Developing an integrated community–based mindful parenting programme

1. Developing an integrated community–based mindful parenting programme • Skills for Life • Eluned Gold & Sophie Pratt

2. Acknowledgements Staff at Corun I Sawdl – for support , encouragement and creative ideas. Davina Plum Sian Davies Sue Hughes Sarah Jones All staff at Centre for Mindfulness Research and Practice esp. Catrin Eames for help with research measures Sarah Silverton

3. This presentation will include • Introduction to the project • Why we chose to develop the programme • The Communities we have been working with • The developing of this programme • Some experiential exercises from the programme • The programme so far • Early learnings and - ?results? • Lessons learnt and wider outcomes from the project • Future developments

4. Introduction to the programme • Experienced MBSR teacher taught a mindful parenting course to young or multiply stressed mothers in this community setting for 2 years alongside the community team. During that time the basic MBSR course has been adapted to be more accessible and meaningful to the client group. • Staff from the community team took the first course alongside clients • One staff member - and later- a second – is undertaking training in teaching MBSR • The community team have continued to develop the programme and now offer the programme in other areas. • Staff teaching this programme continue to have supervision and mentoring from an experienced MBSR teacher

5. Why • Underserved rural community that needed a new programme. • Integration with existing programme • Opportunity for collaboration between NHS – Bangor University • Mindfulness known to be helpful. (Bögels; Duncan;Kabat-Zinn; Singh)

6. Some background The area in question is a ’Sure Start’ and ‘Flying Start’ area: • Government funded initiative for early years – areas identified are at high risk of early childhood behaviour problems - • with all the risk categories Parenting Skills are a potential mitigating factor.

7. So in this community: • Unemployment –24% benefit claimants ( number of adults of working age lower than rest of county) • Educational attainment – 43% have no qualifications • Single parents- 4.5% of working population single parents • 81 % speak Welsh • Geographically isolated • Historically there are high proportion of extended families • Greatest deprivation in county for income, health and housing

8. Issues identified in the client group • Multiple stressors • Low self esteem • Poor literacy skills • Intergenerational habits/schemas • Mental health issues e.g. post-natal depression, chronic anxiety. • Lack of Parenting skills • Existing programme identified as not effective

9. Why mindfulness? Evidence from other programmes indicate mindfulness: • Reduces stress • Improves executive function - Emotion regulation. • Can decrease the cycle of intergenerational habits • Develops self nourishing & compassion • Improves relationships etc

10. Why not mindfulness? • Counter cultural – 81 % Welsh speakers • Middle class and inaccessible • Untried • Lack of Staff skills • Not initially chosen by clients • Too demanding – costly?

11. Early Lessons • We quickly learned that:- • Counter cultural for staff too! (NHS staff solve problems!!). • The approach needs to be relevant and accessible – language and cultural issues • The facilitator needs to know the client group • The participants need to be informed and ‘opt in’ • Home practice can be problematic • It needs to be integrated into the existing programme

12. Nevertheless Even from the early classes there were some encouraging results:- • Measures taken in the first couple of classes showed that the participants with the most need benefited the most. And there were some interesting individual cases.

13. Some solutions • Flexibility of programme • MP3s rather than CDs • Handouts rather than hand book • Shorter practices • Art and creative activities in sessions • Integration into existing programme - mindful exercise and mindful cooking. • Make the Home practice very low key and……….. • Teach out of home practice • Participants developed their own course work book

15. Pre course • Referrals are received from community nurses/health visitors • Assessment visit - includes assessment and an introduction to to the programme - and level of support offered. E.g. An important aspect of the programme is telephone contact between sessions

16. Programme Orientation Session 1 – There’s more right with you than wrong with you Group building We’re all in this together 3SBS Body scan 30mins. Cloudy mind/clear mind Sharing experiences Listen to Body Scan track Write/draw/stick something you noticed • Community building • What’s it all for – glitter balls • Practicalities • Integrated programme • Intro to practices – 3SBS • Discussion of Home Practice

