Relieve Stress and Burnout in Primary Care Physicians with Mindfulness

Relieve Stress and Burnout in Primary Care Physicians with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Dealing with sick, scared, suffering and dying patients is draining all by itself. Throw in distraction by negative emotions like worry, anger, frustration, righteous indignation … and you can easily double the energy drain. . . With an effective mindfulness practice you can notice when you are distracted by thoughts and feelings and release them quickly and effectively — without judging yourself in the process.” – Dike Drummond

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. On the front lines of medical practice are the primary care physicians. It is thus important to assess the effectiveness of mindfulness in reducing stress and burnout in these physicians.

 

In today’s Research News article “Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348323/ ), Wietmarschen and colleagues recruited primary care physicians and provided them with an 8-week Mindfulness-Based Stress Reduction (MBSR) program that includes body scan and focused meditations, yoga practice, and discussion that was modified for physicians’ needs. Training occurred once a week for 2.5 hours and included daily home practice. The physicians were measured before and after the training and 6 months later for perceived stress, self-compassion, and self-reflection ability. A subset of these physicians was also interviewed 3 months after training.

 

They found that immediately after training the physicians has significantly lower perceived stress and significantly improved self-compassion and self-reflection. Six months later the improvements in perceived stress and self-compassion were still large and highly significant. The interviews revealed that “participation in the mindfulness training made the participants more aware of their own feelings and thoughts, and better able to accept situations, experience more peacefulness, and have more openness to the self and others.”

 

It needs to be recognized that the study did not contain a control group for comparison leaving open a number of potentially confounding factors. But, prior published randomized controlled trials have demonstrated that mindfulness training markedly reduces stress and burnout. So, the present results are most likely due to the effects of MBSR training.

 

These are important findings as burnout is a threat to medical careers and the quality of health care. The fact, that a relatively brief training can have lasting effects on the well-being of primary care physicians suggests that mindfulness training should be routinely included in physician training and continuing education.

 

So, relieve stress and burnout in primary care physicians with mindfulness.

 

“mindfulness can be thought of as ‘preventive medicine’ for future doctors, helping them cultivate a way of being that may foster healing and growth in their own lives as well as skills to effectively help others heal and grow in the future.” – Shauna Shapiro

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

van Wietmarschen, H., Tjaden, B., van Vliet, M., Battjes-Fries, M., & Jong, M. (2018). Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study. BJGP open, 2(4), bjgpopen18X101621. doi:10.3399/bjgpopen18X101621

 

Abstract

Background

Primary care physicians are subjected to a high workload, which can lead to stress and a high incidence of burnout. A mindfulness training course was developed and implemented for primary care physicians to better cope with stress and improve job functioning.

Aim

To gain insight into the effects of the mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians.

Design & setting

A pragmatic mixed-methods pre–post design in which physicians received 8 weeks of mindfulness training.

Method

Participants completed validated questionnaires on perceived stress (Perceived Stress Scale [PSS]), self-compassion (Self-Compassion Scale [SCS]), and self-reflection (Groningen Reflection Ability Scale [GRAS]) before the training, directly after, and 6 months later. Semi-structured interviews were conducted with six participants after the training and a content analysis was performed to gain in depth understanding of experiences.

Results

A total of 54 physicians participated in the study. PSS was reduced (mean difference [MD] -4.5, P<0.001), SCS improved (MD = 0.5, P<0.001), and GRAS improved (MD = 3.3, P<0.001), directly after the 8-week training compared with before training. Six months later, PSS was still reduced (MD = -2.9, P = 0.025) and SCS improved (MD = 0.7, P<0.001). GRAS did not remain significant (MD = 2.5, P = 0.120). Qualitative analysis revealed four themes: being more aware of their own feelings and thoughts; being better able to accept situations; experiencing more peacefulness; and having more openness to the self and others.

Conclusion

Mindfulness training might be an effective approach for improving stress resilience, self-compassion, and self-reflection in primary care physicians.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348323/

 

Improve Balanced Time Perspective with Mindfulness

Improve Balanced Time Perspective with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is how we think about the future that determines whether the outcome is beneficial. You can think about what you want and how to make it happen, or you can think about what you don’t want and worry about how to prevent it from happening. The first way increases your chances of bringing positive emotions and experiences into your life, while the second causes you to experience negative emotions about things that may never happen; further, it decreases the amount of time and energy you have for creating positive experiences.” – Jannice Vilhauer

 

Mindfulness stresses present moment awareness, minimizing focus on past memories and

future planning. But, to effectively navigate the environment it is necessary to remember past experiences and project future consequences of behavior. So, there is a need to be balanced such that the amount of attention focused on the past, present, and future is balanced. This has been termed as balanced time perspective. It is possible that mindfulness helps balance time perspective or that it might even overly emphasize the present moment to the detriment of balance. The relationship of mindfulness to this balanced time perspective has not been previously investigated.

 

In today’s Research News article “Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395405/), Ge and colleagues recruited college students and measured them for mindfulness, self-compassion, subjective well-being, balanced time perspective, and time perspective including subscales measuring past negative, past positive, present fatalistic, present hedonistic, and future.

 

They found that mindfulness was positively related to balanced time perspective directly with the higher the levels of mindfulness the better the balance in time perspective. They also observed that mindfulness was positively related to balanced time perspective indirectly through self-compassion and subjective well-being such that high levels of mindfulness was associated with higher levels of self-compassion and subjective well-being which, in turn, were associated with higher balanced time perspective.

