Spirituality and Religion are Associated with Better Well-Being in Medical Residents

Spirituality and Religion are Associated with Better Well-Being in Medical Residents

 

By John M. de Castro, Ph.D.

 

“Most internal medicine residents have positive attitudes toward spirituality, religion, and medicine. They do not have adequate knowledge or skill to care for patients in this area.” – Gina M. Piscitello

 

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. Religion and spirituality have been promulgated as solutions to the challenges of life. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners and patients mostly showing positive benefits, with spirituality encouraging personal growth and mental health. But there is still a need to investigate the relationships of spirituality with psychological well-being in patients and medical residents.

 

In today’s Research News article “Spirituality and religion in residents and inter-relationships with clinical practice and residency training: a scoping review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166631/ ) Chow and colleagues review and summarize the published research on the relationship of spirituality and religion to the psychological well-being of patients and medical residents. They identified 44 published studies.

 

They report that the research found that medical residents believed that spirituality and religion were important to patients and made a difference in the outcomes of treatment. Over half of the residents identified themselves as spiritual or religious. The higher the degree of spirituality but not church going of the residents’ the greater sense of accomplishment and overall health and the lower the levels of burnout and depression. They report that although the patients rarely brought up spirituality and religion and the residents rarely inquired, when the medical issue was very serious and life threatening, it was brought up 72% of the time. They also report that the curriculum for medical residents rarely included spirituality and religion topics.

 

The findings suggest that the majority of medical residents recognize the importance of spirituality and religion for their patients and that it positively relates to treatment adherence and clinical outcomes, but the issues were rarely addressed. Spirituality and religion were important personally to the majority of the residents and were related to better well-being and lower burnout. But there was little instruction in the curriculum about these issues and there was great reticence to bring it up with patients. This suggests that training curricula for medical residents should include greater incorporation of spiritual and religious issues and how to incorporate them into patient care.

 

So, spirituality and religion are associated with better well-being in medical residents.

 

Although religion and spirituality continue to be contested and controversial topics in our society, the existing evidence highlights patients’ desires to have some level of spiritual interaction with their healthcare providers.” – James Behan

 

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

 

Chow, H., Chew, Q. H., & Sim, K. (2021). Spirituality and religion in residents and inter-relationships with clinical practice and residency training: a scoping review. BMJ open, 11(5), e044321. https://doi.org/10.1136/bmjopen-2020-044321

 

Abstract

Objectives

With the increased emphasis on personalised, patient-centred care, there is now greater acceptance and expectation for the physician to address issues related to spirituality and religion (SR) during clinical consultations with patients. In light of the clinical need to improve SR-related training in residency, this review sought to examine the extant literature on the attitudes of residents regarding SR during residency training, impact on clinical care and psychological well-being of residents and SR-related curriculum implemented within various residency programmes.

Design

A scoping review was conducted on studies examining the topic of SR within residency training up until July 2020 on PubMed/Medline and Web of Science databases. Keywords for the literature search included: (Spirituality OR Religion) AND (Residen* OR “Postgraduate Medicine” OR “Post-graduate Medicine” OR “Graduate Medical Education”).

Results

Overall, 44 studies were included. The majority were conducted in North America (95.5%) predominantly within family medicine (29.5%), psychiatry (29.5%) and internal medicine (25%) residency programmes. While residents held positive attitudes about the role of SR and impact on patient care (such as better therapeutic relationship, treatment adherence and coping with illness), they often lacked the knowledge and skills to address these issues. Better spiritual well-being of residents was associated with greater sense of work accomplishment, overall self-rated health, decreased burnout and depressive symptoms. SR-related curricula varied from standalone workshops to continuous modules across the training years.

Conclusions

These findings suggest a need to better integrate appropriate SR-related education within residency training. Better engagement of the residents through different pedagogical strategies with supervision, feedback, reflective practice and ongoing faculty and peer support can enhance learning about SR in clinical care. Future studies should identify barriers to SR-related training and evaluate the outcomes of these SR-related curriculum including how they impact the well-being of patients and residents over time.

Keywords: medical education & training, Education & training (see medical education & training), mental

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166631/

 

Improve Executives’ Attitudes Toward Work with a Mindfulness App

Improve Executives’ Attitudes Toward Work with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

Mindful working means applying focus and awareness to everything you do from the moment you enter the office. Focus on the task at hand and recognize and release internal and external distractions as they arise. In this way, mindfulness helps increase effectiveness, decrease mistakes, and even enhance creativity.” –  Rasmus Hougaard

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. 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 work-related stress 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. These mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in executives in real-world work settings.

 

In today’s Research News article “An App-Based Workplace Mindfulness Intervention, and Its Effects Over Time.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101632/ ) Lu and colleagues recruited working executives who had signed up for an 8-week mindfulness program on the Awakened Mind® platform. The App contained 8 weekly mindfulness meditation sessions. They were measured before, weekly during, and after training for mindfulness, emotional exhaustion, work engagement, and job satisfaction.

