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.