Participating in mindfulness-based group programs via online video conferencing is a feasible strategy for improving mental health in adults with cerebral palsy (CP), but more study is needed to determine the effectiveness of these sessions, a small study suggests.
Therapies for people with CP are often targeted at improving motor function. However, mental health is an important aspect of CP that is often overlooked: Both the condition itself, and navigating society as a disabled person, can take a serious mental toll.
Mindfulness-based stress reduction (MBSR) is a type of meditation aimed at making it easier to deal with stressful situations in life. The general idea behind mindfulness is to bring one’s attention to the present moment, focusing on currently experienced emotions and bodily sensations without judgment.
The overall mental health benefits of mindfulness programs are well-supported; however, no study has assessed MBSR in adults with CP.
To address this, researchers evaluated the feasibility of MBSR for adults with CP conducted via online video conferencing. This method of providing the intervention was chosen because, according to the researchers, “providing in-home interventions might be particularly beneficial for adults with CP, by increasing accessibility despite limitations in mobility.”
Six adults with CP (two men, four women, age range 20–50 years) participated in the study. Four of the participants were ambulatory, and two used wheelchairs; all had at least a high school education, and all but one was employed. Prior to beginning MBSR, all of the participants had clinically relevant pain, fatigue, and/or emotional distress.
The six participants first went through an in-person training phase, then completed eight weeks of MBSR, done trhough 1.5-hour video conferencing sessions once per week.
Before, immediately after, and four months after this eight-week intervention, the participants completed assessments of their symptoms, including pain and mental health parameters.
There were no significant differences in pain (rated on a scale from 1–10) before and after MBSR. However, there were statistically significant decreases on the Pain Catastrophizing Scale, from a median of 17 points before MBSR to 14 points four months after MBSR. This indicates less tendency to catastrophize pain — that is, assuming pain is worse than it actually may be.
There was also a significant decrease in negative affect scores on the Positive Affect and Negative Affect Schedule (PANAS), from a median of 14 points to 10. Negative affect broadly refers to negative emotions (anger, sadness, anxiety, etc.); as such, this suggests a general lessening of negative feelings following MBSR.
Following the intervention, participants completed a questionnaire and a focus group interview to gauge their perceptions of MBSR. All but one of the participants said the intervention was beneficial and that they would recommend it to other adults with CP.
“The participant evaluating no/little benefit elaborated in the focus group that the program did not meet his expectations regarding pain relief, which was the reason why he would not recommend it,” the researchers wrote.
Broadly, participants said that the intervention improved their knowledge of CP and its symptoms, helped them gain acceptance of their body and its limitations, made it easier to regulate emotions, and helped foster communication.
“This course has helped me to be able to focus, to be focused only on the task at hand, complete it, and not think I have to do everything at super speed. … I have also become more conscious of thinking about what I shall prioritize,” one participant said.
“I manage to let trivial things be trivial things and challenges be challenges,” another said. “I manage to stay calm when things get tough, that is to say, in difficult situations in which I used to lose my temper and vent my anger and frustration.”
All of the participants were generally positive about having the sessions online. Technical problems were minimal, and the importance of accessibility was stressed.
“Decisive for me was that I never would have had the opportunity to participate without this [online] arrangement,” said one participant.
Overall, this study shows that doing online MBSR for adults with CP is feasible, and the results hint at the benefits of this type of therapy.
“Since the pilot study had a small sample size, potential treatment benefits should be interpreted with caution,” the researchers wrote. Nonetheless, this study “provides important information in the planning of future studies with a more rigorous scientific design.”
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