Implementing the Mindfulness-Based Interventions; Teaching Assessment Criteria (MBI:TAC) in Mindfulness-Based Teacher Training

Investigating the protective effects of mindfulness-based attention training on mind wandering in applied settings

Introduction

Mind wandering, a phenomenon in which attention drifts away from the task-at-hand, is associated with deleterious effects on performance and well-being. As such, efforts to curb mind wandering are warranted. Recently, mindfulness training (MT) has been found to protect against mind wandering. Yet, many MT programs are at risk of falling off the implementation cliff due to challenges implementing these programs in applied settings. To mitigate against this, early-stage research in small convenience samples may be necessary to spur stakeholder engagement and collaboration. Herein, the effects of MT on mind wandering were examined via an internal meta-analysis of early-stage studies of a manualized, context-adaptable short-form MT program, referred to as Mindfulness-Based Attention Training (MBAT).

Methods

Five longitudinal studies (N = 304) were conducted in a variety of organizational cohorts. Self-reported mind wandering and meta-awareness, as well as accuracy (A') and response time variability (intra-individual coefficient of variation, ICV) during performance of the sustained attention to response task (SART) were assessed at baseline (T1) and 4 weeks later (T2) in MBAT and no-training participants.

Results

Standardized mean change (SMC) from T1 to T2 significantly differed between MBAT and no-training groups for mind wandering (ΔSMC = -0.387, p < 0.001), meta-awareness (ΔSMC = -0.374, p < 0.001), and ICV (ΔSMC = -0.376, p = 0.043), suggesting potential protective effects in self-reported and performance-based metrics of mind wandering.

Discussion

These results serve as preliminary proof-of-concept support for MBAT's protective effects on mind wandering. Further, they suggest that MBAT is amenable to implementation across a variety of applied and organizational settings and warrants additional research employing larger sample sizes in randomized controlled designs.

Rural sixth-grade teachers' and students' perceptions of a mindfulness-based mental health curriculum

Introduction

Mindfulness-based interventions (MBIs) have the potential to improve students' mood, behavior and cognitive functioning; yet, little is known about the feasibility and acceptability of adapting such programs for rural middle schools.

Methods

An exploratory qualitative evaluation was conducted to examine the feasibility and acceptability of an initial trial delivery of AttuneEd®, a trauma-informed, mindfulness-based mental health curriculum. In this single-group design study, 10 weekly lessons were taught in a middle school located in a rural town in the pacific northwest during 6th grade students' P.E. classes. Three P.E. teachers, 26 6th grade teachers, and one school counselor attended trainings before and mid-curriculum implementation, where they provided qualitative feedback. A total of 160 students completed acceptability surveys before and after curriculum delivery.

Results

Three themes were identified from qualitative data: cultural considerations, teacher self-efficacy, and barriers and facilitators to student acceptability. Student acceptability ratings were high. Students reported, on average, that the classes helped them better understand themselves and others.

Conclusion

Some identified needs for future MBIs include (1) the need for culturally sensitive, trauma-informed delivery strategies; (2) teachers' desire for more support in content delivery; and (3) students' desire to have their own teachers deliver the curriculum. Findings elucidate the nuances associated with implementing an MBI in a rural middle school and have notable implications for development, scalability, and sustainability.

The Effects of a Mindfulness-Based Family Psychoeducation Intervention for the Caregivers of Young Adults with First-Episode Psychosis: A Randomized Controlled Trial

OBJECTIVE

In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program.

METHOD

We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes.

RESULTS

Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers' outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F = 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement.

CONCLUSIONS

A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size.

Effect of mindfulness-based programmes on elite athlete mental health: a systematic review and meta-analysis

OBJECTIVE

To determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Eight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes.

RESULTS

Of 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedges g=-0.87, number of studies (n)=6, p=0.017, I ²=90) and stress (g=-0.91, n=5, p=0.012, I ²=74) and increasing psychological well-being (g=0.96, n=5, p=0.039., I ²=89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity.

CONCLUSION

MBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport.

PROSPERO REGISTRATION NUMBER

CRD42020176654.

A Brief Measure of Fidelity for Mindfulness Programs: Development and Evaluation of the Concise Fidelity for Mindfulness-Based Interventions Tool

Background

Mindfulness research and clinical programs are widespread, and it is important that mindfulness-based interventions are delivered with fidelity, or as intended, across settings. The MBI:TAC is a comprehensive system for assessing teacher competence, yet it can be complex to implement. A standardized, simple fidelity/engagement tool to address treatment delivery is needed.

Objective

We describe the development, evaluation, and outcomes of a brief, practical tool for assessing fidelity and engagement in online mindfulness-based programs. The tool contains questions about session elements such as meditation guidance and group discussion, and questions about participant engagement and technology-based barriers to engagement.

Methods

The fidelity rating tool was developed and tested in OPTIMUM, Optimizing Pain Treatment in Medical settings Using Mindfulness. The OPTIMUM study is a 3-site pragmatic randomized trial of group medical visits and adapted mindfulness-based stress reduction for primary care patients with chronic low back pain, delivered online. Two trained study personnel independently rated 26 recorded OPTIMUM sessions to determine inter-rater reliability of the Concise Fidelity for Mindfulness-Based Interventions (CoFi-MBI) tool. Trained raters also completed the CoFi-MBI for 105 sessions. Raters provided qualitative data via optional open text fields within the tool.

Results

Inter-rater agreement was 77-100% for presence of key session components, and 69-88% for Likert ratings of participant engagement and challenges related to technology, with discrepancies only occurring within 2 categories: 'very much' and 'quite a bit'. Key session components occurred as intended in 94-100% of the 105 sessions, and participant engagement was rated as 'very much' or 'quite a bit' in 95% of the sessions. Qualitative analysis of rater comments revealed themes related to engagement challenges and technology failures.

Conclusion

The CoFi-MBI provides a practical way to assess basic adherence to online delivery of mindfulness session elements, participant engagement, and extent of technology obstacles. Optional text can guide strategies to improve engagement and reduce technology barriers.

Mindfulness-Based Teaching Competency Assessment: Comparing Self-Assessment With Expert Evaluation in the Veterans Administration - Compassionate Awareness Learning Module Program

Background

Meditation, including Mindfulness-Based Interventions (MBI), is a required Complementary and Integrative Health intervention at the US Department of Veterans Affairs (VA). Training VA clinicians to provide MBI at scale must address fidelity concerns and the assessment of clinician competency.

Objective

The psychometric properties of the Mindfulness-Based Intervention: Teaching Assessment Criteria (MBI:TAC), a widely used tool for assessing facilitator competence, continue to be explored. To support the dissemination of MBI, the utility of using the MBI:TAC for self-assessment for clinicians in a national training program was evaluated.

Methods

In a training cohort of VA clinicians (n = 39), participant self evaluations on 2 domains of the MBI:TAC are compared to the competency scores of 2 expert evaluators as based on the observations of a 10-minute exercise. Additionally, the inter-rater reliability between the 2 experts was explored.

Results

Intraclass Correlation for the 2 expert evaluators for Guiding Practice was significant (ρ = .83, P = .003), but was not significant for Embodiment of Mindfulness (ρ = .34, P = .186). Self-evaluation scores were not significantly correlated to expert rater scores such that participants rate their level of competence higher than expert scores.

Conclusion

The MBI:TAC, while an essential tool in teacher training, may not produce accurate scores when used for self-assessment. Instruction from a senior teacher is needed for accurate scoring. Interrater reliability may be improved with enhanced domain operationalization and training. Implications for MBI training are explored.