ADHD Mindfulness Based Therapy Research Paper

Abstract
A child with Attention Deficit/Hyperactivity Disorder is often perceived in a negative point of perspective due to their one of their many symptoms of non-compliance in their homes and their schooling systems. Typically, a child with this diagnosis undergoes traditional Cognitive Behavioral Therapies and medication prescriptions. This study explored the effects of Mindful-Based Therapy and interventions for children with Attention Deficit/Hyperactivity Disorder to decrease their symptoms of non-compliancy. Some studies conducted only included the children individually, or in groups, and others were conducted with the parents of the children as well. The results of these interventions will not only prove that Mindful-Based Therapy and trainings will benefit the non-compliant Attention Deficit/Hyperactivity Disorder child’s parent satisfaction, but will also have a significant positive change in the child’s behavior all around.

In Children Who Suffer from ADHD That Experience Non-Compliance Symptoms, Is Mindful Based Therapy Compared to Cognitive Behavioral Therapy, More Effective in Increasing Compliancy

Introduction and Problem Statement
The purpose of the study is conducted is to determine the perceived effectiveness of mindful based therapy as an alternative to cognitive behavioral therapy involving children that experience the symptom of non-compliance behavior stemming from their diagnosis of ADHD – Attention Deficit/Hyperactivity Disorder. It appears that the difficult to comply with parents and authority symptom due to ADHD can be detrimental to long term in the child’s biopsychosocial aspects of their lives. Some risk factors that are included in the lack of recognition of non-compliancy in Attention Deficit/Hyperactivity Disorder children as they age are higher percentage of substance abuse, the inability to make friends, and obtaining successful relationships with peers and adults. The lack of compliancy that follows the Attention Deficit/Hyperactivity Disorder can also have a significant effect on the parents/guardians of the children who may not know how to deal with the stress of the behavior. The result from this research is hopeful to develop the awareness in the performance of children who suffer from this common symptom of ADHD and their change in personnel lives, tasks, and improve their all-around behavior. The effectiveness of this research will also be important to achieve goals in similar fields and to those who are aiming to achieve these goals (De Pauw & Mervielde, 2010).

Mindful based therapy is suitable to be used as an alternative therapy as it helps in determining the behavior of children as well as crucial in determining the ADHD- Attention Disorder/ Hyperactive Disorder. Mindful based therapy is important as it helps in identification of the risk factors which are included in lack of recognition of non-compliance in the ADHD. Therapy for these children is important as it will help them avoid some of the effects that children are likely to be exposed to such as lack of ability to make friends.

Literature Review
Article 1. A study by Saskia van der Oord, Susan M. Bogels, and Dorreke Peijnenburg (2011) aimed to determine the differential efficiency and effectiveness of mindfulness training for children with the diagnosis of ADHD, along with the mindful practices of parenting for these children’s parents and guardians. The study was evaluated over an 8-week period with children aged 8-12 years old diagnosed with ADHD. There was also a within-group waitlist used to control the effects of time and repeated measurement and the training was conducted in group format. The children’s parents completed questionnaires on their child’s ADHD symptoms, their own ADHD symptoms, the stress on the parents, overactivity of the parents, permissiveness, and the mindful awareness before the training. The 8-week training had an 8- week follow up immediately. Teachers of the children subjects reported on the ADHD behavior of the child, there were no significant changes between the waitlist and pre-test, except on the increase of teacher-rated behavior. There was a significant reduction of parent rated ADHD behavior of themselves and their child from pre-to posttest and from pre- to follow-up test. Then, a significant reduction in parental stress and overactivity from pre-to follow-up test. The study concluded to show preliminary evidence for the effectiveness of mindfulness for children with ADHD and their parents, as rate by parents.

Article 2. A study performed by Randye J. Semple, Jennifer Lee, Dinelia Rose, and Lisa F. Miller in 2009 was based on mindfulness-based cognitive therapy for children in ages ranging from 9-13 years old. This was a group psychotherapy developed to specifically increase social-emotional resiliency in the children through enhanced mindful attention in an randomized control trial. A part of this study is to test the hypothesis in reductions not only in anxiety symptoms, but attention and behavioral problems. 25 children were used in a randomized cross-lagged design provided a wait-list control group, a second trial of mindful based cognitive therapy, and a 3-month follow-up of children who completed the first trial. Participants who completed the program showed fewer attention problems than the wait-listed controls and those improvements were maintained at three months following the intervention. These reductions in attention problems were 46% of the variance of changes in behavioral problems – but the attention proved to be a non-significant mediator of behavior problems. Overall, the intervention results proved that mindful based cognitive therapy is a promising intervention for attention and behavioral problems, as well as reducing these symptoms.

