Cultivating Emotional Balance in Professional Caregivers: a Pilot Intervention
Cultivating Emotional Balance (CEB) is an evidenced-based Mindfulness and Compassion-Based Intervention (MCBI) designed to reduce destructive, negative emotional experiences toward oneself and others and to promote skills for experiencing and expressing emotions constructively. The aim of this pilot study was to run a CEB program for professional caregivers of patients with intellectual disability (n = 19, 18 female, mean age = 40.47). Psychometrically validated instruments for the assessment of mindfulness, self-care, emotion regulation, and self-compassion were used. Within the pilot data, preliminary multivariate analysis of variance pointed in the direction of meaningful increases in both the five facets of mindfulness and de-centering. Additional analyses suggest that the pilot intervention can improve self-care self-compassion while reducing symptoms of depression, anxiety, panic, and somatized illness. The pilot findings suggest that CEB may not only help to enhance the regulation of emotional states but could also be associated with improvement of mindfulness, self-care, and self-compassion. New interventions with a randomized control design are encouraged to further examine the benefits of the MCBI with this important population of caregivers supporting people with intellectual disabilities.
KeywordsCultivating Emotional Balance intervention Professional caregivers Mindfulness Self-care Symptoms of emotional distress Self-compassion
Compliance with Ethical Standards
This study was approved by the appropriate ethics committee and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.
- Bazzano, A., Wolfe, C., Zylowska, L., Wang, S., Schuster, E., Barrett, C., & Lehrer, D. (2015). Mindfulness Based Stress Reduction (MBSR) for parents and caregivers of individuals with developmental disabilities: a community-based approach. Journal of Child and Family Studies, 24, 298–308. doi: 10.1007/s10826-013-9836-9.CrossRefGoogle Scholar
- Barbosa, P., Raymond, G., Zlotnick, C., Wilk, J., Toomey, R., & Mitchell, J. (2013). Mindfulness-based stress reduction training is associated with greater empathy and reduced anxiety for graduate healthcare students. Education for health, 26(1), 9–14. doi: 10.4103/1357-6283.112794.CrossRefPubMedGoogle Scholar
- Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on health and well- being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28, 107–113. doi: 10.1080/15555240.2013.779518.CrossRefPubMedPubMedCentralGoogle Scholar
- Cebolla, A., García, A., Soler, J., Guillén, V., Baños, R. M., & Botella, C. (2012). Psychometric properties of the Spanish validation of the Five Facets of Mindfulness Questionnaire (FFMQ). The European Journal of Psychiatry, 26(2), 118–126. doi: 10.4321/S0213-61632012000200005.CrossRefGoogle Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Earlbaum Associates.Google Scholar
- Dos Santos, T. M., Kozasa, E. H., Carmagnani, I. S., Tanaka, L. H., Lacerda, S. S., & Nogueira-Martins, L. A. (2016). Positive effects of a stress reduction program based on mindfulness meditation in Brazilian nursing professionals: qualitative and quantitative evaluation. EXPLORE: The Journal of Science and Healing, 12(2), 90–99. doi: 10.1016/j.explore.2015.12.005.CrossRefGoogle Scholar
- Ekman, E. (2015). Development, delivery, and evaluation of a pilot stress reduction, emotion regulation, and mindfulness training for juvenile justice officers. OJJDP Journal of Juvenile Justice, 4, 71–91.Google Scholar
- Ekman, P. (2007). Emotions revealed: recognizing faces and feelings to improve communication and emotional life. New York: Macmillan.Google Scholar
- Flook, L., Goldberg, S. B., Pinger, L., Bonus, K., & Davidson, R. J. (2013). Mindfulness for teachers: a pilot study to assess effects on stress, burnout and teaching efficacy. Mind Brian Education, 7(3). doi: 10.1111/mbe.12026.
- Franco, C. (2010). Reduction of the stress levels and anxiety in primary care medical doctors through an application of a mindfulness training program [Reducción de los niveles de estrés y ansiedad en médicos de Atención Primaria mediante la aplicación de un programa de entrenamiento en conciencia plena (mindfulness)]. Atención Primaria, 42(11), 564–570. doi: 10.1016/j.aprim.2009.10.020.CrossRefGoogle Scholar
- Fresco, D. M., Moore, M. T., van Dulmen, M. H., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–246. doi: 10.1016/j.beth.2006.08.003.CrossRefPubMedGoogle Scholar
- Garcia-Campayo, J., Navarro-Gil, M., Andrés, E., Montero-Marin, J., López-Artal, L., & Demarzo, M. M. (2014). Validation of the Spanish versions of the long (26 items) and short (12 items) forms of the Self-Compassion Scale (SCS). Health and Quality of Life Outcomes, 12, 4. doi: 10.1186/1477-7525-12-4.CrossRefPubMedPubMedCentralGoogle Scholar
- Kemeny, M. E., Foltz, C., Cavanagh, J. F., Cullen, M., Giese-Davis, J., Jennings, P., Rosenberg, E. L., Gillath, O., Shaver, P. R., Wallace, B. A., & Ekman, P. (2011). Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses. Emotion, 12(2), 338–350. doi: 10.1037/a0026118.CrossRefPubMedGoogle Scholar
- Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., & Quill, T. E. (2009). Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA, 302(12), 1284–1293. doi: 10.1001/jama.2009.1384.CrossRefPubMedGoogle Scholar
- Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4. doi: 10.3389/fpsyg.2013.00863.