 

They found that the higher the levels of mindfulness, the higher the levels of work engagement, and job satisfaction and the lower the levels of emotional exhaustion. They also found that over time mindfulness grew stronger which in turn produced greater levels of work engagement, and job satisfaction and lower levels of emotional exhaustion. These effects grew throughout the 8 weeks of training but the rate of change was greatest early in training slowing later in training. Hence, the app increases mindfulness over time and this in turn improves workplace attitudes.

 

One problem encountered was that participation rates decreased over the 8 weeks of training such that by the end of training only 54% of the original participants were still using the app. This might suggest that experimental mortality could account for the results. But the fact that the effects were present early in the program when participation rates were high suggests that use of the app and not a confounding variable was responsible for the effects.

 

The results suggest that business executives benefit from using a mindfulness meditation app and further suggest that the app increases mindfulness which is responsible for the improved attitudes toward work. Mindfulness has been previously shown to reduce burnout at work. This suggests that this simple, convenient, and inexpensive mindfulness training should be recommended for business executives.

 

So, improve executives’ attitudes toward work with a mindfulness App.

 

a brief two-week mindfulness training app can change a person’s biological response to stress.” – Emily K. Lindsay

 

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

 

Lu, Y., Remond, J., Bunting, M., Ilies, R., Tripathi, N., & Narayanan, J. (2021). An App-Based Workplace Mindfulness Intervention, and Its Effects Over Time. Frontiers in psychology, 12, 615137. https://doi.org/10.3389/fpsyg.2021.615137

 

Abstract

We investigated the week-to-week effects of a mindfulness intervention on emotional exhaustion, work engagement, and job satisfaction in a field study involving 218 participants who participated and reported their weekly outcomes during the 8-week program. To examine how mindfulness impacted work outcomes, we used intraindividual modeling of the 8-week data. Mindfulness increased over time, and time also had indirect effects on emotional exhaustion, work engagement, and job satisfaction, through mindfulness. Supplementary growth curve analyses on the improvement of mindfulness over time showed a slight decrease in the positive effect of time on mindfulness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101632/

 

Improve Psychological Health at Work with Mindfulness

Improve Psychological Health at Work with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful working means applying focus and awareness to everything you do from the moment you enter the office. Focus on the task at hand and recognize and release internal and external distractions as they arise. In this way, mindfulness helps increase effectiveness, decrease mistakes, and even enhance creativity.” – Rasmus Hougaard

 

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, social, and physical health. But, nearly 2/3 of employees 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. It is not known, however, how mindfulness and its benefits grow over training

 

In today’s Research News article “An App-Based Workplace Mindfulness Intervention, and Its Effects Over Time.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.615137/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1616048_69_Psycho_20210504_arts_A) Lu and colleagues recruited participants online to an online mindfulness training (Awakened Mind) once a week for 8 weeks. They were measured before and after each weekly session for mindfulness, emotional exhaustion, work engagement, and job satisfaction.

 

They report that over training mindfulness significantly increases and was associated with higher levels of work engagement and job satisfaction and lower levels of emotional exhaustion. Multilevel growth level analysis revealed that amount of time in training significantly increased mindfulness and it, in turn, increased work engagement and job satisfaction and decreased emotional exhaustion. They also report that the rate of growth in mindfulness significantly slowed over the 8 weeks of training.

 

Previous research has demonstrated that mindfulness training improves work engagement and job satisfaction and reduces emotional exhaustion. The contribution of the present study was to document the growth of mindfulness and its impact on work over 8 weeks of online training. Not surprisingly, the growth in mindfulness was relatively rapid at the beginning of training and slower toward the end of the 8 weeks of training. So, further training produces diminishing returns.

 

The mindfulness training was online and thus did not interrupt the participants’ work. This is important as employers are reluctant to take time away from work for mindfulness training. Having it occur online allows the participants to schedule it at their own convenience without disrupting work and also greatly increases its availability to large numbers of workers at low cost. Online training, then, is an almost ideal method of training workers in mindfulness and thereby improve their psychological state at work.

 

So, improve psychological health at work with mindfulness.

 

To be mindful at work means to be consciously present in what you’re doing, while you’re doing it, as well as managing your mental and emotional state.” – Shamash Alidina

 

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

 

Lu Y, Remond J, Bunting M, Ilies R, Tripathi N and Narayanan J (2021) An App-Based Workplace Mindfulness Intervention, and Its Effects Over Time. Front. Psychol. 12:615137. doi: 10.3389/fpsyg.2021.615137

 

We investigated the week-to-week effects of a mindfulness intervention on emotional exhaustion, work engagement, and job satisfaction in a field study involving 218 participants who participated and reported their weekly outcomes during the 8-week program. To examine how mindfulness impacted work outcomes, we used intraindividual modeling of the 8-week data. Mindfulness increased over time, and time also had indirect effects on emotional exhaustion, work engagement, and job satisfaction, through mindfulness. Supplementary growth curve analyses on the improvement of mindfulness over time showed a slight decrease in the positive effect of time on mindfulness.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.615137/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1616048_69_Psycho_20210504_arts_A

 

University Leaders and Teachers Mindfulness are Associated with Lower Emotional Exhaustion in Teachers

University Leaders and Teachers Mindfulness are Associated with Lower Emotional Exhaustion in Teachers

 

By John M. de Castro, Ph.D.

