Contemplative Intervention Reduces Physical Interventions for Children in Residential Psychiatric Treatment.

A manualized contemplative intervention called Mindful Life: Schools (MLS) was tested with ten children receiving intensive residential psychiatric care. Over one month, children attended 12 sessions of 30-45 minutes. Facility data on seclusions and restraints showed that in the 24 hours after an MLS class, children had significantly lower odds of requiring physical intervention (odds ratio 0.3; 95% CI 0.2, 0.5). Behavioral questionnaires did not show significant effects, and the program was generally acceptable. The findings suggest contemplative practices can acutely reduce the use of physical interventions, and objective measures like incident rates may be more informative than subjective reports.

Study at a glance

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.