 

These results are interesting and for the first time demonstrate a positive relationship of mindfulness to balanced time perspective. Since a balanced time perspective may be seen as an adaptive mix of past, present, and future perspectives, it is possible that this is one of the reasons that mindfulness has such positive effects on mental health and well-being. So, mindfulness may be beneficial not just by increasing present moment awareness but also by producing appropriate allocation of attention to the past or the future where appropriate. It remains for future research to examine these possibilities.

 

So, improve balanced time perspective with mindfulness.

 

“while a mindfulness exercise that shifts attention to internal events extends one’s experience of time, a mindfulness exercise that shifts attention to an external event could potentially make time feel like it’s passing more quickly.” – Emily Nauman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ge, J., Wu, J., Li, K., & Zheng, Y. (2019). Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students. Frontiers in Psychology, 10, 367. doi:10.3389/fpsyg.2019.00367

 

Abstract

Balanced time perspective is associated with optimal social functioning and provides psychological benefits in times of stress. Previous studies have found that mindfulness is positively associated with balanced time perspective and might promote it. However, the mechanism through which mindfulness affects balanced time perspective remains unexplored. The purpose of the present study was to investigate the mediating role of self-compassion and subjective well-being in the relationship between mindfulness and balanced time perspective. A total of 754 Chinese college students, aged 17–27 years, completed the Chinese versions of the Five-Facet Mindfulness Questionnaire, Self-Compassion Scale, Subjective Well-Being Scale, and Zimbardo Time Perspective Inventory. There were significant positive correlations between mindfulness, self-compassion, subjective well-being, and balanced time perspective. Structural equation modeling indicated that in addition to the direct influence of mindfulness on balanced time perspective, self-compassion and subjective well-being played a partial mediating role. On the basis of these findings, we conclude that mindfulness has an important positive influence on balanced time perspective, and highlights the crucial role of the self-compassion in cultivating a balanced time perspective. Limitations of the present study are also discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395405/

 

Relieve Burnout in Practicing Psychologists with Mindful Self-Compassion Training

Relieve Burnout in Practicing Psychologists with Mindful Self-Compassion Training

 

By John M. de Castro, Ph.D.

 

“Mindfulness interventions in the workplace target workplace functioning: reducing stress and improving decision-making, productivity, resilience, interpersonal communication, organizational relationships, perspective-taking, and self-care,”– M. Janssen

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Mindfulness is also known to improve self-compassion, understanding one’s own suffering. It is possible that this may be a key to understanding mindfulness’ effects on burnout.

 

In today’s Research News article “Mindful Self-Compassion Training Reduces Stress and Burnout Symptoms Among Practicing Psychologists: A Randomized Controlled Trial of a Brief Web-Based Intervention.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02340/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_847629_69_Psycho_20181211_arts_A ), Eriksson and colleagues recruited practicing psychologists and randomly assigned them a wait list control condition or to receive mindful self-compassion training online for 6 weeks of 15 minute per day for 6 days per week. The program consisted of mindfulness exercises and compassion-focused exercises with 6 components, “(1) Kind attention, (2) Kind awareness, (3) Loving kindness with oneself and others, (4) Self-compassion—part 1, (5) Self-compassion—part 2, (6) Compassion with others and Quiet Practice.” The participants were measured before and after training for mindfulness, self-compassion, perceived stress, and burnout.

 

They found that compared to baseline and the wait-list control group, the group receiving mindful self-compassion training had significantly higher mindfulness and self-compassion and significantly lower self-coldness, perceived stress and burnout symptoms including fatigue, weariness, tension, and listlessness. They also found that the greater the change in self-compassion the greater the reduction in perceived stress and burnout. This suggests that improvements in self-compassion are an important consequence of mindfulness training in reducing burnout.

 

The fact that the program was delivered online and only involved 15 minutes per day is important for the engagement of busy professionals. This resulted in about 4 out of 5 psychologists successfully completing the program. Importantly, the observed sizes of the effects of the training were comparable to those seen in studies employing face-to-face training. Hence, offering the program online appeared to have the major advantages of convenience and wide availability without reducing effectiveness.

 

These results suggest that mindful self-compassion training delivered online is effective in reducing the symptoms of burnout in practicing psychologists. This should not only relieve the suffering of the psychologists but also make them more effective in relieving the suffering of their clients.

 

So, relieve burnout in practicing psychologists with mindful self-compassion training.

 

Self-compassion enhances our careers by increasing our motivation,16 encouraging us to take risks without fear of failure, to persist despite obstacles; it fosters personal growth, and even reduces medical errors.” – Laurie Keefer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Eriksson T, Germundsjö L, Åström E and Rönnlund M (2018) Mindful Self-Compassion Training Reduces Stress and Burnout Symptoms Among Practicing Psychologists: A Randomized Controlled Trial of a Brief Web-Based Intervention. Front. Psychol. 9:2340. doi: 10.3389/fpsyg.2018.02340

 

Objective: The aims of this study were (a) to examine the effects of a 6 weeks web-based mindful self-compassion program on stress and burnout symptoms in a group of practicing psychologists, and (b) to examine relationships between changes in self-compassion and self-coldness and changes in stress and burnout symptoms.

