By John M. de Castro, Ph.D.
“mindfulness – or intentionally paying attention to the present moment with nonjudgment – turns out to be equally as beneficial for those of us who are caregivers as it is for those of us who need caregiving. A mindfulness practice can improve not only our experiences of caregiving, but also the ways in which we (re)act as caregivers.” – Jennie Crooks
Caring for children and adults with intellectual and developmental disabilities can be difficult. Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have one or more developmental disabilities.
Today, most people with intellectual and developmental disabilities live with their families. This places many stresses on the caregivers and their families and stretches their financial resources. Due to these issues, people with severe cases of intellectual and developmental disabilities are often cared for in community and group homes. The staff of these homes, like family caregivers are under high levels of stress for many reasons including that many individuals with intellectual and developmental disabilities are highly aggressive and at time combative. They sometimes require physical restraint and can cause injuries to the caregiver and to other patients. In addition, the high levels of stress and injury results in many staff leaving.
It should be clear that there is a need for methods to reduce the stress, injuries, and burnout of caregivers in community and group homes. Mindfulness training has been found to be helpful for caregivers in the home setting. So, it would be reasonable to expect that mindfulness training may also be helpful for caregivers in community and group homes. In today’s Research News article “Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial.” See:
or see summary below or view the full text of the study at:
Singh and colleagues recruited caregivers of individuals with intellectual and developmental disabilities in a large institutional setting. They were randomly assigned to receive either a Mindfulness-Based Positive Behavior Support (MBPBS) program or the usual training program offered in the facility (Training as Usual; TAU). “The standard 7-day MBPBS protocol was presented in three parts, spread over a 10-week period.” Before and after training they measured patients’ aggressive events, such as hitting, biting, scratching, punching, kicking, slapping, or destroying property, and emergency medications dispensed, the staff’s stress and turnover, and the institutional costs.
They found that the staff receiving MBPBS had a significantly greater reduction in stress levels (36%) and had fewer resignations than those receiving TAU (9%). The mindfulness training also produced a significant reduction in the number of aggressive events, emergency medications dispensed, and the need for physical restraints. For the institution, MBPBS training reduced the need for staff, the number of days lost due to injury, and medical and physical rehabilitation therapy services for injured staff and thus saved the facility significant funds.
These are exciting findings. Mindfulness training improved the environment and staff stress and reduced costs. That’s quite remarkable given that this is one of the most costly and difficult caregiving challenges there is. It is unclear how improving the mindfulness of the caregivers produced such a marked improvement in the behaviors of the individuals with intellectual and developmental disabilities. Perhaps, being more mindful facilitates the quality of the interactions, calming the patients. As the authors state “We suspect that disciplined meditation practice enables the caregivers to gradually change their relationship to their perceived mental and emotional experiences that arise when providing care to the individuals. . . this mindset enables them to avoid reacting to the challenging behaviors of the individuals based on their premature cognitive commitment to control aggressive behavior through physical restraints and stat medications.”
So, improve caregiving for people with intellectual disabilities with mindfulness
“Learning to quell distress and anxiety is especially important for parents of children with development disabilities because it’s often a lifetime caregiving commitment.” – Elisabeth M. Dykens
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Singh NN, Lancioni GE, Karazsia BT, Chan J and Winton ASW (2016) Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial. Front. Psychol. 7:1549. doi: 10.3389/fpsyg.2016.01549
Caregivers of individuals with intellectual and developmental disabilities (IDD) often end up having their medical and psychological well-being compromised due to the stressful nature of caregiving, especially when those in their care engage in aggressive behavior. In this study, we provided caregivers with mindfulness-based training to enable them to better manage their psychological well-being and, through this, to also enhance specific indices of quality of life of the individuals in their care. Thus, the aim of the present study was to evaluate in a randomized controlled trial (RCT) the comparative effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) and Training-as-Usual (TAU) for caregivers in a congregate care facility for individuals with severe and profound IDD. The comparative effects of the two training conditions were assessed in terms of caregiver variables care recipient variable (number of aggressive events), and agency variables Results showed that MBPBS was significantly more effective than TAU in enabling the caregivers to manage their perceived psychological stress, and to reduce the use of physical restraints and stat medications for aggressive behavior of the individuals in their care. In addition, there were significant reductions in aggressive events by the individuals in their care, 1:1 staffing of individuals with aggressive behavior, and staff turnover. Furthermore, the MBPBS training was significantly more cost-effective than the TAU training. If replicated in future RCT studies, MBPBS may provide an effective means of enhancing socially acceptable bidirectional engagement of caregivers and care recipients within a person-centered context.