Teaching mindfulness to occupational therapy students: pilot evaluation of an online curriculum.

BACKGROUND: How mindfulness can be learned by occupational therapy students to manage their own self-care processes has not been fully examined as yet. PURPOSE: This article describes an online curriculum approach for teaching a general introductory mindfulness course and examines outcomes with master's entry-level occupational therapy students. METHOD: Fifteen students participated in an 8-week online mindfulness curriculum and completed a pre- and post-training survey. The Mindfulness Attention and Awareness Scale (MAAS) was used to measure mindfulness. Demographic, MAAS-scored mindfulness, and clinical utility data were collected. RESULTS: Results showed a statistically significant change (t = -4.82, p = 0.002) in MAAS mindfulness scores from the program start to end. Informal practice exercises and guided meditations were perceived by participants as being more helpful ways for developing an understanding and approach to mindfulness than were readings about mindfulness. IMPLICATIONS: This study suggests that mindfulness can be taught using an online approach.

Exploring arising moments and mindfulness in occupational therapists working in diverse clinical practice areas.

An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.

Mindfulness and flow in occupational engagement: presence in doing.

BACKGROUND: Flow is a psychological state that might be viewed as desirable, and it occurs when a person is aware of his or her actions but is not being aware of his or her awareness. Mindfulness is viewed not as the achievement of any particular state, but as intentional awareness of what is, being aware of awareness. PURPOSE: To examine theoretical perspectives and empirical research on flow and mindfulness, and offer suggestions about the relevance of these concepts to occupational engagement. KEY ISSUES: Both flow and mindfulness involve being present, actively engaged, and attentive. The experience and practice of flow and mindfulness are relevant to the experience of occupational engagement. IMPLICATIONS: Understanding flow and mindfulness may help occupational therapists improve the therapeutic occupational engagement process with their clients through enhancing depth and meaning of occupational experiences, as well as health and well-being.

Capturing presence moments: the art of mindful practice in occupational therapy.

BACKGROUND: This paper explores theoretical and practical views of mindfulness and phenomena of presence moments. The potential for altering life and enabling change through lived experience of mindful presence moments has relevance for occupational therapy practice. PURPOSE: To suggest ways for occupational therapists to become mindfully present during practice. Based on theoretical perspectives drawn from the fields of psychology, philosophy, psychoanalysis, neuroscience, and education, a four-fold approach will be outlined for occupational therapists to practice mindfully and experience presence moments. KEY ISSUES: This approach emphasizes key concepts of awareness, non-judgment, reflection, curiosity, and commitment to practice. A clinical scenario is used to illustrate the approach. IMPLICATIONS: The ideas raised in this paper need to be incorporated into daily practice by occupational therapists so that a culture of mindful practice can be cultivated. Suggestions are provided throughout the paper for an agenda of potential research studies to address aspects of mindfulness and presence moments more fully.

The influence of virtual reality on playfulness in children with cerebral palsy: a pilot study.

The purpose of this paper was to examine the effects of virtual play intervention on the level of playfulness of children with cerebral palsy. Thirteen children aged 8-13 years comprised the study group. Children attended eight one-hour virtual reality play sessions in which they were immersed and interacted with virtual reality. The Test of Playfulness (TOP) was used as the measure to assess playfulness. Participants were videotaped while they played during 12 different environments over the course of their intervention time. Three randomly selected virtual reality play sessions were chosen to score three different virtual reality environments within each session yielding a total of nine trials (environments) for each participant. The types of virtual environments varied across participants. Overall, the different virtual reality play environments produced varying levels of playfulness according to the TOP's four different subscale scores. Motivation ranged from 1.50 to 2.25, internal control ranged from 1.00 to 1.88, suspension of reality ranged from 0 to 0.26, and framing ranged from 1.33 to 1.78. The three environments producing the highest playfulness ratings were called Paint, Trip and Island Sounds. These environments allowed creativity, persistence with the task, pleasure, and a certain degree of control. Two environments did not appear to foster playfulness. A possible reason was that these environments were too unpredictable and frustrating for participants. These results will be useful for creating new virtual reality software applications that will encourage playfulness in children with disabilities.

Doing play: competency, control, and expression.

This qualitative study investigated the personal experiences of children with cerebral palsy engaging in a virtual reality play intervention program. The study involved in-depth, focused interviews that were conducted with 19 participants aged 8-13 who had a diagnosis of cerebral palsy. A constant comparative inductive method of analysis was used, and several themes emerged. Findings were interpreted using the theory of flow, the theory of self-efficacy, and the model of playfulness in virtual reality computer interactions. The three themes uncovered in the data include (a) doing play, (b) it's my way that matters, and (c) how I see me. The sub-theme safety also emerged. Findings from this study showed that children with physical disabilities are often limited in their play experience compared to their peers without physical disabilities. Children perceived engagement in a virtual reality play intervention program as an enjoyable experience which increased their self-competence and self-efficacy. Participants experienced a sense of control and mastery over the virtual environment and were provided a safe way to explore and challenge their abilities. Participants perceived experiencing flow and reported perceived physical changes and increased social acceptance from both peers and family. These findings provide evidence that virtual reality continues to show promise as a pediatric rehabilitation play intervention tool.

Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study.

This paper presents the results of a clinical trial of a virtual reality play-based intervention. The results of three single case studies are presented. The virtual reality intervention used the Mandala Gesture Xtreme technology. It was applied to three school-aged children with cerebral palsy. A pre-test-post-test design was used. The relevant outcome of interest was self-efficacy as measured with the Canadian Occupational Performance Measure (COPM). Group scores on the COPM indicated clinically significant changes in self-efficacy for all children. Two of the participants demonstrated the greatest changes in both perceived performance abilities and satisfaction with performance with respect to task specific domain areas. Qualitative comments from the participants revealed a high degree of motivation, interest, pleasure, and opportunity for engagement in play, activities not previously engaged in. Overall, this pilot study suggests the viability of a virtual reality play-based intervention as part of the rehabilitation process for children with cerebral palsy. These results form the basis of a larger scale randomized clinical trial.