Feasibility, Acceptability, and Clinical Trends of a Mindfulness-Informed Child Welfare Intervention: Implications for Trauma-Focused Practice
Keywords:Child welfare, coping, mindfulness, stress, trauma
AbstractExposure to stress and early life trauma have been linked to child maltreatment and parental substance misuse. These issues often co-occur, yet few child welfare services target their shared underlying causes in a single intervention. Teaching mindfulness-informed strategies to substance-misusing families in the child welfare system may be one promising trauma-informed approach. As part of a larger pilot study testing the initial efficacy of a mindfulness-informed intervention for parents in public child welfare, this study explored the feasibility, acceptability, and clinical trends of the intervention using weekly reports of stress, coping, and mindfulness. Findings show support for the feasibility and acceptability of the intervention as well as positive responses to the intervention on measures of stress and mindfulness. However, the impact of the intervention varied with regard to improving weekly coping among participants. Implications for the integration of mindfulness into child welfare practice as a trauma-informed approach are discussed.
Barnes, S., Brown, K. W., Krusemark, E., Campbell, W. K., & Rogge, R. D. (2007). The role of mindfulness in romantic relationship satisfaction and responses to relationship stress. Journal of Marital and Family Therapy, 33(4), 482-500. doi:https://doi.org/10.1111/j.1752-0606.2007.00033.x
Beasley, L. O., Silovsky, J. F., Owora, A., Burris, L., Hecht, D., DeMoraes-Huffine, P.,…Tolma, E. (2014). Mixed-methods feasibility study on the cultural adaptation of a child abuse prevention model. Child Abuse & Neglect, 38(9), 1496-1507. doi:https://doi.org/10.1016/j.chiabu.2014.04.017
Benotsch, E. G., Brailey, K., Vasterling, J. J., Uddo, M., Constans, J. I., & Sutker, P. B. (2000). War zone stress, personal and environmental resources, and PTSD symptoms in Gulf War veterans: A longitudinal perspective. Journal of Abnormal Psychology, 109(2), 205-213. doi:https://doi.org/10.1037/0021-843X.109.2.205
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., … Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology : Science and Practice, 11, 230-241. doi:https://doi.org/10.1093/clipsy.bph077
Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., & Marlatt, A. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30, 295-305. doi:https://doi.org/10.1080/08897070903250084
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822-848. doi:https://doi.org/10.1037/0022-35184.108.40.2062
Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology, 29(4), 448-474. doi:https://doi.org/10.1016/S0306-4530(03)00054-4
Carver, C. S. (1997). You want to measure coping but your protocol’ too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92-100. doi:https://doi.org/10.1207/s15327558ijbm0401_6
Cloitre, M., Stolbach, B. C., Herman, J. L., van der Kolk, B., Pynoos, R., & Wang, J. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress,22(5), 399-408. doi:https://doi.org/10.1002/jts.20444
Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research. Thousand Oaks, CA: Sage.
Creswell, J. D., & Lindsay, E. K. (2014). How does mindfulness training affect health? A mindfulness stress buffering account. Current Directions in Psychological Science, 23(6), 401-407. doi:doi:https://doi.org/10.1177/0963721414547415
Curenton, S., McWey, L., & Bolen, M. (2009). Distinguishing maltreating versus non-maltreating at-risk families: A discriminant function analysis with implications for foster care and early childhood education interventions. Families in Society: The Journal of Contemporary Social Services, 90(2), 176-182. doi:https://doi.org/10.1606/1044-3894.3871
Davis, K. M., Lau, M. A., & Cairns, D. R. (2009). Development and preliminary validation of a trait version of the Toronto Mindfulness Scale. Journal of Cognitive Psychotherapy, 23(3), 185-197. doi:https://doi.org/10.1891/0889-83220.127.116.11
Dumas, J. E. (2005). Mindfulness-based parent training: Strategies to lessen the grip of automaticity in families with disruptive children. Journal of Clinical Child & Adolescent Psychology, 34(4), 779-791. doi:https://doi.org/10.1207/s15374424jccp3404_20
Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009a). A model of mindful parenting: Implications for parent-child relationships and prevention research. Clinical Child and Family Psychology Review, 12(3), 255-270. doi:https://doi.org/10.1007/s10567-009-0046-3
Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009b). Pilot study to gauge acceptability of a mindfulness-based, family-focused preventive intervention. The Journal of Primary Prevention, 30(5), 605-618. doi:https://doi.org/10.1007/s10935-009-0185-9
Dutton, M. A., Bermudez, D., Matas, A., Mjid, H., & Myers, N. (2013). Mindfulness-based stress reduction for low-income, predominantly African American women with PTSD and a history of intimate partner violence. Cognitive Behavioral Practice, 20, 23-32. doi:https://doi.org/10.1016/j.cbpra.2011.08.003
Follette, V., Palm, K. M., & Pearson, A. N. (2006). Mindfulness and trauma: Implications for treatment. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 24, 45-61. doi:https://doi.org/10.1007/s10942-006-0025-2
Garland, E. L. (2013). Mindfulness-oriented recovery enhancement for addiction, stress, and pain. Washington, D.C.: NASW Press.
Garland, E. L., Gaylord, S. A., Boettiger, C. A., & Howard, M. O. (2010). Mindfulness training modifies cognitive, affective, and physiological mechanisms implicated in alcohol dependence: Results from a randomized controlled pilot trial. Journal of Psychoactive Drugs, 42, 177-192. doi:https://doi.org/10.1080/02791072.2010.10400690
Gopalan, G., Goldstein, L., Klingenstein, K., Sicher, C., Blake, C., & McKay, M. M. (2010). Engaging families into child mental health treatment: Updates and special considerations. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(30), 182-196.
