6. A. What's the Evidence for MBCT? B. Programme Outline (Devon) and Safety Issues. C. Mindfulness: What You Want To Know in 10. D. Where to Find Out More About Mindfulness.

A. Evidence

RESEARCH:

Recommended Websites for Research, Current News, Issues & Training

Check the American Mindfulness Research Association website for the latest

research and development news: https://goamra.org/

Following 6 randomized control trials there is good evidence that MBCT is effective for adults with recurring depression and is recommended by the National Institute for Clinical Excellence (NICE).

Neuroscience and brain imaging (Holzel et al, 2011; Davidson, 2008) has provided evidence of how mindfulness helps the brain to do its job, sorting out and taking care of our emotions.

After reviewing most of the research currently available (see the News page) Mindfulness Based approaches for children and adolescents appear feasible, acceptable and helpful.

In 2012 we successfully ran our first MBCT (Mindfulness Based Cognitive Therapy) group for young people and their parents in Devon Eastern Child and Adolescent Mental Health Services.The group was based on the MBCT-C manualised programme for children which ‘was adapted from two mindfulness programmes (MBCT and Mindfulness Based Stress Reduction) for adults, both of which are supported by many years of research’ (Semple and Lee, MBCT-Children, 2011).

Though Mindfulness is a new and developing area of research in the clinical setting of child and adolescent mental health, if you have checked the ‘mindfulnessinschools’ website, www.mindfulschools.org and www.stressedteens.com, you would have noticed Mindfulness Skills are already being taught in schools and in health settings.

Research and Discovery

Check the American Mindfulness Research Association website for the latest research and development news: https://goamra.org/

Science is showing us that Mindfulness is really helping young people who experience sadness, worry and stress.

As previously stated, Neuroscience research suggests that mindfulness helps the brain to do its job, basically to respond, sort out and process emotions.

Amy Garrett who is a Neuroscientist, explains that Mindfulness Skills may enhance 'the development of brain systems important for emotional regulation and may help to inoculate (protect) the adolescent brain against the negative effects of stress during this critical phase of development' (Biegel, 2009).

One expert called Dr. Amy Saltzman (Biegel, 2009), explained that by discovering simple mindfulness practices, young people will be able to 'deal more successfully with common challenges experienced in school, extracurricular activities, and relationships, and help them live happier, more fulfilling lives.'

B. MBCT 4 Young People and Parents/Carers Programme Outline

(DEVON CAMHS)

(There is a description and outline file at the bottom of this page for printing. Also find an Information & Hyperlinks file)

Dates for Next Programme-See File (scroll to end of page).

Programme Description

The Mindfulness Based Cognitive Therapy (MBCT) programme is not a talking therapy; it’s really about learning new skills. Some experts describe Mindfulness to be a bit like mind training or brain training. The programme will ask you to be a little bit like a scientist, experimenting and exploring the effects of Mindfulness training through: activities, movement, eating, walking, sitting and standing. Reflection is encouraged by simply inviting you to notice what you noticed during a learning activity. Young people will learn about current advances in neuroscience relating to ways training the mind effects changes in the brain.

The programme is aimed at young people between the ages of 13-18.

The programme consists of the following:

1. A group for young people only (6-8) which runs for 8 weeks (90mins per session)

2. A separate group for parents/carers (of the young people attending) which runs for 6 sessions (120mins per session) or 8 sessions (90mins).

The Programme Highlights 3 Main Areas

Recognition: The training of attention, awareness and mindful presence

Connection: The exploration of awareness of living in the present moment (rather than getting caught up in thoughts dwelling on the past or worrying about the future)

Mastery: Understanding and knowing how thoughts, feelings and body sensations are connected; how we learn through practice and awareness that these events arise, develop and pass; how through training we learn that thoughts are not facts, enabling young people to have choices and skills to disengage from negative automatic thinking patterns.

The Programme Intentions

Provide: Instruction for developmentally appropriate mindfulness training, leading to greater wellness

Enhance: Coping skills, resilience and self regulation

Support: Confidence, self appreciation and self compassion

Increase: Social, emotional and interpersonal strength and clarity

Have fun and discover!

If at any time you experience difficulties during the programme

please inform the instructors/teachers, so any difficulties can be

managed as soon as possible.

Parent and Carers Sessions

The sessions are designed for parents/carers of the young people attending the programme. The sessions are based on the evidence based Mindfulness Based Cognitive Therapy (MBCT) programme.

MBCT is a combination of cognitive therapy and mindfulness practices. MBCT is not a talking therapy; it’s really about learning and practicing new skills. The skills can be practiced anywhere, most of the time or simply when needed. Mindfulness with a little practice is simple and enjoyed by young people and adults.

