Changes in Parent Psychological Flexibility after a One-Time Mindfulness-Based Intervention for Parents of Adolescents with Persistent Pain Conditions
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Participant Recruitment Procedure
2.3. Intervention
2.4. Data Collection
2.4.1. Demographic Information
2.4.2. Mindful Attention Awareness Scale (MAAS)
2.4.3. Parent Psychological Flexibility Questionnaire (PPFQ)
2.4.4. Post Session Questionnaire
2.5. Data Analysis
2.5.1. Descriptive Analyses
2.5.2. Quantitative Analyses
2.5.3. Qualitative Analyses
3. Results
3.1. Demographics
3.2. Primary Outcomes
3.2.1. Recruitment and Retention (Feasibility)
3.2.2. Treatment Acceptability
3.3. Secondary Outcomes
3.3.1. Mindfulness
3.3.2. Psychological Flexibility
3.3.3. Post Hoc Exploratory Analyses
3.4. Qualitative Analysis (Post-Session Questionnaire)
3.4.1. Mindfulness Skills
3.4.2. Not Alone
3.4.3. Psychological Flexibility
3.4.4. Parent–Child Interactions
3.4.5. Self-Efficacy
3.4.6. Optimism/Positivity/Hope
3.4.7. Awareness of Values
4. Discussion
4.1. Limitations
4.2. Future Directions
Author Contributions
Funding
Conflicts of Interest
References
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Schedule | Content |
---|---|
5 min | Name tags, tea/coffee, and snacks |
10 min | Welcome and Introduction to Mindfulness |
Teaching: What is mindfulness? | |
Presentation of Jon Kabat Zinn’s definition of mindfulness (Kabat-Zinn, 1996) | |
Mindfulness gives us flexibility/choice in how we respond to situations in our lives (our children, our colleagues, our partners, our own internal experiences). | |
20 min | Ice Breaker and Group Guidelines |
Activity 1: Participants divide into dyads and are encouraged to pair up with someone unfamiliar. They are asked to introduce themselves to their partner and share elements in their lives that bring them joy. They are instructed to do so mindfully. The person speaking is asked to mindfully be aware of any sensations, emotions, thoughts, and/or judgments while they speak, and the listener is instructed to mindfully listen to their partner and be aware of any thoughts, emotions, sensations, or judgments that might take them away from mindful listening. After 4 min, participants are asked to switch roles and then introduce their partner to the group. The exercise is then processed by asking participants what they noticed during the activity and relating their observations back to mindfulness concepts (e.g., nonjudgment, present moment awareness, monkey mind, beginners mind). | |
Review of group guidelines: (1) confidentiality, (2) respectful attitude | |
The talking stick is introduced. When a participant is holding the talking stick, it is an invitation for them to speak from the heart and for others to give the speaker their full attention. | |
Activity 2: | |
Teaching: Suffering is optional (it is the distress, whether emotional or cognitive, associated with the pain that leads to a significant proportion of suffering) | |
Exercises: Suffering Cup (participants add water to the cup to reflect the amount of space taken up by each of the following in their day-to-day lives: their child’s day-to-day physical symptoms, the parent’s own thoughts about their child’s symptoms, the parent’s own emotions about their child’s symptoms, the impact on the parent’s wellness of their child’s symptoms. Not only does their child’s actual symptoms lead to suffering, but a parent’s emotions and thoughts add to suffering, and are optional). | |
30 min | Meditation: Mindful Awareness Meditation |
Participants are taken through a mindful awareness practice of being aware of the quality of their thoughts, emotions, physical sensations, and sounds in the room, and approaching these with nonjudgmental curiosity and openness. | |
30 min | Parenting According to Your Values |
Teaching: Our values are a compass to guide interactions with our children. Mindfulness practice can help us connect with our values during difficult parenting situations. | |
Parents are provided with a list of values and identify their top three values that guide their parenting. | |
Parents were then asked to reflect on a situation where (a) they followed their values as a parent, and (b) they did not follow their values as a parent. In each situation, they notice their experience (their thoughts, emotions, and judgments). | |
