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Mindfulness and Integrative Care

Research has identified that developmental, behavioral, educational, and adverse childhood experiences can have life-long effects on an individual’s health and well-being. In this time of transformation with the integration of the Affordable Care Act, providers are encouraged to tend to the whole person by taking into account the determinants of their health and well-being that extend past the office walls. The time is now for pediatrics to shift towards health and preventive care instead of sick care so to produce healthy child development and lifelong health.

Cross-Cutting Applications of Mindfulness and Integrative Care

Mindfulness and mind-body methods have applications for the promotion of children’s well-being and lifelong health. Mindfulness, the four-pronged capacity to 1) pay attention 2) on purpose 3) in the present moment 4) without judgment, has increasingly been researched over the past couple of decades and found to have many physical, emotional and psychological benefits, such as the reduction of stress and improved self-regulation. Mind-body methods are currently being utilized in pediatrics and several methods are mindfulness-oriented such as meditation, deep breathing and stress reduction training. Integrative medicine, the incorporation of mind-body methods and other complementary approaches with mainstream medicine, has the potential to support the healthy child development and lifelong health amidst the difficulties and stresses of daily life.

Example Mechanisms of Effect Expected By Integrating Mindfulness in Children’s Health Care

In addition to mindfulness-based clinical interventions, the implementation of mindfulness throughout the entire health care system may promote the well-being of children by positively impacting the above aspects of health care.

Mindfulness in Pediatrics Initiative

The Mindfulness in Pediatrics Initiative, a completely voluntary effort with funding from the CAHMI, hopes to generate interest in the integration of mindfulness in the health care realm. The efforts of the Mindfulness in Pediatrics are still under way and we are humbly asking for passionate individuals and organizations to join in the effort. The identified areas of contribution are the following:

  • Demystify and Make Mindfulness Explicit: Bring to life the mindfulness component of High Reliability Organizations within The Joint Commission and in efforts to improve patient centered care.
  • Contribute and Advance Training and Practice: Identify, tailor and streamline mindfulness and mind-body education and training resources for providers and teams caring for children. Specify and foster the narrowing of resource gaps.
  • Monitor and Promote Best in Class Methods: Continuously scan new research and invite case examples in order to identify feasible and effective “best in class” methods to cultivate mindfulness in organizational and health care settings, professional and parenting training and in clinical encounters and processes.
  • Catalyze and Foster Innovation and Knowledge: Articulate and communicate a research agenda and model research ideas for further development and promotion among researchers and innovators.
  • Establish a “Living” Container for Dialogue and Creativity: Create a mutually supportive container to experience and explore the integration of mindfulness into our own lives and spheres of child health (being available to one another; drop in dialogues; online community, etc.)
  • Pursue High Leverage Integration Opportunities: Integrate mindfulness principles and best practices into existing systems change models as well as in national data collection platforms and quality improvement and training and education models.

Integrative Care Efforts

  • The CAHMI was involved in the design and review of a set of CAM survey items to be included in the 2011 National Ambulatory Medical Care Survey (NAMCS).
  • Through supplemental funding from the federal Maternal and Child Health Bureau, the CAHMI took leadership to develop and test an item to be included in the 2009/2010 NS-CSHCN.
  • The CAHMI is developing a research and strategic data framework regarding CAM through an iterative, collaborative process with study advisers and others that includes specification of key premises, principles, components and priority research questions, required data and research support requirements.

Resources

Below you will find resources created by the Mindfulness in Pediatrics Initiative since 2011:

  • Leveraging Mind-Body Neuroscience and Mindfulness to Improve Pediatrics: A national collaboration to promote the translation of research into pediatrics training, practice and policy. This white paper articulates the potential benefits of integrating mindfulness and mind-body methods into pediatrics through the presentation of data on ACE, CSHCN, quality of health care and use of integrative medicine. This national initiative outlines the Mindfulness in Pediatrics strategic guidelines and strategies to promote interest in mindfulness.
  • Engaging Families (and Ourselves) in Quality Improvement: An Optimistic and Developmental Perspective. This article calls for health care professionals to not only do things differently to improve quality of health care, but to be different through fostering mindfulness to better engage patients.
  • CAHMI Mindfulness & Maternal and Child Health Starting Packet of Materials. This starting packet provides overview materials, selected resources and micropractices (short mindfulness practices that can be easily incorporated into your every day life).
  • Mindfulness in Maternal and Child Health Selected Literature. This list is an assembly of characterized existing research and science regarding mindfulness and mind-body methods.
  • Summary of Appreciative Inquiries. The CAHMI has engaged in an ongoing series of Appreciative Inquiry interviews among the Mindfulness in Pediatrics work group and potential partners. Here you will find a summary of the August 2012 Appreciative inquiry.
  • Stewarding the Future of Healthcare, Creating a Culture of Health: Reliable, Excellent, Sustainable, Compassionate and Innovative. This paper, directed at healthcare organization leaders, outlines the importance of developing collective mindfulness to promote a high reliable organization, the benefits of mindfulness, as well as practices and resources to start integrating mindfulness into your daily life.
  • Leveraging New Brain Sciences and Mindfulness to Advance PA Training and Practice
  • Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey. In this research article information is provided on how the CAHMI provided feedback for the 2012 child Complementary and Alternative Medicine (CAM) supplement for the National Health Interview Survey by reviewing the child CAM supplement within the 2007 survey.
  • Complementary and Conventional Medicine Use Among Youth With Recurrent Headaches. This research article evaluates data on use of mind-body methods and associations with conventional medical care experiences and expenditures using the National Health Interview Survey (2007) and the Medical Expenditures Panel Survey (2008).
  • Use of Mind Body Approaches among US Children Age 4-17 Years: Child Characteristics and Reported Reasons and Benefits for Use. This data brief includes tables and graphs that look at reasons and benefits for use of mind-body therapies vs. all complementary and alternative medicine (CAM) use, as well as child demographics, from the 2007 and 2012 National Health Interview Survey CAM supplements.
  • Mind-Body Therapies in Children and Youth. A Clinical Report from the American Academy of Pediatrics (AAP), authored in part by Dr. Bethell, as part of the AAP Section on Integrative Medicine

Additional resources from outside organizations and individuals:

  • Mindfulness Training for Children and Adolescents: A State-of-the-Science Review. This book chapter by David S. Black in Mindfulness Interventions for Healthy Populations presents a review and discussion of empirical evidence on the benefits of mindfulness training for children and youth.
  • Be Mindful Online Mindfulness Course. A 4-week online mindfulness course for anyone who wants to begin using mindfulness in their everyday lives.
  • An Evidence Map of the Effect of Tai Chi on Health Outcomes. This publication, which includes the CAHMI’s Dr. Michele Solloway as an author, uses an evidence map based on a systematic review of systematic reviews treatment effects of Tai Chi on various health and well-being outcomes.
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