A Mindfulness Based group for parents/carers holds the intention of learning: about the cognitive behavioural development and maintenance of low mood/worry; new skills to promote health and well-being, develop emotional resilience, support emotional intelligence and reduce the risk of stress.

The Mindfulness Based sessions for parents/carers will be based on the following evidence based manuals: Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse (Segal, Williams and Teasdale, 2002); and Mindfulness: Finding Peace in a Frantic World (Williams and Penman, 2011).

Each session builds on the previous one, so it is really important participants are able to attend for as many sessions as possible.Mindfulness-Based approaches have become very important in the Western medical and psychological community for helping people.Mindfulness-Based treatments are secular, in other words, they are non religious, meaning anyone can participate in the programme.

The programme includes ‘simple breathing practices’ or mediation and other skill based activities to bring awareness and mindfulness to what is experienced in the present moment. Participants will learn to still the mind and gain some calm. Experts have referred to Mindfulness as a method of mind or brain training. When we practice mindfulness, neuroscientists have found through research that we are changing the structure of the brain, improving the quality of both thought and feeling. Evidence shows mindfulness strengthens parts of the brain and neuro-pathways associated with attention, emotional regulation (balancing), learning, memory, self awareness and compassion.

Practicing Mindfulness skills is just like any of the skills we practice including: playing music, sports, writing, computer gaming, singing, art and creating, dancing, skateboarding, biking, etc. Sometimes it feels a little difficult to start with; then we get a sense of it; then we practice for a little longer and with a bit more flexibility in our approach; then it gets weaved into everyday life, eventually becoming a skill we don't forget and can practice or draw on whenever we like.

ISSUES OF SAFETY

Attending the programme is voluntary and it is important that your participation is based on your own decision after reading what is entailed.

Contraindication

It is not advisable to participate in the Mindfulness Based programme if you are experiencing:

· Recent trauma

· Post-traumatic Stress Disorder

· Recent bereavement

· Acute mental health episode and/or feel at risk

· Mental health problem related to a thought disorder

· Currently receiving a mental health intervention. However, if the mental health care professional you are under the care of is aware of the MBCT intervention described and it is agreed by all that implementation is safe, then participation may continue. Except if the episode is acute or related to a thought disorder

· If you have any other concerns about past issues then discuss with your GP and the MBCT team

· Away for more than 2 session of the programme or is unwilling to participate in a group

Please inform the team of any past mental health problems. Again, this is done on a 1-1 basis.

If at any time you experience difficulties during the programme please inform the instructors/teachers, so any difficulties can be managed as soon as possible.

What can we conclude about the safety of mindfulness practice?

Any program with the potential to be therapeutic may involve risk. Ensuring participants’ wellbeing and minimising any chance of harm requires that mindfulness practices are offered with skill and care. Harmful effects of mindfulness practice appear to be rare but have not yet been thoroughly studied. Until we understand the risks more clearly, the wisest course for anyone interested in mindfulness is to begin with low to moderate-intensity practices. Self-help books, recordings, and apps can provide helpful instruction in introductory practices, especially if written or developed by people with recognized expertise. A popular programme is Mindfulness: A Practical Guide to Finding Peace in a Frantic World (Williams & Penman, 2011). This programme was developed to introduce mindfulness in ways that are believed to be safe and engaging and it shows promising evidence of effectiveness.

People interested in more intensive practice should work with an experienced teacher offering evidence-based classes. Those with mental health difficulties should consult with a mental health professional before beginning a mindfulness program, and should only undertake a programme taught by someone who has the training and experience to support them. They should ask if teachers of such programmes have been appropriately trained. Ideally, those in the UK will be registered with the UK Network of Mindfulness-based Teachers.

People interested in the very intensive practice of a meditation retreat should remember that retreats are operated primarily by meditation teachers, rather than mental health professionals, and psychological research to date tells us very little about their effects. It may be wise to consult with an experienced meditation teacher before undertaking an intensive retreat. For people with mental health difficulties it may be wise to consult with a mental health professional with expertise in mindfulness practice. This is especially for those with little experience with less intensive forms of mindfulness practice.

Finally, participants in any form of mindfulness practice should remember three crucial points:

First, mindfulness is not intended to be a blissful experience. Like exercise, it can be uncomfortable. In fact, mindfulness is about learning to recognise, allow and be with all of our experiences, whether pleasant, unpleasant or neutral, so that we can begin to exercise choices and responsiveness in our lives.

Second, mindfulness practice is not a panacea. It’s not the only way to reduce stress or increase wellbeing, nor is it right for everyone. People should select an approach that matches their interests and needs, whether it be mindfulness, physical exercise, cognitive-behavioural therapy or some other approach.

Third, mindfulness practice is intended to be invitational and empirical. Participants are invited to experiment with the practices in an open-minded and curious way and to be guided by the evidence of their own experience, continuing with practices that seem helpful and letting go of those that don’t.

