Early Life Stress and Pediatric Anxiety Program

Mindfulness Program

 Program History:

The Stanford Early Life Stress Research and Pediatric Anxiety Program (ELSPAP) Mindfulness program began in 2012 with a Seed grant awarded to the ELSPAP to conduct a pilot mindfulness intervention in the Ravenswood City School District (RCSD). This is part of a bigger effort between the Program and the School District to provide an array of services guided by the Positive Behavioral Intervention at Schools (PBIS) model.

Program Description:
Our mindfulness program integrates the work of mindfulness pioneers such as Jon Kabat-Zinn and Amy Saltzman with the experience of the ELSPAP's previous work with children, adolescents, and adults living in high risk communities. The ELSPAP Mindfulness program’s curriculum has adaptations for children and for adults that work with children.

The program components include:

  • 8 Mindfulness sessions over the course of 10 weeks (Week 1 and 10 are group assessment sessions)
  • 30 minutes of mindfulness instruction per week
    • Weekly “Check-In” on Feelings
    • Didactic Lecture focused on the foundations of Mindfulness
    • Mindfulness and Yoga Practice
    • Group Discussion, Sharing, and Feelings “Check-In” at end of session
  • A parent evening at participating schools
  • A school teacher and staff half-day training

Program Goals:

The goals of our youth and adult programs are to 1) increase students’ self-awareness and self-regulation, 2) teach youth to understand the interconnectedness of thoughts, emotions, and behaviors and how stress impacts functioning in these areas, 3) instruct mindfulness based practices, 4) incorporate pro-social behaviors such as empathy and compassion, and 5) learn coping tools, such as relaxation skills and breathing practices.

Carrying forward traditional mindfulness practices, our program utilizes psychoeducation and mindfulness awareness practices such as mindful breathing, meditation, mindful eating, yoga, and sensory awareness skills. Our program however utilizes yoga as the central practice to teach body and emotional awareness skills. Through our work, we came to discover how well youth were able to engage in yoga practice as a way to cultivate calm, increase happiness, and to let go of worry, tension, and stress.

Preliminary Studies:
In collaboration with RCSD administrators and school staff, we launched a pilot study testing the feasibility of implementation of our mindfulness curriculum. Our pilot offered mindfulness training to teachers, staff, students and students' family members at parent and family fitness nights at the schools.

The program components include:

- 8 Mindfulness sessions over the course of 10 weeks
- 30 minutes of mindfulness instruction per week
- 9 classrooms in 3 different schools serving approximately 213 youth

The evaluation components of the program included:
 - The Behavior Assessment for Children Version 2 (BASC-2) - Students were surveyed throughout the program using the BASC-2 to measure our effect on student behaviors and emotions.
- The Child and the Adolescent Mindfulness Measure (CAMM) - Students were surveyed using
the CAMM to assess the degree to which students were understanding mindfulness concepts.
- Teacher Feedback Survey - Teachers were surveyed at the end of the 8 weeks to obtain feedback on the content delivered to students, the effectiveness of our teaching, the relationship between mindfulness instructors and teachers, and the overall impact of the program.

Students were surveyed at three time points (pre-treatment, mid, and post) during the program using the Behavior Assessment for Children Version 2 (BASC-2) to assess student self-report of behavioral and emotion changes. In addition, the Child and the Adolescent Mindfulness Measure (CAMM) to assess student changes in Mindfulness. Teachers were surveyed at the end of the 8 weeks to obtain feedback on the content delivered to students, the effectiveness of our teaching, the relationship between mindfulness instructors and teachers, and the overall impact of the program. In all, the program reached 9 classrooms, with each classroom receiving 30 minutes of mindfulness instruction once per week. Dr.  Rettger compiled a mindfulness toolkit that was given to the teachers at the end of our program for the teachers to use as a future resource. Results from the BASC-2 and CAMM surveys and from the teacher feedback was presented to the RCSD principals and administrators.

Community Work

In addition to work with RCSD, our program has also offered training to a number of other non-profit organizations such as Jobtrain in Menlo Park, an agency that provides vocational training to job candidates, the Center for Youth Wellness in San Francisco, an innovative health Center that provides trauma-informed treatment services to youth, as well as the San Francisco  YMCA.

Current Developments and Implementation:

The 2012 Mindfulness program will be continued in a second iteration during the 2013-2014 academic year, again in the Ravenswood School District. This program will be led by Michael Fu, a second year medical student at the Stanford School of Medicine (Dr. Victor Carrion, Supervisor) who has received support and funding through the Albert Schweitzer Fellowship program. Drs. Carrion and Rettger, will supervise the program. 

The main purpose of the 2013-2014 program will be to further refine our mindfulness curriculum. We are also working to build stronger collaboration with teachers and mental health staff at the schools to promote their role as facilitators of the curriculum.

Program Staff:
Our current mindfulness program staff includes:
John P. Rettger, PhD - Mindfulness Program Director
Michael Fu, SMS2 - Medical Student Trainee
Julia Chandler, SMS2 - Medical Student Trainee
Yoni Zemlyak - High School Student Research Assistant
Victor G. Carrion, MD – Director of the Stanford Early Life Stress and Pediatric Anxiety Program at Lucile Packard Children’s Hospital

Staff Bios:
John P. Rettger, PhD - Mindfulness Program Director

John is a clinical researcher and lab manager in the Stanford University Early Life Stress Research Program, where he is accruing post-doctoral research and clinical psychology training hours. John's current research is focused on developing mindfulness and yoga-based wellness programs for youth, teachers and mental health and wellness professionals. John received a PhD in clinical psychology from the Institute of Transpersonal Psychology at Sofia University in Palo Alto, CA.

His dissertation research focused on the role of spirituality in a mindfulness-based approach to stress reduction and quality of life enhancement in women with non-metastatic breast cancer.  He has taught mindfulness and yoga nationally in a variety of settings including professional development groups; a legal firm; an International Workgroup on War, Violence, and Trauma at Stanford; the Stanford School of Medicine's Residency program; local school district staff development trainings; health retreats and psychology clinics.

John has been studying and practicing a range of meditative practices for more than a decade and has been teaching various styles of yoga in the San Francisco Bay Area for the past three years and is an Experienced Registered Yoga Teacher at the 200 hour level with the Yoga Alliance (E-RYT-200).

Michael Fu - Medical Student

Michael is a second year medical student at the Stanford School of Medicine who joined the ELSPAP near the beginning of the 2012 Mindfulness program. He has worked with Dr. Rettger as a mindfulness program assistant as well as research assistant. Prior to coming to Stanford, Michael taught 7th grade math at Amandla Charter School in Chicago. This is where he developed a passion for working with youth in school and neighborhood environments, and also  an interest in the impact of stress on children. Michael graduated from the University of Pennsylvania in 2010 with a degree in bioengineering.

Julia Chandler – Medical Student

Julia is a second year medical student at the Stanford School of Medicine. She joined the ELSPAP during the spring of 2012 to work on evaluating the impact of the Mindfulness Program. Before coming to medical school, Julia taught high school math in Crown Heights, Brooklyn and worked at a teen health clinic. These experiences made her interested in learning more about early life stress and efforts to minimize its impact. Julia received a BA in Economics from Harvard in 2007 and a MS in Adolescent Education from Pace University in 2009.

 

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