Jurnal stress manajemen (Peace)

8/18/2019 Jurnal stress manajemen (Peace)

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ALTERNATIVE APPROACH TO BEHAVIOR INTERVENTIONS

A n A lte r n a t iv e A p p r o a c h t o B e h a v i o r In t e rv e n t io n s : M in d fS t re s s R e d u c tio n

E R N E S T S O LA R , G E O R G E M A S O N U N I V E R S I T Y

Approximately 10% of school-aged children experienceemotional and behavioral

problems that are serious enough torequire professional attention(Kauffman, 2005). According to theU . S . Dep arfinen t of Educafion (2012)more than 420,000 school-agedstudents betw een the ages of 3 and 21

qualify for special education servicesunder the category of emotional orbehavioral disability (EBD). Of thosestudents, 8 1 participate in someportion of general education classesin public schools while receivingbehavioral supports and academicaccommodafions.

The Nafional LongitudinalTransifion Sfiidy-2 (NLTS-2)(Institute of Educafion Sciences, 2011;NLTS-2 Data Brief 2004; U.S.Department of Education, 2011)indicated that students with EBD stillhave a difficult time performingsuccessfully in school and postschoolenvironments. According to theNLTS-2 and the IES (2011) 25% ofstudents with EBD have poor socialskills as compared with their peers inthe general education population. Inaddifion, almo st 75% have be ensuspended or expelled at least once,and 14% are more likely to receive Dsor Fs on their report card as

compared with all students withdisabilifies. It is also reported that lessthan half of students with EBD havereceived a high school diploma orgeneral equivalency diploma, andmore than 40% have dropped out ofschool.

Bradley, Doolittle, and Bartolotta(2008) summarized from the NLTS-2that early intervention andprevenfion programs show promisefor improving student behavior;

however, students with EBD are at

risk of becoming resistant tobehavioral, social, and academicinterventions as they move throughthe school system. Furthermore,school systems aim to reducenegafive school behaviors, but theyhave a difficult time idenfifyingeffecfive and feasible programs toimplement on a broad scale in the

classroom or school environment thatwill bring about the change theydesire (Everett, Kann, & McReynolds,1997). One approach to the growingproblem of school-related conductand behavior problems with studentswith EBD may be to provide trainingin stress reducfion (Barnes, Bauza, &Treiber, 2003; Meiklejohn et al., 2012)in the form of a type of meditafioncalled mindfulness-based stressreduction.

Mindfulness based StressReduction: Current

Research based Practices

Mindfulness-based stressreduction (MBSR) is a structuredprogram of instruction used in themedical and health care fields toreduce stress, increase relaxafion,alleviate pain, and reduce anxietythrough the use of mindfulnesstechniques (Carmody, Baer, Lykins,

& O lendzki, 2009; Kabat-Zinn, 2009).Grossman, Niemann, Schmidt, andWalach define min fulness as dispassionate, non-evaluative andsustained moment-to-momentawareness of percepfible mentalstates and pro cesse s (2004, p. 36). Inessence, the individual is taughtparficipant-observation in which theindividual becomes aware ofmoment-to-moment experiences anddecreases the sense of going throu ghthe motions.

Over the past 30 years MBSR hasbeen researched by the medical andhealth care community to documentthe many positive effects experiencedby patients. For example, a clinicalstudy showed a reduction in anxietyand depression in adult patients whoengaged in a MBSR program (Miller,Fletcher, & Kabat-Zinn, 1995).Another study showed posifiveresults in 174 adult patients whoengaged in a MBSR program inreducing stress-related problems,anxiety, and chronic pain (Carmody& Baer, 2008). Reibel, Greeson,Brainard, and Rosenzweig (2001)reported a 44% reduction of anxietyand 34% reduction of depression in136 heterogeneous adult pafients.Smalley et al. (2009) invesfigated theassociafion between mindfulness andattention deficit/hyperactivitydisorder (ADHD). The results of theirstudy suggested that mindfulnesstraining could be a technique used toboost attenfion in ADHD. Last, in aMBSR study related to school-agedchildren, Barnes et al. (2003) used ameditation program based on MBSRtechniques with inner-city African-American adolescents from 15 to18 years old and found lower rates ofabsenteeism and school suspensionsin the population of students engaged

in the meditafion program.The medical and psychiatricresearch corrununities continue todocument the effecfiveness ofMBSR interventions in variousheterogeneous and homogeneouspopulations of adults, with evidenceemerging in children and adolescents(Meiklejohn et al., 2012). The researchhas been conducted across amultitude of medical, psychiatric,and healthy populations, related tostress, behavior, and anxiety

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disorders, and studies haveconsistently shown positive effects inhelping individuals with stress- andanxiety-related disorders (Carmody& Baer, 2008; Carm ody, Baer, Lykins,& O lendzki, 2009; Kabat-Zinn, 2009;Reibel et al., 2001).