Method: In a randomized controlled trial, 101 practicing psychologists were assigned to a training group (n = 51) or a wait-list control group (n = 49). The training encompassed 15 min exercises per day, 6 days a week, for 6 weeks. The participants completed the Self-Compassion Scale (SCS), the Five Facets of Mindfulness Questionnaire (FFMQ), the Perceived Stress Scale (PSS), and the Shirom Melamed Burnout Questionnaire (SMBQ) pre and post intervention.

Results: Eighty-one participants (n = 40 in the training group, n = 41 in the control group) took part in the pre and post intervention assessments. Selective gains for the intervention group were observed for SCS total scores (d = 0.86; d = 0.94 for the SCS), FFMQ scores (d = 0.60), while levels of self-coldness was reduced (d = 0.73). Critically, levels of perceived stress (d = 0.59) and burnout symptoms (d = 0.44 for SMBQ total) were additionally lowered post intervention. Finally, the results confirmed the hypothesis that the measures of distress would be more strongly related to self-coldness than self-compassion, a pattern seen in cross-sectional analyses and, for burnout, also in the longitudinal analyses.

Conclusions: This training program appeared effective to increase self-compassion/reduce self-coldness, and to alleviate stress and symptoms of burnout and provide support of the distinction between self-compassion and self-coldness. Additional studies, preferably three-armed RCTs with long-term follow-up, are warranted to further evaluate the effectiveness of the program.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02340/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_847629_69_Psycho_20181211_arts_A

 

Improve the Happiness of Healthcare Workers with Mindfulness

Improve the Happiness of Healthcare Workers with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Thanks to the rapidly growing science of mindfulness, we are now understanding the seamless interconnectedness of brain, mind, body, experience, and well-being — to say nothing of the contributions to health and well-being that stem from social interconnectedness and environmental/planetary concerns.” – Jon Kabat-Zinn

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. Hence, mindfulness may be a means to improve the self-compassion and happiness of healthcare workers and thereby reduce burnout.

 

In today’s Research News article “Compassion, Mindfulness, and the Happiness of Healthcare Workers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598781/ ), Benzo and colleagues recruited adult healthcare workers and had them complete measures of mindfulness, self-compassion, happiness, relationship status, exercise, perceived stress, and spiritual practice. The data underwent a regression analysis to determine the relationship between the measures.

 

They found that the higher the levels of exercise and self-compassion, the greater the levels of happiness and the lower the levels of perceived stress. In addition, they found that the higher the levels of coping with isolation and mindfulness the higher the levels of happiness. The association of mindfulness with happiness occurred for the mindfulness component of self-compassion and both the non-judgmental awareness and non-reactivity to emotions.

 

These results suggest that mindfulness and self-compassion are very important for the happiness of healthcare workers. The most important components of self-compassion appear to be mindfulness and the ability to cope with isolation that is a frequent occurrence with healthcare workers. Being mindfully aware of themselves, non-judgmentally appears to be crucial for happiness of workers this high stress occupation.

 

Although these results are correlational and causation cannot be determined, prior research has demonstrated that mindfulness training works to improve well-being and reduce burnout, reduce perceived stress, and also increases self-compassion. So, the present results likely reflect an underlying causal connection between mindfulness and the happiness of healthcare workers. This further suggests that mindfulness and self-compassion training should be included in the initial training or continuing education of healthcare workers.

 

So, improve the happiness of healthcare workers with mindfulness.

 

“There is increasing evidence that learning to practice mindfulness can result in decreased burnout and improved well-being. Mindfulness is a useful way of cultivating self-kindness and compassion, including by bringing increased awareness to and acceptance of those things that are beyond our control.” – Kate Fitzpatrick

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Benzo, R. P., Kirsch, J. L., & Nelson, C. (2017). Compassion, Mindfulness, and the Happiness of Healthcare Workers. Explore (New York, N.Y.), 13(3), 201-206.

 

Abstract

Context

Decreased well-being of health care workers expressed as stress and decreased job satisfaction influences patient safety and satisfaction and cost containment. Self-compassion has garnered recent attention due to its positive association with wellbeing and happiness. Discovering novel pathways to increase the well-being of health care workers is essential.

Objective

This study sought to explore the influence of self-compassion on employee happiness in health care professionals.

Design, Setting & Participants

400 participants (mean age 45 ± 14, 65% female) health care workers at a large teaching hospital were randomly asked to complete questionnaires assessing their levels of happiness and self-compassion, life conditions and habits.

Measures

Participants completed the Happiness Scale and Self-Compassion Scales, the Five Facet Mindfulness Questionnaire as well as variables associated with wellbeing: relationship status, the number of hours spent exercising a week, attendance at a wellness facility and engagement in a regular spiritual practice.

Results

Self-compassion was significantly and independently associated with perceived happiness explaining 39% of its variance after adjusting for age, marital status, gender, time spent exercising and attendance to an exercise facility. Two specific subdomains of self-compassion from the instrument used, coping with isolation and mindfulness, accounted for 95% of the self-compassion effect on happiness.

Conclusion

Self-compassion is meaningfully and independently associated with happiness and well-being in health care professionals. Our results may have practical implications by providing specific self-compassion components to be targeted in future programs aimed at enhancing wellbeing in health care professionals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598781/

 

Improve Adolescent’s Self-Compassion and Reduce Emotional Eating with Mindful Parenting

Improve Adolescent’s Self-Compassion and Reduce Emotional Eating with Mindful Parenting

 

By John M. de Castro, Ph.D.