17. Programme Session 2-Perception/Raising awareness Session 3-Body as Anchor Show and Tell HP Books HP what gets in the way – enquiry? Movement – body scan 3SBS Mindful T break Mindfulness of breath Movement - Informal Practice 3SBS Body Scan at bed time Draw write or Stick in books • Show and tell HP books • Perception pictures/ video • Body Scan • 3 SBS • Cloudy mind/ Clear mind • Body Scan • Draw write or Stick in books • Noticing

18. Programme Session 4-Finding out about me-Staying with it Session 5-Let it be – Hanging out with the difficult Show and tell HP books Movement Vicious flower Revisiting three circles – what could be helpful? 3 SBS coping – ( salt analogy) Collage or drawing of difficulty – staying with it Story – Sun and wind Nurturing activity for you and children Write draw stick difficulty Sitting practice 3 SBS • Show and tell HP books • Body Jigsaw • Identify Stress in the body • 3 Affect circles – behaviours (Gilbert) • 3SBS • Mindfulness body & breath • What’s working – support in the group • Draw/Write/Stick noticing stress in the body • 3 circles –what’s my typical behaviour? • Mindful activity with the children • Texting one another

19. Programme Session 6-Automatic-Thoughts/behaviours Session 7-Mindfulness in Relationships Show and tell HP books Mindful listening Hand aikido Sitting Practice Movement Mindful listening with children Write draw stick patterns in relationships Nurturing activity – self /children • Show and tell HP books • Raisin • Monkey mind – thoughts • Brain power – approach/Avoid • Own warning signs of stress • Movement ---Sitting • Write draw stick your own monkey chain • Record your warning signs • Mindful eating with children • 3SBS • 10 min sit

21. Programme Session 8 - Coming to our senses Group walk Silent periods Listening seeing Smelling Mindful walking

22. Programme Session 9 Moving on to Community - Bringing it all together Session 10- Follow up • Show and tell HP books • Make sitting cushion • Eating together • Celebration • Movement – body Scan – Sitting

23. Some findings from 2 groups Warwick-Edinburgh Mental Well-being Scale (WEMWBS) Tennant, R., Stewart –Brown, S. et al 2007

24. Observations - What they said From parents • I’m noticing more - • I’m using breathing space to help in managing children - making a noticeable difference in children’s behaviour • I have shared with families & friends • I can talk better with my partner about how I’m feeling • It has built my confidence and helped me with coping From Staff • Noticed an increase in self esteem

25. Spin offs • Further ways to integrate mindfulness, e.g. Mindful baby massage • Interest shown within larger staff group within the NHS -e.g. other Health visitors/Nurses/Managers • Genesis – skills for return to work programme • Spreading out geographically – offering the programme from other centres • Other community organisations are interested. E.g. Women's Aid Centre, Communities First

26. Summary of key findings • The approach can be delivered in an acceptable way. • Early results indicate that the programme appears to lead to an increase in well-being in multiply stressed mothers. • The programme needs to be delivered in a flexible way • Staff development is an important ingredient • This project has initiated interest in other community groups and there is potential to develop more

27. What next? • Training more staff in order to extend the programme • Training welsh speaking teachers • Further and more detailed research into aspects of the programme • Extending the programme beyond the immediate geographical area • ? Mindful community - a collaboration of a number of organisations within one community

29. References • Bögels, S., et al. 2010, Mindful Parenting in Mental Health Care, Mindfulness 1,2 • Duncan, L., et al., 2009.. A Model of Mindful Parenting: Implications for Parent–Child Relationships and Prevention Research. ClinChild FamPsycholRev. • Garrison Institute Report September 2010 Mindful Parenting: Conceptualization and Measurement A Symposium of the Garrison Institute’s Initiative on Contemplation and Education • Gilbert, P., et al. 2009, Compassion Focused Therapy Mind Therapy. Workshop handbook . • Kabat-Zinn, J., Kabat-Zinn, M., 19??? Everyday Blessings, Piatkus NY • Singh, Nirbhay N. et al. 2006. Mindful parenting decreases aggression, noncompliance, and self-injury in children with autism. Journal of Emotional and Behavioural Disorders • Singh, Nirbhay N. et. al. 2010Training in Mindful Caregiving Transfers to Parent–Child Interactions. Journal of Child and Family Studies • Tennant, R., Stewart –Brown, S. et al 2007, Warwick-Edinburgh Mental Well-being Scale.