Article 3. Jillian Haydicky, Judith Wiener, Paul Badali, Karen Milligan, and Joseph M. Ducharme conducted a study in 2012 to evaluate mindfulness-based interventions for adolescents with learning disabilities – including ADHD. The results were an impact of a 20-week mindfulness training program evaluating internal and external behavioral and social skills. These interventions included MMA – Mindfulness Martial Arts. MMA is a group treatment program that incorporates elements of mindfulness meditation, cognitive behavioral therapy, behavior modification, and mixed martial arts. Children as young as 12 years old and their parents completed standardized questionnaires before and after training. Subgroup analyses were then conducted to investigate the intervention impact on youth with ADHD or anxiety diagnosis. The group participates with the ADHD diagnosis improved on parent-rated external behavior, oppositional defiant problems, and conduct problems. Boys with elevated ADHD symptoms improved on parent-rated social problems and monitoring skills.

Article 4. Mindfulness Training interventions were implemented by Nibhay N., Ashving N., and Judy Singh, along with Giulio E. Lancioni, Angela D. Adkins, ,and Alan S. W. Winton for parents and their children with ADHD. The purpose of this training was to increase the children’s compliance who are often non-compliant with parental instructions with mindfulness instead of medication and manipulation of behavioral therapies. In behavioral tactics for ADHD non-compliance require the parents to impose external control on the children – resulting in the children not learning or restricting their self-control strategies. This does not enhance positive interactions between parent and child. Studies have shown that providing the mindful-based therapies instead of behavioral therapies can enhance the positive interactions with a focus on reducing problem behaviors. This mindful strategies benefits both the child and the parents, as well as their relationship with each other. This specific study was interested in finding what effects mindful training to two mothers and their children would have on the compliance of the ADHD children. Using multiple baseline across mothers and children design, the results concluded that giving this training to both mothers and children enhanced compliance in the child. Furthermore, the training in the children alone increased compliance even more markedly and was maintained in follow-up. The mothers reported increased satisfaction with the interactions with their children and happiness with parenting. Mindfulness training produces personal transformations, both in parents and children, rather than teaching strategies for changing behavior by the basic behavioral therapy and medications.

Mindful based interventions (MBI) have been widely used in adults that suffer from stress, illness and depression. The MBI concept is based on a Buddhist concept as well as the Western knowledge of psychology. MBI is the application of a non-judgmental attitude in addressing the issues that an individual is facing. There are two key issues that have been identified by researchers as having significant impact on the MBI and they include the self-regulation of attention which refers to the observation as well as attending to slight changes in the thoughts, sensations or even feelings. In such a case, there will be need for sustained attention. The second issue is the orientation to experience which aims at maintaining the curiosity regarding the location in which the mind wanders as well as being open to current realities existing at the present moment. Based on these crucial concepts therefore, MBI could be viewed the regulatory of the attention. The practice involves lowering one’s arousal as well as controlling the attention to present moments while at the same time keeping a non-judgmental mindset. Therefore, MBI is potentially in a position of providing benefit for children with attention problems for instance ADHD. Intervention mechanisms through clinical practice is among some of the measures that could be used in ensuring that the impacts are addressed appropriately.

Among treatment options for the improvement of the attention in the people with the ADHD include pharmacotherapy for instance the stimulant medication. Alternative approaches could be explored by individuals who wish to reduce use of medication. However, it is advised that an individual could combine the use of both medication as well as other treatment options as a strategy in enhancing the control mechanism. The non-pharmacological treatment alternatives are however preferred by doctors. However, there is insufficient research on the effectiveness of these treatment options that treat the inattention in the adults as well as children suffering from ADHD. There is however lack of empirical evidence used in suggesting as well as in analysis of the true condition of the inattention in the children.