 

“leader mindfulness significantly reduces the emotional exhaustion of university teachers.” – Beini Liu

 

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 not only to productivity in the workplace but also to our psychological and physical health. Mindfulness practices have been implemented in the workplace and they have been shown to markedly reduce the physiological and psychological responses to stress. This, in turn, improves productivity and the well-being of the employees. As a result, many businesses have incorporated mindfulness practices into the workday.

 

Mindfulness may also help to promote leadership in the workplace. It can potentially do so by enhancing emotion regulation, making the individual better able to recognize, experience, and adaptively respond to their emotions, and making the leader better able to listen to and to understand the needs and emotion of the workers they lead. Hence, the mindfulness of the leader may well be associated with University teachers’ well-being.

 

In today’s Research News article “Influence of Leader Mindfulness on the Emotional Exhaustion of University Teachers: Resources Crossover Effect.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959755/ ) Liu and colleagues recruited public university leaders and teachers and had them complete a questionnaire measuring leader mindfulness and teacher mindfulness, workplace telepressure, emotional exhaustion, self-efficacy, working hours, and years in current position.

 

They found that with gender, age, tenure, and hours worked statistically controlled that the higher the level of the leader’s mindfulness the lower the level of the teacher’s emotional exhaustion and the lower the levels of telepressure. A mediation analysis revealed the leader’s mindfulness was associated with lower teacher emotional exhaustion directly and also indirectly by being associated with lower telepressure and telepressure was associated with higher levels of teacher emotional exhaustion. This association between the leader’s mindfulness and the lower teacher’s emotional exhaustions was significantly stronger when the teachers had high levels of mindfulness. Finally, they found that the higher the levels of the teacher’s self-efficacy the weaker the relationship between telepressure and emotional exhaustion.

 

The study was correlational so no conclusions regarding causation can be reached. Nevertheless, the associations between the variables are interesting. It is clear that mindfulness is important both within the individual teacher and also in the leader for being associated with lower teacher emotional exhaustion. It has previously been shown that mindfulness decreases burnout. So, the relationships observed here probably results from a causal connection.

 

Workplace telepressure “is a psychological state in which employees are constantly concerned about urgently responding to work-related ICTs [Information and Communications Technologies] during non-working hours.” These communications appear to be associated with higher levels of emotional exhaustion and these, in part, appear to mediate the effects of mindfulness on emotional exhaustion. In addition, when the teachers had high self-efficacy, telepressure had less of an impact on emotional exhaustion.

 

Preventing teacher burnout is important not only for the teacher’s well-being but also for the students’ education. It is clear that mindful academic leadership is important, suggesting that mindfulness training for leaders may improve the workplace environment for the teachers. The teacher’s level of mindfulness and self-efficacy appear also to be important, suggesting that mindfulness and self-efficacy training for the teachers would also likely improve their well-being. The results also suggest that communications to the teachers should be limited and less urgent. Being cognizant of the importance of these relationships can help to improve the environment, psychological health, and performance of university teachers.

 

So, university leaders’ and teachers’ mindfulness are associated with lower emotional exhaustion in teachers.

 

administrators and school leaders can increase retention and efficacy by seeking out ways to support teachers’ self-care and learning of mindfulness techniques.” – Kelsey Milne

 

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

 

Liu, B., Zhang, Z., & Lu, Q. (2021). Influence of Leader Mindfulness on the Emotional Exhaustion of University Teachers: Resources Crossover Effect. Frontiers in psychology, 12, 597208. https://doi.org/10.3389/fpsyg.2021.597208

 

Abstract

This study combined conservation of resources theory with the job demands-resources model to explore the influence of leader mindfulness on the emotional exhaustion of university teachers Using a time-lagged research design, 388 paired data sets were gathered. Multiple regression and bootstrapping were used to test each hypothesis. The results showed that first, leader mindfulness significantly reduces the emotional exhaustion of university teachers. Second, the results showed that workplace telepressure partially mediates the relationship between leader mindfulness and the emotional exhaustion of university teachers. Third, university teacher mindfulness positively moderates the relationship between leader mindfulness and workplace telepressure. Finally, the results of this study indicate that self-efficacy in managing negative emotions negatively moderates the relationship between workplace telepressure and the emotional exhaustion of university teachers. This study empirically examined the interpersonal influence of leader mindfulness and the initial resources effect of university teacher mindfulness and self-efficacy in managing negative emotions from the bilateral perspective of leaders and university teachers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959755/

 

Workplace Well-Being is Associated with Spirituality

Workplace Well-Being is Associated with Spirituality

 

By John M. de Castro, Ph.D.

