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Gepubliceerd in: Mindfulness 4/2015

01-08-2015 | ORIGINAL PAPER

Effects of Training Staff in MBPBS on the Use of Physical Restraints, Staff Stress and Turnover, Staff and Peer Injuries, and Cost Effectiveness in Developmental Disabilities

Auteurs: Nirbhay N. Singh, Giulio E. Lancioni, Bryan T. Karazsia, Rachel E. Myers, Alan S. W. Winton, Larry L. Latham, Kristen Nugent

Gepubliceerd in: Mindfulness | Uitgave 4/2015

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Abstract

Some individuals with developmental disabilities who reside in community group homes occasionally engage in low-frequency, but high-intensity, aggressive behavior. Over time, staff members assigned to manage the aggressive behaviors of these individuals are repeatedly injured, have to take time off work, become highly stressed, and eventually find alternative employment. In this study, we provided a 7-day intensive Mindfulness-Based Positive Behavior Support (MBPBS) training to staff from three group homes and measured the effects of such training on their use of verbal redirection and physical restraint, staff stress levels and turnover, staff and peer injuries, and benefit-cost analyses. When compared to baseline measures, results showed clinically and statistically significant reductions in the use of verbal redirection, complete disuse of physical restraints within a few weeks of MBPBS training, and cessation of staff and peer injuries. In addition, there was a significant reduction in staff stress and zero staff turnover. Finally, benefit-cost analysis showed substantial financial savings due to staff participation in the MBPBS program. This study adds to the extant research suggestive of mindfulness-based interventions being effective in reducing the use of restraints, decreasing staff stress, and providing financial savings to the service providers of individuals with developmental disabilities.
Literatuur
go back to reference Allen, D., Lowe, K., Brophy, S., & Moore, K. (2009). Predictors of restrictive reactive strategy use in people with challenging behavior. Journal of Applied Research in Intellectual Disabilities, 22, 159–168.CrossRef Allen, D., Lowe, K., Brophy, S., & Moore, K. (2009). Predictors of restrictive reactive strategy use in people with challenging behavior. Journal of Applied Research in Intellectual Disabilities, 22, 159–168.CrossRef
go back to reference Anālayo. (2003). Satipatthana: the direct path to realization. Cambridge: Windhorse Publications. Anālayo. (2003). Satipatthana: the direct path to realization. Cambridge: Windhorse Publications.
go back to reference Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: strategies for studying behavior change (3rd ed.). Boston: Allyn and Bacon. Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: strategies for studying behavior change (3rd ed.). Boston: Allyn and Bacon.
go back to reference Bethay, J. S., Wilson, K. G., Schnetzer, L. W., Nassar, S. L., & Bordieri, M. J. (2013). A controlled pilot evaluation of acceptance and commitment training for intellectual disability staff. Mindfulness, 4, 113–121.CrossRef Bethay, J. S., Wilson, K. G., Schnetzer, L. W., Nassar, S. L., & Bordieri, M. J. (2013). A controlled pilot evaluation of acceptance and commitment training for intellectual disability staff. Mindfulness, 4, 113–121.CrossRef
go back to reference Bluth, K., & Wahler, R. G. (2011). Does effort matter in mindful parenting? Mindfulness, 2, 175–178.CrossRef Bluth, K., & Wahler, R. G. (2011). Does effort matter in mindful parenting? Mindfulness, 2, 175–178.CrossRef
go back to reference Brooker, J. E., Julian, J., Webber, L., Chan, J., Shawyer, F., & Meadows, G. (2013). Evaluation of an occupational mindfulness program for staff employed in the disability sector in Australia. Mindfulness, 4, 122–136.CrossRef Brooker, J. E., Julian, J., Webber, L., Chan, J., Shawyer, F., & Meadows, G. (2013). Evaluation of an occupational mindfulness program for staff employed in the disability sector in Australia. Mindfulness, 4, 122–136.CrossRef
go back to reference Brooker, J. E., Webber, L., Julian, J., Shawyer, F., Graham, A. L., Chan, J., & Meadows, G. (2014). Mindfulness-based training shows promise in assisting staff to reduce their use of restrictive interventions in residential services. Mindfulness. doi:10.1007/s12671-014-0306-2. Brooker, J. E., Webber, L., Julian, J., Shawyer, F., Graham, A. L., Chan, J., & Meadows, G. (2014). Mindfulness-based training shows promise in assisting staff to reduce their use of restrictive interventions in residential services. Mindfulness. doi:10.​1007/​s12671-014-0306-2.
