Exploring

Meditation and

Mindfulness:

Techniques and

Resources for

Cognitive Rehabilitation

Meaghan G. Wright BA,

CBIST

Main Line Rehabilitation

Associates

Objectives

Understand how mindfulness and

meditation can help after a brain injury

Identify at least two mindfulness

techniques to improve thinking, mood,

and self-awareness

Resources for setting up your own

mindfulness practice

What is Mindfulness?

Dr. Jon Kabat-Zinn’s definition:

Paying attention

On purpose

In the present moment

Non-judgmentally

Aspects of mindfulness

Intention- why you are doing it

Attention-inner and outer experience

Attitude- curiosity, acceptance, kindness

Why do people do it?

Manage stress

Manage pain

Improve mood

Increase focus

Find balance

Mindfulness practice improves:

Resilience- Davidson, Kabat-Zinn, 2003

Mood- Hofmann et al, 2010

Anxiety- Spek et al, 2013

Empathy- Lazar, 2005

Working memory- Jha et al, 2010

Attention – Azulay et al, 2012

Grey matter - Holzel et al, 2011

Using Mindfulness to Cope with

Difficult Emotions

R – Recognize the emotion you’re feeling. Name it.

A – Accept the experience you’re having.

I – Investigate Become curious about your experience. Where do you feel the emotion in your body? What kind of thoughts are going through your mind?

N – Non-identification See the emotion as a passing event rather than who you actually are

Some Approaches to Mindful

Meditation

Guided meditation

Self-guided meditation

Passive meditation

Movement meditation

Guided Meditation

Follow along while someone else instructs

Good for those who need help with

initiating and following through

Requires sufficient language processing

Good for those who are new to

meditation

Self-guided Meditation

Body scan, mindful breathing

Requires some familiarity with process

Requires certain level of initiative and

ability to remember directions

Might be better for those who are

distracted or annoyed by someone

directing them

Passive meditation

Sitting in nature, viewing nature scenes

Works well for those with:

Initiation problems

Auditory processing difficulties or receptive

aphasia

Attention difficulties

Resistance to traditional forms of meditation

Movement meditation

Yoga

Walking meditation

Day to Day Informal

Mindfulness

Mindful communication

Mindful walking

Mindful eating

Mindful working

Mindful waiting

Acceptance of others

Enjoying the moment

MLRA’s Mindfulness Study

10 participants

10 week period of guided meditation

Not all data in

Good preliminary findings

Tools used to evaluate the

effects

MARS Moss Attention Rating Scale

MPAI-Mayo Portland Adaptability Inventory

Patient Competency Rating Scale –Clinician (Prigatano)

Patient Competency Rating Scale-Patient

Process Training Attention Activity- Malia

BAI-Beck Anxiety Inventory

Qualitative survey designed by MLRA

Early outcomes

60% noted

on MPAI

Some

noted

on MPAI for 1/3 participants

PCRS scores indicated

PCRS clinician: percent of participants

demonstrating an improvement

0

10

20

30

40

50

60

70

80

Behavior/

Emotional

Social Self Care Cognitive

Qualitative Questionnaire

64% stated they were (lines up

with BAI numbers)

45% stated

on their own

The Mindfulness App

$1.99 -Set alerts to

remind you to stop and

meditate at a certain

time, or day, or when

you enter a certain location.

Mindfulness

Meditation by

Mental Workout

Guided meditations for

both beginners and more experienced

mindfulness practitioners.

Eight-week program,

inspiration talks, body

scans and relaxation instructions

Simply Being

$1.99 Short guided meditations, with or without music and nature sounds. Perfect for beginners looking for something simple, Simply Being is highly rated for being user-friendly and customizable.

Meditate by

Meditation Timer

$3.99 Allows you to follow your

own practice, either silently or

accompanied by bells. The

statistics feature also allows users

to track their practice and chart

progress.

Walking Meditation by

Meditation Oasis

Geared toward mediation on-the-go.

With three different guided walking

meditations, users can plug in their

headphones and unwind in transit. The

app comes with a diary for users to

keep track of their progress.

References

Azulay J, Smart CM, Mott T, Cicerone KD. (2013). A pilot study examining the effect of mindfulness-

based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. J

Head Trauma Rehabil. 2013 Jul-Aug;28(4):323-31

Chiesa A, Calati R, Serretti A. (2011). Does mindfulness training improve cognitive abilities? A systematic

review of neuropsychological findings. Clin Psychol Rev. 2011 Apr;31(3):449-64. doi:

10.1016/j.cpr.2010.11.003. Epub 2010 Dec 1.

Davidson, RJ, Kabat-Zinn, J., et al. (2003). Alterations in brain and immune function produced by

mindfulness meditation. Psychosom Med. 2003 Jul-Aug;65(4):564-70.

Hofmann, S., Sawyer, A., Witt, A., and Oh, D. (2010). The Effect of Mindfulness-Based Therapy on

Anxiety and Depression: A Meta-Analytic Review. J Consult Clin Psychol. 2010 Apr; 78(2): 169–183.

Hölzel, BK, Carmody, J, et al. (2012) Mindfulness practice leads to increases in regional brain gray matter

density. Psychiatry Res. 2011 Jan 30; 191(1): 36–43.

Jha AP, Stanley EA, Kiyonaga A, Wong L, Gelfand L. (2010). Examining the protective effects of

mindfulness training on working memory capacity and affective experience. Emotion. 2010 Feb;10(1):54-

64.

Lazar SW, Kerr CE, Wasserman RH, et al. (2005). Meditation experience is associated with increased

cortical thickness. Neuroreport. 2005 Nov 28;16(17):1893-7.

Malia, K. & Brannagan, A. (2004). How to do cognitive rehabilitation therapy: A guide for all of us.

Surrey, UK: Brain Tree Training.

Malia, K. & Brannagan, A. (2005). How to do Cognitive Rehabilitation: Part one. Surrey, UK: Brain Tree

Training.

Malia, K. & Brannagan, A. (2005). How to do Cognitive Rehabilitation: Part two. Surrey, UK: Brain Tree

Training.

Moore A, Gruber,T, et al. (2012) Regular, brief mindfulness meditation practice improves

electrophysiological markers of attentional control. Front Hum Neurosci. 2012; 6: 18

Spek, A., Van Ham, N., Nyklíček,I. (2013). Mindfulness-based therapy in adults with an autism spectrum

disorder: A randomized controlled trial. Research in Developmental Disabilities Volume 34, Issue 1,

January 2013, Pages 246–253.