 

“Burnout, compassion fatigue, career exhaustion—you can rewire your brain to see these afflictions as opportunities for embarking on a new path. You don’t have to stay on a dead-end street.”- Pamela Milam

 

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.

 

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Perhaps, then, spirituality can be helpful in relieving stress and lowering burnout in the workplace.

 

In today’s Research News article “Employee burnout and positive dimensions of well-being: A latent workplace spirituality profile analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671502/ ) Del Corso and colleagues performed 2 studies of the association of workplace spirituality with the employee well-being. In the first study they recruited employees of 3 different Italian companies and had them complete measures of positive supervisor behavior, burnout, and workplace spirituality.

 

They found that the higher the levels of workplace spirituality the lower the levels of burnout. They also found that positive supervisor behavior was negatively associated with burnout indirectly by being positively associated with workplace spirituality which was in turn negatively associated with burnout. So, spirituality was higher in employees whose supervisors expressed positive supervisory behavior and burnout was lower in employees who were high in spirituality.

 

In the second study they again recruited employees of Italian companies and had them complete measures of workplace spirituality, work engagement, positive emotions, self-efficacy, and resilience. They found that employees who were high in workplace spirituality were significantly higher in positive emotions, resilience, self-efficacy, vigor, dedication, absorption, and work engagement.

 

These studies were correlational and as such caution must be exercised in reaching causal conclusions. With this in mind, the results suggest that workplace spirituality is highly associated with employee well-being and lower levels of burnout. Workplace spirituality is composed of 4 factors; engaging work, sense of community, spiritual connection, and mystical experiences. Two of these components involve a satisfying work environment while two involve dimensions of spirituality. The results suggested that all of these components were significantly involved in the association with well-being.

 

Spirituality has well documented associations with overall well-being of the individuals. This study demonstrates that this extends into the workplace. These results suggest, not surprisingly, that having a satisfying work environment contributes to the employees’ well-being but more surprisingly being spiritual also contributes.

 

So, workplace well-being is associated with spirituality.

 

When people operate with high-stress levels without rest, they reduce productivity and risk their health. . . practices like meditation make your mind strong balanced and flexible and able to focus at will. “ – Spiritual Earth

 

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

 

Dal Corso, L., De Carlo, A., Carluccio, F., Colledani, D., & Falco, A. (2020). Employee burnout and positive dimensions of well-being: A latent workplace spirituality profile analysis. PloS one, 15(11), e0242267. https://doi.org/10.1371/journal.pone.0242267

 

Abstract

In recent years, a new and promising construct has attracted the attention of organizational research: Workplace spirituality. To investigate the role of workplace spirituality in organizational contexts, two studies were carried out. Study 1 explored the mediation role of workplace spirituality in the relationship between positive supervisor behaviors and employee burnout. Results showed that workplace spirituality strongly contributes to reduce burnout and mediates the effect of supervisor integrity in reducing this threat. Study 2 considered the relationships of workplace spirituality with positive affectivity, resilience, self-efficacy, and work engagement. In particular, workplace spirituality profiles were investigated through latent profile analysis (LPA). Findings showed that workplace spirituality is related to higher positive affectivity, resilience, self-efficacy, and work engagement. In contrast, a workplace spirituality profile characterized by a low-intensity spiritual experience is associated with higher negative feelings. The practical implications of these findings are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671502/

 

Reduce College Student Stress and Burnout with Mindfulness

Reduce College Student Stress and Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

a mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.” – American Mindfulness Research Association

 

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. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance and lead to burnout.

 

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. Indeed, these practices have been found to reduce stress and improve psychological health in college students. They have also been shown to reduce burnout.

 

There have been identified 3 different types of burnout, “(1) Frenetic, which is characterized by overload and the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion; (2) under-challenged, which is characterized by lack of development, defined as the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities, and is most strongly associated with cynicism; and (3) worn-out, which is characterized by neglect, defined as an inattentive and careless response to responsibilities, and is closely associated with inefficacy.” It is not known which forms of burnout that mindfulness is associated with.

 

In today’s Research News article “Testing the Intermediary Role of Perceived Stress in the Relationship between Mindfulness and Burnout Subtypes in a Large Sample of Spanish University Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579009/ ) Martínez-Rubio and colleagues recruited Spanish college students and had them complete measures of perceived stress, and mindfulness, and the burnout subtypes of overload, lack of development, and neglect. The associations between these variables was explored with structural equation modelling.

 

They report that perceived stress was positively related to the overload, lack of development, and neglect forms of burnout. So, the greater the levels of stress the greater the levels of burnout. All facets of mindfulness were negatively associated with perceived stress. So, the greater the levels of mindfulness, the lower the levels of perceived stress.

