Abstract
Maladaptive behaviors, such as aggressive and disruptive behaviors, are a significant risk factor for maintaining community placement by individuals with intellectual disabilities. When experienced researchers provide training to individuals with intellectual disabilities on a mindfulness-based strategy, Meditation on the Soles of the Feet, the individuals are able to effectively self-manage their maladaptive behaviors. We investigated whether similar effectiveness would be found if community-based therapists provided the training to similar individuals living in the community. Three adults with mild intellectual disabilities and mental illness living in the community were taught by a community-based therapist to use this strategy to control maladaptive behaviors that included verbal aggression, disruptive behavior and physical aggression. They were taught to shift the focus of their attention from the negative emotions that triggered their maladaptive behavior to a neutral stimulus, the soles of their feet. All three individuals were able to reduce their maladaptive behaviors to near-zero levels and maintain their community placement that they had been at risk for losing, due to their maladaptive behavior. Subjective measures of various psychological symptoms showed a reduction in two of the individuals. Our study suggests that the demonstrated effectiveness of Meditation on the Soles of the Feet can be achieved by a community-based therapist.
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Allen, D. (2000). Recent research on physical aggression in persons with intellectual disability: An overview. Journal of Intellectual and Developmental Disability, 25, 41–57.
Baer, R. A. (2003). Mindfulness as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.
Baer, R. A. (Ed.). (2006). Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications. Burlington, MA: Academic Press.
Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: Strategies for studying behavior change (3rd ed.). New York: Allyn & Bacon.
Beail, N., & Warden, S. (1996). Evaluation of a psychodynamic psychotherapy service for adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 9, 223–228.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.
Benson, B. A. (2004). Psychological interventions for people with intellectual disability and mental health problems. Current Opinion in Psychiatry, 17, 353–357.
Crane, R. (2009). Mindfulness-based cognitive therapy: Distinctive features. NY: Routledge.
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.
Deb, S., Sohanpal, S. K., Soni, R., Lenôtre, L., & Unwin, G. (2007). The effectiveness of antipsychotic medication in the management of behaviour problems in adults with intellectual disabilities. Journal of Intellectual Disability Research, 51, 766–777.
Germer, C. K., Siegel, R. D., & Fulton, P. R. (2005). Mindfulness and psychotherapy. New York: Guilford Press.
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., et al. (1989). The Yale-Brown Obsessive Compulsive Scale, I: Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011.
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.
Howells, K. (1998). Cognitive behavioural interventions for anger, aggression, and violence. In N. Tarrier, A. Wells, & G. Haddock (Eds.), Treating complex cases: The cognitive behavioural therapy approach (pp. 295–318). New York: Wiley.
Kroese, B. S., Dagnan, D., & Loumidis, K. (1997). Cognitive-behaviour therapy for people with learning disabilities. London: Routledge.
Mace, C. (2008). Mindfulness and mental health: Therapy. theory and science. London: Routledge.
Mason, J. (2007). The provision of psychological therapy to people with intellectual disabilities: An investigation into some of the relevant factors. Journal of Intellectual Disability Research, 51, 244–249.
Matson, J. L., & Boisjoli, J. A. (2009). An overview of developments in research on persons with intellectual disabilities. Research in Developmental Disabilities, 30, 587–591.
Matson, J. L., & Duncan, D. (1997). Aggression. In N. N. Singh (Ed.), Prevention and treatment of severe behavior problems: Models and methods in developmental disabilities (pp. 217–236). Belmont, CA: Thomson Brooks/Cole Publishing Co.
Matson, J. L., & Neal, D. (2009). Psychotropic medication use for challenging behaviors in persons with intellectual disabilities: An overview. Research in Developmental Disabilities, 30, 572–586.
McMillan, D., Hastings, R. P., & Coldwell, J. (2004). Clinical and actuarial prediction of physical violence in a forensic intellectual disability hospital: A longitudinal study. Journal of Applied Research in Intellectual Disabilities, 17, 255–265.
