Advances in medical research, the consumer empowerment, and rising cost of health care have demonstrated the need to treatment models that are holistic and client driven. Complementary and alternative medicine (CAM) offers consumers choices. It includes traditional healing practices, medical systems that are thousands of years old and new or innovative treatments that may be consider unconventional. Well known examples of CAM include herbal remedies, mindfulness, meditation, manipulative/movement therapies, and Chinese Medicine. Knowledge of CAM offers social workers in all settings the opportunity to provide education and advocacy in seeking client centered and culturally competent treatment options.







Wednesday, May 18, 2011

Mindfulness Meditation: Dr. Jon Kabat-Zinn

Dr. Kabat-Zinn has made significant contributions to the field of CAM by teaching and conducting research in the use of Mindfulness-Based Stress Reduction (MBSR), was developed at the University of Massachusetts Medical Center.  MBSR is different from other forms of meditation in that it is a clinically standardized practice, based on ancient healing practices.  Patients are encouraged to develop a specialized type of attention consisting of nonjudgmental awareness, openness, curiosity, and acceptance of their internal states.  MBSR includes a combination of 3 different techniques (Chiesa & Serretti, 2009).  The first technique, body scan, involves focusing attention through the entire body from feet to head and on any sensation or feeling in the body.  The body scan involves non-judgment of the sensations and use of breath awareness and relaxation as the patient continues their scan.  The second technique involves a sitting mediation.  During this meditation the patient pays attention to their breathing, rising and falling of their abdomen and any other sensations that flow through the mind.  The final step involves Hatha yoga practice, including breathing exercises, simple stretches, and posture, all designed to strengthen and relax the body.   Increased awareness can enable patients to use internal resources to manage stress, emotions pain management and improved immune function.  MBSR practices consist of eight to ten weeks of guided practices.  Patients start with 2.5 hours weekly classes along with a single all-day class to learn meditation skills, as well as homework to reinforce newly learned skills.
Meditation is practiced by healthy individuals.  The standardization of MBSR as a clinical practice has enabled researchers to study this intervention in multiple settings.  Grossman, Niemann, Schmidt, and Walach (2004) studied the effectiveness of MBSR by reviewing outcomes of twenty studies and concluded that MBSR can assist individuals to cope with multiple medical and psychosocial problems.  In healthy individuals MBSR has been effective in helping reduce stress, ruminative thinking, trait anxiety, increased empathy and self-compassion (Chiesa & Serretti).  Ledesma and Kumano (2009) conducted a meta-analysis of the effects of (MBSR) on the mental and physical health status of patients with different forms of cancer.  They identified ten studies demonstrating a significant effect size in helping improve psychosocial adjustment. 

References

Chiesa, A., & Serretti, A. (2009). Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis. Journal of Alternative & Complementary Medicine, 15(5), 593-600.
Ledesma, D., & Kumano, H. (2009). Mindfulness-based stress reduction and cancer: a meta-analysis. Psycho-Oncology, 18(6), 571-579. doi:10.1002/pon.1400
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43. doi:10.1016/S0022-3999(03)00573-7

6 comments:

  1. I would use mindfulness meditation with my clients who are experiencing a lot of worries and anxiety. Mindfulness meditation helps people to build awareness and acceptance of their life in the present moment. It helps to increase one’s conscious awareness by focusing on the experience of the meditation. The most common one is focusing on the flow of breath. Through this experience, people observe their thoughts and emotions but let all the thoughts flow through without being judgmental. Practice being non-judgmental on their thoughts can help minimize the affect of stressful and anxious thinking. People can do meditation anywhere and anytime during the day and it can be done in as little as a few minutes.

    Annie Yip, MSW Student

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  2. Mindfulness meditation can be assign as one of the homework assignments in CBT. Clients who are experiencing a lot of worries and anxiety can practice mindfulness meditation daily for a minimum of three minutes each time. The client can do this exercise throughout the day as they feel a need to calm down when feelings of anxiousness emerge. This repeated practice can build up one’s self-awareness so they can become resistant to worry thoughts and take control of how they feel. Mindfulness meditation can also be use in the beginning of the CBT session to assist client to draw their focus and attention. This can help them be present and ready for the therapy which follows.

    Annie Yip, MSW Student

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  3. In the first psych class I took as an undergrad I was introduced to the work of Dr. H. Bensen (b. 1935), a medical doctor who took to studying something he later termed the “relaxation response”. His studies evaluated the effects of meditation (ranging from catholic nuns, benedictine monks to transcendentalist lay people) on the brain and body. The term relaxation response came after observing that the physiological response to these various forms of meditation in many ways mimicked the opposite effects of stress. For example, while stress depletes the immune system, meditation was seen to strengthen it (displayed again in the study mentioned above).
    Anyway, I read the book. I don’t recall just how methodologically sound the research was but it inspired me to do my own investigations. Years later I continue to be excited by these kinds of findings. While I never conducted my own formal research, the teens with substance abuse issues I’ve worked with in the past have reported numerous benefits from applying techniques like those mentioned above. I am grateful that we have Medications, genograms, attachment theories and the like. But there is something very gratifying about the efficacy of simple breathing techniques.
    Chris Liberatore Lopez, MSW student

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  4. This type of CAM is an interesting intersection of the models of western mental health intervention and Buddhist/yoga tradition. MBSR seems to be a combination of Buddhist Vipassana mindfulness techniques and Hatha yoga techniques without what we typically categorize as the "religious" aspects of the traditions. This is interesting within the context of the many categories of Western thought traditions and Buddhist traditions that are complementary. For example, the Buddhist abhidharma tradition is complementary to both western psychology as well as ontology. Similarly, the Buddhist philosopher Nagarjuna's second century writings about emptiness and dependent origination are also complementary to 20th century postmodernism. Similarly too, the benefits of MBSR can meet the requirements of science, which is what our modern health care system requires.

    Mark Kunkel, MSW student

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  5. Mindfulness meditation can be extremely helpful for anyone with anxiety. As an anxious person, and having a very anxious daughter I am a current student of such practice. I became familiar with Jon Kabat-Zinn in my work at Kaiser in the department of Health Education. While I have found challenging to learn breathing techniques, I have found that practicing is making it easier and is already becoming helpful as I encounter stressful situations. Being able to mediate even a few minutes a day can make a important difference in my day. I highly recommend the practice of mindfulness meditation, Jon Kabat-Zinn has great CDs available that can guide you through the process.

    Aida Estrada, MSW student

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  6. Nice post thanks for this it is really very helpful for me thanks for this.

    http://www.biof.com/index.asp

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