MiT-C for Children, Adolescents and Families

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Mindfulness Informed Therapy for Children, Adolescents and Families

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  • Time In / Rupture and RepairMarked and Contingent
  • Theory – mapping this on to what they already know
  • Group discussion/brainstorm
  • Coming into a state of Presence Attentional placement: Getting out of rumination and worry Internal awareness Being Mode
  • Wherever you are – doesn’t have to be formal always – can be when at school, tying shoe laces, drinking a drink
  • Predominantly Mindful parenting, therapist, teacher, etc modeling mindfulness then over time child develops skills and begins to incorporate into their lives independently. There will always be that gap. There is likely to be issues over time where child will have to rely on parents for support – mindfulness is a tool to assist but they will still have to use adults.
  • Left side is correlational research – higher levels of mindfulness ass with lower levels of…Right side lists some of things that when mindfulness increases from pre to post intervention
  • Clinician using Mindfulness practice without teaching to clientsTeaching concepts (e.g., attitudes) without formal Mindfulness practiceClinician using Mindfulness practice without teaching to clientsTeaching concepts (e.g., attitudes) without formal Mindfulness practiceAcross all interventions (why umbrella) embodying and modeling of mindfulness with clients is pivotal for all styles of interventions.IS CAM HAPPY WITH THIS SLIDE?
  • Mindfulness assumes that internal experiences occur (thoughts feelings body sensations and urges to act) in response to external stimulus and interactions in relationships. Focus is on the process and relationship with internal experiences rather than content60,000-70,000 thoughts per dayControl of content of automatic thoughts is difficultThoughts and emotions are not factsPsycho-education about the different types of internal experiencesMetaphors for psycho-education about mindfulness conceptsPsychoeducation: Who here has used CBT? Who has found sometimes children struggle to know the difference between thoughts and feelings? So it’s the same here with Mindfulness – we need to teach the children first what we’re wanting them to be on the look out for and to notice.we’ve just spoken about the fact that a lot of mindfulness concepts can be abstract, so it’s important for us to teach children about the types of things that we want them to notice and name. For example, the sheet below explains what a body sensation, a thought and a feeling are and this is really important bc in debriefing an exercise children may not know what these are or how to decribe them.Language: blah blah. Thinking back who has used a CBT framework – so describing what these things are isn’t new.
  • WORKBOOK IS NOT PRINTED – WILL BE PASSWORD PROTECTED PDF FILE TO ACCESS – SOMETHING FOR THEM TO REFER TO IN THEIR PRACTICEDANI’S NOTES: IN TERMS OF THE TABLED SLIDES – PROVIDE ON HANDOUT? DON’T GO OVER…MAYBE JUST ACKNOWLEDGE THE IMPORTANCE OF CONSIDERING THE AGE OF THE CHILD OR ADOLESCENT YOU’RE WORKING WITH AND WHERE THEY ARE LIKELY AT IN TERMS OF ATTENTION AND EXECUTIVE FUNCTION; LANGUAGE & COGNITION; AND KNOWLEDGE OF INTERNAL EXPERIENCE. UNDERSTAND THE DEVELOPMENTAL STAGE THEY ARE AT AND MODIFY EXERCISES ACCORDINGLY. BASICALLY, THE YOUNGER THE CHILD THE MORE CONCRETE, VISUAL AND SENSORY EXERCISES SHOULD BE. AS THEY GET OLDER YOU CAN START MAKING EXERCISES MORE ABSTRACT AND INCLUDE THOUGHTS AND FEELINGS.
  • Matching the mindfulness practices to the developmental needs of the child/adolescentWhen asking kids to sit & pay attn – there is going to be movement – acknowledge this. Do a movement exercise. See if they can notice that they want to move before they move.