- Lama, D., & Ekman, P. (2008). Emotional awareness: overcoming the obstacles to psychological balance and compassion. New York: Macmillan.Google Scholar
- Leary, M. R., Tate, E. B., Adams, C. E., Allen, A. B., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly. Journal of Personality and Social Psychology, 92, 887–904. doi: 10.1037/0022-35126.96.36.1997.CrossRefPubMedGoogle Scholar
- Martín, A., García de la Banda, G., & Benito, E. (2005). Stress reduction through mindful attention: MBSR technique applied to healthcare professionals [Reducción de estrés mediante atención plena: la técnica MBSR en la formación de profesionales de la salud]. Análisis y modificación de conducta, 139(31), 557–571.Google Scholar
- Martín, A., Moix, J., Pujol-Ribera, E., Berenguera, A., Rodríguez-Blanco, T., & Epstein, R. M. (2014). Effectiveness of a mindfulness education program in primary health care professionals: a pragmatic controlled trial. Journal of Continuing Education in the Health Professions, 34(1), 4–12. doi: 10.1002/chp.21211.CrossRefGoogle Scholar
- McConachie, D. A. J., McKenzie, K., Morris, P. G., & Walley, R. M. (2014). Acceptance and mindfulness-based stress management for support staff caring for individuals with intellectual disabilities. Research in Developmental Disabilities, 35(6), 1216–1227. doi: 10.1016/j.ridd.2014.03.005.CrossRefPubMedGoogle Scholar
- Milicevic, A., Milton, I., & O'Loughlin, C. (2016). Experiential reflective learning as a foundation for emotional resilience: An evaluation of contemplative emotional training in mental health workers. International Journal of Educational Research, 80, 25–36. doi: 10.1016/j.ijer.2016.08.001.
- Paller, K. A., Creery, J. D., Florczak, S. M., Weintraub, S., Mesulam, M. M., Reber, P. J., Kiragu, J., Rooks, J., Safron, A., Morhardt, D., O'Hara, M., Gigler, K. L., Molony, J. M., & Maslar, M. (2015). Benefits of mindfulness training for patients with progressive cognitive decline and their caregivers. American Journal of Alzheimer’s Disease and Other Dementias, 30(3), 257–267. doi: 10.1177/1533317514545377.CrossRefPubMedGoogle Scholar
- Palta, P., Page, G., Piferi, L., Gill, J. M., Hayatm, M. J., Connolly, A. B., & Szanton, S. L. (2012). Evaluation of a mindfulness-based intervention program to decrease blood pressure in low-income African-American older adults. Journal of Urban Health, 89(2), 308–316. doi: 10.1007/s11524-011-9654-6.CrossRefPubMedPubMedCentralGoogle Scholar
- Sansó, N., Galiana, L., Oliver, A., Sinclair, S., & Benito, E. (2015). Palliative care professionals’ inner life: exploring the relationships among awareness, self-care and compassion satisfaction and fatigue, burnout and coping with death. Journal of Pain and Symptom Management, 50(2), 200–207. doi: 10.1016/j.jpainsymman.2015.02.013.CrossRefPubMedGoogle Scholar
- Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J., & Oreskovich, M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172(18), 1377–1385. doi: 10.1001/archinternmed.2012.3199.CrossRefPubMedGoogle Scholar
- Shapiro, S. L., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105–115. doi: 10.1037/1931-3918. 1.2.105.CrossRefGoogle Scholar
- Soler, J., Franquesa, A., Feliu-Soler, A., Cebolla, A., García-Campayo, J., Tejedor, R., Demarzo, M., Baños, R., Pascual, J. C., & Portella, M. J. (2014). Assessing decentering: validation, psychometric properties, and clinical usefulness of the experiences questionnaire in a Spanish sample. Behavior Therapy, 45(6), 863–871. doi: 10.1016/j.beth.2014.05.004.CrossRefPubMedGoogle Scholar
- Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Pearson Education.Google Scholar
- Zanesco, A. P., King, B. G., MacLean, K. A., Jacobs, T. L., Aichele, S. R., Wallace, B. A., Smallwood, J., Schooler, J. W., & Saron, C. D. (2016). Meditation training influences mind wandering and mindless reading. Psychology of Consciousness: Theory, Research, and Practice, 3(1), 12–33. doi: 10.1037/cns0000082.Google Scholar