DELANY DEAN, JD, PhD

delanydean.com

KC Mindfulness

crimlawdoc@gmail.com

While I was a professor at Avila University, teaching in the Psychology Department, I worked with the Dean of the School of Behavioral and Social Sciences to develop a “wellness” program for our university (students, faculty, and staff). We applied for and received a grant from the Menorah Legacy Foundation. The foundational elements of the program were drawn from the same areas of research and practice that had inspired the Mindfulness In Action program that I developed for our Counseling Practicum students (see the “Counselors In Training” page on this website): primarily, these were Mindfulness-Based interventions as originally developed by Jon Kabat-Zinn; Acceptance and Commitment Therapy (ACT), developed by Steve Hayes; and some research from positive psychology (see, for example, Seligman’s website for an introduction to this area).

The university (i.e., the funding agency) sent me to the Mind-Body Medicine Training and Retreat, taught by Jon Kabat-Zinn and Saki Santorelli, in June of 2007, for training in MBSR. During the rest of the summer, we prepared to implement the program. The curriculum that I developed was an expanded version of the basic Mindfulness-Based Stress Reduction (MBSR) curriculum; we called the program “Mindfulness-Based Wellness.” In addition to the core components of MBSR, I added the following: training in self-compassion (based on Kristin Neff’s work); and values-based goal setting (loosely based on similar concepts used in ACT). The program involved weekly class meetings (75 minute class periods), for 12 weeks, and a day-long meditation retreat. We did a lot of pre- and post-measures of various wellness-related factors, and we had a wait-list control group (people who signed up for the program, but were assigned to participate in the spring semester, instead of the fall semester).

The results were fantastic, both in terms of informal feedback from the participants, and also as measured on various instruments and scales that we used both before and after their participation in the program. The participants displayed significant improvements on measures of: depression, anxiety, attention, overall psychological discomfort, psychological/emotional sensitivity, impulsivity, attentional deficits, mindfulness, and overall quality of life. The members of the wait-list group did not display any changes, positive or negative, during that same period of time.

We submitted a proposal to the Association for Psychological Science (APS) for a research poster, to be presented at the Annual Meeting in May, 2008. That proposal was accepted; my co-author (Ian Butterbaugh) and I will be going to Chicago for the presentation. Here is what the program entry looks like:

Mindfulness-Based Intervention Enhances Wellness

on University Campus

Time and Location
Brain, Body, Behavior, and Health – Board: BH-020
Friday May 23, 2008, 12:30 PM – 1:30 PM
Chicago 8&9

Delany Dean [E-mail Presenter]
Avila University

Maria Hunt
Avila University

Ian Butterbaugh
Avila University

Abstract

A semester-long program for students, faculty, and staff at a small university combined Mindfulness-Based Stress Reduction with values-based behavioral activation. Participants showed significantly improved scores on measures of: depression, anxiety, attention, overall psychological discomfort, psychological/emotional sensitivity, impulsivity, attentional deficits, mindfulness, and overall quality of life.

*****************************************

Despite this undisputed success, a decision was made that the program needed to undergo radical changes. My co-principal investigator decided that there should no longer be an emphasis on mindfulness (meditation) within the program. She thought the program was, somehow, “too Eastern.” She wanted to pursue some sort of “non-meditative mindfulness.” I vigorously disagreed, but I was overruled. The program changed, and I am no longer working at Avila University. There is still a “wellness” program at Avila; I believe that it is now called “Mindful Wellness.”

This page will provide a record of the blog entries I made while the MBW program was being designed and implemented. At some point, I plan also to provide a full and user-friendly description of the actual curriculum, on this page.

What is Mindfulness-Based Wellness?

Next year at Avila [note: this blog entry was first published in the summer of 2007] we plan to implement an expanded version of the Mindfulness In Action Training, to be offered to students, faculty, and staff. In addition to mindfulness training and practice, and values-based goals and activities, we will incorporate other elements of positive psychology and psychoneuroimmunology, such as: tai chi, yoga, journaling, and spiritual practice. We strongly emphasize the inter-relatedness of mind, body, and spiritual health, and we believe that as we learn and practice together, we will enhance not only the health of individuals in the program, but also the health of our community. Perhaps most importantly, we will begin to live in such a way that we truly recognize that “our community” stretches far past the boundaries of Avila University, to all creation and all that is being created.

