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This chapter explores a range of challenges for students as they learn to apply interpersonal skills within the mental health practicum placement and other non-mental health settings. Exploration of the student’s attitudes, expectations and positive engagement within practice begins the chapter. This is followed by discussion of power relations characterising the therapeutic relationship, including the development of emotional competence. The chapter outlines reflective practice as a critical thinking process and clinical supervision for the beginning mental health nursing student. It explores the importance of developing skills to work within a trauma-informed care and practice framework. How to go about developing objectives for practice, the process of self-assessment and personal problem solving are discussed. Reflection, self in-action and post-placement are explored as they relate to learning in mental health. Throughout this chapter, critical examination of the ethical and political influences on care will be highlighted. This chapter also considers non-traditional opportunities to learn, and the experience of transition programs into mental health nursing.
There is scant research examining both the psychological (individual) and leadership (environmental) influences on older workers. We firstly examine the influence of older workers' mindfulness on their job engagement, job satisfaction and turnover intentions. Secondly, we address effective leadership approaches for older workers, comparing two positive relational leadership styles, leader member exchange and leader autonomy support (LAS). We survey 1,237 participants from 28 organisations in New Zealand and employ structural equation modelling to test our hypotheses using AMOS 24.0. We find that mindful older workers enjoy greater wellbeing and are discerning of the leadership styles that most benefit their engagement, satisfaction and intentions to stay within the organisation. We find that mindfulness has direct importance and LAS has indirect importance on advancing the wellbeing of older workers. Mindful older workers exhibit greater work wellbeing than non-mindful workers, but they also demonstrate greater expectations and discernment of the leadership styles they encounter.
Prevention programs that are ‘transdiagnostic’ may be more cost-effective and beneficial, in terms of reducing levels of psychopathology in the general population, than those focused on a specific disorder. This randomized controlled study evaluated the efficacy of one such intervention program called Resilience Training (RT).
Methods
College students who reported mildly elevated depressive or subclinical psychotic symptoms (‘psychotic experiences' (PEs)) (n = 107) were randomized to receiving RT (n = 54) or to a waitlist control condition (n = 53). RT consists of a four-session intervention focused on improving resilience through the acquisition of mindfulness, self-compassion, and mentalization skills. Measures of symptoms and these resilience-enhancing skills were collected before and after the 4-week RT/waitlist period, with a follow-up assessment 12-months later.
Results
Compared to the waitlist control group, RT participants reported significantly greater reductions in PEs, distress associated with PEs, depression, and anxiety, as well as significantly greater improvements in resilience, mindfulness, self-compassion, and positive affect, following the 4-week RT/waitlist period (all p < 0.03). Moreover, improvements in resilience-promoting skills were significantly correlated with symptom reductions (all p < 0.05). Lastly, the RT-related reductions in PEs and associated distress were maintained at the 12-month follow-up assessment.
Conclusions
RT is a brief, group-based intervention associated with improved resilience and reduced symptoms of psychopathology, with sustained effects on PEs, in transdiagnostically at-risk young adults. Follow-up studies can further assess the efficacy of RT relative to other interventions and test whether it can reduce the likelihood of developing a serious mental illness.
Engineering design induces mental stress for students and the sources of stress for each stage of design are unique. Therefore, strategies are needed to manage the stress of engineering design that are applicable across the design process. This study investigated the effect of a brief mindfulness-based intervention on first-year students’ cognitive stress during concept generation, concept selection and physical modelling. It was found that the mindfulness-based intervention did increase one aspect of students’ state mindfulness (though the effect was small). While prior work indicates that increased mindfulness can lower perceived stress, the increase in students’ state mindfulness during this study was not found to have an observable impact on students’ stress experience. However, students were receptive to completing a mindfulness-based activity in-class and perceived multiple benefits. Physical modelling was the most stressful of the design tasks while concept generation and concept selection produced similar levels of stress. Students used five reoccurring mechanisms for coping with the stress of design including focusing on the task, minimising the importance of their performance, breathing, taking a break and avoidance/distraction. More research should be conducted with longer duration mindfulness-based interventions to understand their potential as a stress management strategy for engineering design.
