inservice training-as-usual condition. Compassion satisfaction increased significantly in the mindfulness condition, followed by psychoeducation, but not in the inservice training-as-usual condition. Symptoms of depression, which were rated in the borderline clinical range prior to intervention, decreased significantly to within normal levels in the mindfulness condition, decreased minimally in the psychoeducation condition, and showed no change in the training-as usual condition. CONCLUSIONS: A 3-day training in mindfulness meditations and associated contemplative practices provides a better basis for enhancing caregivers' quality of life than psychoeducation or inservice training-as-usual.

The extended nervous system: affect regulation, somatic and social change processes associated with mindful parenting.

BACKGROUND: A theoretical model of mindful parenting has the potential to succinctly summarise its various change processes. The primary aim of this study was to investigate some of the change processes associated with mindful parenting, namely, the affect regulation, somatic and social change processes. A secondary aim was to verify whether clinical insights are consistent with the change processes identified in a systematic review of mindful parenting. METHOD: Interpretative Phenomenological Analysis (IPA) was used to analyse semi-structured interviews with four Australian clinicians delivering Mindful Parenting (MP) programs. The clinicians had extensive personal meditation practice. This qualitative study is part of a mixed methods study, which commenced with a quantitative systematic review. RESULTS: Six higher-order themes identified as change processes included reflective functioning, attachment, cognitive, affective, somatic and social change processes. CONCLUSION: The anchor is a new theoretical model summarising the change processes associated with mindful parenting. The mother portrayed as the extended nervous system for the infant is a neologism that also has not been previously mentioned in the literature. Given the limitations with the small sample and potential bias with interpretation, the anchor is a starting point to developing a theoretical model of mindful parenting. Future research with larger sample sizes and objective measures is needed to confirm whether the anchor is a reasonable summary of the change processes.

The effectiveness of mindful parenting programs in promoting parents' and children's wellbeing: a systematic review.

BACKGROUND: The rationale for undertaking this review was to investigate a potential strategy to address the rising prevalence of child and adolescent mental health disorders. The central tenants of mindful parenting appear to be emotional awareness, emotional regulation, attention regulation, intentionality and non-judgmental acceptance. OBJECTIVES: The primary objective of this review was to systematically evaluate the effectiveness of mindful parenting programs in promoting children's, adolescents' and parents' wellbeing, particularly in relation to the intensity of symptoms associated with internalizing (depression, anxiety, stress) and externalizing (conduct) disorders. The secondary objective was to evaluate how effective mindful parenting programs are in improving emotional regulation, attention regulation, quality of the parent-child relationship, resilience and mindfulness of the children, adolescents and parents. INCLUSION CRITERIA TYPES OF PARTICIPANTS: Children aged between 0 and 18 years and their parents who have completed a mindful parenting program were the focus of this review. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: Mindful parenting programs included in this review had a minimum duration of one to two hours per week for 6 to 8 weeks, delivered in a group format, by a facilitator with appropriate training. It included parenting programs that drew upon mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-based cognitive behavior therapy, dialectical behavior therapy or acceptance commitment therapy. The comparator was the control or waitlist conditions. TYPES OF STUDIES: This review focused on randomized controlled trials evaluating the effectiveness of mindful parenting programs. OUTCOMES: Primary outcomes were wellbeing or intensity of symptoms associated with internalizing disorders (depression, anxiety, stress) and externalizing disorders (conduct disorders) in children, adolescents and parents. Secondary outcomes were emotional regulation, quality of the parent-child relationship, resilience and mindfulness of the children, adolescents and parents. SEARCH STRATEGY: Eight databases were searched for studies evaluating mindful parenting programs from 1997 to November 2014. A three-step search strategy was utilized to retrieve both published and unpublished studies written in English from PubMed, PsycINFO, EMBASE, Scopus, Psychological and Behavioral Sciences Collection, CINAHL, Cochrane Library and ProQuest Dissertations and Theses databases. A logic grid was developed for each of the eight databases to identify the indexing terms and synonyms for the keywords "mindful" and "parenting". METHODOLOGICAL QUALITY: Methodological limitations included small sample sizes leading to lack of statistical power, multiple testing leading to increased alpha errors in addition to information bias caused by a lack of blinding in the implementation and assessment phase. DATA EXTRACTION: The data extraction process entailed using the standardized data extraction form from Joanna Briggs Institute Meta-analysis of Statistics Assessment and Review Instrument to extract data from the selected studies. DATA SYNTHESIS: The heterogeneity of the samples, the measurement tools and outcomes measured precluded data synthesis through meta-analysis. Conclusions on intervention effects were based on comparisons of the overall statistical significance of the outcomes data. RESULTS: The search yielded 1232 articles, from which seven randomized controlled trials met the inclusion criteria. The findings indicate mindful parenting programs may reduce parental stress, increase parents' emotional awareness of their 10-14-year-old children and reduce preschool children's symptoms associated with externalizing disorders. A recurring finding was that the mindful parenting programs reduced parents' emotional dismissal of their adolescents and preschoolers. CONCLUSIONS: At present, there is insufficient evidence to conclude that mindful parenting programs can improve parents' and children's wellbeing because of the methodological quality of the few studies that met the inclusion criteria. IMPLICATIONS FOR PRACTICE: Although there is currently insufficient evidence, mindful parenting programs are increasingly used in a variety of contexts. It may not be appropriate for psychotic or severely traumatized individuals. IMPLICATIONS FOR RESEARCH: Future studies could make a significant contribution to the field by designing studies with sufficient sample sizes, adequate statistical power as well as blinding participants, facilitators and assessors.

Conceptualizing the key processes of Mindful Parenting and its application to youth mental health.

OBJECTIVE: Youth mental health disorders are rising across the world. Mindful Parenting could be a potential tool to promote youth mental health. The primary distinction between Mindful Parenting programs and other behavioral parenting programs is the focus on emotional literacy and compassion. However, this emerging field has gaps in its theory and evidence. In order to objectively evaluate the impact of Mindful Parenting, it is important to identify how it promotes change. This theoretical paper aims to articulate the key change processes of Mindful Parenting that promote positive outcomes. METHOD: A literature review was conducted to synthesize the change processes outlined by different authors in the field. RESULTS: Key processes argued to promote Mindful Parenting were aligned with five main categories, namely attention, intention, attitude, attachment and emotion. More specifically the change processes were listening, emotional awareness, emotional regulation, attentional regulation, attunement, attention to variability, intentionality, reperceiving, compassion and non-judgmental acceptance. CONCLUSIONS: This preliminary analysis attempted to understand how Mindful Parenting fosters change and transformation. Whilst there are numerous change processes, the essence of Mindful Parenting appears to be the ability to be responsive to a child's needs.