Ruth Baer and Willem Kuyken

Declaration of interests

Ruth Baer is author of Practicing Happiness: How Mindfulness Can Free You From Psychological Traps and Help You Build the Life You Want and receives royalties from its sales. She is Professor of Psychology at the University of Kentucky and is spending a sabbatical year at the University of Oxford Mindfulness Centre.

Professor Willem Kuyken receives no payment for public engagement or consultancy, and any remuneration is paid in full to the not-for-profit charity Oxford Mindfulness Foundation. He is Director of the Oxford Mindfulness Centre and Principal Investigator of several NIHR and Wellcome Trust grants evaluating MBCT. Willem is Professor of Clinical Psychology at the University of Oxford.

WARNING: Do not practice mindfulness meditation when attending to matters of safety

(i.e., driving, riding, crossing the road and many, many more).

NOTE: PLEASE READ CONTRAINDICATIONS BEFORE COMMENCING THE PROGRAMME

The Mindfulness Programme is not a 24-hour service and cannot respond to emergencies. If at any stage you need to speak to someone urgently, you should do this in the normal way through your GP. Out of hours, your practice should have access to an “out of hours service” or, alternatively, Accident and Emergency Departments are always open.

Contraindication for parents/carers

You may wish to discuss an issue outlined below after the Orientation Meeting with a member of the team on a 1-1 basis. If this is required-just say, for example, ‘Could I have a few minutes after the meeting to discuss a couple of things?’

The Orientation Meeting is a meeting held before the programme begins just to check any matters or questions you may have and to orientate families to the mindfulness programme.

It is not advisable for a parent/carer to participate in the Mindfulness Based programme if they are experiencing:

Recent trauma.
Post-traumatic Stress Disorder.
Recent bereavement.
Acute mental health episode.
Mental health problem related to a thought disorder.
Currently receiving a mental health intervention.
However, if the mental health care professional you are under the care of
is aware of the MBCT intervention described and it is agreed by all that implementation is safe,
then participation may continue. Except if the episode is acute or related to a thought disorder.
If you have any other concerns about past issues then discuss with your GP and the MBCT team.
Away for more than 2 session of the programme or is unwilling to participate in a group.

Please inform the team of any past mental health problems.

Again, this may be done on a 1-1 basis.

WARNING: Do not practice mindfulness meditation when

attending to matters of safety (i.e., driving, riding, crossing

the road and many, many more).

C. Mindfulness: What You Want To Know in 10

(There is a 'Mindfulness: What You Want To Know in 10' file at the bottom of this page for printing)

1. What you are thinking, what shape your mind is in, is what makes the biggest difference of all.’- Willie Mays (professional baseball player).

2. Experts have referred to mindfulness as a method of mind or brain training.

3. Mindfulness is about learning and practicing new skills. Just as physical fitness relies on repeated exercise to generate specific muscular or cardiovascular changes, mind fitness relies on attention and concentration exercises to effect changes in neural structures and cognitive functions.

4. Mindfulness Based Cognitive Therapy is an evidenced based training which strengthens and protects parts of the brain associated with attention, emotional resilience, learning, memory, self compassion and self awareness.

5. Students and people working in demanding situations probably deserve and need methods like mindfulness for maintaining and protecting these cognitive functions.

6. Mindfulness has been embraced by: Google, Apple, Police, US Military, NHS, Reebok, British Telecom, PricewaterhouseCoopers, London Business School, Home and Cabinet Office; Real Madrid FC, AC Milan FC, Chicago Bulls, Los Angeles Lakers and many more.

7. Mindfulness has been clinically proven to reduce stress, blood pressure, depression and anxiety; to help people sleep better, work more effectively and improve their personal and professional relationships.

8. Be Here Now: Mindfulness means being fully aware of the present moment, rather than the mind getting distracted or caught up in dwelling on past related thoughts and/or worrying about the future. Sports people refer to being in the present moment as ‘in the zone’ and musicians refer to it as ‘flow states.’

9. Mindfulness is easy, enjoyable and after a short training programme and a little ongoing practice, the skills are always available, flexible and sustainable.

10.’You can’t stop the waves, but you can learn to

surf.’ – Professor Jon Kabat-Zinn (Founder of

the Stress Reduction Clinic, University of

Massachusetts Medical School).

D. Where Can I Find Out More About This Mindfulness Stuff?

To find out more go to the web:

10 Science-Based Reasons To Start Meditating Today INFOGRAPHIC

By Emma Seppala, PhD (emmaseppala.com)

The infographic is a summary of Emma's Psychology Today article on 20 Science-Based Reasons to Start meditating Today.