 

They also found that the facets of mindfulness, acting with awareness, and non-reacting, were also associated directly with the three types of burnout.  Acting with awareness was positively directly associated with overload burnout while negatively associated with lack of development and neglect forms of burnout. Non-reacting was positively associated with lack of development and neglect burnout. On the other hand, the non-judging and describing facets of mindfulness were only indirectly associated with the burnout types. They were negatively associated with perceived stress thereby being associated with lower burnout.

 

These results are correlative and must be interpreted with caution as causation cannot be determined. Nevertheless, they suggest that mindfulness tends to be associated with lower levels of all types of burnout by being associated with lower levels of perceived stress. This association of mindfulness with lower stress levels and lower burnout has been well documented previously. Given these associations, the further direct associations of acting with awareness and non-reacting mindfulness with the different forms of burnout are more complex.

 

It would appear that the primary association of mindfulness with burnout is via a negative association with perceived stress, regardless of the facet and the burnout type. It can be speculated that mindfulness reduces the students’ reactions to stress and thereby reduces all types of burnout.

 

So, reduce college student stress and burnout with mindfulness.

 

students . . . mindfulness practices became fundamental to easing their stress and creating resilience. Having a foundation in mindfulness will serve them throughout their life as they continue to navigate the increasing complexities of our world.” – Nina Paul

 

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

 

Martínez-Rubio, D., Sanabria-Mazo, J. P., Feliu-Soler, A., Colomer-Carbonell, A., Martínez-Brotóns, C., Solé, S., Escamilla, C., Giménez-Fita, E., Moreno, Y., Pérez-Aranda, A., Luciano, J. V., & Montero-Marín, J. (2020). Testing the Intermediary Role of Perceived Stress in the Relationship between Mindfulness and Burnout Subtypes in a Large Sample of Spanish University Students. International journal of environmental research and public health, 17(19), 7013. https://doi.org/10.3390/ijerph17197013

 

Abstract

The burnout syndrome is the consequence of chronic stress that overwhelms an individual’s resources to cope with occupational or academic demands. Frenetic, under-challenged, and worn-out are different burnout subtypes. Mindfulness has been recognized to reduce stress, comprising five facets (observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience). This cross-sectional study aimed to assess the relationship between mindfulness facets, perceived stress, and burnout subtypes in a sample of 1233 students of Education, Nursing, and Psychology degrees from different universities of Valencia (Spain). Structural Equation Modelling (SEM) was computed showing an adequate fit (Chi-square, CFI, TLI, RMSEA, and SRMR). Four mindfulness facets (all but observing) significantly correlated with general second-order mindfulness. Unexpected results were found: Acting with awareness facet was positively associated with frenetic subtype, while the non-reacting facet was positively associated with frenetic and under-challenged subtype. Ultimately, mindfulness facets negatively predicted the perceived stress levels, which in turn, predicted burnout. However, mindfulness plays different roles in the early stages of burnout syndrome (i.e., frenetic and under-challenged).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579009/

 

Mindfulness Improves Mental Health in Spite of the Covid-19 Pandemic

Mindfulness Improves Mental Health in Spite of the Covid-19 Pandemic

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness is an easy, free and natural way to boost your anxiety coping skills. Not only that, but it also helps our ability to manage emotions, and with some aspects of our physical health. If the coronavirus lockdowns has left you with some extra time, make this crisis into an opportunity for you to start (or strengthen) a healthy habit – mindfulness practice.” – Paul Green

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. 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. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress. So, mindfulness training may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559290/ ) Matiz and colleagues recruited female school teachers in Italy and provided them with a mindfulness training program that was scheduled for 8 weekly 2-hour meetings with 30 minutes of daily home practice. But, the lockdown in Italy from Covid-19 occurred a few weeks into the program. So, the last few weeks of mindfulness training was provided online. They were measured before and after training for mindfulness, empathy, personality, interoceptive awareness, psychological well-being, anxiety, depression, teacher burnout, and evaluation of the mindfulness training course. They separated the teachers into high and low resilience groups based upon their personality resilience score.

 

They found that from baseline to follow-up both groups increased in mindfulness and the personality factors of cooperativeness and self-transcendence, but the high resilience group had significantly greater increases. Both groups increased in psychological well-being but the low resilience group had a significantly greater increase in the positive relations with others subscale. Both groups decreased in anxiety and depression but the low resilience group had significantly greater decreases. Both groups had significant improvements in empathy, interoceptive awareness, and teacher burnout.

