Anxiety Reduction in Acute In-Patient Care Assignment 1 Solution

Anxiety Reduction in Acute In-Patient Care Assignment

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Anxiety Reduction in Acute In-Patient Care Assignment

RUNNING HEAD: MINDFULNESS, ANXIETY, AND PSYCHOSIS

Mindfulness Based Therapy as it relates to Anxiety Reduction in Acute In-Patient Care with

Individuals Who Experience Psychosis

Students Name

CNS 6529 Research and Evaluation

June 5, 2016

Dan Lawther, PhD

South University

2

MINDFULNESS, ANXIETY, AND PSYCHOSIS

Abstract

Mindfulness is described as “paying attention in a particular way: on purpose, in the present

moment, and non-judgmentally” (Chadwick, Taylor, and Abba p 351, 2005). This study

purposes that mindfulness based training will have a greater effect in reducing anxiety in patients

that are in acute inpatient facilities who are experiencing psychosis better than the facilities

standard training which is rational behavior therapy based. Thirty participants will be asked to

join the study in which fifteen of the participants shall receive mindfulness training while the

other fifteen participants will receive the standard hospital therapy. The participants will be

asked to rate their anxiety levels using State-Trait Anxiety Inventory (STAI) and Beck’s Anxiety

Inventory (BAI) prior to their first group and after their last group has been administered. It is

expected that the mindfulness group will experience greater reduction in anxiety symptoms as

reported by BAI and STAI. This study can help influence future directions in therapy in acute

inpatient facilities.

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MINDFULNESS, ANXIETY, AND PSYCHOSIS

Introduction

Davis, Strasburger, and Brown (2007) used mindfulness training to see if there would be

a reduction in anxiety as it relates to patients who were diagnosed with the DSM IV-TR

definition of schizophrenia. They found that mindfulness training helped to reduce anxiety in

participants with schizophrenia in comparison to intensive therapy (Davis, Stasburger, and

Brown 2007). Mindfulness is defined as “purposefully paying attention in each moment to all

life experiences, regardless of how ordinary” (Davis, Strasburger, and Brown p. 24, 2007).

Although, numerous studies have looked into mindfulness as a way to cope with both

psychological and non-psychological distress, many fail to see how mindfulness can improve the

quality of life in those with psychosis in acute inpatient facilities (Carmody and Baer 2008).This

study seeks to explore mindfulness training and its effects on reduction of anxiety in acute

inpatient, patients that are experiencing psychosis. It is expected that mindfulness training will

help reduce anxiety and increase mindfulness in those participants that are given mindfulness

training.

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MINDFULNESS, ANXIETY, AND PSYCHOSIS

Review of Literature

More holistic approaches have been taken in recent years to improve the quality of life in

those experiencing psychosis (Lukoff, Wallace, Liberman, and Burke 1986). Holistic approaches

tend to involve more than just psychoeducational therapy. The idea is to continue the already

existing continuation of mind and body. Lukoff and colleagues (1986) used a holistic approach

to see if there was a significant reduction in stress, in individuals with schizophrenia. The

comparison group of social skills training and holistic approach to stress reduction showed no

difference in prevention of relapse back into a hospital setting.

From holistic approach, the idea of positive psychology arose as a method to enhance

well-being, both psychological and physical. Positive psychotherapy (PPT) was developed to

increase positive emotion, engagement and meaning (Seligman, Rashid, and Parks 2006).

Positive psychotherapy has been used in various clinical settings and parallels mindfulness in

that it teaches the individual to focus on their well-being and engagement with their body.

Positive psychology interventions are effective in enhancement of subjective well-being,

psychological well-being and reduction of depressive symptoms (Bolier et al 2013). Thus, a

focus on well-being will be beneficial for individuals with psychosis.

It is also important to consider how holistic approaches can be used to prevent

hospitalization. In research conducted by Drvaric, Gerristen, Rashid, Bagby, and Mizrahi (2015)

defined resilience as the ability to adapt to stress and adversity. The study shows that

interventions addressing well-being as it relates to resilience can help people at clinical high risk

for developing psychosis. Well-being is important focus for psychosocial interventions. Thus, it

is important to begin prevention mechanisms in those that are more likely to experience

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MINDFULNESS, ANXIETY, AND PSYCHOSIS

psychosis. Prevention mechanisms like mindfulness may be used to help the individual increase

their well-being and reaction to stress, so resilience to stressful situations can reduce an

individual likelihood of experiencing psychosis and becoming hospitalized.

The inclusion of the mind and the body into therapeutic treatment is thought to help

reduce distress. With reduction of distress, people with psychosis may be able to have a higher

functioning life, in which they may be able to even work. Davis and colleagues, (2015) used

mindfulness training to see if individuals with schizophrenia will have better job performance.

Their Mindfulness Intervention for Rehabilitation and Recovery in Schizophrenia (MIRRORS)

program helped increase job performance and job attendance than an intensive support group.

Although, this study used mindfulness in an outpatient setting with participants in stable phase of

schizophrenia it still shows that mindfulness is an effective therapy.

Laithwaite and associates (2009) use compassionate focused therapy in a high security

setting to promote help seeking and to develop compassion towards oneself. It used inpatient

facility to improve the well-being of participants by having them focus on themselves, similarly

to meditation. As Penn and colleagues (2004) have shown, schizophrenia and therapeutic

progress is increased with some type of therapy than with medication alone.

Therefore, mindfulness should be taken into great consideration when working with

populations experiencing psychosis. Kuyken and fellow researchers (2008) used mindfulness

based cognitive therapy (MBCT) to prevent relapse into hospitals. Although, their targeted

population was those with recurrent depression they still found that relapse in those with

medication and MBCT was less than those that just had anti-depressant and standard therapy

(Kuyken et al 2008).

Anxiety Reduction in Acute In-Patient Care Assignment

6

MINDFULNESS, ANXIETY, AND PSYCHOSIS

In their 2005 study, Chadwick, Taylor and Abba, used mindfulness training to see if

individuals with psychosis could better deal with their psychotic episodes and understand what it

means to be mindful. Although, it was a pilot study they found that the participants seem to have

greater awareness of their psychosis and through mindfulness were able to cope better and not be

distressed by their hallucinations. They were able to maintain their well-being and use their

awareness of their senses to recognize external stimuli from their internal stimuli.

Holistic approaches have been beneficial in continuing the connection between the mind

and body. Mindfulness focuses on this connection in greater detail than other holistic

approaches. Through mindfulness based training, greater awareness to psychosis and dealing

with internal stimuli has been found (Chadwick, Taylor, and Abba 2005). Although, many

studies have found a link between mindfulness and improvement of quality of life they have

neglected to include an environment that many who experience psychosis tend to get counseling

and treatment from, an inpatient facility. Therefore, purpose of this study is to evaluate whether

mindfulness training will reduce anxiety in individuals experiencing psychosis in an acute

inpatient facility.

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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