go back to reference Buksbazen, J. D. (2002). Zen meditation in plain English. Boston: Wisdom Publications. Buksbazen, J. D. (2002). Zen meditation in plain English. Boston: Wisdom Publications.
go back to reference Chödrön, P. (2007). Don’t bite the hook: finding freedom from anger, resentment, and other destructive emotions. Boston: Shambhala Audio. Chödrön, P. (2007). Don’t bite the hook: finding freedom from anger, resentment, and other destructive emotions. Boston: Shambhala Audio.
go back to reference Chödrön, P. (2010). Taking the leap: freeing ourselves from old habits and fears. Boston: Shambhala. Chödrön, P. (2010). Taking the leap: freeing ourselves from old habits and fears. Boston: Shambhala.
go back to reference Cohen, S., & Williamson, G. (1988). Psychological stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health: Claremont symposium on applied social psychology (pp. 31–67). Newbury Park: Sage. Cohen, S., & Williamson, G. (1988). Psychological stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health: Claremont symposium on applied social psychology (pp. 31–67). Newbury Park: Sage.
go back to reference Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.PubMedCrossRef Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.PubMedCrossRef
go back to reference Hastings, R. P. (2002). Do challenging behaviors affect staff psychological well-being? Issues of causality and mechanism. American Journal on Mental Retardation, 107, 455–467.PubMedCrossRef Hastings, R. P. (2002). Do challenging behaviors affect staff psychological well-being? Issues of causality and mechanism. American Journal on Mental Retardation, 107, 455–467.PubMedCrossRef
go back to reference Hawkins, S., Allen, D., & Jenkins, R. (2005). The use of physical interventions with people with intellectual disabilities and challenging behavior: the experiences of service users and staff members. Journal of Applied Research in Intellectual Disabilities, 18, 19–34.CrossRef Hawkins, S., Allen, D., & Jenkins, R. (2005). The use of physical interventions with people with intellectual disabilities and challenging behavior: the experiences of service users and staff members. Journal of Applied Research in Intellectual Disabilities, 18, 19–34.CrossRef
go back to reference Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford.
go back to reference Hensel, J. M., Lunsky, Y., & Dewa, C. S. (2011). Exposure to client aggression and burnout among community staff who support adults with intellectual disabilities in Ontario, Canada. Journal of Intellectual Disability Research, 56, 910–915.PubMedCrossRef Hensel, J. M., Lunsky, Y., & Dewa, C. S. (2011). Exposure to client aggression and burnout among community staff who support adults with intellectual disabilities in Ontario, Canada. Journal of Intellectual Disability Research, 56, 910–915.PubMedCrossRef
go back to reference Heyvaert, M., Saenen, L., Maes, B., & Onghena, P. (2014a). Systematic review of restraint interventions for challenging behavior among persons with intellectual disabilities: focus on experiences. Journal of Applied Research in Intellectual Disabilities. doi:10.1111/jar.12095. Heyvaert, M., Saenen, L., Maes, B., & Onghena, P. (2014a). Systematic review of restraint interventions for challenging behavior among persons with intellectual disabilities: focus on experiences. Journal of Applied Research in Intellectual Disabilities. doi:10.​1111/​jar.​12095.
go back to reference Heyvaert, M., Saenen, L., Maes, B., & Onghena, P. (2014b). Systematic review of restraint interventions for challenging behaviors among persons with intellectual disabilities: focus on effectiveness in single-case experiments. Journal of Applied Research in Intellectual Disabilities. doi:10.1111/jar.12094. Heyvaert, M., Saenen, L., Maes, B., & Onghena, P. (2014b). Systematic review of restraint interventions for challenging behaviors among persons with intellectual disabilities: focus on effectiveness in single-case experiments. Journal of Applied Research in Intellectual Disabilities. doi:10.​1111/​jar.​12094.
go back to reference Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6, 537–559.CrossRef Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6, 537–559.CrossRef
go back to reference Howard, R., Rose, J., & Levenson, V. (2009). The psychological impact of violence on staff working with adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 22, 538–548.CrossRef Howard, R., Rose, J., & Levenson, V. (2009). The psychological impact of violence on staff working with adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 22, 538–548.CrossRef
go back to reference Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. NY: Delta. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. NY: Delta.