  • AND WE’RE GOING TO HAVE A LOOK NOW AT WHAT ARE THE BUILDING BLOCKS. PRACTICES THAT ARE LOWER ON THE WALL ARE THE ONES WE WILL BE DOING WITH YOUNGER CHILDRENWith dual attention – metaphor of focused attn of spotlight – shining it on one aspect of our experience. Dual attn if we think of our experience as a house – like lights in house being turned on as well as spotlight outside being turned on – we can focus on internal and external expreriences
  • Not going to use the words cognitive defusion with kids for example. Keeping it simple: slowing down, noticing, naming. Visuals:e.g list of words you want them to use when describing experience back to you.
  • This section is about setting the framework (the ‘how). When we think about Mindfulness what I want you to take away today is that there are 3 components to mindfulness – Attention, Intention, and Attitude. So looking at definition of mindfulness before it’s… paying attention in a particular way, …etcChoosing: mindfulness is a choice – reminding them that they have a choice about being mindful and noticing what is going on for them. Choose to get off auto pilot. It’s actually very tricky – remembering is half the struggleAttitude: just call out some of the words that describe the attitude of mindfulness…..ok great concepts – but really not going to fly with kids – here are some of the words that might be usefulKindness: kind to myself for having difficult thoughts and feelings – not getting angry with myself; being kind to our wandering mindWillingness: e.g., an externalising child who feels really angry about a situation – their willingness to do something that’s not harmful to express and manage this anger
  • Mindfulness assumes that internal experiences occur (thoughts feelings body sensations and urges to act) in response to external stimulus and interactions in relationships. Focus is on the process and relationship with internal experiences rather than content60,000-70,000 thoughts per dayControl of content of automatic thoughts is difficultThoughts and emotions are not factsPsycho-education about the different types of internal experiencesMetaphors for psycho-education about mindfulness conceptsPsychoeducation: Who here has used CBT? Who has found sometimes children struggle to know the difference between thoughts and feelings? So it’s the same here with Mindfulness – we need to teach the children first what we’re wanting them to be on the look out for and to notice.we’ve just spoken about the fact that a lot of mindfulness concepts can be abstract, so it’s important for us to teach children about the types of things that we want them to notice and name. For example, the sheet below explains what a body sensation, a thought and a feeling are and this is really important bc in debriefing an exercise children may not know what these are or how to decribe them.Language: blah blah. Thinking back who has used a CBT framework – so describing what these things are isn’t new.
  • When asking kids to sit & pay attn – there is going to be movement – acknowledge this. Do a movement exercise. See if they can notice that they want to move before they move.
  • FREYA COMING IN HERE
  • Ask them to bring their attention to the present moment and to notice something that they are experiencing. If needed, provide some options of experiences that they could notice (e.g., their rate of breathing, a thought or feeling they are having in response to the current conversation, any current body sensations, whether they can hear a salient noise in the room or surrounds). If necessary, choose a relevant sensory system and create a situation where there is a change in the input. If they are standing, one option could be to have them rock back and forward and invite them to describe where they feel the changes in pressure. Another option could be to have them to exaggerate the inward and outward movement in the abdomen for a few breaths and then ask them to breathe naturally and notice the natural movement in their belly.
  • Sight and touch – sensory ballSound – bell & favourite music (depressing versus non-favoured music)Taste – lollies (discuss comfort eating with mindful observation of urge)Movement (pressing alternate foot into the floor) Get a volunteer & do a touch exercise – exercise in desrcribing/noticing – not judgingThen get everyone to pick an object and walk through sight, touch, sounds exercise – WHAT & HOW was it Other sound exercises: bell – notice when can’t hear sounds anymore – good for classroomAdolescents – with music – bring in their music – notice different thoughts, feelings sensations that arise during different songs.
  • DON’T do
  • Be a bit more inclusive a little bit – we know that anxiety is often v future orientated - feeling of tightness comes along with this and sense of overwhelming and I can’t cope with this.This is a a bit different to depression which tends to be caught up in past.1st thing is awareness – noticing that I’m a mess today – I’m an anxious mess today. of where my mind is – curious explorer about where it is. AS much of the journey comes bringing acceptance and compassion to how mind is – so that become less judgmental.