Current Mindfulness Practicesin Education

In 2005, the Garrison Institutereleased the Garrison Institute Reporton Contemplation and Education, asurvey of contemplative practicesused in K-12 educational settings.This report defines contempl tionpr ctices as m editation practices

that are not related to religiousorganizations. The report organizedprograms into two categories:contemplative programs orcontemplative techniques. In defininga contemplative program , the GarrisonReport based its definition on thestructure of the MBSR program . Acontemplative program specificallyemphasizes mindfulness andimprov ing a stud ent's capacity for seLf-awareness. Contemplative techniquesuse metho ds (not related to a program)that include teaching students howto pay better attention to theirsurroundings. The report outlined 16contemplation program s, 7 programsthat use contemplation techniques,and 5 teacher training programs thattrain teachers to use contemplation inthe education system.

The Garrison Report (2005)asserted that the MBSR model isappropriate for educational settingsby stating, wherea s pain and stress

can be symptomatic of disease,trauma or other health-related causes,academic failure and anti-socialbehaviors at school often indicatesystemic problems within the schoolcom mu nity (p. 7). The Center forMindfulness at the University ofMassachusetts Medical School believes that students, teachers andother members of the schoolcommunity can benefit frommindfulness and other contemplativetechniques in an effort to become

more responsive and less reactive,more focused and less distracted,more calm and less stressed(Garrison Institiate, 2005, pp. 7-8).The assumption of these statements isif teachers, administrators, schoolstaff and students incorporate MBSRpractices and principles, then theschool community in general will becalmer, less distracted, and respondmore appropriately to each other. Inessence, it would create a better andmore efficient learning and workingenvironment for everyone.

There is still a concern thatschools are having a difficult timeimplementing adequate supports forstudents with EBD (Buüock &

Gable, 2006). Buüock and Gableacknowledge that a large array ofresearch-based interventions havebeen developed to help students w ithEBD; how ever, the ultimate goal isto teach the students sküls that willenable them to regulate their ownbeh avio r (2006, p. 9). Mindfulness-based stress reduction may enablestudents with EBD to improve theirability to regulate their own behavior,which would complement many ofthe research-based interventions theyare already participating in at school.

Practicing PE CE

Chris, a special education studentreceiving services under the category ofemotional or behavior disorders (EBD),walks into the classroom and throws awater bottle across the room and slamshis textbook on the desk. To no one inparticular, he rele ses a string ofinappropriate words about a te cher who

gave him a consequence in the classroomin front of his peers. Mr. Barrett, thespecial education teacher in theclassroom, quietly ppro ches Chris andcalmly asks him to stop. It takes severalattempts to get C hris to stop talking andlisten.to Mr. Barrett. When he stops, Mr.Barrett asks Chris to p use for a momentand take three slow deep breaths. Chrisrolls his eyes and reluctantly takes thefirst breath. With each successive breathMr. Barrett watches as some of thetension leaves Chris s shoulders. Mr.

Barrett quietly suggests to Chris to letout each exhale of bre th with a sigh ofrelief.

When Chris s breathing becomesrelaxed and steady, M r. Barrett asksChris to explain what happened in theclassroom. Chris describes what h ppenedin the classroom from his perspective. M r.Barrett quietly listens without judgmentand when Chris is finished he asks Christo acknowledge the situation. Chris needsto acknowledge he was asked to leave thecl ssroom for a reason he felt was unfair,but this does not mean he needs to like theoutcome of being removed fiom the class.From this point, Mr. Barrett asks Christo accept what has happened and hisreaction to the event. This means

accepting that he is mad, angry,fiustrated an d embarrassed. Last, Mr.Barrett asks Chris to allow the experienceto happen. This means allowing theemotions and reactions to happen withoutsuppressing what he h s felt andexperienced. In the case of Chris, he hasbeen through this process severa l times sohe quickly becomes more rel xed and opento talking to Mr. Barrett.

