Integrative Body-Mind-Spirit (I-BMS) Interventions for Posttraumatic Stress Disorder (PTSD): A Review of the Outcome Literature

ABSTRACT

Background: A growing interest in integrative body-mind-spirit (I-BMS) approaches to treatment of PTSD has resulted in a significant increase in related research. Method: This study conducted a synthesized review of randomized controlled trials of I-BMS treatments for PTSD, yielding thirteen studies that included: mindfulness/meditation (7), yoga (3), acupuncture (1), spiritually-based intervention (1), and relaxation (1) from 2004–2015. The study used a modified Delphi List (mDL) and the California Evidence-Based Clearinghouse (CEBC) to evaluate study rigor and level of research support for each practice. Results: Overall, I-BMS interventions demonstrated positive outcomes. Based on an mDL range between 0 and 7, scores were: 6 for meditation/mindfulness, 5.67 for yoga, 7 for acupuncture, 3 for spiritually-based intervention, and 4.5 for relaxation training. All interventions were recommended as practices with Promising Research Evidence (Level 3). Effect sizes (d) ranged from .51 to 1.88 for relaxation, .38 to 1.02 for spiritual, .31 to 1.4 for acupuncture, .1 to 1.54 for yoga and .2 to 1.53 for mindfulness meditation. Discussion: This study identified acupuncture, meditation, and yoga as high-quality alternative therapeutic practices for PTSD with promising evidence as effective and safe approaches. Future studies should assess long-term effects to further elevate the level of research support.     

The effects of mindfulness on mother–child relationships and maternal well-being during the first COVID-19 lockdown in Israel

Research indicates associations of mindfulness with better relationships and well-being because it promotes decentering and relationship-related capacities. This study examined the effects of mindfulness on mothers' relationships with their children and well-being in a challenging time – the first COVID-19 lockdown. We hypothesized that mothers' relationships and well-being would deteriorate during the lockdown, but a mindfulness-based intervention (MBI) would mitigate this process because of its effect on mothers' mindfulness and decentering. We surveyed 109 mothers caring for their children (mean age 8.61) during the first lockdown in Israel. First, they completed online questionnaires assessing their interpersonal mindfulness, decentering, relationships with their children and well-being (including positive and negative affect and life satisfaction). Then, they were randomly assigned to a group: MBI, relaxing music intervention or no intervention. Participants completed the questionnaires again after 2 weeks of daily interventions. Unexpectedly, mothers in all groups improved their relationships with their children and well-being (their satisfaction with life increased and negative affect decreased) with no significant group differences. Furthermore, the increase in relationship quality was associated with increases in mindfulness and decentering. The findings suggest that crises initially perceived as a threat to mother–child relationships may also present a beneficial opportunity in certain circumstances.     

Cultivating students’ reflective capacity through group-based mindfulness instruction

ABSTRACT

Cultivating critically reflective practitioners is a vital professional competency for social work students. However, few reflective models support undergraduate students to foster nonconceptual skills important to developing reflective capacity. This article presents a group-taught mindfulness teaching intervention applied in a professional practice course to facilitate reflective capacity of social work students preparing for their first placement. Trial data derived from pre–post course administration of the Five Facet Mindfulness Questionnaire show significant gains in awareness were produced on two of the questionnaires’ five mindfulness facets of describe and nonjudgment. A developmental model detailing these shifts and its implications for group-based learning is outlined.     

Prison Experiences and Psychological Distress among Older Inmates

This study investigates relationships between older prisoners’ social experiences and their levels of distress. One hundred and seventy-three older prisoners (aged ≥ 50 years) from 8 Australian prisons were administered the Kessler Psychological Distress (K10) Scale, with additional information collected via individual interviews. Psychological distress scores were significantly associated with measures of self-reported safety (p < .001), prison victimization (p < .05), perceived social support from staff (p < .01) and inmates (p < .001), current employment (p < .05), and level of exercise (p < .001) among older inmates. Findings suggest that strategies for improving sense of safety, social support and level of exercise may ameliorate distress among older prisoners.     