  • Curious explorer!Need to talk about what to do when created space for thoughts & feelings. Choose effective action (behaviour activation). In ACT – choosing values and committed action. Once created space – can choose how to react – if we react – we might choose an action or we might just notice and let it pass. Mindfulness gives us the space and awareness to choose reaction.Top table: I’ve got all the child friendly term for the 3 components from that mindfulness map I showed you earlier. Over the next few slides – the things that are highlighted in purple are the terms most salient for this disorder. It’s not to saythe others aren’t important – the highlighted ones could just be argued to be the most prominent.In the second table on the coming slides I’ve highlighted the mindfulness practices and considerations in intervention planning for that particular disorder. Individual practice will depend on the client presentation but these tools are likely to be useful for you in intervention planning.
  • Comment: If still want to go down path of core beliefs and identifying negative thoughts – not saying you can’t – this is just how we integrate it.Knowing why: about values and valued direction (ACT); or goal setting – it’s going to be our motivation and what drives us
  • I’m just going to hang out with anger – this externalising thing – when my blood is boiling – how do we ourselves create space and defuse from this.Developing a common language with people in the system. Signals, cues/early warning signs. What practices would you change if this child had ADHD – draw it out and discussExternalising behaviour is really about the intention/choice (hence why everything in that column is highlighted)
  • MiT-C for Children, Adolescents and Families

    1. 1. Children, Adolescents and Families Cameron Aggs Dr. Danielle McCarthy Mindfulness Training Australia Copyright (c) 2013 Freya Combes and Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy Australian College of Community Services
    2. 2. Overview  Session 1:  Components of mindfulness and key concepts  Session 2:  Developmental considerations  Session 3:  Challenges of childhood and adolescence (with case studies)  Session 4:  Facilitation practice
    3. 3. Aims....  Theory: To present an overview of mindfulness and applicable developmental considerations that scaffolds integration of MiT-C concepts and practices  Experiential: To provide a space for you to experience mindful state of consciousness, to give you techniques and concepts to help you get back there:  Both independently and when working with clients.  Resources: To provide exercises and resources to get you forming new habits and practicing in new ways Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    4. 4. Methods  Powerpoints  COS Worksheets  Video  Brief Meditations  Participation in brief meditations is voluntary  Evoking mindfulness as the best method for learning Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    5. 5. Mindfulness  What is it?  How does it enhance the process and content of working with clients?  Mindfulness and Emotion Regulation  Working through difficult emotions  Knowing and Naming  The importance of Scaffolding…  Modeling Mindfulness: Using your faculty of attention and your willingness „feel into‟ experience as tools.  What does it mean to be present? Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    6. 6. Working with Therapist Factors Who among us can evoke a state of presence at will? Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    7. 7. True…? “The mind if not stirred, will become clear” -Sogyal Rinpoche Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    8. 8. What is Mindfulness……?
    9. 9. “Bringing one‟s complete attention to the experiences occurring in the present moment, in a nonjudgmental or accepting way” (Brown & Ryan, 2003; Kabat-Zinn, 1990). A Definition of Mindfulness…
    10. 10. Our “map”: IAA model of mindfulness (Shapiro et al., 2006) Intention Attention Attitude Paying attention in a particular way… Kabat-Zinn, 1994, p4 and non-judgmentally. on purpose, in the present moment,
    11. 11. Holding in Mind: Intentions  What do you want from mindfulness?  This moment…?  This meditation / workshop / this session…?  More generally inc this treatment episode? Tip #1: Mindfulness is an intentional activity
    12. 12. Attending Skills Placing your attention where you want it…  Attentional placement:  Shifting and sustaining attention  Non-judgmental Awareness  Inhibiting secondary appraisals  Noticing and Naming  Ability to put inner experience into words
    13. 13. Attending:  Using your faculty of attention as a tool: Disengaging from worry and rumination  Inwardly: Fostering Internal Attunement / Meta-Cognitive Awareness: What‟s happening for me now..?  Outwardly: Promoting the ability to use relationships and the world around us to heal and  To come into a state of “Presence”
    14. 14. What do we really mean by „being present‟?