Mr. Barrett then suggests to Christhat he needs to choose what he will donext. He explains to Chris that it maytake several minutes, hours, or days forhim to choose his next action in regard tothe situation, but he must choose. Mr.Barrett reminds Chris that choosingmeans being clear about what h e wants,his limits, and his responsibility to thesituation. Chris must have the cour ge tospeak the truth to the te cher and listen tofeedback with an open mind. Chris musthave comp ssion fo r himself the teacher,and the other students bec use at times itcan be difficult to be a student or a

teacher. Last, Mr. Barrett asks Chris tofind the humor in his dramatic reaction tohis consequence of being asked to leaveclass.

This particular time Chris chooses totalk about his options with Mr. Barrett.He discusses his responsibility to thesituation, his expectations of the teacher,and wha t he can handle. Mr. Barrett andChris role-play how Chris will speak withthe te cher and possible feedb ck he mayhear fiom the teacher. M r. Barrett shareswith Chris som e of the difficulties of

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ble MINDFULNESS PEACE PRACTICE

p

E

A

C

E

Pause

Exhale

A c k n o w l e d g e

Choose

Engage

Definition

Pause when you become aware of a difficult

situation.When you pause to breathe, exhale a sigh, groan.or moan. Then inhale and continue to breathe.

• Acknowledge and recognize the situation asit is, whether you like it or not

• Accept the situation and your reaction to itwithout judgment.

• Allow the experience to happen.Choose how you will respond to the situation

and your emotions with:• Clarity about what you want, your limits.

and responsibility• Courage to speak the truth and hear the truth.• Compassion for yourself and others because

we are all humans who make mistakes.• The willingness to find the humor in the

situation and your emotional response.Engage with people, with the situation, and

with Ufe again.

Action

Stop everything you are doing, close your eyes, and

take a big deep breath.Exhale each breath with an audible sound. Thenbreathe again.

Observe,the situation and your reaction from a bird seye view without judgment. Simply let it happenwithout getting mad at yourself for your actions orfeelings.

It s okay to take minutes, days, or weeks to choosehow you will react to a situation or your emotions.There may be times that you have to make yourchoice sooner as opposed to later, but always layout your expectations and limits, be strong withcompassion, and do not forget to laugh.

If you feel you cannot do this alone, find someoneyou trust to help you

Source: Based on Saltzman (n.d.).

managing a large classroom of teenagestudents, and Chris laughs at how upsethe got over the situation. Mr Barrettends the conversation with Chris byreminding him that he will need todetermine when and how he will continuethe school day and when he will engagethe teacher about the situation.

How PEACE Works

WTiat M r. Barrett used was amindfulness practice based onSaltzm an s (n.d.) PEACE acron ym(see able 1 , which was developed tohelp adolescents deal with difficultsituations. In this particular situation,

Chris has been practicing the PEACEacronym for almost 2 years and isfamiliar with the concept. Newstudents entering M r. Barrett sclassroom are introduced to theacronym over time and in small steps.M r. Barrett also has the acronym andthe meaning posted in the classroomas a reference for his students.

The purpose of using PEACEwith a student with EBD is not toreplace the current behavior

interventions put in place by the

school or special education teacher,but to complement and enhancethe interventions and copingmechanisms that are already in placefor the stud ent to be successful in thelearning envirorunent. ThroughPEACE, students become aware andaccept their thoughts and emotions atthat moment in time, choose theirnext step, and then reengage in thelearning community.

The first step in using PEACE isrenünding the student to stop andbreathe . This process m ay be difficultfor the student to understand;however, it is essential in helping thestudent relax when his or her trigger

behaviors have occurred. In the caseof M r. Barrett and Chris, when Chriswould become upset over a situationhe would become red-faced withanger, slur his words, speak in fastuncontrollable sentences, and oftenuse inappropriate language. In orderto understand what Chris was upsetabout, M r. Barrett wou ld calmly askChris to stop and breathe in order tocalm down. Once Chris was calmand the crisis had resolved, MrBarrett would speak to Chris about

the importance of breathing and ho wthat would be their cue that it wastime for Chris to stop and gather histhoughts. Other techniques can beused as well, such as using ameditation bell or tracing a fingerlabyrinth to give the student anopportunity to paus e from his or herrunaway emotions.

Once the student has learned theimportance of pausing and exhaling,the teacher can explain theimportance of acknowledging thesituation that has triggered theemotional response. This is animportant process in the respect thatit does not place blam e or

responsibility on the student, butacceptance of what has occurred andhow he or she felt ab out the situation.Therefore, blame of the situation isremoved from all parties involvedan d the studen t s emotions arerecognized and accepted withoutconsequenc e. After the student hasacknovyledged and accepted theexperience he or she can then chooseho w to move forward.

