An Integral Mindfulness Approach for Looked After Children

In 2014, 36.7% of looked after children had an emotional and behavioural health issue that was considered a cause for concern [1].

The number of looked after children has increased steadily over the past seven years [2]. This is an alarming situation when you consider that looked after children are more vulnerable to developing mental health problems [3]. This can be partly explained by the children’s background situation. Many of the children and young people come from disadvantaged backgrounds where a number of social and environmental risk factors are present. This has a direct impact on how they face situations in their daily lives, how well they manage anxiety, and how they perform in school.

To be successful any intervention aimed at improving their mental health and wellbeing should adopt an integrated approach that addresses the needs of children, parents, carers, teachers and the needs of the school. Mindfulness-based interventions have now been acknowledged as an effective approach to improving health and wellbeing and performance, including looked after children.

What is mindfulness?

Mindfulness is an adaptation of Buddhist meditation. Supported by over 40 years of research across a number of sectors and applications; Mindfulness is the practice of purposely focusing attention on the present moment and accepting it without judgement [4]. The aim is to become more aware of thoughts and feelings, in a non-judgemental and accepting way, so that instead of being overwhelmed by them, we can manage them better.

Mindfulness can be cultivated both formally and informally in a variety of ways. Yoga and sitting-meditation are the most common methods taught. The meditator sits in relaxed but alert posture, either on the floor cross-legged or in a chair, and places attention on the in and out flow of the breath. When attention wanders, the person simply notes the distraction in an accepting way and returns to the breath [5].

Sessions of one to two minutes, as silent or guided meditations, several times a week can be effective for children and young people. Also, connecting mindfulness with regular daily activities such as eating, working and playing are also useful ways to develop mindfulness. In their daily lives, children and young people have a number of opportunities to reflect on and discuss experiences that have affected them. For example practices meditations may involve experiences in which when they did not get what they wanted, or were given what they did not want. They then have an opportunity to reflect on the experience and talk about it e.g. the physical sensations they experienced, thoughts and emotions that arose and how they behaved.

Why mindfulness for looked after children?

The practice of mindfulness has the potential to help looked after children learn to focus on their feelings and thoughts without judging their experiences i.e. to be more accepting of thoughts and emotions. This helps to promote a psychological state in which they are aware of who they are, how they are feeling, and what they are doing. This helps them to build their capacity to recover quickly from difficulties by improving their tolerance of stress and conflict, and by enhancing their social and problem solving skills [6].

This is backed up by recent neurobiological and neuropsychological studies [7]. Evidence shows that practicing mindfulness positively affects brain areas related to our executive functions (attention, memory, reasoning, etc.) and emotion regulation (anger, happiness, fear, etc.), among others. Working together these changes help protect our brain from toxic stress and its harmful effects on the body, to reduce our impulsive and irritable reactions to demanding situations, to supress our aggressive responses when we feel under attack, and to increase our openness to different approaches and points of view in facing life’s daily problems [8].

As such, mindfulness-based interventions have helped children and young people to handle the pressures and challenges they face in life. Mindfulness interventions provide opportunities for them to talk about their experiences and to explore their thoughts and feelings, helping them to develop a greater awareness and understanding of themselves and their situation, and to develop the emotional resilience needed throughout their lives. Similar outcomes can be achieved with teachers, parents, and carers when implementing mindfulness in 360°.

A 360° Mindfulness-Based Intervention

Mindfulness can be an effective intervention when implemented in a 360° approach.  As such, mindfulness-based interventions have the potential of improving looked after children’s mental health and wellbeing by bringing together children, parents/carers, and teachers. This approach can help to build resilience – or the capacity to be transformed and strengthened by adversity – in children who are looked after as a key resource for their current and future mental health and wellbeing:

Mindfulness in the Classroom: By using mindfulness-based interventions in the classroom, children and young people can benefit from positive outcomes in well-being such as reducing anxiety and distress as well as improving behaviour. For example, a study which introduced mindfulness training to secondary schools students found that children reported fewer depressive symptoms, lower stress levels, and an improved sense of psychological well-being even after 3-months follow-up [9].

Mindfulness for Teachers: Teachers can increase their well-being and teaching effectiveness by improving their ability to manage classroom behaviour and establish and maintain supportive relationships with students. Research on mindfulness training for teachers has also shown positive effects. In one study a group of primary school teachers undertook an 8-week mindfulness course. The results showed improvement for most teachers for anxiety, depression, and stress [10]. Another study underlined the role of the teachers-students interaction in the learning process. A group of pre-school teachers attended an 8-week mindfulness course. During the mindfulness training, levels of challenging behaviours decreased and there was an increase in compliance with teacher’ requests [11]. 