 

Interestingly, parents who simply had higher trait mindfulness did not see significantly better outcomes for their kids, suggesting that being mindful and being a mindful parent may be two different things.” – Jill Suttie

 

Raising children, parenting, is very rewarding, but it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. These challenges require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves the ability to maintain attention and focus in the face of high levels of distraction. Mindful parenting involves the parents having emotional awareness of themselves and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child.

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (BMI > 25). Sadly, children and adolescents have not been spared with 1 in 5 school age children and young people (6 to 19 years) classified as obese. This can be particularly troubling to adolescents who are very sensitive regarding their bodies and appearance and can be the victim of ridicule or shaming by peers.

 

One helpful method to reduce intake and help to control body weight is mindful eating. It involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake. Indeed, high levels of mindfulness are associated with lower levels of obesity and mindfulness training has been shown to reduce binge eating, emotional eating, and external eating. In addition, mindfulness has been shown to improve the individual’s ability to respond adaptively to emotions. Hence, mindfulness may be an antidote to emotional eating. It is not known if mindful parenting can reduce emotional eating in adolescents.

 

In today’s Research News article “Is Mindful Parenting Associated With Adolescents’ Emotional Eating? The Mediating Role of Adolescents’ Self-Compassion and Body Shame.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02004/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_812127_69_Psycho_20181030_arts_A ), Gouveia and colleagues recruited parent-adolescent dyads of mother or father and their 12-18 year old adolescent. The parents were measured for body size and mindful parenting. The adolescents were measured for body size, self-compassion, body shame, and emotional eating. The dyads were separated based upon the Body Mass Index (BMI) of the adolescents into normal weight and overweight and obese (BMI > 85th percentile) groups. They then performed a regression analysis of the data.

 

They found that the best fitting model of the data indicated that mindful parenting of the adolescents by the parents was associated indirectly with reduced emotional eating by the adolescents. The indirect path indicated that mindful parenting was associated with increased adolescent self-compassion which was in turn associated both with reduced emotional eating and reduced feelings of shame concerning their bodies which in turn was associated with reduced emotional eating. They also found that the facet of mindful parenting that was most associated with the benefits was the parents’ compassion for the child.

 

These results are correlational, so no conclusions regarding causation can be inferred. The results, however, are suggestive that the parents’ compassion for the child affects the child’s feelings of compassion toward itself which helps the child overcome feeling of shame about its body, all of which contribute to reduced eating in response to emotions. It remains for future research to determine if promoting parental compassion toward the adolescent may cause positive change in the adolescent, improving self-compassion, reducing body shame, and in turn reducing emotional eating.

 

So, improve adolescent’s self-compassion and reduce emotional eating with mindful parenting.

 

“Mindful parenting means that you bring your conscious attention to what’s happening, instead of getting hijacked by your emotions. . . It’s about accepting whatever is going on, rather than trying to change it or ignore it. Being a mindful parent means that you pay attention to what you’re feeling. It does not mean that you will not get angry or upset. Of course you will feel negative emotions, but acting on them mindlessly is what compromises our parenting.” – Parent Co

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Gouveia MJ, Canavarro MC and Moreira H (2018) Is Mindful Parenting Associated With Adolescents’ Emotional Eating? The Mediating Role of Adolescents’ Self-Compassion and Body Shame. Front. Psychol. 9:2004. doi: 10.3389/fpsyg.2018.02004

 

This study aimed to explore whether parents’ mindful parenting skills were associated with adolescents’ emotional eating through adolescents’ levels of self-compassion and body shame. The sample included 572 dyads composed of a mother or a father and his/her child (12–18 years old), with normal weight (BMI = 5–85th percentile) or with overweight/obesity with or without nutritional treatment (BMI ≥ 85th percentile) according to the WHO Child Growth Standards. Parents completed self-report measures of mindful parenting (Interpersonal Mindfulness in Parenting Scale), and adolescents completed measures of self-compassion (Self-Compassion Scale-Short Form), body shame (Experience of Shame Scale), and emotional eating (Dutch Eating Behavior Questionnaire). Two path models, one with the total score for mindful parenting and the other with its dimensions, were tested in AMOS. Mindful parenting, specifically the dimension of compassion for the child, was indirectly associated with emotional eating through adolescents’ self-compassion (point estimate = −0.27, p = 0.03, CI 95% [−0.61, −0.06]) and through self-compassion and body shame sequentially (point estimate = −0.19, p = 0.03, CI 95% [−0.37, −0.05]). The path model was invariant across weight groups but not across adolescents’ sex (the indirect effects were significant among girls only). This study provides a novel comprehensive model of how mindful parenting, especially the dimension of compassion for the child, can be associated with adolescents’ emotional eating behaviors by suggesting a potential sequence of mechanisms that may explain this association. This study suggests the beneficial effect of both mindful parenting and adolescents’ self-compassion skills for adolescent girls struggling with feelings of body shame and emotional eating behaviors.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02004/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_812127_69_Psycho_20181030_arts_A

 

Reduce Stress and Improve Well-Being in a Workplace with Mindfulness

Reduce Stress and Improve Well-Being in a Workplace with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Becoming aware of what’s going on around you can make a huge difference, because we spend so much time wrapped up in our thoughts that we lose contact with the real world. That’s especially the case if you’re constantly bombarded by email, Facebook posts and Twitter. It’s not really conducive to a calm and productive work environment.“ – Danny Penman

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological and physical health. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnoutmindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress and burnout.