Choosing what to do next is a

new concept for some students with 6 B E Y O N D B E H A V I O R


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ALTERNATIVE APPROACH TO BEFLWIOR INTERVENTIONS

EBD to learn. In the past they wereused to having decisions forced uponthem based on their actions to eventsor impulsively reacting to situationsand hoping for the best. The choosephase of PEACE may take hours,

minutes, or weeks for the student todetermine w hat the next course ofaction may b e. This is a good time forthe teacher to talk to the studentabout options and possible positiveand negative consequences and torole-play scenarios with the student ifhe or she is going to have to beengaged in a conversation. In the caseof Chris, he had 48 hours to choosehow he was going to face his teacherat the next class session.

Oftentimes after a student withEBD experiences a situation when hisor her emotional response istriggered, he or she disengages fromthe learning conimuxüty for anextended period of time. This may beevident by the student placing his orher head on the desk, ignoringteachers and peers, taking a nap, orrefusing to attend class. At this timethe teacher will need to help engagethe student with EBD back into thelearning environment. This may takethe form of the student taking a selftime-out for a specified period oftime, the teacher walking the studentback to class, or creating a plan ofwhen the student will return to class.

The overall process of teaching astudent with EBD how to use PEACEmay be a time-consuming process;however, it will teach a skùl that thestude nt can take after grad uation fromhigh school. When students are awareof their thoughts and feelings, they

can choose their behavior, and bychoosing their behavior, they createtheir ow n lives (Saltzman, n.d.).

onclusion

Research tells us that earlyintervention and preventionprograms show promise forimproving student behavior.However, students with EBD are atrisk of becoming resistant to

behavioral, social, and academic

interventions as they move throughthe school system (Bradley et al.,2008). Furthermore, although schoolsystems are interested in reducingnegative school behaviors, they havea difficult time identifying effectiveand feasible programs to implementon a broad scale in the classroom orschool environment that will bringabout the change they desire (Everettet al., 1997). One approach to thegrowing problem of school-relatedconduct and behavior problems withstudents w ith EBD may be to providetraining in stress reduction (Barneset al., 2003).

As the Garrison Report (2005)and medical research have shown,

MBSR is becoming more prevalent ineducational, medical, and therapeuticsettings as a successful interventionin helping all different tj^es ofindividuals across various agegroups. Semple, Reid, and Miller(2005) believed the delivery ofmindfulness in a group setting in aschool-based envirorunent is a morecost-effective approach thanindividualized, clinical treatments.Smalley et al. (2009) suggested thatmindfulness training may be acomplementary tool for improvingattention and behavior. Furthermore,Gulchak and Lopes (2007) found thatwhereas the United States uses moreof an analytic approach with the useof ftuictional behavior assessments,applied behavior analysis, andpositive behavior support plans,other countries base behaviorinterventions on the use of holisticand therapeutic treatments to changeundesirable behaviors.

It is clear that more researchneeds to be conducted in schoolsettings with general education andspecial education students in the useof MBSR or meditation practices.However, there is enough research tosuggest that MBSR could be used asan extension of self-managementinterventions, which would empowerstudents to control their ownbehaviors in an academic setting(King-Sears, 2006). Perhaps the time

has come for schools to provide

therapeutic-based interventions tostudents with EBD in the schoolenvironment, including mindfuiness-based stress reduction.

R F R N S

Barnes, V., Bauza, L., Treiber, F. (2003).Impact of stress reduction onnegative school behavior inadolescents. ealth an d Quality of LifeOutcomes 1(10), 1-7.

Brad ley, R., Doolittle, J., Bartolo tta, R.(2008). Building on the data andaddin g to the discussion: Theexperiences and outcomes of studentswith emotional disturbance. Journal ofBehavioral Education 17 4-23 .

Bullock, L., Gable, R. (2006). Prog ramfor children and adolescents withemotional and behavioral disordersin the un ited states: A historicaloverview, current perspectives, andfuture directions. Preventing SchoolFailure 50 7-13.

Carm ody , J., Baer, R. (2008).Relationship between mindfulnesspractice and levels of mindfulness,medical and psychological symptomsand well-being in a mindfuiness-based stress reduction program.Journal of ehavioral Medicine 3123-33.

Carmody, J., Baer, R., Lykins, E.,Olendzki, N. (2009). An empiricalstudy of the mechanisms ofmindfulness in a mindfuiness-basedstress reduction program. Journal ofClinical Psychology 65 613-626.

Everett, S., Kann , L., McR eynolds, L.(1997). The youth risk behaviorsurveillance system: Policy andprogram applications. Journal ofSchool Health 67 333-335.

