Providing ADHC group home staff with brief training in mindfulness based stress reduction practice can help to reduce behaviours of concern exhibited by clients, and contributes to staff emotional well being.
Results of a controlled feasibility study by ADHC practitioners Paul North and Beth Matters in Southern Region. July 2012
Why train group home staff in mindfulness based practices?
Staff working in group homes for individuals with an intellectual disability do important work assisting clients to achieve personally meaningful goals. A particular focus of this work is supporting clients to participate as fully as possible in their community. Sometimes interactions in group homes for persons with an intellectual disability can become strained due to goal frustration, misunderstandings and emotional difficulties. Occasionally, this can lead to behaviours of concern including self harm and aggression. Everyone involved can find such incidents difficult to cope with successfully as well as emotionally upsetting. Such incidents can significantly affect a person’s ability to take part more fully in community life. Additionally, the stress on staff can contribute to emotional exhaustion and burn-out.
What did we do?
Psychologists with the NSW Department of Family and Community Services Ageing, Disability and Home Care were convinced that learning mindfulness techniques could benefit staff members by helping them to manage their own emotional reactions to behaviours of concern. Mindfulness training teaches staff skills to handle stressful situations that are based on eastern meditation practices as well as western psychology principles.
Building on the earlier work of a study in the United States they introduced staff in three group homes to mindfulness based practices via brief training sessions spread over several weeks. What makes this study so significant is that it also included a control group of staff who did not receive the training but who still filled out measures of occupational stress. Incidents of behaviours of concern were monitored in all houses in both groups.
Thus, this study went a step further than the American research. By including a control group of staff for comparison purposes the psychologists were able to say with more confidence if any changes observed were really due to the training and were not just due to staff being aware their reactions were being assessed.
Over a 10 week period ADHC staff in three group homes were provided with training (10 x 2 hour session) in mindfulness based stress reduction techniques. Staff learned practices such as breathing exercises and tuning into surrounding sounds, all of which would assist them to keep their minds in the present. They were also introduced to meditation exercises aimed at enhancing feelings of self-compassion.
The staff in the three control group homes operated business as usual. They also filled in a questionnaire about challenging behaviour and levels of stress at the beginning and end of the study.
What did we find?
The results of the study demonstrated a significant lowering in the number of incidents of behaviours of concern in the homes that received training. There was also a trend for staff in the training group to have improved emotional functioning, particularly in the area of self-kindness. Self-kindness is an important component of compassion and is the tendency to be caring and understanding with oneself rather than being harshly critical or judgmental. Staff said they found they were better able to respond to situations calmly and were able to take more time to consider clients’ views. As one male participant commented, “I come into work with a fresh mind everyday. The training brings you back to why you do the job, you get in touch with caring”.
Due to the study having a control group the psychologists can be 95% sure that that changes exhibited were a result of the training received. Helpfully, many staff also found the skills useful in their life outside work drawing on mindfulness techniques and meditation to help them cope with sometimes difficult situations they faced at home and in the community.
What to do next?
The psychologists will now be presenting their findings to Ageing, Disability and Home Care executives to propose training tools and resources for interested staff working in group homes. The tools aim to lower the incidents of behaviours of concern by helping staff to cope with the emotional reactions such behaviours can elicit.
The results of this study suggest teaching group home staff brief mindfulness based practices can help to maintain a pleasant living environment for both staff and persons with an intellectual disability. This in turn can help to reduce the frequency of behaviours of concern and enhance staff emotional well being.
Enquiries about this research can be directed to Paul North Senior Specialist Psychologist with ADHC southern region email Paul.North@facs.nsw.gov.au or Beth Matters Behaviour Support Specialist email Beth.Matters@facs.nsw.gov.au
Beth and I will be presenting the full report on this study at the Australasian Society for Intellectual Disability in November at Wellington, New Zealand. See you there!