Mindfullness Meditation
Combining
Mindfulness-Based Cognitive Therapy with Safety Planning
Intervention to Reduce Suicidal Behavior Mindfulness meditation is the practice of being more in touch with the present moment, bringing one’s attention inward without judgment of current thoughts or experiences. Mindfulness-Based Cognitive Therapy (MBCT) is an intervention that has been shown to reduce depression relapse in individuals who also have suicidal ideations and behaviors. Mindfulness-Based Cognitive Therapy and Safety Planning Intervention (MBCT+SPI) is a mindfulness-based cognitive therapy tailored specifically for managing suicidal ideation and behavior. Both interventions have been not been formally developed or used in a group format. Dr. Megan Chesin’s research aims to explore the practice of mindfulness meditation and cognitive therapy practices in combination with Safety Planning Intervention MBCT+SPI in a group therapy environment for reducing suicidal ideation and behavior. Question Can Mindfulness Intervention and Safety Planning be combined using a group therapy environment to treat people with suicidal ideation and behaviors? Study Treatment is delivered in a group setting over about nine weeks. The first session is aimed at Safety Planning (SPI), a manualized, brief one-session intervention lasting 20-45 minutes. SPI helps individuals recognize their own warning signs of a suicidal crisis, and provides them with coping strategies, a ready-list of safety contacts, and a plan for limiting their access to lethal means. Dr. Chesin’s study included outpatients who had suicidal ideation, a history of suicide attempt, and those with a method and plan of attempt within the past six months. Suicidal ideation was measured using the Scale for Suicidal Ideation (SSI), and depression with the Beck Depression Inventory-II. The study also assessed level of mindfulness, attention, and cognitive reactivity, i.e. negative patterns of thinking that can quickly be re-triggered. Phase One consisted of a preliminary study with five participants, collecting feedback as to the accessibility and feasibility of using mindfulness meditation as part of an intervention that targets suicidal ideation. In Phase Two, 13 additional individuals received the manualized treatment of MBCT+SPI, measuring their level of mindfulness, attention, and cognitive reactivity. Results Treatments delivered in a group setting showed promise in increasing feelings of connectedness, due to the added peer support. MBCT+SPI was deemed safe, and depression, hopelessness and suicidal thinking were found to decrease over the course of treatment. Participants gave positive feedback on both the mindfulness training component and the safety planning. Takeaway Group Therapy treatments directed at suicidal ideations and behaviors is a novel approach to targeting suicidal ideation and behavior, particularly when there is a greater susceptibility to relapse and recurrence. Advantages of a group format are more cost effectiveness, stigma reduction and greater accessibility. This study revealed the safe and positive effects of using Mindfulness-Based Cognitive Therapy and Safety Planning Intervention in a group therapy setting for individuals experiencing suicidal ideation and behavior. Click here to read about Dr. Chesin’s Postdoctoral Fellowship. Grant-Related Publications Chesin, M., Interian, A., Kline, A., Benjamin-Phillips, C., Latorre, M., & Stanley, B. (2016). Reviewing mindfulness-based interventions for suicidal behavior. Archives of suicide research, 20(4), 507-527. Chesin, Megan, and Barbara Stanley. “Risk assessment and psychosocial interventions for suicidal patients.” Bipolar disorders 15.5 (2013): 584-593. Chesin, Megan S., and Elizabeth L. Jeglic. “Factors associated with recurrent suicidal ideation among racially and ethnically diverse college students with a history of suicide attempt: the role of mindfulness.” Archives of suicide research 20.1 (2016): 29-44. Chesin, Megan S., et al. “Preliminary effectiveness of adjunct mindfulness-based cognitive therapy to prevent suicidal behavior in outpatients who are at elevated suicide risk.” Mindfulness 6.6 (2015): 1345-1355. Chesin, Megan S., and
Elizabeth L. Jeglic. “Suicidal behavior among Latina
college students.” Hispanic Journal of Behavioral
Sciences 34.3 (2012): 421-436. Six
Mindfulness Tips 1. Be present in your everyday activities. Going for a walk? Take your earbuds out and listen to what you hear – birds in nature, the sound of the wind. Pay attention to how your senses are engaged. Literally stop and smell the flowers, pick a blade of grass and feel it between your fingers. 2. Experience the food you eat. The next time you eat something, really pay attention to the experience of eating. Imagine describing the taste to another person who has never tried it. Is it sweet? Salty? What is the texture? Do you have memories associated with the food? Do you remember the experience the first time you ate it? 3. Engage with the people around you. Pay attention to the words they are choosing when they talk. This is about more than verbal communication. Really notice the people with whom you are engaging. Give them your full attention. Look into their eyes. Let them look into yours. 4. Pay attention to your ‘internal judge.’ We all have an internal voice that at times can be a source of self-criticism. I like to imagine one’s internal judge to be a little mouse that speaks up when you are feeling self-critical. When you notice that mouse whispering things like, “I am not strong enough,” imagine yourself placing it into a soundproof glass jar. You can see the mouse squeaking its criticism, but can no longer hear it. Similarly, you can be mindful of those thoughts – noticing them, and recognizing how frequently you have them – without acting on them or allowing them to be a part of how you evaluate yourself. 5. Notice your distracting thoughts and ‘let them float.’ One of the challenging things about practicing mindfulness are the many thoughts that distract us on a daily basis: things we have to do that day, for example. When you are trying to be mindful of your immediate experience and a distracting thought occurs, try imagining your thought as a helium balloon – notice it, then let it float by without spending any time on it. 6. Focus on your breathing. Most of us breathe without thinking about it. Spend some time watching your normal breathing patterns. Do you breathe quickly? In a shallow way (not taking deep breaths)? Take a few deep breaths and imagine blowing all the air out of your lungs until they are empty. Follow that with a deeper inhale. You will notice that deep breathing is one way we can slow down our heart rate when life feels like it is moving too quickly or when we feel stressed. Try out these tips, and see if they
can help you focus more fully on the present moment.
It’s a great way to ward off feelings of anxiety, leave
yourself more open to positive experiences, and better able
to handle whatever your day may throw at you. The
AFSP Mindfulness Mixtape! For some, achieving a state of mindfulness involves taking a relaxing stroll in nature; for others, some alone time in a quiet room does the trick. For many, music can be helpful. With that in mind, here are some songs that may help you to achieve a peaceful state of calm. Without further ado, we present… The AFSP Mindfulness Mixtape! 1.”A
Beautiful Day” –
India.Arie
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