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.

Yoga as Complementary Care for Young People Placed in Juvenile Institutions—A Study Plan

“…preventative practices (manualized meditation-, mindfulness-based intervention) have been suggested in residential psychiatric care for children with severe psychiatric disabilities to reduce their need for physical intervention in response to dangerous behavior (30). A few studies have reported decreased anxiety and/or depression in children and adolescents (not institutionalized) having participated in yoga programs (31)(32)(33)(34)(35).…”

A systematic review of the effectiveness of children’s behavioral health interventions in psychiatric residential treatment facilities

“…Educational or alternative programs largely took the form of supplemental programs or services in which youth being treated in residential facilities could engage. Mindful Life: Schools, a program focused on secularized yoga and mindfulness practices, was associated with lower rates of youth physical restraints and seclusion (Felver, 2017). Another study evaluating yoga yielded inconclusive findings with respect to youth psychological and behavioral problems (McCabe, 2010).…”

Art therapy is associated with a reduced rate of restrictive practices on an inpatient child and adolescent mental health unit

“…There has been an increased emphasis on prevention-oriented strategies and interventions to lower rates of restrictive practices in inpatient care. The literature on restrictive practices highlights the effectiveness of strategies which can improve self-regulation (Andrassy, 2016;Felver et al 2017, Huckshorn, 2005LeBel et al, 2004;NSW Health, 2020), interventions which are multimodal (Delaney, 2001;Gaskin et al, 2007;Huckshorn & LeBel, 2013), and those which integrate a person's individualised interests (Caldwell et al, 2014).…”