Exploring Meditation and Mindfulness: Techniques and Resources for Cognitive Rehabilitation

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1 Exploring Meditation and Mindfulness: Techniques and Resources for Cognitive Rehabilitation Meaghan G. Wright BA, CBIST Main Line Rehabilitation Associates

2 Objectives Understand how mindfulness and meditation can help after a brain injury Identify at least two mindfulness techniques to improve thinking, mood, and self-awareness Resources for setting up your own mindfulness practice

3 What is Mindfulness? Dr. Jon Kabat-Zinn s definition: Paying attention On purpose In the present moment Non-judgmentally

4 Aspects of mindfulness Intention- why you are doing it Attention-inner and outer experience Attitude- curiosity, acceptance, kindness

5

6 Why do people do it? Manage stress Manage pain Improve mood Increase focus Find balance

7 Mindfulness practice improves: Resilience- Davidson, Kabat-Zinn, 2003 Mood- Hofmann et al, 2010 Anxiety- Spek et al, 2013 Empathy- Lazar, 2005 Working memory- Jha et al, 2010 Attention Azulay et al, 2012 Grey matter - Holzel et al, 2011

8 Using Mindfulness to Cope with Difficult Emotions R Recognize the emotion you re feeling. Name it. A Accept the experience you re having. I Investigate Become curious about your experience. Where do you feel the emotion in your body? What kind of thoughts are going through your mind? N Non-identification See the emotion as a passing event rather than who you actually are

9 Some Approaches to Mindful Meditation Guided meditation Self-guided meditation Passive meditation Movement meditation

10 Guided Meditation Follow along while someone else instructs Good for those who need help with initiating and following through Requires sufficient language processing Good for those who are new to meditation

11 Self-guided Meditation Body scan, mindful breathing Requires some familiarity with process Requires certain level of initiative and ability to remember directions Might be better for those who are distracted or annoyed by someone directing them

12 Passive meditation Sitting in nature, viewing nature scenes Works well for those with: Initiation problems Auditory processing difficulties or receptive aphasia Attention difficulties Resistance to traditional forms of meditation

13 Movement meditation Yoga Walking meditation

14 Day to Day Informal Mindfulness Mindful communication Mindful walking Mindful eating Mindful working Mindful waiting Acceptance of others Enjoying the moment

15 MLRA s Mindfulness Study 10 participants 10 week period of guided meditation Not all data in Good preliminary findings

16 Tools used to evaluate the effects MARS Moss Attention Rating Scale MPAI-Mayo Portland Adaptability Inventory Patient Competency Rating Scale Clinician (Prigatano) Patient Competency Rating Scale-Patient Process Training Attention Activity- Malia BAI-Beck Anxiety Inventory Qualitative survey designed by MLRA

17 Early outcomes 60% noted MPAI on Some noted on MPAI for 1/3 participants PCRS scores indicated

18 PCRS clinician: percent of participants demonstrating an improvement Behavior/ Emotional Social Self Care Cognitive

19 Qualitative Questionnaire 64% stated they were (lines up with BAI numbers) 45% stated on their own

20 The Mindfulness App $1.99 -Set alerts to remind you to stop and meditate at a certain time, or day, or when you enter a certain location.

21 Mindfulness Meditation by Mental Workout Guided meditations for both beginners and more experienced mindfulness practitioners. Eight-week program, inspiration talks, body scans and relaxation instructions

22 Simply Being $1.99 Short guided meditations, with or without music and nature sounds. Perfect for beginners looking for something simple, Simply Being is highly rated for being user-friendly and customizable.

23 Meditate by Meditation Timer $3.99 Allows you to follow your own practice, either silently or accompanied by bells. The statistics feature also allows users to track their practice and chart progress.

24 Walking Meditation by Meditation Oasis Geared toward mediation on-the-go. With three different guided walking meditations, users can plug in their headphones and unwind in transit. The app comes with a diary for users to keep track of their progress.

25 References Azulay J, Smart CM, Mott T, Cicerone KD. (2013). A pilot study examining the effect of mindfulnessbased stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. J Head Trauma Rehabil Jul-Aug;28(4): Chiesa A, Calati R, Serretti A. (2011). Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clin Psychol Rev Apr;31(3): doi: /j.cpr Epub 2010 Dec 1. Davidson, RJ, Kabat-Zinn, J., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med Jul-Aug;65(4): Hofmann, S., Sawyer, A., Witt, A., and Oh, D. (2010). The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review. J Consult Clin Psychol Apr; 78(2): Hölzel, BK, Carmody, J, et al. (2012) Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res Jan 30; 191(1): Jha AP, Stanley EA, Kiyonaga A, Wong L, Gelfand L. (2010). Examining the protective effects of mindfulness training on working memory capacity and affective experience. Emotion Feb;10(1): Lazar SW, Kerr CE, Wasserman RH, et al. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport Nov 28;16(17): Malia, K. & Brannagan, A. (2004). How to do cognitive rehabilitation therapy: A guide for all of us. Surrey, UK: Brain Tree Training. Malia, K. & Brannagan, A. (2005). How to do Cognitive Rehabilitation: Part one. Surrey, UK: Brain Tree Training. Malia, K. & Brannagan, A. (2005). How to do Cognitive Rehabilitation: Part two. Surrey, UK: Brain Tree Training. Moore A, Gruber,T, et al. (2012) Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control. Front Hum Neurosci. 2012; 6: 18 Spek, A., Van Ham, N., Nyklíček,I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial. Research in Developmental Disabilities Volume 34, Issue 1, January 2013, Pages

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