    15. 15. Presence…. What are the qualities of that?
    16. 16. 3 Qualities of Presence  Light: As in buoyant in the Mind  Unencumbered by past and future and fixation  Relaxed: As in soft in the body  Particularly the belly, chest, shoulders, jaw  Grounded: The bum in the chair and the feet on the floor  Mind „riding‟ the breath Light. Relaxed. Grounded.
    17. 17. 4 Breaths Technique Coming into a state of presence:  Lightly, mindfully watching the breath  Coordinating with the fingers: Motor-movement  Rounds of 4  Combine with FBB technique “These 4-Breaths are Mine”
    18. 18. “The mind if not stirred, will become clear” Sogyal Rinpoche
    19. 19. Mindful Attitudes: More than just Attention The anesthetic of internal attunement….
    20. 20. Attitudes GOAL  Curiosity :  Openness  Acceptance  Love Metaphor / key principles  Curious Explorer  “It is already here: Let me feel it  As an active state  Friendliness Saying „Yes‟ to Experience
    21. 21. Focusing on Acceptance It‟s an intentional activity… Saying “Yes” to experience - Tara Brach “It‟s already here…. Let me feel it” -John Kabat-Zinn Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    22. 22. Learning to let it flow… Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    23. 23. 2-Step process  Before „Letting-flow‟, we must chart the course of this stream. We must know its texture…. The feelings, the pain of it, the impact. We must learn how to make a space for it as it is. = Acceptance Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | info@bemindful.com.au
    24. 24. 3 Minute Breathing Space = Making a Space for What is Happening now Step 1: Taking stock / Gathering the mind Step 2: Focusing and redirecting the attention Step 3: Expanding awareness and returning Hot tip: Bookmark: youtube “3 minute breathing space” (it‟s the first one that comes up) Experiential Exercise: 3MBS:
    25. 25. I-SIFT I (me) Sensations Images Feelings Thoughts
    26. 26. “Mindfulness is an intentional activity which consists of: 1. Bringing one‟s complete attention 2. To the present moment, 3. In a nonjudgmental or accepting way” Recapping So Far….
    27. 27. Mindfulness Pro‟s and Cons Positives  Transportable  Immediate  Experiential  Stretches the full continuum of mental health experience  Formal and informal practices Disadvantages  Intentional (forgetting is a big problem)  Difficult to operationalise and explain  We can be “dissmissing” sometimes when using it
    28. 28. The process of mindfulness (the WHAT and HOW) Noticing and naming with mindful attitudes (internal & external experiences) Letting go (creating space) Focus/Re-focus attention Choose an aspect of internal or external experience to focus attention on
    29. 29. Embodied Mindfulness Applying Mindfulness: Who Teaching Mindfulness: Child‟s independent practice  Adults and children  Increasing capacity with age (and development) for children to engage in independent mindfulness practice
    30. 30. Why Greater mindfulness associated with lower:  Depressive symptoms  Anxiety  Stress  Internalizing symptoms  Externalizing behaviour problems  Worry and rumination  Negative affect  Substance use coping  Somatic complaints  Psychological inflexibility and thought suppression and control Mindfulness interventions resulting in lower:  Depressive symptoms and low mood  Anxiety  Stress  Internalizing symptoms  Externalizing behaviour problems  Difficulties with emotion regulation  Problem behaviours in the classroom
    31. 31. Why Greater mindfulness associated with higher:  Healthy self-regulation  Emotion regulation  Positive affect  Quality of life & life satisfaction  Social skills  Academic competence Mindfulness interventions resulting in greater:  Feelings of calm/relaxation  Social skills  Personal and social well-being  Self-esteem and self-acceptance  Awareness and recognition of types of emotions  Attention and executive functioning  Self-efficacy for reducing substance use  Sleep
    32. 32. Where does MiT-C fit? Mindfulness-informed interventions • MiT-C: utilising and integrating your existing clinical skills into a mindfulness framework •Acceptance and Commitment Therapy (ACT) • Dialectical Behaviour Therapy – adolescents (DBT-A) Mindfulness-based interventions • Mindfulness-based stress reduction for children (MBSR-C) • Mindfulness-based cognitive therapy for children (MBCT-C) • Independently developed mindfulness programs Embodying and modeling of mindfulness with clients
    33. 33. MiT  Therapy process skill: Embodying mindfulness  Intervention technique: eg 2-hands, 4-breaths, Metaphore, POC exercise, 3-Minute Breathing Space, Body Scan, Working with Discomfort  Flexible delivery of client-centred techniques  Use of mindfulness in assessement, psychoeducation, intervention, and in the relational space  Targets Emotional Regulation capacity
