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The Integration of the Workable Range Model into a Mindfulness-Based Stress Reduction Course: a Practice-Based Case Study.

ABSTRACT: Didactic teaching about stress is part of the Mindfulness-Based Stress Reduction (MBSR) curriculum. The content and methods of integrating conceptual teaching within the experiential pedagogy are rarely explored. Workable range is a model of stress and emotion regulation that illustrates patterns of physical, emotional and cognitive reactivity in relation to mindful presence. This is a qualitative case study of the inclusion of the workable range model into an MBSR course as a refinement of the didactic teaching about stress. The focus is to illuminate how the inclusion worked in practice. Ten staff, on a MBSR course in a higher educational setting, were recruited as participant researchers with an overlap between their own first-person investigation during the course and the research data. Adapted diagrams and written answers to two question schedules, completed as reflective exercises within the course, were analysed thematically using template analysis. This revealed how participant researchers engaged with and intuitively used the model to notice and describe their own patterns of feeling balanced or stressed and explore how they related to those experiences. How learning the model integrated with MBSR and the applicability of workable ranges as a teaching resource in MBSR is discussed. The study highlights questions about how conceptual and experiential teaching and learning interrelate in mindfulness-based interventions. There is scope for further research using mindfulness practice as a first-person methodology to investigate the processes within mindfulness-based programs.

SUBMITTER: Rose SA

PROVIDER: S-EPMC5866833 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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The Integration of the Workable Range Model into a Mindfulness-Based Stress Reduction Course: a Practice-Based Case Study.

Rose Sally A SA Sheffield David D Harling Martyn M

Mindfulness 20170829 2

Didactic teaching about stress is part of the Mindfulness-Based Stress Reduction (MBSR) curriculum. The content and methods of integrating conceptual teaching within the experiential pedagogy are rarely explored. Workable range is a model of stress and emotion regulation that illustrates patterns of physical, emotional and cognitive reactivity in relation to mindful presence. This is a qualitative case study of the inclusion of the workable range model into an MBSR course as a refinement of the ...[more]

PMID: 29599849

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Project description:BACKGROUND:Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents. OBJECTIVE:To determine the effectiveness of MBSR in reducing burnout in residents. DESIGN:A randomized controlled trial comparing MBSR with a waitlist control group. PARTICIPANTS:Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred. INTERVENTION:The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day. MAIN MEASURES:The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory-Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work-home interference, mindfulness skills, self-compassion, positive mental health, empathy and medical errors. Assessment took place at baseline and post-intervention approximately 3 months later. KEY RESULTS:Of the 148 residents participating, 138 (93%) completed the post-intervention assessment. No significant difference in emotional exhaustion was found between the two groups. However, the MBSR group reported significantly greater improvements than the control group in personal accomplishment (p = 0.028, d = 0.24), worry (p = 0.036, d = 0.23), mindfulness skills (p = 0.010, d = 0.33), self-compassion (p = 0.010, d = 0.35) and perspective-taking (empathy) (p = 0.025, d = 0.33). No effects were found for the other measures. Exploratory moderation analysis showed that the intervention outcome was moderated by baseline severity of emotional exhaustion; those with greater emotional exhaustion did seem to benefit. CONCLUSIONS:The results of our primary outcome analysis did not support the effectiveness of MBSR for reducing emotional exhaustion in residents. However, residents with high baseline levels of emotional exhaustion did appear to benefit from MBSR. Furthermore, they demonstrated modest improvements in personal accomplishment, worry, mindfulness skills, self-compassion and perspective-taking. More research is needed to confirm these results.

Project description:BackgroundIn 2017, the American College of Physicians (ACP) designated Mindfulness-Based Stress Reduction (MBSR), an eight-week group program, as first-line non-pharmacological treatment for chronic low back pain. However, interprofessional collaboration between mindfulness instructors and Primary Care Providers (PCP) remains largely unknown.ObjectiveWe developed a survey to assess communication between mindfulness instructors and PCPs, identify predictors of referral to MBSR, and determine areas where interventions could increase patient access to MBSR.MethodsThe 25-question survey was sent via email to PCPs at the Division of General Internal Medicine, University of Pittsburgh, PA, the Piedmont Health Services Family Medicine Section, Chapel Hill, NC, the Boston Medical Center General Internal Medicine and Family Medicine Sections, Boston, MA, and the UMass Memorial Medical Center Family Medicine Section, Worcester, MA. We used descriptive statistics and logistic regression to analyze the data.ResultsAmong 118 eligible respondents, 85 (72.0%) were female PCPs, mean age was approximately 41.5±10.1, and the majority (65.2%) had been in medical practice ≤10 years. Of these PCPs, 83 (70.1%) reported familiarity with MBSR (95% CI: 62.1, 78.5), and 49 (59.0%) of them referred patients at least yearly. Of those who referred, 8 (16.3%) reported collaboration with mindfulness instructors. PCPs who were quite a bit or very much familiar with MBSR had 5.10 (1.10, 22.50) times the odds (P=.03), and those who were 50 years or younger had 3.30 times the odds (P=.04) of referring patients to MBSR. Frequency of PCPs' personal practice of mindfulness was not significantly associated with referrals (P=.30).ConclusionThis is the first study to assess interprofessional collaboration between mindfulness instructors and PCPs. Suggestions for a potential integrative health care model are included; further studies on methods to augment communication and education are warranted to improve the referral process and ultimately increase accessibility and utilization of mindfulness-based programs.

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The Integration of the Workable Range Model into a Mindfulness-Based Stress Reduction Course: a Practice-Based Case Study.

Publications

The Integration of the Workable Range Model into a Mindfulness-Based Stress Reduction Course: a Practice-Based Case Study.

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