Garrison Institute. (2005). GarrisonInstitute report: Contemplation andeducation: A survey of programsusing contemplative techniques in K-12 educational settings: A mappingreport. New York: Author.

Grossman, P., Niem ann, L., Schmidt, S.,Walach, H. (2004). Mindfuiness-based stress reduction and healthbenefits: A meta-analysis. Journalof Psychosomatic Research 57

35-43.

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Gulch ak, D., Lopes, J. (2007).Interventions for students withbehavioral disorders: Aninternational literature review.Behavioral Disorders, 32, 267-281.

Institute of Educational Sciences. (2011).Secondary school programs andperformance of students withdisabilities: A special topic report offindings fiom the National LongitudinalTransition Study-2 NLTS2).Wash ington, DC : U.S. Departm ent ofEducation, Retrieved from http://policyweb.sri.com/cehs/publications/20123000.pdf

Kaba t-Zinn, J. (2009). Full catastrophelivin Using the wisdom of your bodyand mind to face stress, pain, and illness

(15th ed.). New York: Bantam Dell.Kauffman, J (2005). Characteristics ofemotional and behavioral disorders ofchildren and youth (8th ed.). UpperSaddle River, NJ: Pearson Prentice HaU.

King-Sears, M. (2006). Self-managementfor students with disabilities: Theimportance of teacher follow-up.International Journal of SpecialEducation, 21(2), 94-108 .

Meiklejohn, J., Phillips, C, Freedman, M .L., Griffin, M. L., Biegel, G., Roach,A., et al. (2012). Integratingmindfulness training into K-12education: Fostering the resilience ofteachers and students. Mindfulness, 3.

doi: 10.1007/S12671-012-0094-5MiUer, J., Fletche r, K., Kab at-Zin n, J.

(1995). Three-year follow-up andclinical implications of a mindfulnessmeditation-based stressed reductionintervention in the treatment ofanxiety disorders. Ceneral HospitalPsychiatry, 17 , 192-200.

NLTS2 Data Brief (2004, August). Thecharacteristics, experiences, andoutcomes of youth with emotionaldisturbances. A rep ort from the National

Longitudinal Transition Study-2.Available at www.ncset.org/publications/viewdesc.asp?id=1687

Reibel, D., Greeson, J., Brainard, G.,Rosenzweig, S. (2001). Mindfulness-based stress reduction and health-related quality of life in aheterogeneous patient population.General Hospital Psychiatry, 23 ,183-192.

Saltzman, A. (n.d.) M indfulness: A g uide forteachers. Retrieved from http ://ww w.contemplativemind.org/admin/wp-content /uploads/2012/09/MmdfuIniess-A_Teachers_Guide.pdf

Sem ple, R., Reid, E., Miller, L. (2005).

Treating anxiety with mindfulness:An open trial of mindfulness trainingfor anxious children. Journal ofCognitive Psychotherapy: AnInternational Quarterly, 19, 379-392.

Smalley, S., Loo, S., Hale, T. S., Shrestha,A., McG ough , J., Flook, L., et al.(2009). Mindfulness and attentiondeficit hj^eractivity disorder. Journalof Clinical Psychology, 65 , 1087-1098.

U.S. Department of Education. (2011).Trends in high school dropout and

completion rates in the united states:1972-2009. Washington DC: Author,Retrieved from http://nces.ed.gov/pubs2012/2012006.pdf

U.S. Department of Education, NationalCenter for Education Statistics.(2012). Digest of education statistics,2 1 (NCES 2010-013), Chapter 2.Retrieved from http://nces.ed.gov/f astf acts / display .asp?id=6 4

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C o p y r i g h t o f B e y o n d B e h a v i o r i s t h e p r o p e r t y o f C o u n c i l fD i s o r d e r s a n d i t s c o n t e n t m a y n o t b e c o p i e d o r e m a i l e d t o mw i t h o u t t h e c o p y r i g h t h o l d e r ' s e x p r e s s w r i t t e n p e r m i s s i o n d o w n l o a d , o r e m a i l a r t i c l e s f o r i n d i v i d u a l u s e .


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C o p y r i g h t o f B e y o n d B e h a v i o r i s t h e p r o p e r t y o f C o u n c i l fD i s o r d e r s a n d i t s c o n t e n t m a y n o t b e c o p i e d o r e m a i l e d t o mw i t h o u t t h e c o p y r i g h t h o l d e r ' s e x p r e s s w r i t t e n p e r m i s s i o n d o w n l o a d , o r e m a i l a r t i c l e s f o r i n d i v i d u a l u s e .

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