    34. 34. Central Concepts, Psycho-education and Debriefing  Internal experiences (reactions) occur  Thoughts, feelings, body sensations, urges to act  Internal experiences are transient and change with time  Acknowledges that “negative” thoughts and feelings are experienced by everyone  Experiential avoidance
    35. 35. Developmental Modifications: Psycho-education in child friendly terms  Things happen inside of us (thoughts, feelings, body sensations, urges to act). These things change with time (e.g., intensity, location).  Most people find it difficult to control feelings and thoughts that pop into our heads.  How we feel about (and relate to) what happens inside of us is important.  Sometimes people see certain thoughts and feelings as “bad”. When we mindfully notice our thoughts or feelings we see them just as thoughts or just as feelings.  There is a difference between describing and judging what is happening inside of us.  “Creating Space” (instead of defusion, decentering and reperceiving)  Creating Space allows us to choose our reaction
    36. 36. The Three Rs of Mindfulness  Release the mind from „too much thinking‟ and/or the struggle against „what is‟.  Relax the body, notice your breathing.  Return to this moment; where you have all the resources you need…
    37. 37. Developmental considerations
    38. 38. Developmental Considerations  Receptive language skills are needed  Concepts can be abstract  Mindfulness inherently uses skills that are less well developed in children and adolescents than adults  Language (understanding and expressing themselves)  Meta-cognition  Executive function and attention skills  Mindfulness practice builds on developmental capacities (e.g., attention and executive function)
    39. 39. Principles of Developmental Modifications  Matching the mindfulness practices to the developmental needs of the child/adolescent  7 years: selective attention develops and self-talk is becoming internalised  Enables focused attention practices  10 years and onwards: dual attention skills developing  More capable of noticing internal and external experiences simultaneously  Adolescence: increase in abstract thinking, attention and executive function skills  Easier to understand abstract concepts inherent in mindfulness
    40. 40. Mindfulness Practices: Building Blocks Sensory information FeelingsThoughts Breath Focused attention practices Body sensations InteractionsDual attention practices
    41. 41. Developmental Modifications: Language  Use developmentally appropriate/child friendly language  Scaffold descriptive language with word lists or visuals Slowing down NOTICING and NAMING what is happening RIGHT HERE, RIGHT NOW Being CURIOUS about what is happening for you Being WILLING to feel Being KIND to yourself & don’t judge yourself for what you are experiencing LETTING GO CREATING SPACE TO CHOOSE
    42. 42. Child Friendly IAA terms Intention Attention Attitude Focusing/refocusing on the here and now Noticing and naming Letting go and creating space Checking in Curiosity Kindness Willingness Choosing Slowing down Remembering Knowing why
    43. 43. Developmental Modifications: Psycho-education in child friendly terms  Things happen inside of us (thoughts, feelings, body sensations, urges to act). These things change with time (e.g., intensity, location).  Most people find it difficult to control feelings and thoughts that pop into our heads.  How we feel about (and relate to) what happens inside of us is important.  Sometimes people see certain thoughts and feelings as “bad”. When we mindfully notice our thoughts or feelings we see them just as thoughts or just as feelings.  There is a difference between describing and judging what is happening inside of us.  “Creating Space” (instead of defusion, decentering and reperceiving)  Creating Space allows us to choose our reaction
    44. 44. Developmental Modifications  Using metaphors to illustrate and explore mindfulness concepts  Keep it simple  Don’t overload with too many or varied metaphors  Use of visual props  Length of practices  Kids want to (and will) move  Formal „mindful movement‟ exercises  „Curious‟ observation of urge/intent to move and of the actions when they do move
    45. 45. Debriefing  What level of structure do they need in the debrief?  Will they get lost in verbal discussion?  Use a visual prompt or debrief sheet?  Use an expressive debrief (e.g., using line, colour and shape in a body outline to represent the practice experience) or a written reflection?  Can they identify the difference between thoughts, feelings and body sensations?