go back to reference Kongtrül, D. (2008). Light comes through: Buddhist teaching on awakening to our natural intelligence. Boston: Shambhala. Kongtrül, D. (2008). Light comes through: Buddhist teaching on awakening to our natural intelligence. Boston: Shambhala.
go back to reference Kyabgon, T. (2003). Mind at ease: self-liberation through Mahamudra meditation. Boston: Shambhala. Kyabgon, T. (2003). Mind at ease: self-liberation through Mahamudra meditation. Boston: Shambhala.
go back to reference Martinez, C. K., & Betz, A. M. (2013). Response interruption and redirection: current research trends and clinical application. Journal of Applied Behavior Analysis, 46, 549–554.PubMedCrossRef Martinez, C. K., & Betz, A. M. (2013). Response interruption and redirection: current research trends and clinical application. Journal of Applied Behavior Analysis, 46, 549–554.PubMedCrossRef
go back to reference McDonald, K. (2005). How to meditate: a practical guide. Boston: Wisdom Publications. McDonald, K. (2005). How to meditate: a practical guide. Boston: Wisdom Publications.
go back to reference Mérineau-Côté, J., & Morin, D. (2014). Restraint and seclusion: the perspective of service users and staff members. Journal of Applied Research in Intellectual Disabilities, 27, 447–457.PubMedCrossRef Mérineau-Côté, J., & Morin, D. (2014). Restraint and seclusion: the perspective of service users and staff members. Journal of Applied Research in Intellectual Disabilities, 27, 447–457.PubMedCrossRef
go back to reference Myers, R. E., Winton, A. S. W., Lancioni, G. E., & Singh, N. N. (2014). Mindfulness in developmental disabilities. In N. N. Singh (Ed.), Psychology of meditation (pp. 209–240). New York: Nova Science. Myers, R. E., Winton, A. S. W., Lancioni, G. E., & Singh, N. N. (2014). Mindfulness in developmental disabilities. In N. N. Singh (Ed.), Psychology of meditation (pp. 209–240). New York: Nova Science.
go back to reference Noone, S. J., & Hastings, R. P. (2009). Building psychological resilience in support staff caring for people with intellectual disabilities: pilot evaluation of an acceptance-based intervention. Journal of Intellectual Disabilities, 13, 43–53.PubMedCrossRef Noone, S. J., & Hastings, R. P. (2009). Building psychological resilience in support staff caring for people with intellectual disabilities: pilot evaluation of an acceptance-based intervention. Journal of Intellectual Disabilities, 13, 43–53.PubMedCrossRef
go back to reference Noone, S. J., & Hastings, R. P. (2010). Using acceptance and mindfulness-based workshops with support staff caring for adults with intellectual disabilities. Mindfulness, 1, 67–73.CrossRef Noone, S. J., & Hastings, R. P. (2010). Using acceptance and mindfulness-based workshops with support staff caring for adults with intellectual disabilities. Mindfulness, 1, 67–73.CrossRef
go back to reference Parker, R. I., & Vannest, K. (2009). An improved effect size for single-case research: nonoverlap of all pairs. Behavior Therapy, 40, 357–367.PubMedCrossRef Parker, R. I., & Vannest, K. (2009). An improved effect size for single-case research: nonoverlap of all pairs. Behavior Therapy, 40, 357–367.PubMedCrossRef
go back to reference Parker, R. I., Hagan-Burke, S., & Vannest, K. (2007). Percentage of all non-overlapping data (PAND): an alternative to PND. Journal of Special Education, 40, 194–204.CrossRef Parker, R. I., Hagan-Burke, S., & Vannest, K. (2007). Percentage of all non-overlapping data (PAND): an alternative to PND. Journal of Special Education, 40, 194–204.CrossRef
go back to reference Richards, S. B., Taylor, R. L., & Ramasamy, R. (2013). Single subject research: applications in educational and clinical settings. Belmont: Wadsworth. Richards, S. B., Taylor, R. L., & Ramasamy, R. (2013). Single subject research: applications in educational and clinical settings. Belmont: Wadsworth.
go back to reference Sameroff, A. J. (1995). General systems theories and developmental psychopathology. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology. Vol. 1: theory and methods (pp. 659–695). New York: Wiley. Sameroff, A. J. (1995). General systems theories and developmental psychopathology. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology. Vol. 1: theory and methods (pp. 659–695). New York: Wiley.
go back to reference Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press.
go back to reference Singh, N. N. (2014). Psychology of meditation. New York: Nova. Singh, N. N. (2014). Psychology of meditation. New York: Nova.