For those who may be interested in the scientific basis for our program, below you will find several of the key findings in recent peer-reviewed literature:

1. The neural correlates of psychological well-being include an asymmetry in frontal lobe activity (increased on the left side). Left-side asymmetry is also associated with emotion regulation and behavioral engagement in the pursuit of valued goals.
Urry, Heather L. et al. (2004). Making a life worth living: Neural correlates of well-being. Psychological Science, 15, 367-372.

2. Impulsive violence appears to be related to dysfunction in the control functions of the frontal lobes, resulting in failures in emotion regulation.
Davidson, Richard J., Putnam, K.M., and Larson, C.L. (2000). Dysfunction in the neural circuitry of emotion regulation—a possible prelude to violence. Science, 289, 591-594.

3. Meditation training and practice (in an 8-week training program) results in enhanced immune function and changes in patterns of brain waves in the direction of greater left-sided anterior [frontal lobe] activation (associated with resilience and more positive mood).
Davidson, Richard J. et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570.

4. Emerging data indicate that training and repeated practice in techniques related to attention and emotion regulation (including mindfulness practice) can lead to enduring changes in patterns of brain activation.
Baxter, L.R., et al. (1992). Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Archives of General Psychiatry, 49, 681-689.
Davidson, Richard J. (2000). Affective style, psychopathology, and resilience: Brain mechanisms and plasticity. American Psychologist, 55, 1196-1214.

5. A comprehensive review of meditation research indicates that “the psychological variable mindfulness… is increased after meditative training and [is] associated with the experience of well-being.”
Cahn, B. Rael and Polich, John (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological Bulletin, 132, 180-211.

6. Meditation practice results in increased cortical thickness, including in the prefrontal area.
Lazar, S.W., et al. (2005). Meditation experience is associated with increases in cortical thickness. Neuroreport, 16, 1893-1897.

7. Tai Chi practice results in enhanced immune function.
Motivala, S.J., et al. (2006). Tai Chi Chih acutely decreases sympathetic nervous system activity in older adults. Journal of Gerontology, 61, 1177-1180.

8. In a pilot study at UCLA, following an 8-week training program in mindfulness, participants showed significantly enhanced executive (frontal lobe) functioning, an enhanced sense of well-being, and an increased capacity focus attention and resist impulses.
Zylowska, L. et al. (submitted). Behavioral and cognitive change in ADHD using mindfulness meditation.

This program is designed to bring the best of contemporary psychology to our campus, in order to enhance mind-body-spirit wellness in individuals, and in our community. The practices we use in this program are drawn from two traditions: mindfulness practice, and positive psychology.

Much like Mindfulness-Based Stress Reduction (MBSR; see http://www.umassmed.edu/cfm/index.aspx), we offer weekly sessions in a group format, within which we teach various forms of mindfulness practice. The MBSR program has been offered for nearly 30 years to people who are looking for help in all sorts of situations, and relief from many types of problems (chronic pain, chronic illness). It has been successfully adapted (Mindfulness-Based Cognitive Therapy; see http://cebmh.warne.ox.ac.uk/csr/mbct.html ) specifically for mental health treatment, as well.

We are interested in offering the benefits of MBSR-type practice to individuals who are functioning within the “normal” range: specifically, the students, faculty, and staff here at Avila University. We are influenced by the principles of Positive Psychology (see Wikipedia entry at http://en.wikipedia.org/wiki/Positive_psychology), which is a branch of psychology that investigates strengths, values, and practices that help individuals to move past the baseline of “non-pathological” into enhanced functioning, or genuine wellness.

Our program will consist of a semester-long series of weekly sessions, within which we will teach mindfulness practice and assist our participants in identifying goals (and, in particular, wellness-related goals) that are congruent with their deeply held values. We will encourage the adoption of specific achievable behavioral changes that will tend to help the participant to reach his or her goals. We will also teach and encourage yoga, and journaling practice. Each participant will be assigned a trained mentor/coach, who will meet the participant in individual sessions for additional support and encouragement. We are re-furnishing a room that is designated entirely for the use of this program, as well. Daily mindfulness practice will be scheduled in this room, as well as class sessions, yoga practice, tai chi practice, and mentoring sessions.

We are supported by a generous grant from the Menorah Legacy Foundation (see: http://www.menorahlegacy.org/ ). We are investigating the impact of this program on a variety of wellness-related outcomes, including: blood pressure, overall quality of life, self-compassion, attentional capacity, and impulsivity.

Watch this site for reports on our progress! If you have questions, please contact me through Avila University, http://www.avila.edu/ ).