    46. 46. Developmental Modifications: Debriefing  Can they recall and verbalise their experiences?  Did they report that they “noticed nothing”, that they “can‟t remember” or answer “I don‟t know”?  Normalise that many children and adolescents find it difficult to be able to notice and then describe what occurred for them  Future intervention:  Facilitate an experience of them being able to notice and name something that is happening for them right now  Example:  choose a relevant sensory system and create a situation where there is a change in the input  highlight a concrete physical sensation that they are likely to be feeling. Suggest a range of possible adjectives and ask them to identify a few relevant words  Dialoguing to build in situ verbal reporting skills
    47. 47. Mindfulness Practice: 2 Hands  Place one hand is on the chest and the other hand on the abdomen.  Breathe and notice:  Where is the breath moving?  Is the breath deep or shallow? Fast or slow?  Which hand is moving more?
    48. 48. Mindfulness Practices: 4 Breaths or Breath Counting  With each breath touch the thumb to finger-tip and note an experience. As you begin a new breath move your thumb to the next finger.  Notice (with curiousity):  4 breaths  4 external experiences  sensory information like sights, sounds, smells, what they are touching  4 internal experiences  thoughts feelings, body sensations, urges  A combination of internal and external experiences  The process of „letting go‟ by moving your fingers physically „creates space‟.
    49. 49. Mindfulness Practices: Sensory Information  Sight and touch  Sound  Taste  Movement  Identify the sense or sensory system that is to be the focus of the practice.  Notice:  Physical sensations or describing words  Whether the sensations or experiences change in intensity, location or size  Automatic judgments (thoughts)  Debrief:  Did they noticed their attention shifting to, or being caught in, other internal experiences (thoughts and feelings) during the practice
    50. 50. Mindfulness Practice: Mindful Movement  Notice:  the physical sensations involved in the movement (including the sense of pressure and weight)  the way that sensations change during the stages of the movement  the sense of body as a whole
    51. 51. Challenges of childhood and adolescence
    52. 52. Formulation of Disorders Disorder Fusion with thoughts and feelings Experiential Avoidance Anxiety Worry & future focused thoughts (“what if…”) Avoiding anxiety provoking situations. Depression Rumination & past focused thoughts. Negative view of self, world and future. Maladaptive coping strategies to manage feelings. Anger and externalising behaviour “I can‟t control it” “It happens so fast” “It‟s not fair ” “It‟s not my fault” Of own distressing feelings. Of owning responsibility.
