The Mind-Body Team:
Mindfulness in College Health
American College Health Association
June 2, 2010
Robin Boudette, Ph.D.
Shefalika Gandhi, LCSW
Deanna Nobleza, MD
Victoria Rosenfeld, RD, CSSD
Laura Rubinstein, Health Educator
Today’s Objectives
Introduction to mindfulness
Overview of mindfulness based interventions
Mindfulness in college health, why?
Evolution the Mind-Body Team at Princeton
Case Study
Applications for college counseling centers
Best practices in bringing mindfulness to college
health settings
Definitions
Introduction to mindfulness
Overview of mindfulness based interventions
Mindfulness in college health, why?
Evolution the Mind-Body Team at Princeton
Case Study
Applications for college counseling centers
Best practices in bringing mindfulness to college
health settings
Mindfulness Based Interventions
Dialectical Behavior Therapy
Acceptance and Commitment Therapy
Integrating mindfulness in individual therapy
Mindfulness-Based Stress Reduction
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MBCT
MBRP
MB-EAT
MBRE
MBAT
MBSR: John Kabat-Zinn
Developed in 1979 at U Mass
Most researched mindfulness intervention
Involves 8 week psycho-education program
Participants learn and practice mindfulness
meditation and mindfulness in a variety of
activities
Suggested practice: meditation 40 minutes 6
times per week
Program appropriate for all stress-related
conditions
Positive Clinical Outcomes with MBSR
Chronic Pain:
Anxiety:
Fibromyalgia:
Psoriasis:
Binge Eating:
Depression:
Cancer:
Immune Function:
Kabat-Zinn, 1985
Kabat-Zinn, 1992
Goldenberg, 1994
Kabat-Zinn, 1998
Kristeller, 1999
Teasdale, 2000
Speca, 2002
Davidson, 2003
Studies Funded by National Institutes
of Health
Does Mindfulness Change the Brain:
Findings in Neuroscience
The Impact of Mindfulness:
Domains of Possibility
Physical
Cognitive
Psychological
Behavioral
Social
Spiritual
Mindfulness in College Health: Why?
Chronic stress in college students is implicated in:
▫ Physical Illness: sleep disturbance, colds, headaches
▫ Psychological disorders: anxiety and depression
▫ Unhealthy behaviors: substance use, suicidal
ideation
▫ Declining academic performance
National College Health Association Survey:
Students reported the following factors affected
their academic performance
National results
2006
N=94,806
2008
N=80,121
2009
N=87,105
Stress
32.0%
33.9%
27.8%
Sleep
23.9%
25.6%
20.o%
Cold & Flu
26.0%
28.8%
19.0%
2006
N=543
2008
N=752
2009
N=641
Stress
29.3%
31.1%
29.5%
Sleep
21.6%
22%
20%
Cold & Flu
26%
31.1%
16.7%
Princeton results
Mindfulness in College Health:
Research
Shapiro, et al. (1998) RWLC Medical students
reported decreased levels of stress and depression
with reductions maintained during exams;
findings replicated with WL group.
Rosenzweig et al. (2003) Medical students
reported significant reduction in negative mood
and increased ability to cope with stress.
Jain et al. (2007) RWLC Pre-med undergrads
students reported significant reduction in
psychological distress and increased empathy.
Integrated Approach at UHS
Comprehensive Health Service
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Medical Services
Counseling and Psychological Services
Employee Health Services
Health Promotion and Wellness Services
Inpatient Service
Multidisciplinary Team Approach
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Eating Disorders Team
Alcohol and Other Drugs Team
Mind/Body Health Team
Integrative Case Conference
Evolution of the Mind Body Team
Partner with
Student Life and
Student Groups,
offer Drop-in
groups
Outreach Programs,
Education for UHS
Staff, Clinical
Services
UHS
Training and
Treatment
Team
UHS Mind Body Team: Mission
Create a culture that supports use of mind/body
interventions in the treatment of stress related
problems.
Give treatment providers the education, skills and
materials to inform students about the effectiveness of
mind/body interventions and resources available on
campus.
Develop a multidisciplinary team within UHS that
specializes in behavioral medicine and provides
medical, psychological and nutritional services to
students with stress-related problems.
Liaison with campus groups that provide mind/body
services to create a network of resources for students
beyond UHS.
Mind Body Interventions
Psycho-education on mind body connection
Relaxation Response
Mindfulness
Attuned Eating
Healthy Exercise
Mental Imagery
Cognitive Behavioral Therapy
Mind Body Team: Clinical
Take a holistic approach to treating physical illness
and psychological disorders.
Educate staff and students about the mind/body
connection and the effectiveness of mind/body
interventions in healing physical and psychological
concerns.
Use mind/body interventions such as meditation and
relaxation to address psychological and physical
concerns.
Refer staff and students to campus activities for
mind/body health.
Provide prevention services for staff and students.
Support the Peer Health Educators.