The elaborated intrusion theory of desire proposes that craving is a cognitive motivational process involving intrusive thoughts. Changing the way we react to them, cognitive defusion (CD), should limit thought elaboration and craving. We induced chocolate craving in female chocolate cravers before CD (Study 1). A decrease in craving measured by a single-item scale, Visual Analogical Scale (VAS; p < .001, ηp2 = .449) and as a state, State Food Craving Questionnaire (FCQ-S; p = .029, ηp2 = .106) were found in the experimental group, while similar results were also found in group control. The reduction in craving (VAS) in group CD correlated negatively with chocolate consumption on a bogus taste test (r = –.439, p = .036), while the correlation was positive in the case of group control (r = .429, p = .047). Food craving as a trait, measured by the Trait Food Craving Questionnaire (FCQ-T), showed negative correlations with measures of CD and mindfulness skills (lowest r = –.313, p = .018). In Study 2 participants made use of a smartphone application implementing the CD procedure in real contexts whenever they experienced food craving. A corresponding decline in self-reported craving was found, as well as in consumption of the craved food (indulgence) compared with the control condition. Our findings indicate that CD may be a promising intervention for tackling the elaboration of intrusive thoughts and eating behavior in young female food cravers, both in a controlled laboratory environment after a cue-food exposure craving induction procedure, as well as responding to naturally occurring food cravings in real-life settings.
To offer support for patients who decide to discontinue antipsychotic and antidepressant medication, identifying which potentially modifiable factors correlate with discontinuation success is crucial. Here, we analyzed the predictive value of the professional support received, circumstances prior to discontinuation, a strategy of discontinuation, and use of functional and non-functional coping strategies during discontinuation on self-reported discontinuation success and on objective discontinuation.
Methods
Patients who had attempted discontinuing antipsychotics (AP) and/or antidepressants (AD) during the past 5 years (n = 316) completed an online survey including questions on subjective and objective discontinuation success, sociodemographic, clinical and medication-related factors, and scales to assess the putative predictors.
Results
A regression model with all significant predictors explained 20–30% of the variance in discontinuation success for AD and 30–40% for AP. After controlling for baseline sociodemographic, clinical and medication-related factors, the most consistent predictor of subjective discontinuation success was self-care behavior, in particular mindfulness, relaxation and making use of supportive relationships. Other predictors depended on the type of medication: For AD, good alliance with the prescribing physician predicted higher subjective success whereas gradual tapering per se was associated with lower subjective success and a lower chance of full discontinuation. In those tapering off AP, leaving time to adjust between dose reductions was associated with higher subjective success and fewer negative effects.
Conclusions
The findings can inform evidence-based clinical guidelines and interventions aiming to support patients during discontinuation. Further studies powered to take interactions between variables into account are needed to improve the prediction of successful discontinuation.
In this chapter, we examine the contribution of routine dynamics studies toward the management of unexpected events. In particular, we explore how routine dynamics studies have extended our insights into flexible coordination in the face of the unexpected and how such a perspective generates novel insights into the way people make sense of unexpected events, how they mindfully operate during the occurrence of unexpected events, and how improvisation is enacted as routine performance. In this review, we connect routine dynamics studies with research on crisis management and discuss how a routine dynamics perspective expands the research agenda for the management of unexpected events and crises.
Meditation is commonly implemented in psychological therapies since the ‘third wave’ of cognitive–behavioural therapy has increased the focus on mindfulness-based interventions. Although extensive research literature demonstrates its benefits, little is known about potential adverse effects.
Aims
The aim of this study is to report the prevalence, type and severity of particularly unpleasant meditation-related experiences in the largest cross-sectional study on this topic to date, with 1370 regular meditators.