 

In today’s Research News article “A mindfulness training program based on brief practices (M-PBI) to reduce stress in the workplace: a randomised controlled pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060839/ ), Arredondo and colleagues recruited stressed employees and randomly assigned them to either be in a wait-list control group or to receive an 8-week mindfulness training program. The training occurred once a week for 1.5 hours and included daily practices. The participants were measured before and after training and 20 weeks later for mindfulness, perceived stress, self-compassion, decentering, burnout, and heart rate variability.

 

They found that in comparison to baseline and the wait-list control group the mindfulness trained group had significant decreases in perceived stress and the components of burnout of emotional exhaustion, depersonalization, and reduced personal accomplishment, and significant increases in mindfulness, self-compassion, and decentering. These differences were enduring as they were still significant at the 20-week follow-up. They also found an increase in heart rate variability indicative of reduced stress.

 

These results are very encouraging and suggest that mindfulness training can be very beneficial in reducing workplace stress levels and burnout. It also appears to improve the overall psychological well-being of the employees improving mindfulness, self-compassion, and decentering. The ability of mindfulness training to reduce stress and burnout, and to increase self-compassion and decentering have been previously observed with different participant population. The study would have been stronger had an active control group been included. But, nevertheless the findings are suggestive that mindfulness training can be quite beneficial for stressed employees.

 

So, reduce stress and improve well-being in a workplace with mindfulness.

 

“Toxic emotions disrupt the workplace, and mindfulness increases your awareness of these destructive patterns, helping you recognize them before they run rampant. It’s a way of reprogramming your mind to think in healthier, less stressful, ways.” –  Drew Hansen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Arredondo, M., Sabaté, M., Valveny, N., Langa, M., Dosantos, R., Moreno, J., & Botella, L. (2017). A mindfulness training program based on brief practices (M-PBI) to reduce stress in the workplace: a randomised controlled pilot study. International Journal of Occupational and Environmental Health, 23(1), 40–51. http://doi.org/10.1080/10773525.2017.1386607

 

Abstract

Work stress is a major contributor to absenteeism and reduced work productivity. A randomised and controlled study in employee-volunteers (with Perceived Stress Scale [PSS-14]>22) was performed to assess a mindfulness program based on brief integrated mindfulness practices (M-PBI) with the aim of reducing stress in the workplace. The PSS-14 of the employees before and after 8-weeks M-PBI program, as well as after a 20-week follow-up, was assessed (primary endpoint). The employees also carried the following questionnaires (secondary endpoints): Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale (SCS), Experiences Questionnaire-Decentering (EQ-D), and Maslach Burnout Inventory-General Survey (MBI-GS). Heart Rate Variability (HRV) was measured during each session in a subgroup of employees (n = 10) of the interventional group randomly selected. A total of 40 employees (77.5% female median [SD] age of 36.6 [5.6] years) took part in this study: 21 and 19 in the intervention and control group, respectively. No differences in baseline characteristics were encountered between the groups. Results show a significant decrease in stress and increase in mindfulness over time in the intervention group (PSS-14 and FFMQ; p < 0.05 both). Additionally, an improvement in decentering (EQ-D), self-compassion (SCS) and burnout (MBI-GS) were also observed compared to the control group (p < 0.05 in all). HRV measurement also showed an improvement. In conclusion, a brief practices, 8-weeks M-BIP program is an effective tool to quickly reduce stress and improve well-being in a workplace.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060839/

 

Reduce Perceived Stress with Mindfulness

Reduce Perceived Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness not only reduces stress but also gently builds an inner strength so that future stressors have less impact on our happiness and physical well-being.” – Shamash Alidina

 

Mindfulness training has been shown to be effective in improving physical and psychological health. One reason for these benefits is that mindfulness training improves the individual’s physical and psychological reactions to stress. Stress is an integral part of life, that is actually essential to the health of the body. In moderation, it is healthful, strengthening, and provides interest and fun to life. If stress, is high or is prolonged, however, it can be problematic. It can significantly damage our physical and mental health and even reduce our longevity, leading to premature deaths. So, it is important that we develop methods to either reduce or control high or prolonged stress or reduce our responses to it.

 

Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress. The research, however, at times, involves weak research designs and suffers from lack of control for social support and experimenter and participant expectancy effects. In addition, it is not known how mindfulness training influences levels of perceived stress. In today’s Research News article “Investigating the Specific Effects of an Online Mindfulness-Based Self-Help Intervention on Stress and Underlying Mechanisms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061241/ ),  Gu and colleagues examined the effects of mindfulness training on stress levels in a well controlled experimental design.

 

They recruited university students and staff and randomly assigned them to one of three conditions; online Mindfulness-Based Self-Help training, listening to classical music online, or to a wait list. The Mindfulness training occurred over 2 weeks with 4 times per week 10-minute online recordings and home practice. The online listening to classical music conditions paralleled the mindfulness condition in being presented over 2 weeks with 4 times per week 10-minute recorded instructions and home practice. The participants were measured before during and after the training for mindfulness, self-compassion, worry, perceived stress, how engaged was the participant in practice, and participant expectancies.