Mind Body Services Flyer
Team Members
Counseling
Medical
Psychiatry
Nutrition
Health Education
Athletic Trainer
Team Members: Counseling
 Mindfulness-Based Therapy
o Acceptance
o Patience and Compassion
o Mindfulness Meditation Practice
 Applications
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Stress, Management
Depression and anxiety
Interpersonal issues
Medical issues
 Psycho-education/ Interpretation
o Triangle of Awareness
o Reacting vs. Responding to
Stress
o Mind’s Conditioning
o Holding on vs. Letting go
 Therapeutic Effects
o Present Moment Awareness
o Tolerance of Rumination/
Worry
o Ability to Disengage
o Shift Perspective
o Cultivate Positive Emotions
 Mindfulness Training
o Mindfulness and
Psychotherapy conferences
o MBSR
o MBCT
o MB EAT
o MBRP
Mindfulness Groups
Clinical
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Mindfulness Skills Training for Graduate Students
Mindfulness for Undergraduates
Mindfulness for Health and Healing
Mindfulness-Based Performance Enhancement for Athletes
Mindfulness- Based Graduate Women’s Therapy group
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Lunch Time Stress Management
Mindful Food Group
Meditation for Staff
Monthly Series at the Graduate School
Outreach
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Mindful Time Management
Mindful Interpersonal Skills
Mindfulness Skills for Job Search
Mindfulness and Happiness
Groups Flyer
Mindfulness Skills Training for Graduate
Students: Outcomes
42 participants over 6 semesters
Formal mindfulness practice
▫ 71% of students found it “very helpful”
▫ 64% would continue to practice
Mindful activities
▫ 57% of students found it “very helpful”
▫ 62% would continue to practice
Weekly group
▫ 86% of students found it “very helpful”
▫ 75% of students expressed an interest in
participating in another group in the future
Mindfulness Skills Training Group:
Student Feedback
“My stress level went down. My awareness of my moods went
up. I learned to be more accepting of myself.”
“I feel happier somehow. I use the methods to ground myself
when I run away from problems.”
“Thoughts are not facts”
“I’m more attentive to thoughts, feelings, at least some of the
time. I meditate more regularly.”
“Group participants made me realize that I am not alone with
feeling anxieties about graduate school, my work, etc.”
“Helped me very much with dealing with my depression.”
Team Members: Psychiatry
 Evaluations with an ear to…
o Medical comorbidities
o Somatic symptomatology
o Openness (or not) to
psychotropic medications
o Self care
 Psychoeducation
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Exercise
Mind/Body Interventions
Sleep Hygiene
Light therapy
Herbals/Supplements
 Referrals
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Individual
Groups
Nutrition
Massage Therapy
Medical
Herbalist/CAM specialist
 Mindfulness Training
o Nutritional and
Complementary Approaches
to Mental Health Disorders
o Herbal Medications in
Psychiatry
o Orthomolecular Psychiatry
Team Members: Medicine
 Evaluations with an ear to…
 Illnesses that have a Med/Psych
and/or Stress Component
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Chronic pain
IBS
Headaches
Insomnia
 Role of stress and lack of self-care
on presenting problem(s)
 Psychoeducation
o Students
o Medical Staff
 Referrals
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Mind/Body Interventions
Mind/Body Team
Nutrition
Counseling
 Mindfulness Training
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UHS Wide training
Mindfulness Based Stress
Reduction for HealthCare
Providers
Team Members: Nutrition
 Nutrition assessment including:  Approach:
o Spiritual practice
o Current or past use of mind body
modalities- meditation, guided
imagery, yoga
o Stress
o Sleep
o Coping skills
 Presenting problems
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BED
IBS
Ulcerative Colitis
Weight worried
HTN
o Integrate M/B practices into treatment
plan
o Mindful eating/Intuitive eating
o Mindful awareness
o Correct sleep and stress management
early in process
o Refer to other team members, groups,
written and online resources
 Mindfulness Training
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UHS Wide training
Mindfulness Based Stress Reduction
for HealthCare Providers
 Future directions:
o Additional training
o Intuitive eating groups
o Integration of structured
HAES/Intuitive eating process
Team Members: Health Promotion and
Wellness
 Outreach
o Team Marketing
o Mindfulness Workshops
o Eating Mindfully at the holidays
o Graduate Mindfulness Series
 Peer Advisor Training
o Healthy Minds
o Eating Concerns Advisors
o Student Athlete Wellness Leaders
 Infusing into “Traditional”
Content
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Smoking Cessation
“Healthy Eating”
Eating Disorders
Depression
Stress
Order in’s
 Educational Resources:
o Online information
o Audio Downloads
o Books and DVDs at the UHS
lending library
Case Study
EG
Mindfulness Initiatives in University
Settings
Mindfulness Centers:
▫ Teach mindfulness through programs, courses,
workshops
▫ Engage in research that furthers the understanding
of mindfulness and its benefits
▫ Serve campus community through special events,
publications, and other activities
Groups and online resources:
▫ Mindfulness Programs for students, staff and faculty
▫ For credit MBSR classes
▫ Extensive educational materials, audio downloads
Mindfulness At Other Universities
Training in mindfulness for post-doctoral clinicians
Campus-wide initiatives:
▫ Centers, departments and groups partner to support and
offer education and training in mindfulness
Mind-Body Lab:
▫ Self-paced environment designed to help students
explore various resources for improving their emotional
and physical health
▫ Features self-directed audio and video instructions on
mind-body practices, biofeedback equipment and other
interactive tools
Integrated health services- Medical and counseling
within one service department
Mindfulness in College Health
Benefits
Challenges
 Holistic approach to healthcare
 Evidenced-based, short-term
clinical interventions
 Effectively and efficiently
offered in large group settings
 Attracts diverse student groups
to services
 Appropriate for prevention and
treatment
 Encourages participants to take
and active role in healthcare
 Fosters health of campus
community
 Competing clinical demands
within health services
 Barriers to engaging students
in stress management
 Motivating students for groups
and home practices
 Competing interests for
students’ time
Future Directions
What ideas or experience do you have in bringing
mindfulness into college health?
What are some “best practices” in bringing
mindfulness into college health?
Best Practices for Mindfulness in
College Health
Professional training for designated staff members
in the Health Services Department
An integrative, multi-disciplinary team approach
In-service trainings across disciplines
Diversity of services for students
 Clinical interventions
 Outreach activities
Monitor outcomes
Partner with student groups
Partner with other student life departments
Opportunities for staff and faculty to learn and
practice