 

This is an interesting natural experiment with the Covid-19 pandemic lockdown intervening in the middle of an otherwise simple study of mindfulness training effects on school teachers’ mental health. Obviously, there is no control condition. So, the before and after training results are confounded by the lockdown. As a result, no clear conclusions can be reached. But, the Covid-19 lockdown had to have been very upsetting to the teachers. So, a decrease in their mental well-being would be expected. In prior studies it has been well established that mindfulness training lowers anxiety depression, and burnout and increases well-being, interoceptive awareness and empathy. Indeed, in the present study after the mindfulness course the teachers’ mental well-being was improved. So, mindfulness training appears to improve the mental health of the teachers in spite of the inferred negative effect of the pandemic lockdown. In addition, these effects appear to be modulated by the teachers’ levels of resilience.

 

So, mindfulness improves mental health in spite of the Covid-19 pandemic.

 

Fear leaves people feeling helpless and exhausted, seeing that “we’re in it together” helps ease the emotional burden we feel and encourages more agency—the sense that we can do something constructive to fight the pandemic.” – Jill Suttie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Matiz, A., Fabbro, F., Paschetto, A., Cantone, D., Paolone, A. R., & Crescentini, C. (2020). Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy. International journal of environmental research and public health, 17(18), 6450. https://doi.org/10.3390/ijerph17186450

 

Abstract

The Covid-19 pandemic and subsequent public health measures were shown to impact negatively on people’s mental health. In particular, women were reported to be at higher risk than men of developing symptoms of stress/anxiety/depression, and resilience was considered a key factor for positive mental health outcomes. In the present study, a sample of Italian female teachers (n = 66, age: 51.5 ± 7.9 years) was assessed with self-report instruments one month before and one month after the start of the Covid-19 lockdown: mindfulness skills, empathy, personality profiles, interoceptive awareness, psychological well-being, emotional distress and burnout levels were measured. Meanwhile, they received an 8-week Mindfulness-Oriented Meditation (MOM) course, through two group meetings and six individual video-lessons. Based on baseline personality profiles, analyses of variance were performed in a low-resilience (LR, n = 32) and a high-resilience (HR, n = 26) group. The LR and HR groups differed at baseline in most of the self-report measures. Pre–post MOM significant improvements were found in both groups in anxiety, depression, affective empathy, emotional exhaustion, psychological well-being, interoceptive awareness, character traits and mindfulness levels. Improvements in depression and psychological well-being were higher in the LR vs. HR group. We conclude that mindfulness-based training can effectively mitigate the psychological negative consequences of the Covid-19 outbreak, helping in particular to restore well-being in the most vulnerable individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559290/

 

Improve Compassion and Self-Compassion in Health Care Professionals with Mindfulness

Improve Compassion and Self-Compassion in Health Care Professionals with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Burgeoning research is showing that self-compassion skills can be of particular benefit to health care professionals, allowing them to experience greater satisfaction in their caregiving roles, less stress, and more emotional resilience.” – CMSC

 

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. 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. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout 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 and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep.

 

One way that mindfulness may help reduce burnout is by improving self-compassion. Self-compassion is “treating oneself with kindness and understanding when facing suffering, seeing one’s failures as part of the human condition, and having a balanced awareness of painful thoughts and emotions” (Kristin Neff). This may reduce the perfectionism and self-judgement that is common among physicians and thereby reduce burnout.

 

In today’s Research News article “Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What’s New? A Systematic Review.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01683/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1401267_69_Psycho_20200811_arts_A) Conversano and colleagues review and summarize the published research studies of the effects of mindfulness on compassion and self-compassion and the symptoms of burnout in health care professionals. They identified 57 published studies consisting of: “randomized controlled trials (4), studies with pre-post measurements (23), cross-sectional studies (12), cohort studies (11), and qualitative studies (7)”.

 

They report that the published research found that the Mindfulness-Based Stress Reduction (MBSR) program was effective in increasing mindfulness and self-compassion and reducing burnout, stress, anxiety and depression. Other mindfulness trainings were effective in increasing mindfulness and self-compassion and reducing negative emotions and compassion fatigue. Compassion training programs were effective in increasing mindfulness, positive emotions, and self-compassion and reducing interpersonal conflicts, negative emotions and compassion fatigue.

 

This research summary suggests that mindfulness training and compassion training are both useful in combatting the stress of healthcare work and reducing potential burnout of these professionals. The large number of studies employing different mindfulness and compassion training programs makes a strong case for the use of mindfulness and compassion training to reduce the likelihood of burnout of health care professionals and thereby improve the quality of the delivery of health care to the patients. This all suggests that mindfulness and compassion training should be routinely incorporated in the training and continuing education of healthcare workers,

 

Improve compassion and self-compassion in health care professionals with mindfulness.