    53. 53. Anxiety Intention Attention Attitude Slowing down Focusing/refocusing on the here and now Curiosity Remembering Noticing and naming Kindness Choosing Letting go and creating space Willingness Knowing why Checking in/checking out Practices and Considerations for Intervention Planning Checking In (thoughts, feelings, body sensations, urges)/Triggering relaxation response: 2 Hands, 4 Breaths, POC, 3MBS Psychoeducation about experiential avoidance Mindful exposure (thoughts, feelings, and behaviour)
    54. 54. Case Study: Anxiety Child  9 year old male  Presenting difficulties:  Separation anxiety  When mother drops child at school in the morning, child becomes distressed – crying, begging mum to stay, saying he feels sick – and not wanting her to go. Adolescent  15 year old female  History of bullying  Presenting difficulties:  Can talk to adults without difficulties  Experiences difficulties talking with same-aged peers  Avoids or tries to avoid going to social events (e.g., parties), outings (e.g., to the beach) and school activities (e.g., giving a speech in class).
    55. 55. Case Study Points For Discussion  Developmental and/or systemic considerations  Formulation  Mindfulness-informed intervention plan Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy
    56. 56. Depression Intention Attention Attitude Slowing down Focusing/refocusing on the here and now Curiosity Remembering Noticing and naming Kindness Knowing why Letting go and creating space Willingness Choosing Checking in/checking out Practices and Considerations for Intervention Planning Checking In (thoughts, feelings, body sensations, urges)/Triggering relaxation response: 2 Hands, 4 Breaths, POC, 3MBS Risk Assessment & Planning Behaviour Activation
    57. 57. Case Study: Depression  Adolescent  15 year old female  History of bullying  Parents divorced 5 years ago  Presenting difficulties:  Low mood  Poor sleep  Lethargy  Reduced appetite (although some emotional eating)  Reduced concentration and motivation  Loss of pleasure in previously enjoyed activities  Suicidal ideation – suicidal thoughts; no plan or intent
    58. 58. Anger and Externalising Behaviour Intention Attention Attitude Slowing down Focusing/refocusing on the here and now Curiosity Remembering Noticing and naming Kindness Choosing Letting go and creating space Willingness Knowing why Checking in/checking out Practices and Considerations for Intervention Planning Checking In (thoughts, feelings, body sensations, urges)/Triggering relaxation response: 2 Hands, 4 Breaths, POC, 3MBS Mapping warning signs Choosing a helpful expression of feelings Sensory and movement practices
    59. 59. Mindfulness Practices: situational training for identified triggers  Soles of the feet  Asking clients to breath naturally and then remember an anger-provoking incident.  Notice bodily signs of anger  Shifting attention to the soles of the feet (a neutral part of the body)  Standing Strong  Soles of feet up to abdomen to check-in with the speed and depth of their breath  Role Plays
    60. 60. ADHD Intention Attention Attitude Slowing down Focusing/refocusing on the here and now Curiosity Remembering Noticing and naming Kindness Choosing Letting go and creating space Willingness Knowing why Checking in/checking out Practices and Considerations for Intervention Planning Checking In (thoughts, feelings, body sensations, urges)/Triggering relaxation response: 2 Hands, 4 Breaths, POC, 3MBS Mapping signs of being “off task”. Use of visual cues. Nonverbal or visual signal between child and adult (parent/teacher) that attention has wandered. Sensory and movement practices
    61. 61. Case Study: Anger & Externalising Behaviour  7 year old boy  ADHD  Presenting difficulties:  Suspensions at school due to aggression towards peers  Aggressive at home when he doesn‟t get what he wants  Aggressive behaviour: hitting, yelling, swearing, throwing objects
    62. 62. Accessing Resources  Password Resources: See feedback form  3R‟s Meditation: http://bemindful.com.au/general/download/  Youtube: „Hidden Holding / Always Held‟  Youtube: 3 Minute Breathing Space  Youtube: Rest In Natural Great Peace Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy
    63. 63. Resources –Books  Semple, R.J., & Lee, J. (2011). Mindfulness-Based Cognitive Therapy for anxious children: a manual for treating childhood anxiety. New Harbinger Publications Inc.  Kaiser Greenland, S. (2010). The Mindful Child. Free Press.  Greco, L.A., & Hayes, S.C. (Eds) (2008). Acceptance & Mindfulness Treatments for Children & Adolescents: A Practitioner's Guide. Context Press.  Miller, A.L., Rathus, J.H., & Linehan, M.M. (2007). Dialectial Behaviour Therapy with Suicidal Adolescents. The Guilford Press.  Schoeberlein, D. (2009). Mindful teaching and teaching mindfulness: a guide for anyone who teaches anything. Wisdom Publications.  McCurry, C. (2009). Parenting your child with mindfulness and acceptance. New Harbinger Publications Inc. Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy
    64. 64. Resources – Story Books  Nhat Hanh, T., & Vriezen, W. (2008). Mindful Movements: Mindfulness Exercises Developed by Thich Nhat Hanh and the Plum Village Sangha. Parallax Press. [Mixed media product – includes DVD]  Nhat Hanh, T., Plum Village Community & Vriezen, W. (2011). Planting Seeds: Practicing Mindfulness with Children. Parallax Press. [Mixed media product – includes CD]  Nhat Hanh, T. (2012). A Handful of Quiet: Happiness in Four Pebbles. Parallax Press.  Bowden, T., & Bowden, S. (2010). I just want to be me! Building resilience in young people. Exisle Publishing Limited. [Aimed at adolescents]  Alderfer, L. (2011). Mindful monkey, happy panda. Wisdom Publications. [This storybook is aimed at children in early-mid primary school] Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy
    65. 65. Thank You! Danielle@mindfultherapy.com.au cam@bemindful.com.au Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy
    66. 66. Additional Material
    67. 67. Metaphors Copyright (c) 2013 Mindfulness Training Australia, All Rights Reserved | MiT - Mindfulness Informed Therapy Metaphor Target area Clouds in the sky Concepts of mindfulness and „creating space‟ Leaves on a stream Concepts of mindfulness and „creating space‟ No pest control Attitude of non-judgement and „creating space‟ to allow (rather than trying to control or change) experience Spotlight/Torch Attention in mindfulness practices Puppy on a leash Nature of attention and attitudes of kindness Train of thought Nature of thoughts and „creating space‟ Thought parade Nature of thoughts and „creating space‟
    68. 68. Using Metaphors Clouds in the Sky  Mentally “placing” internal experiences (usually thoughts) on the object and allow it to move (or not move) as it naturally wants to.  Does … (object) stick around?  Does it feel ok if … (object) is not moving on?  Background (sky) is „observing self‟/„self-as-context‟  Noticing that the background can observe the objects that move through it  Are you the … (object) or the … (background)? [„self-as-context‟ rather than „self-as-content‟]  If the child has the capacity, you can link other internal experiences (e.g., feelings) to other objects/events that occur in the background  Are you still able to be … (the background) even when … (feeling) is also happening?
    69. 69. No Pest Control (reactions happen)  Imagine your distressing or unwanted thoughts, feelings, body sensations are like … cockroaches…  Being able to let the experience be…  Not feeling bad that it is here  Not trying to get rid of it  Not running away from it  Not letting the cockroaches control how you act  Not trying to make the experience positive (e.g., a butterfly)  Being ok with the experience coming and going… like cockroaches running around you...  Being able to notice the experience and still being able to chose what to do
    70. 70. Nature of Attention Spotlight  Shining light on where you want to focus your attention Puppy on a leash  Like a puppy attention naturally wanders (jumps around)  It takes time to train a puppy (attention) to be able stay in the one place for any length of time  Getting angry at the puppy doesn‟t help  Be kind to your wandering mind
    71. 71. Train of thought  Thoughts don‟t stop and they often jump from one topic to another.  The train of thought can be fast or slow  Creating Space: “Are you standing on the platform or are you riding on the train?”
    72. 72. Thought Parade

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