Announcing the new MBW program on campus:

Today we had our first Faculty/Staff meeting of the new academic year. Our agenda included an announcement about our new Mindfulness-Based Wellness program; Dr. Maria Hunt and I explained the the program, and solicited participants. We were delighted to receive a very enthusiastic reception; it’s clear that the numbers of volunteers for our first year will easily meet, and probably exceed, the number of openings that we had planned. What a great dilemma for us!

Following is the text of part of my comments to the assembled faculty and staff:

Mindfulness practice has been a part of every major religious and spiritual tradition for thousands of years. It has been cultivated because it is a way to move from a position of conflict to a place of peace. We all understand what it is like to live in conflict, conflict within ourselves and with the world around us. It may seem that our lives are full of uneasiness, dissatisfaction, and distraction. When we have a regular mindfulness practice, we feel more grounded, at peace, focused, and emotionally strong and balanced.

So, there have been many reasons for people to engage in mindfulness practice; now there are scientific findings that are showing us what happens in our brains when we engage in mindfulness practice.

We have learned that when people practice mindfulness, which is a type of attentional training, their brain functions improve in ways that help them to respond better to stressful and upsetting conditions and situations, like chronic pain, or upsetting thoughts. They become more peaceful, happier, more awake and present to reality and to their own lives.

What this means is that we have found that we can harness the power of the brain to change its own circuitry; and, when we do this, we can achieve goals that may have always seemed un-achievable.

Because of these findings, universities and hospitals across the United States are offering mindfulness training to staff members as well as to patients , and they are finding that individuals who have gone through mindfulness training gain benefits in a wide variety of areas: improved stress management, enhanced spirituality and well-being; increased capacity for empathy; and reductions in anxiety and symptoms of burn-out.

Getting Started:

Mindfulness-Based Wellness (MBW) at Avila is off to a fantastic start! We have 24 participants in the Fall Semester group, each of them meeting weekly with one of 5 mentors/coaches (in addition to our weekly classes of 1 hour, 15 minutes). Participants are engaging in daily (or most days of the week) mindfulness practice (we’ve been working with the body scan these last couple of weeks). They are working on a project to identify values, goals, and activities in support of their goals (what kind of person do I want to be? what kind of life do I want to live? and, how do I get there, from here?). We have weekly yoga classes (thanks to Tom Jacobs) and tai chi classes (thanks to Royal Scanlon) that are available, free, to the whole campus. There is a LOT of excitement and active partipation in the yoga and tai chi!

Our Mindfulness Room is nearly finished, enough so that we can actually use it next week for class, mindfulness practice, meetings with mentors, etc. We will still need to borrow chairs till our new chairs arrive, but we have cushions and mats, and the lighting is very lovely (halogen track lighting installed in a spiral pattern in the ceiling).