 

They found that in comparison to before training and the music and wait list conditions, the mindfulness group had significantly lower levels of perceived stress and worry and significantly higher levels of mindfulness and self-compassion. They also performed a mediation analysis to investigate whether the effects of stress may have been mediated by the effects on mindfulness, worry, and or self-compassion. They found that higher mindfulness scores produced by the mindfulness intervention were associated with lower perceived stress. Similarly, lower worry scores produced by the mindfulness intervention were associated with lower perceived stress and higher self-compassion or scores produced by the mindfulness intervention were associated with lower perceived stress. Importantly, there were no significant differences between the conditions in engagement or expectancy effects.

 

These results demonstrate that mindfulness training lowers perceived stress levels and this could not be accounted for by expectancy or engagement effects. They further demonstrated that a mindfulness intervention lowers perceived stress by increasing mindfulness and self-compassion and lowers worry. Previous research has demonstrated that mindfulness training decreases perceived stress and worry, and increases mindfulness and self-compassion. The contribution of the current study is to demonstrate that the effects were not due to experimental contaminants and that the effects on perceived stress are due to effects on all three of these variables.

 

So, reduce perceived stress with mindfulness.

 

“There is nothing a busy man is less busied with than living; there is nothing harder to learn.” — Seneca

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Gu, J., Cavanagh, K., & Strauss, C. (2018). Investigating the Specific Effects of an Online Mindfulness-Based Self-Help Intervention on Stress and Underlying Mechanisms. Mindfulness, 9(4), 1245–1257. http://doi.org/10.1007/s12671-017-0867-y

 

Abstract

Previous research examining the effects of mindfulness-based interventions (MBIs) and their mechanisms of change has been hampered by failure to control for non-specific factors, such as social support and interaction with group members, facilitator contact and expectation of benefit, meaning that it remained possible that benefits of MBIs could have been attributable, perhaps entirely, to non-specific elements. This experimental study examined the effects of a 2-week online mindfulness-based self-help (MBSH) intervention compared to a well-matched classical music control condition and a waitlist control condition on perceived stress. This study also tested mindfulness, self-compassion and worry as mechanisms of the effects of MBSH versus both control conditions on stress. University students and staff (N = 214) were randomised to MBSH, classical music, or waitlist conditions and completed self-report measures pre-, mid- and post-intervention. Post-intervention, MBSH was found to significantly reduce stress compared to both control conditions. Bootstrapping-based mediation analyses used standardised residualised change scores for all variables, with mediators computed as change from baseline to mid-intervention, and the outcome computed as change from baseline to post-intervention. Changes in mindfulness, self-compassion and worry were found to significantly mediate the effects of MBSH versus both control conditions on changes in stress. Findings suggest that cultivating mindfulness specifically confers benefits to stress and that these benefits may occur through improving theorised mechanisms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061241/

 

Relaxation and Mindfulness Training Have Differing Psychological and Neural Effects

Relaxation and Mindfulness Training Have Differing Psychological and Neural Effects

 

By John M. de Castro, Ph.D.

 

“this practice of nonjudgmental self-awareness is one of the most effective ways to improve mood and anxiety.” – Neda Gould

 

Mindfulness training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies. One problem with understanding mindfulness training effects is that there are, a wide variety of mindfulness techniques and it is not known which work best for improving different conditions.

 

There are a number of different types of meditation. Many can be characterized on a continuum with the degree and type of attentional focus. In focused attention meditation, the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future. In open monitoring meditation, the individual opens up awareness to everything that’s being experienced regardless of its origin. These include bodily sensations, external stimuli, and even thoughts.

 

These techniques have common properties of restful attention on the present moment, but there are large differences. These differences are likely to produce different effects on the practitioner. One way to distinguish between the effects of these different meditation techniques is to observe the effects of each technique on the brain.  In today’s Research News article “Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976535/ ), Sevinc and colleagues recruited adults and randomly assigned them to receive 8 weekly 2-hour group sessions with 20 minutes of daily home practice with guided recordings of either a Relaxation Response program or a Mindfulness-Based Stress Reduction (MBSR) program.

 

In the Relaxation Response program, the participants practiced a body scan with emphasis on relaxation and focused meditation on the breath in a 20-minute session. In the MBSR program the participants practiced body scan with focus on awareness of the sensations from the body for 2 weeks, yoga for 2 weeks, and open monitoring meditation for 2 weeks. The last 2 weeks the participants could chose whichever of the practices they wanted to perform. They were measured before and after training for perceived stress, mindfulness, self-compassion, rumination, and life stressors. They also underwent Magnetic Resonance Imaging (MRI) while they listened to a guided recording for the body scan from their home practices.

 

They found that both practices equivalently reduced perceived stress and increased mindfulness. But the Mindfulness-Based Stress Reduction (MBSR) program also significantly increased self-compassion and decreased rumination. Interestingly, although both practices produced increases functional connectivity between the prefrontal cortex and motor cortex, the two practices also produced different connectivities. When the body scan was practiced with emphasis on relaxation there was increased functional connectivity was with the right inferior frontal gyrus. This is an area that’s involved in behavioral inhibition. On the other hand, when the body scan was practiced with emphasis on awareness of sensations there was increased functional connectivity between the Insula and Cingulate Cortex, areas associated with sensory awareness.

 

Hence, although both practices were beneficial, the MBSR program appears to create better psychological well-being. In addition, the body scan technique used in the MBSR program, emphasizing sensory awareness, appears to increase the connectivity between brain areas that are involved in sensory awareness. On the other hand, a relaxation instruction with the body scan appears to produce increased brain systems devoted to restraining responses. Different mindfulness techniques produced different psychological and neural outcomes. Both appear to improve stress responding and mindfulness, but the MBSR program also produces better compassion for the self and less repetitive negative thinking, rumination.

 

So, there may be a place for the relaxation response program, but with these otherwise healthy adults, the Mindfulness-Based Stress Reduction (MBSR) program appears to produce superior results.

 

 “If you have unproductive worries,” you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sevinc, G., Hölzel, B. K., Hashmi, J., Greenberg, J., McCallister, A., Treadway, M., … Lazar, S. W. (2018). Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs. Psychosomatic Medicine, 80(5), 439–451. http://doi.org/10.1097/PSY.0000000000000590

 

ABSTRACT

Objective

We investigated common and dissociable neural and psychological correlates of two widely used meditation-based stress reduction programs.

Methods

Participants were randomized to the Relaxation Response (RR; n = 18; 56% female) or the Mindfulness-Based Stress Reduction (MBSR; n = 16; 56% female) programs. Both programs use a “bodyscan” meditation; however, the RR program explicitly emphasizes physical relaxation during this practice, whereas the MBSR program emphasizes mindful awareness with no explicit relaxation instructions. After the programs, neural activity during the respective meditation was investigated using functional magnetic resonance imaging.

Results

Both programs were associated with reduced stress (for RR, from 14.1 ± 6.6 to 11.3 ± 5.5 [Cohen’s d = 0.50; for MBSR, from 17.7 ± 5.7 to 11.9 ± 5.0 [Cohen’s d = 1.02]). Conjunction analyses revealed functional coupling between ventromedial prefrontal regions and supplementary motor areas (p < .001). The disjunction analysis indicated that the RR bodyscan was associated with stronger functional connectivity of the right inferior frontal gyrus—an important hub of intentional inhibition and control—with supplementary motor areas (p < .001, family-wise error [FWE] rate corrected). The MBSR program was uniquely associated with improvements in self-compassion and rumination, and the within-group analysis of MBSR bodyscan revealed significant functional connectivity of the right anterior insula—an important hub of sensory awareness and salience—with pregenual anterior cingulate during bodyscan meditation compared with rest (p = .03, FWE corrected).

Conclusions

The bodyscan exercises in each program were associated with both overlapping and differential functional coupling patterns, which were consistent with each program’s theoretical foundation. These results may have implications for the differential effects of these programs for the treatment of diverse conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976535/

 

Reduce Anxiety and Depression in Stressed College Students with Mindfulness

Reduce Anxiety and Depression in Stressed College Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is so vital. It’s being right there in the moment. It helps you be successful in everything you do. College students are under a lot of stress — that’s been a given forever. Now, they have the tools in their pocket.” – Cathleen Hardy Hansen

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditationmindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. So, it would seem important to examine various techniques to relieve the stress and its consequent symptoms in college students.

 

In today’s Research News article “A Randomized Controlled Trial Comparing the Attention Training Technique and Mindful Self-Compassion for Students with Symptoms of Depression and Anxiety.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00827/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_662896_69_Psycho_20180605_arts_A ), Haukaas and colleagues explore the ability of attention training and mindfulness training to help relieve the anxiety and depression in college students resulting from stress.

 

They recruited undergraduate and graduate students who self-reported depression, anxiety, and stress. They were randomly assigned to receive 3 group sessions for 45 minutes for three consecutive weeks of either Attention Training or Mindfulness and Self-Compassion training. Each training included daily home practice with pre-recorded audio recordings. Attention training was designed “to strengthen attentional control and promote external focus of attention, to interrupt and break free of the cognitive attentional syndrome, consisting of prolonged worry or rumination, threat monitoring, and different unhelpful coping styles accompanied by a heightened self-focused attention.” Mindfulness and Self-Compassion training consisted of training to pay attention to the present moment and “to relate to oneself in a kinder and more accepting manner.” Training including Loving Kindness Meditation practice. Participants were measured before and after training for depression, anxiety, self-compassion, responses to thoughts, and mindfulness.

 

They found that both Attention Training and Mindfulness and Self-Compassion training produced significant reductions in general and test anxiety and depression and significant increases in mindfulness, self-compassion, attention flexibility, and self-esteem. The effects were moderate to large indicating fairly powerful effects of the treatments. It should be noted that there wasn’t a control condition and both treatments were associated with significant changes. It is thus possible that confound or bias was present that could account for some or all of the changes. But, the effects were strong and commensurate with previous findings that mindfulness training reduces anxiety and depression and increases self-compassion. Thus, it would appear that the two treatments are effective for improving the psychological health of stressed university students.

 

So, reduce anxiety and depression in stressed college students with mindfulness and attention training.

