Mindful Musings
Copyright © 2008
eMindful
Editor:
Kelley McCabe
Writer:
Richard Mahler
Design:
Alan L. Kosow
Editorial Advisor:
Paul Sugar
Support:
David Lesak
|
|
|
|
DEBORAH ACKERMAN: A MINDFUL ON-LINE SURVEY
By Richard Mahler
Can mindfulness really change a person's life for the better? An increasing number of studies have tackled that question, with results that generally report favorable outcomes from mindfulness interventions. But few if any researchers have asked practitioners to monitor such phenomena themselves. Until now.
"[Mindfulness] meditation changed my life," says Deborah Ackerman, lead investigator on a project to study the outcomes of mindfulness practices and their interactions with stress and coping skills. "Once you start to pay attention to how your mind works, you can't stop. It's like a paradigm shift." Besides her ongoing academic studies, Ackerman found herself immersed in the writings of such meditation facilitators as Pema Chödrön, Jack Kornfield, Eckhart Tolle, and Thich Nhat Hanh. "I decided I wanted to apply research methods that haven't been applied outside of clinical trials to the practice of meditation."
The centerpiece of her resulting project, conducted through the University of California-Los Angeles Schools of Public Health and Medicine, is an interactive data collection and information website called PROCAIM (People-Reported Outcomes from Complementary, Alternative, and Integrative Medicine). The website was developed under a grant from the National Center for Complementary and Alternative Medicine as a tool for large-scale research on the effectiveness of various mind-body medical interventions and other complementary and alternative therapies, as well as interactions among stress, pain, and responses to available treatments.
"I'm not a teacher of Mindfulness-Based Stress Reduction", notes Ackerman, PROCAIM's director. "But I've read Jon Kabat-Zinn's 'Full Catastrophe Living' and listened to his tapes." And while there is no MBSR program affiliated with UCLA, the researcher sought the help of Trudy Goodman and other long-time area instructors.
PROCAIM (www.procaim.org) collects data directly from participants using standardized questionnaires that address self-perceived changes over time in mindfulness, spirituality, optimism/pessimism, mood, stress, coping skills, and quality of life. Subjects enroll, provide informed consent, contribute descriptive data, and answer a series of standardized questions at intervals over a period of one year - all via the Internet. PROCAIM also serves as an information and networking resource for participants.
(continued below) |
 Gina Biegel: Advocating Mindfulness for Children and Teens
By Richard Mahler
Gina Biegel is quick to challenge the conventional wisdom that children and teenagers are poor prospects for mindfulness.
"When I first started using meditation with these age groups, people said it just wouldn't work," recalls Biegel, a San Jose-based psychotherapist specializing in children and adolescents. "But I have found the total opposite to be true. Many of them are more open to meditation than adults." Whereas grown-ups may have preconceived notions about meditative practices, the younger generation is apparently willing to check them out.
"They respond to the idea of taking a moment to settle, a few minutes to follow the breath," says Biegel.
Kids and teens, it seems, are eager to find ways of being still and dealing with distractions. Although individuals in these age groups are subject to an overabundance of stimulation, peer pressure, conflicting emotion, and hormonal changes, many among them seem to welcome the chance to learn and use skills that help to mitigate their stress, anxiety, and difficulties with teachers, friends, and family members. For some teens, mindfulness provides a route to increased self-confidence, closer relationships, and better understanding of their emotions.
What's more, according to Biegel, such mindfulness-based interventions have been shown to be "statistically and anecdotally very effective." Besides empirical research, Biegel backs up her conclusions with experiences teaching MBSR classes to teens through Kaiser Permanente, a regional HMO, and mindfulness workshops she has led for teens, parents, schools, corporations, and fellow health professionals.
|
eMindful Offering
7 New Courses Earning CME Credits
At the forefront of offering Internet-based complementary and alternative medicine (CAM) using virtual classroom technology, eMindful.com is now offering seven additional CAM courses earning CMEs via live, online classes. eMindful.com recently added these classes sponsored for accreditation by the University of Arizona College of Medicine at the Arizona Health Sciences Center for Continuing Medical Education (CME) credits ranging from 4 to 34 CMEs. eMindful.com is an Internet-based educational company offering CMEs for physicians and other medical personnel, as well as Continuing Education Units (CEUs) for nurses, dietitians, and nutritionists. Complementary and alternative medicine class topics include Mindfulness for the Adolescent, Mindfulness-Based Cognitive Therapy (MBCT), and Giving the Gift of Presence. These courses are taught by live teachers using streaming video and real-time audio on people's home and office computers. Students see and interact with their teacher as well as other course participants.
Click here for more detailed information on CME offerings.
***********
|
|
DEBORAH ACKERMAN: A MINDFUL ON-LINE SURVEY
(continued from top)
"By making PROCAIM widely available," says Ackerman, "we hope to obtain high-quality observational data from large numbers of people who are trained in mindfulness practices." The adjunct professor in the department of epidemiology is also affiliated with the UCLA Mindful Awareness Research Center. Trained in pharmacology and epidemiology, her major research interests have been the rigorous evaluation of psychotherapeutics, placebo effects, and outcome measures.
