title: Contemplative Intervention Reduces Physical Interventions for Children in Residential Psychiatric Treatment.
abstract: This research explored the effectiveness of a manualized contemplative intervention among children receiving intensive residential psychiatric care. Ten children with severe psychiatric disabilities received 12 sessions (30-45 min) of "Mindful Life: Schools" (MLS) over the course of a month. Facility-reported data on the use of physical intervention (i.e., seclusions and restraints) were analyzed. Acceptability questionnaires and broad-band behavioral questionnaire data were also collected from children and their primary clinicians. Robust logistic regression analyses were conducted on person-period data for the 10 children to explore the timing of incidents resulting in the use of physical intervention. Incidents within each person-period were regressed on indicators of days of contemplative practice and days without contemplative practice. Results indicated that during the 24-h period following MLS class, relative to a comparison 24-h period, children had significantly reduced odds of receiving a physical intervention (OR = 0.3; 95 % CI 0.2, 0.5; p < 0.001). Behavioral questionnaires did not indicate significant contemplative intervention effects (ps >0.05), and MLS was found to be generally acceptable in this population and setting. These data indicate that contemplative practices acutely reduced the utilization of physical interventions. Clinicians seeking to implement preventative strategies to reduce the necessity of physical intervention in response to dangerous behavior should consider contemplative practices. Those wishing to empirically evaluate the effectiveness of contemplative practices should consider evaluating objective measures, such as utilization of physical intervention strategies, as oppose to subjective reports.
authors.affiliation: Syracuse University, Syracuse, USA. jcfelver@syr.edu.
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Felver
authors.affiliation: Alpert Medical School of Brown University, Providence, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Jones
authors.affiliation: Alpert Medical School of Brown University, Providence, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Killam
authors.affiliation: Youth Villages Oregon, Lake Oswego, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kryger
authors.affiliation: Mindful Life, Carbondale, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Race
authors.affiliation: University of Oregon, Eugene, USA.
authors.forename: Laura Lee
authors.initials: LL
authors.lastname: McIntyre
mesh_terms: D002648:Child; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D016015:Logistic Models; D008297:Male; D064866:Mindfulness; D010356:Patient Isolation / Q000706:statistics & numerical data*; D011614:Psychotherapy, Brief / Q000592:standards*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Children; Mindfulness; Residential treatment; Seclusion and restraint; Yoga