New Zealand’s engagement with the Five Ways to Wellbeing: evidence from a large cross-sectional survey

ABSTRACT

The Five Ways to Wellbeing were developed in 2008 as a set of simple daily practices for individuals to improve their wellbeing. While there is some evidence to support the association between individual practices and wellbeing, it is unknown whether engaging in multiple practices – and in certain combinations – is associated with higher levels of wellbeing. A survey was undertaken with 10,012 adults throughout Aotearoa, New Zealand, to assess individual wellbeing and participation in the Five Ways to Wellbeing (Connect, Give, Take Notice, Keep Learning and Be Active). Wellbeing was assessed with the Flourishing Scale (Md?=?46, IQR 39–49). Three objectives explored the cross-sectional association between the Five ways to Wellbeing and wellbeing: (1) multiple wellbeing practices and wellbeing, (2) clustering of multiple wellbeing practices, and (3) wellbeing practices as predictors of wellbeing. Results show that levels of wellbeing increased with each additional practice (rho?=?.53, p?<?.001), regardless of the combination. However, the most important predictors of wellbeing were Keep Learning (β?=?.23, p?<?.001) and Take Notice (β?=?.22, p?<?.001). Studies investigating ways to increase participation in the Five Ways to Wellbeing are warranted to promote wellbeing in Aotearoa.     

The Impact of Acculturation on Depression Among Older Muslim Immigrants in the United States

Using a cross-sectional design, this study utilized a self-administered survey to examine the relationship between acculturation, physical and emotional health, health locus of control (LOC), life events and depression among a convenient sample of 70 immigrant Muslim elderly in United States of America. In addition to demographic variables, 5 standardized measures including the Vancouver Index of Acculturation, Center for Epidemiologic Studies Depression Scale (CESD), Iowa Self-Assessment Inventory, Multidimensional Health Locus of Control Scale, and the Geriatric Scale of Recent Life Events were utilized in this study. The results showed that about 50% of participants reported a score of 16 and above on the CESD scale, indicating a presence of depressive symptoms. In addition, most participants identified with their heritage culture compared to the American culture. The results of multiple regression analysis revealed 4 significant predictors of depression: cognitive status (β =??.34, p < .01), heritage culture (β = .35, p < .01), physical health (β =??.27, p < .05), and internal health locus of control (β =??.25, p < .05). These factors explain about 37% of the total variance in levels depression (R = .61).     

The serene student: Evaluating a group-based mindfulness training program for MSW students

ABSTRACT

Social work educators are exploring the benefits of mindfulness training for social work pedagogy. The authors evaluate the outcomes of a mindfulness program for MSW students. The authors assessed changes in mindfulness, self-compassion, affect, mood, and impairment due to emotional distress before and after the program, and at 4-month follow-up. The authors examine how the group process may facilitate the development of mindfulness and consider how mindfulness practices can support group development and student learning. Results demonstrate that mindfulness training supports student self-regulation and well-being and suggest that the active ingredients of the group process may play a role in mindfulness training outcomes.     

Mindfulness-based forgiveness groups for older adults

ABSTRACT

Interventions that enable individuals to be more forgiving toward themselves and others are important for older adults. This article describes a group intervention for adults aged 60 or older that integrates forgiveness-related skills with a mindfulness approach. The Mindfulness-based Forgiveness Group was designed to meet for eight sessions. The skills taught included: recognizing one’s own expectations and unenforceable rules, broadening one’s perspectives about the context of the transgression, and discovering positive intentions through exercises as well as a variety of meditations to cultivate mindfulness, self-compassion and forgiveness. Data from five Mindfulness-Based Forgiveness Groups were collected. Based on pre- and post-test measures, analyses indicate that participants improved significantly in relation to forgiveness, mindfulness/self-compassion, and mental health. Using qualitative post-test data from participants, we identify elements of the intervention that appear to be helpful. Suggestions are provided for social workers seeking to replicate and build upon this promising intervention.     