 

health care professionals who completed the MBSR program reported an increase in feelings of self-compassion and reduced stress.” – Elaine Mead

 

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

 

Conversano C, Ciacchini R, Orrù G, Di Giuseppe M, Gemignani A and Poli A (2020) Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What’s New? A Systematic Review. Front. Psychol. 11:1683. doi: 10.3389/fpsyg.2020.01683

 

Health care professionals (HCPs) are a population at risk for high levels of burnout and compassion fatigue. The aim of the present systematic review was to give an overview on recent literature about mindfulness and compassion characteristics of HCPs, while exploring the effectiveness of techniques, involving the two aspects, such as MBSR or mindfulness intervention and compassion fatigue-related programs. A search of databases, including PubMed and PsycINFO, was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the methodological quality for this systematic review was appraised using AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews-2). The number of articles that met the inclusion criteria was 58 (4 RCTs, 24 studies with pre-post measurements, 12 cross-sectional studies, 11 cohort studies and 7 qualitative studies). MBSR intervention was effective at improving, and maintaining, mindfulness and self-compassion levels and to improve burnout, depression, anxiety, stress. The most frequently employed interventional strategies were mindfulness-related trainings that were effective at improving mindfulness and self-compassion, but not compassion fatigue, levels. Compassion-related interventions have been shown to improve self-compassion, mindfulness and interpersonal conflict levels. Mindfulness was effective at improving negative affect and compassion fatigue, while compassion satisfaction may be related to cultivation of positive affect. This systematic review summarized the evidence regarding mindfulness- and compassion-related qualities of HCPs as well as potential effects of MBSR, mindfulness-related and compassion-related interventions on professionals’ psychological variables like mindfulness, self-compassion and quality of life. Combining structured mindfulness and compassion cultivation trainings may enhance the effects of interventions, limit the variability of intervention protocols and improve data comparability of future research.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01683/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1401267_69_Psycho_20200811_arts_A

 

Reduce Occupational Stress in School Principals with Yoga

Reduce Occupational Stress in School Principals with Yoga

 

By John M. de Castro, Ph.D.

 

yoga is a good practice in the workplace as a means of reducing stress,” said Stacy Hunter

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. In a school setting, this exhaustion not only affects teachers and administrators personally, but also the students and schools, as it produces a loss of enthusiasm, empathy, and compassion. School principals are in a particularly stressful position dealing not only with teachers, staff, and students, but also with parents, school boards, and system administrators.

 

Hence, there is a need to identify methods of reducing stress and improving school principal psychological health. Mindfulness has been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. Yoga practice has the extra benefits of not only being mindfulness training but also as an exercise. Hence, it’s important to study the effects of yoga practice on the psychological health and burnout symptoms of school principals.

 

In today’s Research News article “Impact of residential yoga training on occupational stress and health promotion in principals.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161695/) Verma and colleagues recruited veteran school principals with at least 15 years of experience and provided them with 7 days of yoga practice for 1 hour and 45 minutes twice daily along with 3 hours of daily lectures on stress management, yoga for total health, meditation, yoga in school education, and scientific basis of yoga and pranayama. They were measured before and after the week’s training for occupational stress, including role overload, role ambiguity, role conflict, unreasonable group and political pressure, responsibility for persons, under participation, powerlessness, poor peer relations, intrinsic impoverishment, law status, strenuous working condition, and unprofitability.

 

They found that in comparison to baseline, after yoga training there were significant improvements in occupational stress, including role overload, role ambiguity, role conflict, under participation, powerlessness, intrinsic impoverishment, and law status. But the study should be considered as a pilot study as there was no control group. The before-after research design is subject to a large number of alternative confounding interpretations including demand characteristics, participant expectation effects, attention effects, experimenter bias, etc. So, the positive findings of a significant reduction in occupational stress after the training should be seen as suggesting that is reasonable to conduct a randomized controlled trial.

 

So, reduce occupational stress in school principals with yoga.

 

If you find yourself feeling cranky, wound up, or lethargic during the workday, get your body moving! See if you can take a break for some “office yoga,” especially beneficial if your job keeps you seated for most of the day.” – Nishita Morris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Verma, A., Shete, S. U., & Doddoli, G. (2020). Impact of residential yoga training on occupational stress and health promotion in principals. Journal of education and health promotion, 9, 30. https://doi.org/10.4103/jehp.jehp_394_19

 

Abstract

BACKGROUND:

Occupational stress is known as harmful physical and emotional responses that occur when the requirements of the job do not match the resources, needs, or capabilities of an employee, leading to poor mental and physical health.

OBJECTIVE:

The objective of the present study was to assess the effect of 1-week residential yoga training program on occupational stress and its subscales among principals.

METHODS:

Thirty-three principals with ages 40–59 years completed the assessment. They received yoga training at Kaivalyadham Yoga Institute. All the participants were recruited by Kendriya Vidyalaya Sangathan as part of their on-duty yoga training. At the baseline and after 1 week of yoga training participants were assessed for occupational stress. The yoga intervention was given in the morning and evening for 105 min. Apart from yoga training, all the participants were engaged in lectures based on stress management, yoga for total health, meditation, yoga in school education, and scientific basis of yoga, daily for 3 h.