Rutter, M., & Plomin, R. (2009). Pathways from science findings to health benefits. Psychological Medicine, 39, 529–542.
Salmon, P., Sephton, S., Weissbecker, I., Hoover, K., Ulmer, C., & Studts, J. L. (2004). Mindfulness meditation in clinical practice. Cognitive and Behavioral Practice, 11, 434–446.
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.
Singh, N. N., Wahler, R. G., Adkins, A. D., Myers, R. E., & The Mindfulness Research Group. (2003). Soles of the Feet: A mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 158–169.
Singh, N. N., Wahler, R. G., Winton, A. S. W., Adkins, A. D., & The Mindfulness Research Group. (2004). A mindfulness-based treatment of obsessive-compulsive disorder. Clinical Case Studies, 3, 275–287.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Curtis, W. J., Wahler, R. G., Sabaawi, M., et al. (2006a). Mindful staff increase learning and reduce aggression in adults with developmental disabilities. Research in Developmental Disabilities, 27, 545–558.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Fisher, B. C., Wahler, R. G., McAleavey, K., et al. (2006b). Mindful parenting decreases aggression, noncompliance and self-injury in children with autism. Journal of Emotional and Behavioral Disorders, 14, 169–177.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Wahler, R. G., Sabaawi, M., et al. (2007). Individuals with mental illness can control their aggressive behavior through mindfulness training. Behavior Modification, 31, 313–328.
Singh, N. N., Lancioni, G. E., Singh, A. N., Winton, A. S. W., Singh, J., McAleavey, K. M., et al. (2008a). A mindfulness-based health wellness program for an adolescent with Prader-Willi syndrome. Behavior Modification, 32, 167–181.
Singh, N. N., Lancioni, G. E., Singh, A. N., Winton, A. S. W., Singh, J., McAleavey, K. M., et al. (2008b). A mindfulness-based health wellness program for managing obesity. Clinical Case Studies, 7, 327–339.
Singh, N. N., Lancioni, G. E., Wahler, R. G., Winton, A. S. W., & Singh, J. (2008c). Mindfulness approaches in cognitive behavior therapy. Behavioural and Cognitive Psychotherapy, 36, 659–666.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2008d). Clinical and benefit-cost outcomes of teaching a mindfulness-based procedure to adult offenders with intellectual disabilities. Behavior Modification, 32, 622–637.
Spielberger, C. D. (1983). Manual for the state-trait anxiety inventory: STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press.
Taylor, J. L. (2002). A review of assessment and treatment of anger and aggression in offenders with intellectual disability. Journal of Intellectual Disability Research, 46(Suppl. 1), 57–73.
Taylor, J. L., Novaco, R. W., Gillmer, B. T., Robertson, A., & Thorne, I. (2005). Individual cognitive-behavioural anger treatment for people with mild-borderline intellectual disabilities and histories of aggression: A controlled trial. British Journal of Clinical Psychology, 44, 367–382.
Tyrer, F., McGrother, C. W., Thorp, C. F., Donaldson, M., Bhaumik, S., Watson, J. M., et al. (2006). Physical aggression towards others in adults with learning disabilities: Prevalence and associated factors. Journal of Intellectual Disability Research, 50, 295–304.
Tyrer, P., Oliver-Africano, P. C., Ahmed, Z., Bouras, N., Cooray, S., Deb, S., et al. (2008). Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with intellectual disability: A randomised controlled trial. The Lancet, 371, 57–63.
Wolpe, J. (1968). Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press.
Workgroup, National. Advisory. Mental. Health. Council. Behavioral. Science. (2000). Translating behavioral science into action (No. NIH 00–4699). Bethesda, MD: National Institute of Mental Health.
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Adkins, A.D., Singh, A.N., Winton, A.S.W. et al. Using a Mindfulness-Based Procedure in the Community: Translating Research to Practice. J Child Fam Stud 19, 175–183 (2010). https://doi.org/10.1007/s10826-009-9348-9
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DOI: https://doi.org/10.1007/s10826-009-9348-9