Structural Relationship Analysis Among Variables of Mentoring Network Characteristics,Mentoring Functions,and the Working Attitudes of North Korean Defectors

This study was conducted with a purpose to examine the structural relationship among mentoring network characteristics, mentoring functions, and the work attitudes of North Korean defectors. One hundred twenty-one North Korean defectors participated in the study, who were involved in settlement programs in Seoul, Korea. Amos 20.0 and SPSS 21.0. were used for statistical analysis. According to the developmental network theory, mentoring network characteristics include: network range, number of networks, and network intimacy. Mentoring functions include: career function, role function, and psychosocial function. The results are as follows. Mentoring network characteristics have a positive (+) effect on mentoring functions (β?=?0.267, C.R.?=?2.329, p?<?.05) and mentoring functions have a positive (+) effect on work attitude (β?=?0.703, C.R.?=?6.748, p?<?.001). Mentoring characteristics also have an indirect effect on work attitude through mentoring functions (β?=?0.188). The results of this study implicate the need for expanding mentoring networks and developing mentoring functions for North Korean defectors in both formal and informal social network areas.     

Drumming and Mindfulness Integrations into an Evidence-Based Group Intervention

Community mental health, to protect the integrity of service to a highly vulnerable population, has sought to increase the use of evidence-based practice. However, most evidence-based practices have a narrow scope challenging the breadth of effectiveness with consumers with higher levels of comorbidity. This article explores the use of mindfulness and drumming integrated into an evidence-based program: Seeking Safety. In response to the challenges of conducting a cognitive-focused intervention for members diagnosed with posttraumatic stress disorder, addictions, and co-occurring severe/persistent mental illness, mindfulness principles and drumming are used to help manage the emotional needs of group members. This article outlines the foundational principles supporting the group program.     

Mindfulness,meditation, and breathing exercises: reduced anxiety for clients and self-care for social work interns

ABSTRACT

The purpose of this article is to identify and describe a teaching tool that supports social work student success in the classroom and in field placement. The project introduced mindfulness, meditation, and breathing techniques to 2nd-year master of social work (MSW) students in a group classroom setting and engaged students as they applied those techniques in their internship settings with clients. Students were introduced to mindfulness, meditation, and breathing techniques through lecture, experimental exercises, video clips, and case studies and used the group setting to learn to use those tools to add trauma-informed mindfulness interventions to the clinical techniques they concurrently practiced in field placement. Students learned methods to incorporate those interventions into their psychotherapy/counseling sessions with clients and discovered that mindfulness-specific interventions also helped regulate their own autonomic nervous systems, contributing to decreased anxiety. Thus, mindfulness skills taught in social work programs have significant multidimensional benefits; engaging a group classroom setting to learn to utilize mindfulness, meditation and breathing techniques can reduce stress and anxiety for clients and promote adaptive self-care skills for MSW students.     

Quality of Work Life of Teaching Staff Working at a Higher Education Institution in Saudi Arabia: A Cross-sectional Study

A cross-sectional survey design was adopted to study the quality of work life (QoWL) of the teaching staff employed at a Saudi higher education institution, focusing on their ethnic backgrounds and the academic clusters in which they were employed. A total of 360 teaching staff were randomly selected using a two-stage cluster sampling method, and a self-structured quality of work life questionnaire was used to collect data. Statistical analysis was done using SPSS 19.0. The results indicated that 71% of the respondents were satisfied with their QoWL at Imam Abdulrahman Bin Faisal University (IAU), Saudi Arabia. A significant difference of opinion was observed among the teaching staff on two dimensions of QoWL, viz. ‘working conditions’ and ‘psychosocial factors’ (p < 0.05). However, no significant difference was observed on other QoWL attributes, such as ‘opportunity for training and development’ and ‘job satisfaction and job security’ (p > 0.05). Given that all public universities in Saudi Arabia are governed by regulations framed by the Ministry of education, this study provides important indicators to educational policy planners on understanding the QoWL of teaching staff employed in universities across Saudi Arabia.     