There exist various types of MBI which are used with the ADHD. However, a significant component of them is self-regulation of attention. For instance, the mindfulness-based cognitive therapy (MBCT) is basically the combination of the behavioral therapy and mindfulness (De Pauw & Mervielde, 2010). The MBCT emphasizes predominantly on the sustained attention training and believes that if an individual is in a position of controlling their internal state, then there is a possibility of enabling insights as well as adapting the use of maladaptive cognitions as well as behaviors underlying the psychiatric symptoms. Mindfulness awareness practice (MAP) is the act of intentionally bringing an individual’s attention to present moment as well as experience. Meditation is seen as the major component of MAP. Other therapies existing for the ADHD could be the use of mindfulness-based stress reduction (MBSR) training which is the meditation using yoga as to increase and reduce stress significantly. Through such, an individual will learn on ways they use to reduce stress as well as some of the best therapies that they could use in enhancing stress.

ADHD is a neurobiological disorder that is not only found in children but in adolescents as well as adults (De Pauw & Mervielde, 2010). Clinical findings from previous research studies reveal a consistent pattern in the ADHD symptoms is likely to change with the age, with the hyperactivity-impulsivity being significant than the inattention in the childhood. However, inattention is likely to become evident that the hyperactivity-impulsivity in adults. In as much evidence show that the mindfulness-based training is effective for improvement of attention in the adults that suffer from ADHD due to the changes in sensitivity of inattention as well as the development pathway of ADH individuals are the different levels of development.

Research Methodology
Studies to be included in the research met the following criteria:
Participants- individuals diagnosed with the ADHD
Intervention- MBT for instance the mindfulness based cognitive training (MBCT), Mindfulness awareness practices (MAP) and mindfulness based stress reduction (MBSR).
Outcome measures- outcomes in the attention performance, the inattention symptom
Study design- the study was designed such that there was an analysis of the individuals affected by the ADHD disorder.

The studies used in the research were ones published in 10years from between 2008-2017.

Data Extraction
Data was extracted with the team screening and selecting the literature based on the title, publication, methodology, participants’ outcome measures as well as the interventions that are critical in the studies. Children who are affected by the ADHD formed a significant chunk of the participants in the study as they were the focus of the study. Adopting an observation research methodology framework, appropriate results on the impacts of MBI on the children who are affected by the ADHD.

Research Design
The methodology for this study was chosen to assist the researcher in developing a coherent hypothesis which was aimed at building groundwork for the research of the impacts of MBI in the analysis and understanding of the ADHD. Therefore, this research will adopt an exploratory research design which is aimed at ensuring that the researcher uses predominantly the secondary research sources in developing his procedural research.

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References
Cassone, A. R. (2013). Mindfulness training as an adjunct to evidence-based treatment for ADHD within families. Retrieved from https://journals.sagepub.com/doi/full/10.1177/1087054713488438
De Pauw, S. S. W., & Mervielde, I. (2010). The role of temperament and personality in problem behaviors of children with ADHD. Retrieved from https://link.springer.com/article/10.1007/s10802-010-9459-1
Haydicky, J., Wiener, J., Badali, P., Milligan, K., & Ducharme, J. M. (2012). Evaluation of a mindfulness-based intervention for adolescents with learning disabilities and co-occurring ADHD and anxiety. Mindfulness,3(2), 151-164. doi:10.1007/s12671-012-0089-2
Kendall, P. C. (2011, September 26). Child and adolescent therapy. 4th Edition. Retrieved from https://books.google.com/books?hl=en&lr=&id=c0MJjigA8-YC&oi=fnd&pg=PR1&dq=Mindful based therapy versus behavioral therapy for children with ADHD&ots= uDuW0zdbD&sig=_94zjz2yxHGktwjyrUfJ1s7jI3o#v=onepage&q=Mindful based therapy versus behavioral therapy for children with ADHD&f=false
Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2009). A Randomized Trial of Mindfulness-Based Cognitive Therapy for Children: Promoting Mindful Attention to Enhance Social-Emotional Resiliency in Children. Retrieved from https://link.springer.com/article/10.1007/s10826-009-9301-y
Singh, N. N., Singh, A. N., Lancioni, G. E., Singh, J., Winton, A. S., & Adkins, A. D. (2009). Mindfulness training for parents and their children with ADHD increases the children’s compliance. Journal of Child and Family Studies,19(2), 157-166. doi:10.1007/s10826-009-9272
Oord, S. V., Bögels, S. M., & Peijnenburg, D. (2011, February 02). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their Parents. Retrieved from https://link.springer.com/article/10.1007/s10826-011-9457-0#citeas