go back to reference Singh, N. N., Lancioni, G. E., Winton, A. S. W., Wahler, R. G., Singh, J., & Sage, M. (2004). Mindful caregiving increases happiness among individuals with profound multiple disabilities. Research in Developmental Disabilities, 25, 207–218.PubMedCrossRef Singh, N. N., Lancioni, G. E., Winton, A. S. W., Wahler, R. G., Singh, J., & Sage, M. (2004). Mindful caregiving increases happiness among individuals with profound multiple disabilities. Research in Developmental Disabilities, 25, 207–218.PubMedCrossRef
go back to reference Singh, N. N., Lancioni, G. E., Winton, A. S. W., Curtis, W. J., Wahler, R. G., Sabaawi, M., Singh, J., & McAleavey, K. (2006). Mindful staff increase learning and reduce aggression by adults with developmental disabilities. Research in Developmental Disabilities, 27, 545–558.PubMedCrossRef Singh, N. N., Lancioni, G. E., Winton, A. S. W., Curtis, W. J., Wahler, R. G., Sabaawi, M., Singh, J., & McAleavey, K. (2006). Mindful staff increase learning and reduce aggression by adults with developmental disabilities. Research in Developmental Disabilities, 27, 545–558.PubMedCrossRef
go back to reference Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2008). Clinical and benefit-cost outcomes of teaching a mindfulness-based procedure to adult offenders with intellectual disabilities. Behavior Modification, 32, 622–637.PubMedCrossRef Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2008). Clinical and benefit-cost outcomes of teaching a mindfulness-based procedure to adult offenders with intellectual disabilities. Behavior Modification, 32, 622–637.PubMedCrossRef
go back to reference Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2009). Mindful staff can reduce the use of physical restraints when providing care to individuals with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 22, 194–202.CrossRef Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2009). Mindful staff can reduce the use of physical restraints when providing care to individuals with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 22, 194–202.CrossRef
go back to reference Singh, N. N., Singh, J., Singh, A. D. A., Singh, A. N. A., & Winton, A. S. W. (2011). Meditation on the soles of the feet for anger management: a trainer’s manual. Raleigh, NC: Fernleaf. (www.fernleafpub.com). Singh, N. N., Singh, J., Singh, A. D. A., Singh, A. N. A., & Winton, A. S. W. (2011). Meditation on the soles of the feet for anger management: a trainer’s manual. Raleigh, NC: Fernleaf. (www.​fernleafpub.​com).
go back to reference Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., Myers, R. E., Latham, L. L., & Singh, J. (2014). Mindfulness-Based Positive Behavior Support (MBPBS) for mothers of adolescents with autism spectrum disorder: effects on adolescents’ behavior and parental stress. Mindfulness, 5, 646-657. doi:10.1007/s12671-014-0321-3. Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., Myers, R. E., Latham, L. L., & Singh, J. (2014). Mindfulness-Based Positive Behavior Support (MBPBS) for mothers of adolescents with autism spectrum disorder: effects on adolescents’ behavior and parental stress. Mindfulness, 5, 646-657. doi:10.​1007/​s12671-014-0321-3.
go back to reference Tenneij, N. H., & Koot, H. M. (2008). Incidence, types and characteristics of aggressive behavior in treatment facilities for adults with mild intellectual disability and severe challenging behavior. Journal of Intellectual Disability Research, 52, 114–124.PubMed Tenneij, N. H., & Koot, H. M. (2008). Incidence, types and characteristics of aggressive behavior in treatment facilities for adults with mild intellectual disability and severe challenging behavior. Journal of Intellectual Disability Research, 52, 114–124.PubMed
go back to reference Van Oorsouw, W. M. J., Embregts, P. J. C. M., Bosman, M. T., & Jahoda, A. (2014). Writing about stress: the impact of a stress-management programme on staff accounts of dealing with stress. Journal of Applied Research in Intellectual Disabilities, 27, 236–246.PubMedCrossRef Van Oorsouw, W. M. J., Embregts, P. J. C. M., Bosman, M. T., & Jahoda, A. (2014). Writing about stress: the impact of a stress-management programme on staff accounts of dealing with stress. Journal of Applied Research in Intellectual Disabilities, 27, 236–246.PubMedCrossRef
Metagegevens
Titel
Effects of Training Staff in MBPBS on the Use of Physical Restraints, Staff Stress and Turnover, Staff and Peer Injuries, and Cost Effectiveness in Developmental Disabilities
Auteurs
Nirbhay N. Singh
Giulio E. Lancioni
Bryan T. Karazsia
Rachel E. Myers
Alan S. W. Winton
Larry L. Latham
Kristen Nugent
Publicatiedatum
01-08-2015
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 4/2015
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-014-0369-0

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