Compassion Satisfaction,Compassion Fatigue,and Burnout: A Replication Study with Victim Advocates

Abstract

Past research has investigated the rates of compassion satisfaction (CS), compassion fatigue (CF), and burnout within health-care providers. Findings indicate higher levels of CS and lower levels of CF predict lower rates of burnout. The current study extended prior research by replicating past research findings, but with victim advocates. This study enrolled a national sample of 142 victim advocates. A hierarchal linear regression was run to test the research questions. In level 1, years of experience was not significant and only accounted for 1.1% of the variance in burnout. When adding CS, the model became significant (p?<?.001) and CS accounted for an additional 51.8% of the variance. When CF was added to the final model, it was significant (p?<?.001), and accounted for an additional 19.3% of the variance. When comparing the findings to past studies, our findings were similar; however, our study did find that CS and CF accounted for significantly more variance than past studies with health-care providers. Therefore, CS and CF might be greater predictors of burnout in victim advocates than in health-care providers. Future studies should aim to create interventions to increase CS and decrease CF, to reduce burnout.     

Social support,self-efficacy and gender as predictors of reported stress among inpatient caregivers

The study examined the predictive role of social support, self-efficacy and gender on self-reported stress among inpatients’ caregivers. One hundred and sixty eight (36 males and 132 females) inpatients’ caregivers were sampled from University of Nigeria Teaching Hospital (97) and Niger Foundation Hospital (71) all in Enugu, Nigeria. Three instruments were used for the data collection, namely, Multidimensional Scale of Perceived Social Support (MSPSS), New General Self Efficacy Scale (NGSES), and the Perceived Stress Scale (PSS). The study adopted a cross sectional design and Multiple Regression was used for data analysis. Results showed that social support negatively predicted inpatient caregivers’ reported stress (β = ?.28, p < .001). Gender significantly predicted stress among the inpatients’ caregivers (β = .35, p < .001). Findings were discussed and implications of the study highlighted.     

A Pilot Randomized Trial of an Intervention to Enhance the Health-Promoting Effects of Older Adults’ Activity Portfolios: The Engaged4Life Program

The purpose of this study was to evaluate the feasibility and outcomes of the Engaged4Life program, an intervention to encourage inactive community-dwelling older adults to embed physical activity, cognitive activity, and social interaction into their everyday lives in contexts that are personally meaningful and natural for them. Fifteen participants were randomized to the intervention group (technology-assisted self-monitoring of daily activity via pedometers and daily tablet-based surveys; psychoeducation + goal-setting via a 3-hour workshop; and peer mentoring via phone 2×/week for 2.5 weeks) and 15 to the control (technology-assisted self-monitoring only). Recruitment was shown to be feasible and efficient, but not able to reach the target for men. Retention rate was 83% and participants manifested high adherence and engagement with the intervention. Though this pilot trial was not powered to demonstrate significant differences between groups, daily steps increased by 431 (11% increase) from baseline to Week 4 for the intervention (p < .05), but decreased by 458 for the control, for a net difference of 889 steps (p < .05). Findings were sustained at Week 8 (p < .01). In a future trial, difficulties in recruiting men, barriers due to the technology-intensive design, and the optimization of secondary outcome measures should be addressed.     

Fostering supportive interactions in the neighbourhood: Using visualized narratives

The use of art (e.g. visualized narratives) in social work may stimulate dialogue between community members about family support in their neighbourhood. The Visualized Narratives on Parenting Interactions in the Neighbourhood (VN-PIN) were developed in order to foster this dialogue. The aim of this study was to evaluate the implementation of the VN-PIN in social work practice and to gain insight in mechanisms that stimulate dialogues supported by visualizations. A qualitative process evaluation was conducted to explore the use of the VN-PIN in various urban settings. We observed meetings (N = 14) where the VN-PIN was applied and interviewed professionals and community members (N = 81). The results of this study show that the VN-PIN intervention gives parents a voice and allows them to recognize and reflect on their own parenting behaviour, thereby contributing to mutual exchanges in a supportive community. The conclusion of this study is that the VN-PIN is a useful intervention that social work professionals can use to foster dialogues about parenting within diverse contexts in super-diverse neighbourhoods. The intervention fosters a supportive structure to share experiences of various community members. Future research is needed to further evaluate the experiences and satisfaction of community members with the intervention.     

