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. 2016 Oct 6:7:1549.
doi: 10.3389/fpsyg.2016.01549. eCollection 2016.

Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial

Nirbhay N Singh  1 , Giulio E Lancioni  2 , Bryan T Karazsia  3 , Jeffrey Chan  4 , Alan S W Winton  5
Affiliations

Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) vs. Training-as-Usual (TAU): A Randomized Controlled Trial

Nirbhay N Singh et al. Front Psychol. .

Abstract

Caregivers of individuals with intellectual and developmental disabilities (IDD) often end up having their medical and psychological well-being compromised due to the stressful nature of caregiving, especially when those in their care engage in aggressive behavior. In this study, we provided caregivers with mindfulness-based training to enable them to better manage their psychological well-being and, through this, to also enhance specific indices of quality of life of the individuals in their care. Thus, the aim of the present study was to evaluate in a randomized controlled trial (RCT) the comparative effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) and Training-as-Usual (TAU) for caregivers in a congregate care facility for individuals with severe and profound IDD. The comparative effects of the two training conditions were assessed in terms of caregiver variables care recipient variable (number of aggressive events), and agency variables Results showed that MBPBS was significantly more effective than TAU in enabling the caregivers to manage their perceived psychological stress, and to reduce the use of physical restraints and stat medications for aggressive behavior of the individuals in their care. In addition, there were significant reductions in aggressive events by the individuals in their care, 1:1 staffing of individuals with aggressive behavior, and staff turnover. Furthermore, the MBPBS training was significantly more cost-effective than the TAU training. If replicated in future RCT studies, MBPBS may provide an effective means of enhancing socially acceptable bidirectional engagement of caregivers and care recipients within a person-centered context.

Keywords: 1:1 staffing; MBPBS program; Mindfulness-Based Positive Behavior Support; aggressive behavior; benefit-cost analysis; physical restraints; psychological stress; staff turnover.

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Figures

FIGURE 1
FIGURE 1
Participant flow through the trial (CONSORT diagram).
FIGURE 2
FIGURE 2
Ratings of caregiver perceived stress on PSS-10 on the first day of training and the last day of post-training in the two conditions, Mindfulness-Based Positive Behavior Supports (MBPBS) and Training-as-Usual (TAU). Note that higher scores indicate greater psychological stress. Error bars report standard error of the mean.
FIGURE 3
FIGURE 3
Mean number of physical restraints per week used by caregivers contingent on aggressive behavior of the individuals in the MBPBS and TAU conditions. Error bars report standard error of the mean.
FIGURE 4
FIGURE 4
Mean number of stat medicines per week used by caregivers contingent on aggressive behavior of the individuals in the MBPBS and TAU conditions. Error bars report standard error of the mean.
FIGURE 5
FIGURE 5
Mean number of aggressive events per week exhibited by the individuals in the MBPBS and TAU conditions. Error bars report standard error of the mean.
FIGURE 6
FIGURE 6
Mean number of additional caregivers used for 1:1 staffing in the MBPBS and TAU conditions. Error bars report standard error of the mean.
See this image and copyright information in PMC

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