RESULTS:

The principals showed a significant decrease in role overload (P < 0.001), role ambiguity (P < 0.01), role conflict (P < 0.05), under participation (P < 0.001), powerlessness (P < 0.001), intrinsic impoverishment (P < 0.01), law status (P < 0.001), and overall occupational stress (P < 0.001) after 7 days of yoga training intervention. However, there was no significant change in unreasonable group and political pressure (P > 0.05), responsibility for persons (P > 0.05), poor peer relations (P > 0.05), strenuous working conditions (P > 0.05), and unprofitability (P > 0.05) after yoga training intervention.

CONCLUSION:

The present study suggests that 1 week of residential yoga training program can improve occupational stress in principals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161695/

 

Improve Children with Intellectual and Developmental Disabilities, their Caregivers, and the Agency with Mindfulness

Improve Children with Intellectual and Developmental Disabilities, their Caregivers, and the Agency with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practices could be helpful for these caregivers because they encourage a nonjudgmental interpretation of their child’s situation, and increased acceptance of their reality.” – Emily Nauman

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost exacting a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Caring for children with intellectual and developmental disabilities can be particularly 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 a one or more developmental disabilities.

 

The challenges of caring for a child with intellectual and developmental disabilities require that the caregiver be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to the 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, and can reduce burnout.

 

In today’s Research News article “Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223775/) Singh and colleagues recruited caregivers from a home for children with intellectual and developmental disabilities. They were randomly assigned to receive either Mindfulness-Based Positive Behavior Support (MBPBS) of Positive Behavior Support (PBS).  The interventions were for 10 weeks and consisted of “an 8-h day on the first day of week 1 of training, followed by daily practice for 4 weeks. . .  a second part included five 8-h days (i.e., 40 h) during week 5, followed by daily practice for 4 weeks. . . and third part was again an 8-h day on the first day of week 10, followed by daily practice for the rest of the week.” During the next 30 weeks data were collected. The caregivers were measured before and after training for compassion satisfaction, compassion fatigue, perceived stress, professional quality of life, and meditation practice. The children’s behavior was rated for aggressive events, staff injury, and peer injury. The agency was evaluated for the use of physical restraints, emergency medication, staffing, and cost effectiveness.

 

They found that both interventions produced significantly increased compassion satisfaction, and decreased perceived and traumatic stress, and burnout for the caregivers. The Mindfulness-Based Positive Behavior Support (MBPBS) group, however, had significantly greater improvements than the Positive Behavior Support (PBS) group. Similar results were found for the children’s behavior with both treatments producing significant decreases with aggression, staff injuries, and peer injuries. Once again, the mindfulness group had significantly superior results. For the agency outcomes Mindfulness-Based Positive Behavior Support (MBPBS) produced significantly reduced use of physical restraints, emergency medication, and one-on-one staffing. In addition, the mindfulness treatment had significantly greater cost effectiveness.

 

These are very encouraging results that demonstrate that Mindfulness-Based Positive Behavior Support (MBPBS) is highly effective in improving the situation for staff, children, and the agency in an institution for children with intellectual and developmental disabilities. It increased

caregivers’ well-being and the children’s behavior, and decreased the strains on the agency. Amazingly, the mindfulness-based treatment was even more cost-effective.

 

So, improve children with intellectual and developmental disabilities, their caregivers, and the agency with mindfulness.

 

“the greater effects associated with mindfulness techniques may be due to “the immediacy of physiologic relaxation responses incurred in mindfulness practice, including strengthened attention to bodily sensations, and less reliance on rumination or other automatic emotions.” – Summer Allen

 

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

 

Singh, N. N., Lancioni, G. E., Medvedev, O. N., Myers, R. E., Chan, J., McPherson, C. L., Jackman, M. M., & Kim, E. (2020). Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial. Mindfulness, 11(1), 99–111. https://doi.org/10.1007/s12671-018-0895-2

 

Abstract

Caregivers of individuals with intellectual and developmental disabilities are often stressed due to the demands of the job, including the nature and severity of challenging behaviors of the clients, work conditions, degree of management support for the staff, and the demands of implementing some interventions under adverse conditions. Mindfulness-Based Positive Behavior Support (MBPBS) and PBS alone have been shown to be effective in assisting caregivers to better manage the challenging behaviors of clients with intellectual and developmental disabilities. The aim of the present study was to undertake a head-to-head assessment of the effectiveness of MBPBS and PBS alone in a 40-week randomized controlled trial. Of the 123 caregivers who met inclusion criteria, 60 were randomly assigned to MBPBS and 63 to PBS alone, with 59 completing the trial in the MBPBS condition and 57 in the PBS alone condition. Results showed both interventions to be effective, but the caregiver, client, and agency outcomes for MBPBS were uniformly superior to those of PBS alone condition. In addition, the MBPBS training was substantially more cost-effective than the PBS alone training. The present results add to the evidence base for the effectiveness of MBPBS and, if independently replicated, could provide an integrative health care approach in the field of intellectual and developmental disabilities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223775/