Responding versus Reacting | |
Teaching: Responding versus reacting to strong sensations, emotions, or thoughts | |
15 min | How to bring mindfulness into your life |
Informal versus formal meditation practices | |
List of local mindfulness resources and books/apps provided | |
Home practice: To practice informal mindfulness | |
15 min | Stone ceremony |
Participants provide a good wish to one another, in turn. |
Characteristic | Full Sample | Chronic Pain | IBD |
---|---|---|---|
(n = 34 Parents) | (n = 14 Parents) | (n = 20 Parents) | |
Parent gender, n (%) | |||
Female | 27 (79%) | 11 (79%) | 16 (80%) |
Male | 7 (21%) | 3 (21%) | 4 (20%) |
Adolescent age (years, mean SD) | 14.9 ± 1.5 | 15.5 ± 1.6 | 14.2 ± 1.2 * |
Adolescent gender, n (%) | |||
Female | 23 (68%) | 14 (100%) | 9 (45%) |
Male | 11 (32%) | 0 (0%) | 11 (55%) * |
Primary diagnosis for adolescent, n (%) | Musculoskeletal: 7 (50%) | Ulcerative colitis: 7 (41%) | |
Neuropathic: 2 (14%) | |||
Musculoskeletal + Neuropathic: 3 (21%) | Crohn’s disease: 10 (59%) | ||
Other 1: 2 (14%) | |||
Chronic pain: Adolescent’s duration of pain (months, mean SD) | 59.7 ± 57.8 | ||
IBD: Adolescent disease activity 2 | 13.1 ± 11.8 |
Theme | Parents (N = 32) | Subthemes | Exemplar Quotes |
---|---|---|---|
Mindfulness Skills | 29 (91%) | Present-Moment Awareness | “Trying to be more present and not just making it through the day” (Participant, IBD Group) |
Compassion | “I need to learn how to take care of myself so I can look after my child” (Participant, Chronic Pain Group) | ||
Acceptance | “The pain will stay, but we need to work collectively to develop and maintain coping strategies and work with our daughter to achieve some level of normalcy” (Participant, Chronic Pain Group) | ||
Secondary Suffering | “Understanding the potential for how much of my thinking can be consumed by worry for my child” (Participant, IBD Group) | ||
Importance of Regular Practice | “Strive to do mindfulness (MBSR) each day; to incorporate it into my daily routine” (Participant, IBD Group) | ||
Not Alone | 19 (59%) | Sense of Community/Shared Experience | “We aren’t alone—many people/families are dealing with pain issues, and that there are people and resources available to help” (Participant, Chronic Pain Group) |
Connection | “Parent sharing was very helpful” (Participant, IBD Group) | ||
Psychological Flexibility | 11 (34%) | Emotion Regulation | “The STOP method of responding—it’s a good quick way to remind myself to take a step back from a knee-jerk response when I’m on edge” (Participant, Chronic Pain Group) |
Perspective Taking | “Good experience to listen to other parents comments and struggles. Gain different perspectives and ideas” (Participant, IBD Group) | ||
Parent–Child Interactions | 8 (25%) | N/A | “Understanding how my actions can impact my daughter’s health” (Participant, IBD Group) |
Self-Efficacy | 7 (22%) | N/A | “I am not doing a bad job” (Participant, IBD Group) |
Optimism/Positivity/Hope | 6 (19%) | N/A | “There are people and resources available to help” (Participant, Chronic Pain Group) |
Awareness of Values | 5 (16%) | N/A | “To take the time to really realize what is important in the moment” (Participant, IBD Group) |
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Share and Cite
Ruskin, D.; Campbell, L.; Stinson, J.; Ahola Kohut, S. Changes in Parent Psychological Flexibility after a One-Time Mindfulness-Based Intervention for Parents of Adolescents with Persistent Pain Conditions. Children 2018, 5, 121. https://doi.org/10.3390/children5090121
Ruskin D, Campbell L, Stinson J, Ahola Kohut S. Changes in Parent Psychological Flexibility after a One-Time Mindfulness-Based Intervention for Parents of Adolescents with Persistent Pain Conditions. Children. 2018; 5(9):121. https://doi.org/10.3390/children5090121
Chicago/Turabian StyleRuskin, Danielle, Lauren Campbell, Jennifer Stinson, and Sara Ahola Kohut. 2018. "Changes in Parent Psychological Flexibility after a One-Time Mindfulness-Based Intervention for Parents of Adolescents with Persistent Pain Conditions" Children 5, no. 9: 121. https://doi.org/10.3390/children5090121