Mindfulness for Parents: Integrating parents and carers into these interventions can have an enormous impact on looked after children. Mindfulness-training can be a powerful tool for parents coping with a mental health condition. A study explored how parents with a history of recurrent depression experience their relationships with their children after mindfulness-training. After a year of the intervention, parents reported positive changes in the emotional relationships with their children, an increased ability to manage their emotions, to be emotionally available to their children, and  a greater ability to teach their children how to manage their emotions [12].

Caring Mindfully: The practice of mindfulness for children’s carers can help to create an effective caring environment, to increase the capacity for empathy and appreciation of others, and to improve the ability to be present during children-carer interactions.

How to Implement a Successful Mindfulness-Based Intervention

The implementation of mindfulness-based interventions should give careful consideration to several elements in their design. Poor programme design and implementation can adversely affect its effectiveness. Competent instruction, institutional support including both a shared vision and engaged staff, and consistent support from parents/cares are critical ingredients to ensuring high-quality implementation.


Additionally, the design of a 360° mindfulness-based intervention should therefore clearly answer a number of related questions::

Who is the programme for?: This can be easily answered; however, it is important to adapt the programme according to the answer. A programme for parents/carers should be adapted to the specific needs and challenges they face. A programme for teachers should probably focus on the development of a constructive relation with students if the children’s wellbeing is the aim. Similarly, the programme for children should be adapted according to their age and specific mental health and wellbeing condition. This does not mean there is a need to create differentiated programmes for looked after children, but to consider their specific situation in the general training for children.

How to Choose the Right Mindfulness Teacher: The programme needs to assure high quality by choosing the correct mindfulness teacher.  Engaging looked after children in mindfulness training can be particularly challenging for an inexperienced teacher. It requires a qualified approach that takes into account their shorter attention spans and particular emotional needs. To choose the correct teacher, in 2011 the UK Network for Mindfulness-Based Teachers developed the Good practice guidelines for teaching mindfulness-based courses [13] in order to specify the minimum standards a good mindfulness teacher needs to have. This can be a useful check list to take into account. 

When should the programme be evaluated?: The programme needs to include a continuous evaluation (pre, during, and post). The strength, capacity, and resources of interventions needs to be assessed ongoing in order to achieve successful outcomes.  The comparison between a pre and post evaluation is key to understanding the progress made by the mindfulness training. Similarly, keeping a record of the reactions during the training can help to re-design the following stages in the programme.


References:

1 Department for Education. (2014). Outcomes for children looked after by Local Authorities in England, as at 31 March 2014. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/191969/SFR32_2012Text.pdf

2 Department for Education. (2015). Children looked after in England (including adoption and care leavers) year ending 31 March 2015. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/464756/SFR34_2015_Text.pdf

3 McAuley, C., & Davis, T. (2009). Emotional well-being and mental health of looked after children in England. Child and Family Social Work, 14(2), 147–155.

4 Kabat-Zinn, J. (2003).Mindfulness-based Interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144-156.

5 Weiss, A. (2004). Beginning Mindfulness: Learning the Way of Awareness. New World Library.

6 Coholic, D. (2011). Exploring the feasibility and benefits of arts-based mindfulness-based practices with young people in need: Aiming to improve aspects of self-awareness and resilience. Child and Youth Care Forum, 40, 303–317.

7 Congleton, C., Hölzel, B. K., & Lazar, S. W. (2015). Mindfulness can literally change your brain. Harvard Business Review.

8 Vago, D. & Silbersweig, D. (2012). Self-awareness, Self-regulation, and Self-transcendence (S-ART): A Framework for Understanding the Neurobiological Mechanisms of Mindfulness. Frontiers in Human Neuroscience, 6, 1–30.

9 Kuyken, W., et al. (2013). Effectiveness of the Mindfulness in Schools Programme: Non-randomised controlled feasibility study. British Journal of Psychiatry, 203(2), 126–131.

10 Gold, E., et al. (2010). Mindfulness-based stress reduction (MBSR) for primary school teachers. Journal of Child and Family Studies, 19(2), 184–189.

11 Singh, N., et al. (2013). Mindfulness training for teachers changes the behaviour of their preschool students. Research in Human Development, 10(3), 211–233.

12 Bailie, C., Kuyken, W., & Sonnenberg, S. (2012). The experiences of parents in mindfulness-based cognitive therapy. Clinical Child Psychology and Psychiatry, 17(1), 103–119.

13 UK Network for Mindfulness. (2011). Based Teachers Good practice guidelines for teaching mindfulness-based courses. Retrieved from http://mindfulnessteachersuk.org.uk/pdf/teacher-guidelines.pdf


Mindfulness & Looked After Children

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