Harris-McKoy, D., Meyer, A. S., McWey, L. M., & Henderson, T. L. (2014). Substance use, policy, and foster care. Journal of Family Issues, 35(10), 1298-1321. doi:https://doi.org/10.1177/0192513X13481439
Helton, W. S. (2004). Validation of a Short Stress State Questionnaire. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 48(11), 1238-1242. doi:https://doi.org/10.1177/154193120404801107
Hillson, J. M. C., & Kuiper, N. A. (1994). A stress and coping model of child maltreatment. Clinical Psychology Review, 14(4), 261-285. doi:https://doi.org/10.1016/0272-7358(94)90025-6
Kabat-Zinn, J. (1990). Full catastrophe living. NY: Delacorte Press.
Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion.
Kabat-Zinn, J. (2015). Mindfulness, healing, and transformation. Eau Claire, WI: Psychotherapy Networker & PESI, Inc.
Kabat-Zinn, M., & Kabat-Zinn, J. (1997). Everyday blessings: The inner work of mindful parenting. New York, NY: Hyperion.
Kendall, P. C., & Chu, B. C. (2000). Retrospective self-reports of therapist flexibility in a manual-based treatment for youths with anxiety disorders. Journal of Clinical Child Psychology, 29(2), 209-220. doi:https://doi.org/10.1207/S15374424jccp2902_7
Kimbrough, E. Magyari, T., Langenberg, P., Chesney, M., & Berman, B. (2010). Mindfulness intervention for child abuse survivors. Journal of Clinical Psychology, 66(1), 17-33.
King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A. M., Robinson, E.,… Lberzon, I. (2013). A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD). Depression and Anxiety, 30(7), 638-645. doi:https://doi.org/10.1002/da.22104
Lau, M. A., Bishop, S. R., Segal, Z. V., Buis, T., Anderson, N. D., Carlson, L., … Devins, G. (2006). The Toronto Mindfulness Scale: Development and validation. Journal of Clinical Psychology, 62, 1445-1467. doi:https://doi.org/10.1002/jclp.20326
Littell, J., Alexander, L., & Reynolds, W. (2001). Client participation: Central and under-investigated elements of intervention. Social Service Review, 75, 1-28. doi:https://doi.org/10.1086/591880
Littell, J. H., & Tajima, E. A. (2000). A multilevel model of client participation in intensive family preservation services. Social Service Review, 74, 405-435. doi:https://doi.org/10.1086/516411
Lundahl, B., Risser, H., & Lovejoy, M. (2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86-104. doi:https://doi.org/10.1016/j.cpr.2005.07.004
National Center on Addiction and Substance Abuse at Columbia University. (2005). Family matters: Substance abuse and the American family. Retrieved from http://www.casacolumbia.org/addiction-research/reports/family-matters-substance-abuse-and-american-family
National Child Traumatic Stress Network. (2011). Birth parents with trauma histories and the child welfare system: A guide for child welfare staff. Retrieved from http://nctsn.org/sites/default/files/assets/pdfs/birth_parents_trauma_history_fact_sheet_final.pdf
Oliver, J. E. (1993). Intergenerational transmission of child abuse: Rates, research, and clinical implications. American Journal of Psychiatry, 150, 1315-1324. doi:https://doi.org/10.1176/ajp.150.9.1315
Patterson, R. G. (1982). A social learning approach: Coercive family process (Vol. 3). Eugene, OR: Castalia.
Scruggs, T. E., & Mastropieri, M. A. (1998). Synthesizing single subject research: Issues and applications. Behavior Modification, 22, 221-242. doi:https://doi.org/10.1177/01454455980223001
Scruggs, T. E., Mastropieri, M. A., & Casto, G. (1987). The quantitative synthesis of single subject research: Methodology and validation. Remedial and Special Education, 8, 24-33. doi:https://doi.org/10.1177/074193258700800206
Segal, Z., V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, J., Singh, A. N., Adkins, A. D., & Wahler, R. G. (2010). Training in mindful caregiving transfers to parent-child interactions. Journal of Child and Family Studies, 19(2), 167-174. doi:https://doi.org/10.1007/s10826-009-9267-9
Sinha, R. (2001). How does stress increase risk of drug abuse and relapse? Psychopharmacology, 158(4), 343-359. doi:https://doi.org/10.1007/s002130100917
U.S. Department of Health and Human Services, National Clearinghouse on Child Abuse and Neglect. (2003). Substance abuse and child maltreatment. Retrieved from http://nccanch.acf.hhs.go
Weinstein, N., Brown, K. W., & Ryan, R. M. (2009). A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. Journal of Research in Personality, 43(3), 374-385. doi:https://doi.org/10.1016/j.jrp.2008.12.008
Williams, K. A., Kolar, M. M., Reger, B. E., & Pearson, J. C. (2001). Evaluation of a wellness-based mindfulness stress reduction intervention: A controlled trial. American Journal of Health Promotion, 15(6), 422-432. doi:https://doi.org/10.4278/0890-1171-15.6.422
Yusoff, N., Low, W. Y., & Yip, C. H. (2010). Reliability and validity of the Brief COPE scale (English version) among women with breast cancer undergoing treatment of adjuvant chemotherapy: A Malaysian study. Malaysian Journal of Psychiatry, 65, 41-44.
Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P. (2011). Mindfulness meditation improves cognition: Evidence of brief mental training. Conscious Cognition, 19, 597-605. doi:https://doi.org/10.1016/j.concog.2010.03.014
Author note: Address correspondence to: Samantha M. Brown, Department of Psychology, University of Denver, 2155 S. Race Street, Denver, CO 80211, 303-871-7774, Samantha.M.Brown@ucdenver.edu