FALL UPDATE on the Mindfulness-Based Wellness program
October 10, 2007

Our first group of participants has just passed the half-way point in the Mindfulness-Based Wellness (MBW) program!
During this first semester, we have seen a lot of changes! We are no longer a vagabond group, traveling on campus from one classroom to another: The renovations of our (beautiful!) Mindfulness Room were completed! We have cushions and mats for sitting on the floor; as for chairs, at first we were using borrowed brown plastic chairs but, finally, our very lovely chairs arrived and so the room looks great and it is very functional, as well.
In our MBW curriculum we have covered the following topics:
  • What is mindfulness?
  • How to practice various mindfulness methods: the body scan; sitting meditation with awareness of breath sensations; how to work with thoughts; and the three-minute breathing space.
  • Values-Based Goal Setting: Who, and How, Do I Want To Be? What are my wellness goals, and are they consistent with my values? What are daily or frequent activities I can choose that are supportive of my goals?
  • Self-Compassion: What is it? How does it differ from Self-Esteem? How Do I Practice Self-Compassion, and Why Should I?
Participants are engaged in frequent formal and informal mindfulness practice: some use the body scan, some use the three-minute breathing space; some engage in formal sitting meditation. One of our mentor/coaches has applied a mindful approach to her piano practice! In addition to mindfulness practice, our participants have identified various wellness-related goals, and have chosen activities in support of their goals. Their mentor/coaches are assisting them with this process. Some activities I have heard about include: flossing my teeth; eating breakfast; walking 2-3 miles per day; attending weekly yoga class. A central idea for us is that small, positive, measurable changes are the necessary groundwork in support of major sustainable change.
A mid-semester questionnaire sent to all participants was returned to us with highly positive comments, including the following:
  • “[This program has] helped reduce stress of working 60-80 hours per week year round. Am able to refocus thinking quicker when distractions or stressors occur. Lowered frustration and internal anger levels caused by stressors and workload.” (Avila Executive Staff Member)
  • “[This program has been] VERY helpful! I’m more conscious of the choices I make throughout my day – from prioritizing to how my body feels. For instance, several times throughout the day, I’m aware that I’m holding tension in my body. I take the time to do a three minute breathing and I’m all set. These moments are becoming less and less – overall, I feel more free, not carrying EVERYTHING with me. I acknowledge it and let it go. I’m also more aware of my mental processes – the stress I used to feel while preparing papers or studying for tests is way less. One of the most helpful things I’m practicing is not letting my inner critic define how I feel. I’m now able to gently tell her ‘thanks for playing’ or ‘duly noted’ and move on.” (Kara Werner, Avila Graduate Student)
  • “I have to say that I am thoroughly enjoying the atmosphere that the Mindfulness room offers. From the moment you drop off your shoes and step into that room, there is a tranquility and peace that envelopes me. Fabulous! Also, I am grateful for all of the handouts that allow a somewhat concrete person like myself to refer back to once our weekly sessions come to an end. What I appreciate is that this is not something just for this 16-week period (or however many sessions we will have), but this is something for life. I can carry this with me throughout my life, and practice practice practice! It’s not something like a “gym” where you have to “GO TO” to receive benefits. I am the vessel through which this experience can be the best it can be for me.” (Avila Graduate Student)

One more update: we have a new website: it is brand new and will soon have more features, so keep checking us out at:

Delany Dean, PhD
MBW Instructor, Avila University

Mindfulness-Based Wellness: Crunching Numbers!

Ask me how much I miss the students who have gone home for their holidays? LOTS!! There were 5 or 6 grad students, and one undergrad, who were helping to collect data, score all the instruments, check each other’s scoring, and enter the data in the computer, at the close of our Fall ‘07 Semester Mindfulness-Based Wellness program. It’s no small task; we are using around 12 instruments and questionnaires, and this yields more than 100 variables. Most of the instruments take some time (and careful attention) to accurately score them, and not all of our participants and control group members have been easy to reach; they have to find time to sit down for the 1-2 hours it takes to do the whole procedure. And we have to try to persuade them to actually do that!

Our fantastic grad students, Ian and Crystal (the “data boss” and “underboss”) got everything wrapped up as well as they could for me on Friday, and then they and all their helpers were gone.

Meanwhile, data is (or “are,” if you prefer) still coming in; I was up this morning at 5am to continue wrestling with all of it, and got in a good 6 hours before lunch. Now, taking a break to eat some soup and dink around on the computer, I am thinking that there may be light at the end of this tunnel. And, best of all, early indications are that the program was successful. It appears, based on one questionnaire, to have been judged as very “helpful”; for example, on a scale of one to four (1= “not at all helpful”; 4 = “very helpful”), the Fall Group participants said that formal mindfulness practice (sitting meditation, etc.) rated a “3.6″ for “helpfulness in meeting their wellness goals.” They also found informal mindfulness practice and class sessions very helpful, and those who participated in yoga found that to be very helpful, as well. Later this week, I hope to be able to begin looking at what the psychometric and biometric variables, pre- and post-, are showing.

Mindfulness-Based Wellness program

at Avila University, Fall ‘07

I am still scoring and re-scoring some instruments, and checking data entry… BUT, early indicators (pending all that re-checking) are that we had GREAT results:

The people who participated in our program showed:

significant mean INCREASES in: Mindfulness; Quality of Life; Self-Compassion; and Personal Growth;

and they showed: significant mean DECREASES in: Deficits in Attention; Depression; Anxiety; Overall Psychological Distress; Systolic Blood Pressure; and Body Fat %.

And, there were NO significant mean changes, on any of those measures, in the control group.

This is consistent with our “qualitative” outcome data in which participants said, both formally (narrative questionnaire responses) and informally (conversations all across campus) that they LOVED this program! We had an initial group of 24 participants; only 4 dropped out over the course of the semester (i.e., a dropout rate of 17%, which is very respectable).

Advertisements

One Response to “Mindfulness-Based Wellness”

  1. bunny krein, BSN, PA-C Says:

    This is the first time I’ve been on your site and I find it exciting and so very informative.
    Thank you


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: