Novel adaptations of mindfulness in the UK Armed Forces during peacetime.

Mindfulness approaches to promoting resilience and mental fitness within the UK Armed Forces have very recently emerged against a backdrop of studies from abroad, leading to a plethora of initiatives. These studies have used biological and cognitive markers of sustained attention and the human stress response, before and after training, in the period prior to deployment and made assertions of effectiveness on this basis. Progress has similarly been made in applying versions of mindfulness meditation to veteran patient groups with several difficult-to-treat conditions, to combat high dropout from services when little patient choice is offered. In short, a case has been made for offering mindfulness interventions as a further treatment option in combination with other approaches to maximise engagement with mental health services. Meanwhile, within the mindfulness literature more and more focus has been placed on ways to improve treatment fidelity and enhance teacher competency, and investment in teacher training is seen as essential for successful outcomes in any controlled trial.

Is gardening a stimulating activity for people with advanced Huntington's disease?

This study evaluated adapted gardening as an activity for people with advanced Huntington's disease (HD) and explored its therapeutic aspects. Visitors and staff completed a questionnaire and participated in structured interviews to capture further information, whereas a pictorial questionnaire was designed for residents with communication difficulties. Staff reported that gardening was a constructive, outdoor activity that promoted social interaction, physical activity including functional movement and posed cognitive challenges. Half the staff thought the activity was problem free and a third used the garden for therapy. Visitors used the garden to meet with residents socially. Despite their disabilities, HD clients enjoyed growing flourishing flowers and vegetables, labelling plants, being outside in the sun and the quiet of the garden. The garden is valued by all three groups. The study demonstrates the adapted method of gardening is a stimulating and enjoyable activity for people with advanced HD.

Using music in leisure to enhance social relationships with patients with complex disabilities.

Acquired and complex disabilities stemming from severe brain damage and neurological illness usually affect communication, cognitive, physical or sensory abilities in any combination. Improved understanding of the care needs of people with complex disabilities has addressed many functional aspects of care. However, relatives and carers can be left at a loss knowing how to provide or share in meaningful activities with someone who can no longer communicate or respond to their environment. As a result, the individual with complex needs can become increasingly isolated from their previous support network. Based on theoretical foundations for music as instinctive in human beings, this paper offers practical recommendations for the creative use of music for people with complex physical and sensory needs which prevent active participation in previous leisure pursuits. Recommendations are made for relatives and carers to manage the environment of an individual who has limited capacity to control their environment or make choices about leisure activities. Particular emphasis is given to activities which can be shared between a facilitator and the patient, thereby enhancing social relationships.

Parental accounts of blaming within the family: a dialectical model for understanding blame in systemic therapy.

The aim of this study was to further understanding of blame in systemic therapy. Five families were chosen by their therapeutic team as engaging in blaming of a kind that the therapists found difficult to work with. Couples from each of the five families participated. A video extract from therapy identified by therapists as typifying blaming within the family was used as a focus for semistructured interviews with each parent. Transcripts were analyzed according to the procedures of grounded theory. On the basis of this inductive qualitative analysis, a framework of understanding emerged from the data consisting of the core category, "dialectical understanding," and an accompanying set of overarching themes. These themes capture the way in which participants oscillated among 13 dialectics in their discussion of blame within their family and within family therapy. The model provides a framework for analyzing the style and content of therapy conversations with a view to helping therapists facilitate therapeutic change in this difficult client group.