Method
The participants were asked whether they ever encountered particularly unpleasant experiences as a result of their meditation experience. For the first time, the type and severity of those experiences were assessed and the association with several predictors, such as pre-existing mental disorders, were explored via logistic and linear regression.
Results
Similar to previous studies, 22% of participants (95% CI 20–24) reported having encountered unpleasant meditation-related experiences, and 13% of participants (95% CI 3–5) reported experiences that were categorised as adverse. Those were mostly of affective, somatic and cognitive nature. Unpleasant meditation-related experiences were more likely to occur in participants with pre-existing mental illnesses (P = 0.000, 95% CI 1.25–2.12).
Conclusions
This study demonstrates that unpleasant meditation-related experiences are prevalent among meditators and, to a relevant extent, severe enough to warrant further scientific inquiry. Longitudinal studies are needed to examine whether the unpleasant meditation-related experiences are merely negative and thus should be avoided, or are an inherent part of the contemplative path.
This study aimed to translate, culturally adapt, and validate the Mindful Self-Care Scale (MSCS, 33-item) in a Brazilian hospice and palliative care context.
Method
This was a cross-sectional study with a sample of 336 Brazilian hospice and palliative care providers. The European Organisation for Research and Treatment of Cancer — Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation process. Psychometric properties supporting the use of the MSCS were examined through confirmatory factor analysis (CFA) and correlation analysis with other instruments to assess congruence to related constructs (resilience and self-compassion). The reliability of the Brazilian-Portuguese version of the MSCS was assessed using Cronbach's α and composite reliability coefficients.
Results
The six-factor (33-item) model showed a good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. Further validity is evidenced in the significant, positive correlations found between the MSCS, and similar well-being constructs, namely the Self-Compassion and Resilience scales.
Significance of results
The findings reveal that the MSCS (33-item) is a valid, reliable, and culturally appropriate instrument to examine the practice of mindful self-care by hospice and palliative care providers in Brazil. More broadly, it represents a promising instrument for future research into self-care practices and well-being among Brazilian healthcare providers.
What does it actually mean to be professional? How can students develop their own sense of self, and how might this interact with their professional identify and performance? This chapter explains self-awareness and the importance of understanding your own values, beliefs and motivations in order to better understand the diverse experiences of others, and to nurture the therapeutic and professional relationships that are essential for quality nursing practice.
The role of emotional and social intelligence in understanding ourselves and others is also explored, as this concept is closely linked to self-awareness. Critical reflection and mindfulness are suggested as two strategies for fostering the development of greater self-awareness and better self-care, which may assist in caring for others with empathy, compassion and ‘intelligent kindness’. In essence, enhancing your self-awareness,self-care, understanding and compassion for others will help you interact and communicate more effectively, reconcile any differences or conflicts that may arise, and better cope with the emotional demands inherent in healthcare practice (Foster et al. 2015, Kelly, Runge & Spencer 2015).
We discuss music as a reflection of our deepest and most important existential concerns. Indeed, music connects us with the transcendent and is used to express our spirituality. The term “requiem” refers to music that honors those who have died. In this chapter we discuss death and dying, and our approach to living that gives us comfort, hope, and a sense of finality. We posit spirituality as a key thread in the various social theories of aging, and recognize music as a vehicle to and key aspect of the sacred moment. We also explore Buddhist thought (e.g., right view, right livelihood) as a metaphor and method to apply to our attitude toward music and music as a profession. This chapter recognizes how music may be involved in spiritual expressions and in the celebration of the End-of-Life.
The concept of resilience and mindfulness is becoming increasingly popular in schools worldwide in response to critical issues such as escalating teacher stress and burnout. This article explores the concept of mindfulness as a supportive practice to build resilience in times of stress in relation to reducing or preventing teacher burnout. It aims to provide practical strategies for psychologists and counsellors in schools to empower teachers with coping strategies when encountering stress. What current research literature reveals about the effectiveness of resilience and mindfulness for supporting the wellbeing of preservice and inservice teachers is discussed. Overall, the research shows that practising mindfulness to build resilience is beneficial because it helps teachers focus on the present and improves attention, self-awareness and emotional regulation, which can reduce stress and enhance wellbeing. However, further empirical studies are needed to provide deeper insights of these benefits for teachers. Recommendations for psychologists and counsellors in supporting teachers on practising mindfulness and resilience are provided.
