MBCT with TBI Groups
A practitioner’s journey
through training and practice
with TBI patient groups
Elly Nadorp, MSW.,RSW
[email protected]
What is Mindfulness Based Cognitive
Therapy (MBCT)
• Therapeutic approach rooted in mindfulness
based stress reduction and cognitive
behavioural therapy
• Geared towards persons with depressive
symptoms and who are at risk of depressive
relapses
Mindfulness Means:
• Paying attention in a particular way,
on purpose, in the present moment,
non-judgmentally.
Jon Kabat -Zinn
How the Journey began and continues
• Research project re MBCT with TBI Population
• Recruitment and Training of Facilitators
• Ongoing Practice and Training
Why MBCT with TBI population
• Growing evidence that MBCT is consistently
effective in relapse prevention in recurrently
depressed individuals
Ma and Teasdale 2004; Segal et al.2002, 2010; Teasdale et al.2000
• Previous study results indicated that MBCT
applied to TBI population showed significant
improvement in health status and depression
Bedard, Felteau et al.,2012;2005;2003
MBCT research study for TBI 2009-2011
• A pilot-tested MBCT program was facilitated at our
rehab hospital with patients with TBI
• Multi –site MBCT research study was funded by
Ontario Neuro-trauma Foundation in 2009 and was
supported by medical and management teams for
implementation on 3 different rehab hospital sites in
Ontario
• 10 facilitators were recruited (through application
and interview process) to participate in this study
Facilitator Training during MBCT
Research Project
• Initial 2 day training retreat in Toronto (2009)
• Biweekly telephone group learning conferences with a
certified MBCT teacher (2009-2011)
• MBCT 5 day training with Dr. Zindel Segal ,Dr. Steve
Hickman and Dr. Sarah Bowen in California ( 2010)
• Practice Teaching with a health care providers group
(2010)
• Several MBCT groups with patients for research study
(2010-2011)
Skills/Knowledge required
for TBI client groups
• Knowing the MBCT curriculum
• Knowing how to pace and teach the content
• Being able to guide the meditations and the
mindfulness activities
• Knowing how to do the inquiry process
• Facilitating the group process and managing group
dynamics
• Understanding brain injury and adjusting the curriculum
and the teachings to persons with a brain injuy
Research Outcomes
• Study outcomes are still being processed however
unpublished data to date indicates a statistically
significant (26%) reduction in overall depression
symptoms
• Recent publication in Mindfulness Journal November
2012 “Training Clinicians to deliver a mindfulness
intervention” Gibbons, Felteau, Marshall, Rees et al
• Research findings to be available in near future
The Impact of
Mindfulness on the Clinician
• Attitude towards Mindfulness
• Benefits of Mindfulness on Social Work Practice
• Mindfulness and Therapeutic Relationship
Attitude toward Mindfulness Practice
• The practitioner needs to embody its practices
(formal and informal)
• Regular peer support by participating in
meetings with other practitioners, attending
retreats, and ongoing training opportunities
Facilitator Training after the MBCT
Research Project
• MBCT 5 day advanced teacher training
(Inquiry process) at Omega Institute,
Maryland , Susan Woods and Char Wilkins
( 2011)
• Mindfulness for Health Care Professionals
Course -Ottawa Mindfulness Clinic ( 8 week
sessions,+ a full day silent retreat, 2013)
• 3 day silent retreat (2013)
Clinical Benefits for Social Work Practice
• Deeper level of awareness and noticing
• Attitude that is less judgmental, more accepting
• Taking a more reflexive, less reactive stance
• Cultivation of compassion, empathy
• Decreased stress, improved well being
• Sense of interconnectedness
Mindfulness
and the Therapeutic Relationship
• Being” mode vs “Doing” mode
• Therapeutic alliance/Therapeutic presence
• Open and egalitarian relationship with client
Steven Hick and Thomas Bien, 2010
Acknowledgments and Contact Information
• Patients and fellow practitioners
• MBCT - TBI Research team
• MBCT and MBSR trainers
• The Ottawa Hospital Rehab Centre-Medical team and
Management support
[email protected]
Tel” 613-737-7350, ext: 75593
Ottawa, Canada