"So many clinical studies are small," Ackerman points out, "that their results may not apply to the general population. I'm interested in doing a large study [with a broad, heterogeneous sample size]." With this goal in mind, PROCAIM is being promoted among clinics, hospitals, HMOs, and teachers who apply mindfulness meditation in a therapeutic setting. Use of standardized scales and other materials, along with such interactive features as regular e-mail reminders, are designed to help validate the website's measured results.
"One thing I'm very interested in is whether [mindfulness meditation] helps participants become better able to cope with stress," says Ackerman. "This is pretty important when you consider that stress, in association with related factors, is a leading cause of mortality and morbidity in the world today." Increasingly, participants in MBSR programs are reporting stress-related symptoms, including chronic pain, that may not have any discernible physical cause. Past studies and anecdotal evidence have suggested that mindfulness-based interventions do in fact improve the stress-coping abilities of practitioners and help them to become more resilient, self-compassionate, and even optimistic.
Ackerman has no enrollment goal for the PROCAIM survey, adding "the more people who participate the better." The survey, she says, "will continue indefinitely." By initiating nationwide outreach, she hopes to reach some individuals who might otherwise be reluctant to detail their experiences. "I think there is an advantage in doing something like this anonymously," she says. "For example, there may be less desire to please or to conform [as there might be if individuals are questioned in front of others]." Intake questions collect demographic information and inventory treatment history, health status, and so on.
Consistency in data collection over time is an implicit goal of the Internet-based program. Ackerman wants to know: "Are the effects [of an MBSR course] and 'staying present' going to continue beyond the eight weeks? What is going on with the respondent at three-month intervals? Are they continuing with things like yoga, meditation, acupuncture, and so on? Are they less reactive and more likely to respond to stressors in a positive way? It's hard to say without long-term study."
It is only within the last few years that medical research has evolved to a point where such undertakings have been viable. A decade ago there were few patient records accessible on line and medical surveys eschewed the Internet. This was, in part, because of security concerns that have since been addressed to the satisfaction of institutional review boards. (PROCAIM, for instance, requires participant input of e-mail addresses and self-generated passwords.) At the same time, social networking via the Web has exploded.
"I want this to be a place where participants can create a 'virtual healing community' and have access to mind-body knowledge," says Ackerman. "It should be a place where people can feel comfortable." With this in mind, PROCAIM allows enrollees to share their experiences with others, if they desire. A forum component is being added, along with links to a wide range of health-related resources. No fees are assessed to any participants in the on-line program.
For additional information, download descriptive brochures from the www.PROCAIM.org or write Deborah Ackerman at dackerma@ucla.edu.
Deborah Ackerman, Ph.D. is Adjunct Associate Professor and Associate Researcher, Department of Epidemiology, at UCLA. Deborah has written more than 20 peer-reviewed publications. She is also currently the director for the NIH funded PROCAIM Network which collects a wide range of data on mood, stress, and quality of life. The Network facilitates study of the effects of various therapies on patient self-reported outcomes and symptoms. Dr. Ackerman received her doctorate at the University of California, School of Public Health in 1993.
|
Mindfulness for Attention Deficit Hyperactivity Disorder: MAPs for ADHD
Class Offered on eMindful
One of our most important qualities is attention. It is a doorway into our experience and a foundational quality of our awareness. Where we place our attention or how other things grab our attention determines our daily experiences, relationships with ourselves and others, and the quality of our lives. This connection between attention and one's well-being is illustrated through a condition called Attention Deficit Hyperactivity Disorder (ADHD) and an approach called mindfulness training. In both, the role of attention is crucial to the balance of thoughts, emotions, and behaviors. While ADHD is characterized by difficulties in self-regulation, mindfulness training is a tool to enhance self-regulation.
Mindful Awareness Practices (MAPs) for ADHD* is a program which provides an overview of ADHD and uses mindfulness meditation to enhance the well-being of adults with ADHD.
The class discusses latest scientific understanding of ADHD, meditation's impact on the brain and attention regulation. Mindfulness exercises are taught in a gradual way, suitable for those with attentional difficulties and/or new to meditation. Others who want to know more about mindfulness and ADHD: spouses of ADHD adults, parents, teachers, or clinicians working with ADHD individuals will also benefit from the class by learning basic mindfulness skills for themselves and a mindful and compassionate approach to ADHD.
A 6-week course is offered:
Dates: Tuesdays, September 30th through November 6, 2008
Time: 12:00-1:30 PM ET (9:00-10:30 AM PT)
Cost: $295.00
Registration: Click here
MAPs for ADHD is taught by: Lidia Zylowska, M.D.