Just click on the link below or download the document at the bottom of this page.

www.emmaseppala.com/10-science-based-reasons-start-meditating-today-infographic#sthash.YbmMSntc.EfH9YxAp.dpbs

Books

Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman (2011). Go to: franticworld.com
The stress reduction workbook for teens: mindfulness skills to help you deal with stress. Canada. Instant Help Books. A Division of New Harbinger Publications, Inc. Gina M Biegel (2009)
The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segal and Jon Kabat-Zinn.
Full Catastrophe Living: How to Cope with Stress, Pain and Illness Using Mindfulness Meditation by Jon Kabat-Zinn
Mindfulness for Health: A Practical Guide to Reducing Stress and Restoring Wellbeing by Vidyamala Burch and Danny Penman (2013). Piaktus.

iTunes

If you have access to iTunes University then go to: UNIVERSITY OF OXFORD, The New Psychology of Depression Lectures by Professor Mark Williams and Dr Danny Penman. The lecture series contains 3 audio podcasts and 3 videos explaining what mindfulness is and the current evidence for the intervention.

To watch a video about mindfulness and how the brain works to regulate our emotions and mood, then go to:

‘Staying in the Now: Mental Health Through Mindfulness: The science of the mind: How the brain works to regulate mood, emotion, stress and sleep (Feb. 2010 Dr Stuart Eisendrath): https://www.youtube.com/watch?v=mdZwybJF8Uc

Research

It may be helpful to take a look at some publications and research articles evaluating the effectiveness of Mindfulness research.

If you want to take a look at any of the papers referenced below, simply Google the authors name in Google Scholar:

Biegel, G. M., Brown, K., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-Based Stress Reduction for the Treatment of Adolescent Psychiatric Consulting Outpatients: A Randomised Clinical Trial. Journal of and Clinical Psychology. 77 (5), 855-866.

Bogels, S., Hoogstad, B., Lieke, van D., Schutter, de S., & Restifo, K. (2008). Mindfulness Training for Adolescents and Externalising Disorders and their Parents. Behavioural and Cognitive Psychotherapy. 36, 193-209.

Brown, K. W., West, A. W., Loverich, T. M., & Biegel, G.M. (2011). Assessing Adolescent Mindfulness: Validation of an Adapted Mindful Attention Awareness Scale in Adolescent Normative and Psychiatric Populations. Psychologial Assessment. Online First Publication, February 14, 2011.

Burke, C. A. (2010). Mindfulness-Based Approaches with Children and Adolescents: A Preliminary Review of Current Research in an Emergent Field. Journal of Child and Family Studies. 19, (2

Cheisa, A., and Serrenti, A. (2010) A Systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40, 1239-125

Holzel, B. K., Lazar, S, W., Gard, T., Schuman-Oliver, Z., Vago, D. R., & Ott, U. (2011). How Does Mindfulness Meditation Work? Prposing Mechanisms of Action From a Conceptual and Neural Perspective. Perspectives on Psychological Science. 6 (6) 537-559.

Kuyken, W., Byford, R. S., Watkins, E., White, K., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology. 16 (3), 334-336.

Kuyken, W., Watkins, E., Holden, E., White, K., White, K., Taylor, R. S., Byford, S., Evans, A., Radford, S., Teasdale, J. D., & Dalgleish, T. M. (2010). How does mindfulness-based cognitive therapy work?Behaviour Research and Therapy. 48. 1105-1112.

Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology. 72 (1), 31-40

McLaughlin, K. A., & Nolen-Hoeksema, S. (2010). Ruminations as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy. 49, 186-193.

Mental Health Foundation, (2010). Mindfulness Report 2010. Mental Health Foundation.

Semple, R. J., Lee, J., & Miller, L. F. (2006). ‘ Mindfulness-Based Cognitive Therapy For Children’, in Baer, R. (ed) Mindfulness-Based Treatment Approaches. Clinician’s Guide to Evidence Base and Application. United States of America. Elsevier Academic Press.

Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A Randomized Trial of Midfulness-Based Cognitive Therapy for Children: Promoting Mindful Attention to Enhance Social-Emotional Resiliency in Children. Journal of Child and Family Studies. 19. 218-229.

Semple, R. J., & Lee, J. (2011). Mindfulness-Based Cognitive Therapy for Anxious Children. A Manual for Treating Childhood Anxiety. Oakland: New Harbinger Publications.

Teasdale, J. D., Segal, Z., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68 (4), 615-623.

References

Biegel, G. M. (2009). The stress reduction workbook for teens: mindfulness skills to help you deal with stress. Canada. Instant Help Books. A Division of New Harbinger Publications, Inc.

Semple, R. J., & Lee, J. (2011). Mindfulness-Based Cognitive Therapy for Anxious Children. A Manual for Treating Childhood Anxiety. Oakland: New Harbinger Publications.