Q&A: Mindfulness Based Stress Reduction

Admin/ November 28, 2012/ Special Features

by Camaree Turman
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Q&A: Mindfulness Based Stress Reduction

I had an engaging conversation with Dr. Bernadette Evans-Smith Clinical Director and Licensed Clinical Psychologist at RNBC.  Dr. Evans-Smith offered great insight into Mindfulness Based Stress Reduction, it’s effectiveness in helping children with Autism Spectrum Disorders and ADHD, and how parents can help their children reduce stress and improve attentiveness with mindfulness techniques.

CT: How do you explain Mindfulness Based Stress Reduction (MBSR) to your clients?

BES: Mindfulness is the ability to stay aware of your breathing, to stay aware of your experience in the moment, and the ability to let thoughts that enter your mind go. It’s the ability to discipline your mind to be more in tune with what’s going on around you, to become more aware of yourself and different sensory experiences.  It is a technique that has been extracted from Buddhist practices, but I use it in a more secular way. The techniques can help regulate and control emotions, behavior and attention more effectively.

Mindfulness techniques help you to relax and clear your mind. One aspect of the process is to be aware of your breathing in a natural way and to sustain focus on your breathing.  Another method is to briefly reflect on your thoughts and let the thought pass. You learn to distance yourself from the emotional impact of the thought. Learning to let certain thoughts come and go is part of the process. This is especially helpful for those who may stay focused on a thought that contributes to stress, anxiety or depression. Additionally, you notice the natural sensory experiences around you.  For example you focus on something that you’re listening to, pay attention to something you’re looking at, or something you’re tasting. Mindfulness is being able to keep your attention on the sensory experience in the moment and letting go of any intrusive thoughts coming into your mind.

CT: Could you give an example of one of the mindfulness techniques that you use with your clients?

BES: A traditional exercise is using a raisin to taste and look at, but I use jellybeans. The kids and their parents pick a jellybean and we focus on the way it looks.   Then I instruct the family to put the jellybean in their mouth, move it around, notice the way it feels, then gradually let it dissolve. I encourage them to do this slowly. If they have a thought that is about something else, I ask them to gently remind themselves to think about the jellybean. As they’re doing this, I ask them to notice how the jellybean changes in texture and taste and then once it’s disintegrated to gradually swallow and notice the way it feels when swallowing.

CT:  When did you become interested in using mindfulness to treat children with neurobehavioral challenges? 

BES: Well in 1995 I worked in Children’s Hospital Oakland in Hematology Oncology  and my colleague and I were looking into methods to help children manage pain.  At that time, mindfulness was mainly used with people for whom stress could seriously impact their medical condition, for example, for patients with heart conditions.  It was being promoted by Dr. Jon Kabat-Zinn in Massachusetts. He had written a book about it and the treatment was spreading in pockets in the country. When an individual who had been trained in Massachusetts moved to the San Francisco Bay area, he offered mindfulness training to practitioners, but they were all focused on adults. To my knowledge, my colleague and I were the only ones working with children.  We conducted a study with about 10 children. The group was for one hour a week for eight weeks. We found that there were significant improvements in the children’s ability to manage pain more effectively.  From that experience, I then saw that mindfulness was very beneficial to use with children and began integrating it into my clinical work with children who had problems regulating their behavior, emotions and attention.  I found it to be especially useful for children with Autism Spectrum Disorders, ADHD, anxiety, and depression.

CT: How effective are mindfulness techniques in helping children with neurobehavioral challenges? What have your studies been finding?

BES: There have not been a lot of studies done to look at its effectiveness with children on the spectrum or with ADHD. Recently we were able to collaborate with Summit School in Elgin, Illinois, to look at the value of mindfulness in a closer way. Summit is a day treatment school that works with children and teens who may have an Autism Spectrum Disorder, ADHD, or learning disability, along with greater challenges in controlling their behavior and emotions.

We had two active groups and one that served as a control who later participated in mindfulness training. The children were in 4th through 7th grades. Each week the groups focused on a particular sensory experience so we had a variety of activities that they did to emphasize that experience. We kept it moving and changing so that they would enjoy it and also allowed an opportunity for the kids to evaluate and reflect on the experience for themselves.  We not only discovered improvements in attention, but the school staff and children shared that they really enjoyed the activities.  The children were eager to try it and thought it was fun and helpful. The staff found the techniques helped children to regulate better too.

CT: What mindfulness techniques can parents use at home to help their children with stress reduction?

BES:  I’ve seen that mindfulness is really helpful in my own practice.  I’ve seen a number of kids with behavior management challenges benefit from the jellybean activity. At home, they’ll ask to have a jellybean when they’re starting to get upset.  They’ll be able to shift over and start to pay attention to the taste of the jellybean; they really can get into it and calm down.

Parents can use mindfulness when they recognize their child is starting to feel stressed. Depending on the child’s cognitive functioning and level of self-awareness, he may need to be cued that this is a time to use a mindfulness technique. So, parents can cue their child by saying something like “you’re starting to look a little stressed, how about doing your tasting mindfulness exercise?” or ““stand/sit still and take a moment to notice your breathing.” These cues can help the child shift his focus away from the stressful situation or thought and calm his body and mind.

For more information about Dr. Evans-Smith, learning to practice mindfulness with your child, mindfulness research, or the RNBC Stress and Anxiety Clinic, please contact us at 847–933-9339 or info@rnbc.org

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