Mindfulness-based interventions have received growing attention over the last years for the treatment of various mental disorders, including schizophrenia spectrum disorders (SSD), demonstrating their transdiagnostic validity. However, no study has examined the relationship of probable mechanisms underlying the therapeutic effects of mindfulness in SSD.
Objectives
The current study examines the relationship between mindfulness, depression, anxiety, and quality of life in individuals with SSD through quantitative measures.
Methods
A total of 83 participants with SSD were recruited at the in- and outpatient facility of the Charité – Universitätsmedizin Berlin in Germany. Participants completed the Southampton Mindfulness Questionnaire, Comprehensive Inventory for Mindful Experiences, and Freiburger Mindfulness Inventory, the Depression, Anxiety, Stress Scale, and the World Health Organization Quality of Life Questionnaire. PROCESS analysis examined the relationship between mindfulness and quality of life and the mediating role of depression and anxiety.
Results
Indicated a significant positive association between mindfulness and physical health, psychological and environmental quality of life. Depression and anxiety were found to mediate this relationship, with higher depression and anxiety scores being related to lower mindfulness and quality of life. In this relationship, however, depression was found to be the stronger predictor.
Conclusions
The findings of this study provide insight into the mechanisms of mindfulness. Initial evidence for the transdiagnostic and process-based clinical relevance of MBIs for SSD has been found and future studies can further explore the role of mindfulness for central therapeutic processes of change by employing longitudinal designs.
Cognitive test anxiety is acknowledged as intense anxiety that prevents the effective use of the previously learned knowledge during the exam and leads to a decrease in success. Mindfulness is indicated as the ability to bring one’s attention to experiences in the present moment in a non-judgmental way. Despite promising outcomes of mindfulness techniques in regulating stress levels, much uncertainty still exists about the specific associations between cognitive test anxiety and mindfulness subcategories.
Objectives
The aim of this study was to investigate the relationship between cognitive test anxiety and subcategories of mindfulness among university students which may help improving current mindfulness interventions that show promising results to tackle cognitive test anxiety.
Methods
One hundred-eighty-two university students were recruited for the study via online forms. Mindfulness was measured with Five Facet Mindfulness (FFMQ-S) and the cognitive test anxiety was assessed with Cognitive Test Anxiety Scale-Revised (CTAR).
Results
Total scores of CTAR-R has an association between subscales of FFMQ; act-aware and non-judge in a positive direction, whereas; observe and describe in a negative direction. In addition, according to our regression model, FFMQ subscales of describing to indicated lower levels of CTAR scores, whereas act aware and non-judge indicated higher levels of CTAR scores.
Conclusions
The findings of the study partially corroborated the previous results by offering inferences about the subcategories of mindfulness. Additionally, these findings suggest that current interventions may target specific subcategories of mindfulness to maximize the positive outcomes of the treatment.
Eating disorders (ED) are characterized by perturbed eating habits or behaviors (APA, 2013). Even if treatments are available, they need to be more adapted to ED (Monthuy-Blanc, 2018). A complementary approach as yoga or mindfulness demonstrated positive effects with ED, such as an augmentation of mindfulness while eating (Rachel, Ivanka, Amanda, & Carlene, 2013), a better body satisfaction (Beccia, Dunlap, Hanes, Courneene, & Zwickey, 2018; Neumark-Sztainer, MacLehose, Watts, Pacanowski, & Eisenberg, 2018) and less preoccupation with food (Carei, Fyfe-Johnson, Breuner, & Brown, 2010). As the effects of yoga and mindfulness vary between the different ED and different uses, it is difficult to generalize the results obtained about the efficacy of yoga or mindfulness with ED.