 

“taking time to catch your breath and meditate can help increase students’ overall life satisfaction. We found that underneath the stress that students are experiencing is a deep desire to appreciate life and feel meaningful connections with other people.” – Kamila Dvorakova

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Haukaas RB, Gjerde IB, Varting G, Hallan HE and Solem S (2018) A Randomized Controlled Trial Comparing the Attention Training Technique and Mindful Self-Compassion for Students With Symptoms of Depression and Anxiety. Front. Psychol. 9:827. doi: 10.3389/fpsyg.2018.00827

 

The Attention Training Technique (ATT) and Mindful Self-Compassion (MSC) are two promising psychological interventions. ATT is a 12-min auditory exercise designed to strengthen attentional control and promote external focus of attention, while MSC uses guided meditation and exercises designed to promote self-compassion. In this randomized controlled trial (RCT), a three-session intervention trial was conducted in which university students were randomly assigned to either an ATT-group (n = 40) or a MSC-group (n = 41). The students were not assessed with diagnostic interviews but had self-reported symptoms of depression, anxiety, or stress. Participants listened to audiotapes of ATT or MSC before discussing in groups how to apply these principles for their everyday struggles. Participants also listened to audiotapes of ATT and MSC as homework between sessions. Participants in both groups showed significant reductions in symptoms of anxiety and depression accompanied by significant increases in mindfulness, self-compassion, and attention flexibility post-intervention. These results were maintained at 6-month follow-up. Improvement in attention flexibility was the only significant unique predictor of treatment response. The study supports the use of both ATT and MSC for students with symptoms of depression and anxiety. Further, it suggests that symptom improvement is related to changes in attention flexibility across both theoretical frameworks. Future studies should focus on how to strengthen the ability for attention flexibility to optimize treatment for emotional disorder.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00827/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_662896_69_Psycho_20180605_arts_A

 

Improve Mental Health in Medical Residents with Mindfulness

Improve Mental Health in Medical Residents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“increasing physician resilience, or the ability to “bounce back” from experiences such as burnout, has been shown to have a significant positive impact on patient care and physician wellbeing. . . benefits include improved quality of care, reduced errors and minimized attrition . . . mindfulness-influenced wellness programs for residents can improve self-compassion, empathy, burnout and stress reactions. Mindfulness meditation introduces a way of cultivating awareness of one’s relationship with the present moment. With practice, it may lead to healthier ways of working with stressful life experiences, including those inherent to residency training.” – Vincent Minichiello

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical residency is an extremely stressful period and many express burnout symptoms. This would seem to be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880763/ ), Verweij and colleagues examined the ability of a Mindfulness-Based Stress Reduction (MBSR) program to treat the symptoms of burnout in medical residents. They recruited medical residents and randomly assigned them to either receive an 8-week, once a week, 2,5 hour session of Mindfulness-Based Stress Reduction (MBSR) or be assigned to a wait-list control condition. MBSR consists of a combination of meditation, yoga, and body scan practice in combination with discussion and home practice. The residents were measured before the program and 3 weeks later for emotional exhaustion, worry, home-work interference, mindfulness, self-compassion, positive mental health, physician empathy, and medical errors.

 

They found that in comparison to baseline and to the wait-list control condition, the residents who received MBSR training had significantly higher mindfulness, self-compassion, personal accomplishment, and perspective taking empathy, and significantly lower worry. These outcomes were all of moderate effect sizes. There were no significant effects on the primary measure of burnout, emotional exhaustion. But, the residents who had the highest levels of emotional exhaustion did show a significant improvements in emotional exhaustion after treatment.

 

These results suggest that Mindfulness-Based Stress Reduction (MBSR) maybe an effective treatment to improve the mental health of medical residents and perhaps reduce the tendency toward burnout. It should be noted, however, that medical residents are very restricted for time and MBSR training requires a considerable investment of time both in the training sessions and in home practice, making participation difficult. Future research should include an active control condition such as aerobic exercise to help control for potential sources of confounding and bias.

 

So, improve mental health in medical residents with mindfulness.

 

“I experienced burnout as a resident, and meditation was a key aspect to my recovery. My mother advised me to meditate, and afterwards, I felt like my brain had been rebooted.” – Louise Wen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Verweij, H., van Ravesteijn, H., van Hooff, M. L. M., Lagro-Janssen, A. L. M., & Speckens, A. E. M. (2018). Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial. Journal of General Internal Medicine, 33(4), 429–436. http://doi.org/10.1007/s11606-017-4249-x

 

Abstract

Background

Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents.

Objective

To determine the effectiveness of MBSR in reducing burnout in residents.

Design

A randomized controlled trial comparing MBSR with a waitlist control group.

Participants

Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred.

Intervention

The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day.

Main Measures

The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory–Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work–home interference, mindfulness skills, self-compassion, positive mental health, empathy and medical errors. Assessment took place at baseline and post-intervention approximately 3 months later.

Key Results

Of the 148 residents participating, 138 (93%) completed the post-intervention assessment. No significant difference in emotional exhaustion was found between the two groups. However, the MBSR group reported significantly greater improvements than the control group in personal accomplishment (p = 0.028, d = 0.24), worry (p = 0.036, d = 0.23), mindfulness skills (p = 0.010, d = 0.33), self-compassion (p = 0.010, d = 0.35) and perspective-taking (empathy) (p = 0.025, d = 0.33). No effects were found for the other measures. Exploratory moderation analysis showed that the intervention outcome was moderated by baseline severity of emotional exhaustion; those with greater emotional exhaustion did seem to benefit.

Conclusions

The results of our primary outcome analysis did not support the effectiveness of MBSR for reducing emotional exhaustion in residents. However, residents with high baseline levels of emotional exhaustion did appear to benefit from MBSR. Furthermore, they demonstrated modest improvements in personal accomplishment, worry, mindfulness skills, self-compassion and perspective-taking. More research is needed to confirm these results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880763/