Dr. Zylowska is a psychiatrist specializing in adult ADD/ADHD and mindfulness-based approaches. Working with patients in private practice in West LA, Dr. Zylowska is also a co-founder and an Assistant Clinical Professor at the UCLA Mindful Awareness Research Center where she led the investigation of the MAPs for ADHD program.
*MAPS for ADHD was co-developed by Zylowska and Smalley with contributions from Diana Winston. See Zylowska, L et al, J of Attention Disorders, 2008
|
Gina Biegel: Advocating Mindfulness for Children and Teens
(continued from top)
A busy Mindfulness-Based Stress Reduction facilitator and health education consultant, the Santa Clara University counseling psychology graduate has completed an article on the results of a randomized clinical trial Biegel oversaw the application of MBSR for the treatment of 102 teens (aged 14-to-18) seen in an outpatient psychiatric clinic. The study's approach deviated only slightly, such as the trimming of meditation periods to accommodate shorter attention spans, from the standard MBSR program for adults. Biegel's study, to be published in the Journal of Consulting and Clinical Psychology, found over a five-month period "a higher percentage of diagnostic improvement" (80 percent versus two percent) and "significant increases in their Global Assessment of Functioning" for the adolescents completing the eight-class MBSR program relative to the control group. Those receiving MBSR self-reported "reduced symptoms of anxiety, depression, and somatic distress" as well as "increased self-esteem and sleep quality."
Other research in the U.S. and Canada during the last five years suggests wide-ranging benefits for mindfulness among schoolchildren, including reduced anxiety, improved optimism, greater attentiveness, better aggression control, and improve academic as well as athletic performance. Some teachers are interested in the potential for such interventions to help students feel more calm, safe, and focused. At the University of California-Los Angeles, a mindfulness program for preschoolers has been developed, with results of a pilot study finding improvement in memory, planning, and organization skills.
While only a handful of studies have examined the efficacy of mindfulness interventions beyond adult populations, Biegel is challenging the status quo on several fronts. She is writing a research application, for example, to measure the effectiveness of an ongoing mindfulness program in many of the public schools of Oakland, CA. Over the last two years about 2000 elementary-through-high-school students have participated in the curriculum, whereby MBSR facilitators work directly with schoolteachers and students to integrate mindfulness exercises and concepts into classrooms. The interventions typically occur three times each week, over a five-week period, for sessions lasting about 15 minutes. Anecdotal and self-report results suggest the program is making a positive difference, but Biegel's evaluation will be the first clinical analysis.
"We've had focus groups and talked directly with administrators, teachers, and parents [about the impact of mindfulness in Oakland schools]," says Biegel. "The response has been very positive."
For older students, Biegel is writing a new book entitled "I'm So Stressed Out: A Teenager's Guide to Mindfulness Stress Reduction." Due out in December 2009 from New Harbinger, this "hands-on" guide will include experiential exercises, real-life stories, and a basic outline of mindfulness principles.
"It's not going to be boring read," laughs Biegel. "The exercises and stories will be ones teen readers can relate to because they are based on things that actually happened to other teenagers, and that others in their age-group who've gone through the MBSR program have found most useful."
Information grounded in real-life situations has been woven into a number of talks Biegel has presented at the Center for Mindfulness and other venues about the use of MBSR in treating schoolchildren and at-risk or life-challenged adolescents. She notes that mindfulness for a younger population has quickly gained acceptance around the country. "When I started almost nobody was teaching to teens," Biegel points out. "Now it is much more commonplace and welcomed. Certainly, educators and administrators are becoming more open to it." While acceptance seems to remain highest in California and the Northeast, successful programs also are underway in Texas, Pennsylvania, and other states. "The most important thing in many cases," she says, "is to remind them that we are not promoting any sort of religious beliefs and that many of the adult programs are in universities or hospitals, most of which have no religious affiliation. There still is some confusion out there about mindfulness and religion."
Gina M Biegel, MA, LMFT is a psychotherapist working both independently and for a large Health Management Organization (HMO) in California primarily with adolescents, children and families. She has vast experience utilizing the Mindfulness-Based Stress Reduction (MBSR) program with adolescents and is the first person in the world to conduct and publish a Randomized Control Trial assessing the efficacy of this program with adolescents with very significant results. Ms. Biegel's focal area of interest is in teaching the MBSR program with adolescents, children, adults, teachers, health and business professionals. She conducts workshops and conferences around the world on MBSR training with a variety of populations.
Mindfulness for the Adolescent will start on Tuesday, October 7, 2008 at 8:00 PM Eastern Time and end at approximately 10:00 PM EDT and run for 8 consecutive Tuesdays, concluding on November 25, 2008. Cost: $425
Click here to register for this class titled GB 120
A Four Hour Introduction to Mindfulness for Teens will start on Saturday, November 8, 2008at 1:00 PM Eastern Time and end at approximately 5:00 PM EST concluding on the same day. Cost: $125
Click here to register for this class titled GB 121
| |
|
|
|
|
|