Objectives
A scoping review is actually done to map the evidence about the use (length, intensity, frequency) of yoga and mindfulness among ED and their effects.
Methods
The realization of the scoping review is based on the Joanna Briggs Institute Methodological Framework(Peters, Godfrey, McInerney, Baldini Soares, Khalil, & Parker, 2017). Research will be done in the following databases: CINAHL, PsycInfo, PubMed/MEDLINE, Web of Science, EBM Reviews/Cochrane. Different types of papers are going to be included and a content analysis is going to be done among the extracted data.
Results
Preliminary results of the scoping review are going to be presented.
Conclusions
Among the different treatments used with ED, yoga and mindfulness have demonstrated positive effects. These approaches as part of integrative health are helpful to improve physical and mental health of individuals suffering from ED.
Clinical studies had shown a correlation between mindfulness and changes in the immune response. Other studies had observed an interaction between sensory neurons and neuropeptide-mediated immune response.
Objectives
This research aims to provide theoretical support to carry out a clinical study based on psychoneuroimmunology.
Methods
For this, An epistemological analysis of the concepts of autopoiesis and evocative body was carried out to explain the self-conformation of the organism.
Results
The result of this analysis indicates that the autopoietic process of the organism can be experienced from the three levels proposed by the concept of the evocative body (preontological, ontological and logical). It is posible to generate a nexus between the preontological and the logical in the autopoietic process through the ontological level. Mindfulness is the tool through which it is possible to access the ontological and thus express the preontological in the logical, thereby generating the theoretical possibility of being able to influence our therapeutic process.
Conclusions
This analysis supports the concept of the self-management in health as a measurable therapeutic tool in a clinical study.
Mindfulness-based cognitive therapy (MBCT) is a third wave cognitive-behavioral therapy (CBT) that incorporates meditation exercises in the classical, structured intervention. Mindfulness has been associated with psychological well-being, and certain symptoms that occur in major depressive disorder (MDD), e.g. worries, ruminations, ideas of incapacity or self-devaluation, are considered potential targets for MBCT.
Objectives
To evaluate the current level of evidence for the MCBT efficacy in MDD.
Methods
A literature serach was performed in the main electronic databases, targeting clinical trials that evaluated in a randomized manner the efficacy of MCBT versus active comparators or placebo in patients with MDD.
Results
MBCT was efficient in a 10-week randomized controlled trial (RCT) versus standard treatment, and it decreased ruminations, increased patients quality of life, mindfulness abilities, and self-compassion. In another randomized, 8-week RCT, MBCT prevented relapses in MDD, with similar rates when compared to psychoeducation and standard treatment. A 26-month follow-up study evidenced the persistence of symptoms improvement detected after 12 months of the trial, when compared to active control group and treatment as usual. MCBT was compared to cognitive therapy in a randomized 8-week trial, and both treatments had similar efficacy in MDD relapse prevention.
Conclusions
MCBT may be an useful adjuvant to the current treatment in acute MDD, but it may also decrease the risk of relapse after psychotherapy termination.
Genital pain is a heterogeneous chronic pain condition and the relationship between biological, psychological and social factors sets a complex clinical challenge. The importance of negative thoughts and emotions has opened up an opportunity for the role of third generation cognitive-behavioral therapies (CBT). While the majority of evidence revolves around female sexual desire and arousal problems, research on genital pain disorders is beginning to take shape.
Objectives
To review the evidence of third generation CBT on genital pain disorder.
Methods
Review of literature using the Pubmed platform.