Coping and Post-traumatic Stress after Hurricanes Katrina and Rita: Racial Disparities in Social Work Student-Practitioners

ABSTRACT

Recent hurricanes have focused on lives and properties lost, however, additional mental health concerns may emerge in these post-disaster settings. Post-traumatic stress symptoms (PTSS) are particularly problematic for minorities due to pre-disaster disparities. Scholars must thus examine the antecedents of PTSS to support these and other vulnerable individuals and communities. This study examined racial disparities regarding active and avoidant coping, prayer, and subsequent relative contribution of each to PTSS following Hurricanes Katrina and Rita among social work student-practitioners. Using secondary data, results revealed that minority students (n = 233) used coping via prayer more often than their non-minority peers (n = 124; t = 7.18, p < .000; d = 0.76). Moderate, positive relationships emerged between avoidant coping and PTSS for both groups (r = .58–.63, p<.01), though prayer did not emerge as inversely related to PTSS as anticipated. Avoidant coping accounted for the largest variation in PTSS for both groups (β = .35–.51, p<.001). Sampling, survey methods, and PTSS measures limit generalizability and temper findings. Directions for future research include use of PTSS measures that account for severity and cultural context and examination of coping measure psychometrics. Practice implications include enhanced publicity regarding social services available to student-practitioners on college campuses and within the community.     

The Effects of South Korean Social Workers' Professional Resources on their Understanding of a Patient's Right to End‐of‐Life Care Decisions in Long‐term Care Facilities

The aims of this study were to examine South Korean social workers' understanding of a patient's right to end‐of‐life care decisions (EOLCD) in long‐term care facilities and to explore the effectiveness of their professional resources in their understanding of this issue. A survey was conducted of 297 social workers from multiple long‐term care facilities in South Korea using structured questionnaires and face‐to‐face interviews. A multiple regression model was used, controlling for gender and religion. The participants' professional resources were measured by years of work, license type, number of beds, knowledge of advanced directives, experience in the EOLCD process, and training. The results demonstrated that South Korean social workers' understanding of a patient's right to EOLCD was moderate (mean 3.46), and their general (β = 0.576, P < 0.001) and medical knowledge (β = 0.117, P < 0.001) of advance directives, experience in the EOLCD process (β = 0.222, P < 0.001), and training (β = 0.028, P < 0.001) positively and significantly increased their understanding of patient rights (R² = 0.449, P < 0.001). The findings suggested that the development of academically supported and legally enforced standards and regulations for an EOLCD practice manual for long‐term‐care social workers would be beneficial.     

Cognitive-Behavioral Therapy for Bipolar Disorder: Implications for Clinical Social Workers

ABSTRACT

The purposes of this review article are to orient clinical social workers to cognitive-behavioral theory, intervention, and research on bipolar disorder (BD); identify pros and cons of applying cognitive-behavioral therapy (CBT) to social work clients with BD; and identify specific implications for clinical social work practice. Of the 545 articles that were obtained via the systematic review, 18 studies were identified as being potentially eligible for inclusion, and 9 of those studies ultimately satisfied the inclusion criteria. The results of each study were summarized via identifying statistically significant (p< .05) differences that existed between experimental cohorts who received CBT (plus pharmacotherapy) and control cohorts who received treatment as usual. Outcomes showed CBT cohorts as having significant improvement over their respective control groups. The review's implications for clinical social workers and the need for future research are discussed.