Results
We identified 21 publications. Evidence shows that mindfulness-based CBT (MbCBT) improves reduction of fear linked to sexual activity, pain acceptance, catastrophizing and decentering. MbCBT shows significant improvements on secondary outcomes (overall sexual function, sexual satisfaction, depression and anxiety) while reduction of genital pain has yielded contradictory results. Acceptance and commitment therapy (ACT) has been studied for chronic pain disorders with improvements on pain acceptance, psychological flexibility, anxiety, depression and functioning. Compassion-focused therapy (CFT) has yielded favorable results on pain distress and intensity, self-efficacy, self-acceptance, anxiety and depression. Self-compassion may be a promising protective factor in genital pain. Both ACT and CFT have not yet been studied specifically for genital pain.
Conclusions
Third generation CBT are most commonly used for depressive, anxiety and chronic pain disorders which signals the logical role that these interventions may have in genital pain. While MbCBT has started to present favorable results in treating genital pain (as well other sexual problems), ACT and CFT require more research.
The therapeutic effectiveness of mindfulness-based interventions (MBIs) has been shown for various mental disorders. However, for schizophrenia spectrum disorders (SSD), only a few trials have been conducted, mostly in outpatient settings.
Objectives
This study aimed to investigate feasibility, acceptability, and preliminary effectiveness of a four-week mindfulness-based group therapy (MBGT) for in-patients with SSD.
Methods
A pre-registered randomized controlled trial (RCT) was conducted at the in-patient ward for SSD. All measures were employed at baseline, post-intervention (4-weeks), and follow-up (12-weeks). The primary outcome was ‘mindfulness’. Secondary outcomes were rater-blinded positive- and negative symptoms, depression, social functioning, as well as self-rated mindfulness, depression, anxiety, psychological flexibility, quality of life, and medication regime.
Results
N=40 participants were randomized into either four-week treatment-as-usual (TAU; n=19) or MBGT+TAU (n = 21). Protocol adherence was 95.2%, and the retention rate to treatments was 95%. ANCOVA analysis revealed significant improvements in the MBGT+TAU compared to TAU for the primary outcome and negative symptoms. Exploratory analyses showed medium-to-large intervention effects on secondary outcomes mindfulness, positive, negative, and depressive symptoms, psychological flexibility, quality of life, and social functioning for MBGT+TAU and small-to-moderate changes on positive symptoms and social functioning for TAU. No serious adverse effects were reported.
Conclusions
This study supports the feasibility and acceptability of MBGT for in-patients with SSD, including high protocol adherence and retention rates. A proof of concept of the MBIs and corresponding improvements on various clinical and process parameters warrant a fully powered RCT to determine effectiveness, cost-efficiency, and longitudinal outcomes of MBGT for SSD.
Cognitive behavioral therapies (CBT) represent a heterogeneous group of psychotherapies in continuous development that share a directive, structured, collaborative approach. Due to a high degree of treatment-resistant cases of major depressive disorder (MDD), new augmentation therapies are urgently needed, in order to increase the chance of recovery in these patients.
Objectives
To analyze data that may support the indication of third wave CBT in patients with MDD.
Methods
A literature search was performed in the main electronic databases, and papers published between January 2000 and August 2020 were included.
Results
Acceptance and commitment therapy has been associated with positive results, but data are derived from low quality trials (n=2). Dialectical-behavioral therapy (DBT)-based skill group have been also associated with favorable outcome, in MDD patients (n=2). Mindfulness-based cognitive therapy (MBCT) was also proven effective in the treatment in MDD (n=4), treatment-resistant MDD included, but the difference between MBCT and active comparators was not always significant. Metacognitive therapy (MCT) has been evaluated in good quality clinical trials (n=4), and its efficacy was confirmed. Mild and moderate MDD patients may benefit from compassion-focused therapy (CFT) (n=1). Behavioral activation (BA) is dedicated to MDD patients and according to a meta-analysis (n=26 randomized controlled trials) BA is superior to other active comparators, although the quality of clinical trials was modest.
Conclusions
Third generation CBT could be useful in MDD patients as augmentative strategy, but more good-quality data are necessary before recommending them in an evidence-based treatment guideline as a distinctive intervention from classical CBT.