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Mindfulness-Based Stress Reduction at Hines & Associates

Rationale / Objectives

Mindful-based stress reduction was initiated to reduce employees' levels of stress and burnout. The goals of mindful practice are to be aware of one’s own mental processes as well as what is occurring around oneself and thereby be able to act with compassion.

Project/Program Description & Major Achievements

Hines & Associates, a Chicago-based provider of personalized managed care services to employers and insurers, began exploring new offerings to differentiate its suite of utilization review, case management, disease management and other services. Hines selected a wellness program partner after reviewing evidence that mindfulness-based practices reduce stress and that stress impairs productivity at work. 33 employees participated in the online program and significant improvements in perceived stress and total mood disturbance including subscales on tension, anger, fatigue, confusion and vigor were observed.

Lessons Learned

The amount of time the participants spend in home practice is likely to vary significantly. This issue may be of particular importance in relation to mindfulness programs when offered to health care professionals, as preliminary research suggests that this population may be particularly likely to have higher attrition due to time and scheduling issues. Further, future research could examine the aspects of the program that are most difficult to adhere to (i.e., class attendance, time spent on daily home practice, or the exercises themselves).


Greater attention should also be directed towards behavioral variables, such as adherence in order to assess the frequency and intensity of mindfulness practice required to contribute to sustainable effects.In order to do this, a means of measuring both the quality and quantity of formal and informal meditation practice needs to be refined.

It was also found that instructor training and treatment integrity are topics which warrant further attention in future studies.

People / Organizations Involved

Further Description

Hines decided to pilot the wellness company’s eight-week online program in Mindfulness-Based Stress Reduction (MBSR). Hines offered the course to its staff, and enrollment filled the class to capacity within a day. Thirty-three employees from Illinois and Iowa participated in the online program.

Mindfulness is a traditional Buddhist state of being that fosters the ability to pay attention to the present moment on purpose and without any judgment. The use of mindfulness is a key component of Mindfulness-Based Stress Reduction (MBSR) and may be beneficial in reducing symptoms associated with anxiety.


Spanning 8 weeks, the MBSR program consists of weekly 2.5 h-long classes in groups varying between 10 and 40 participants and one ‘‘day of silence’’ in between the 6th and 7th weeks. The group sessions are conducted by a leader who is trained in mindfulness, and cover exercises and topics that are examined within the context of mindfulness. Participants are taught various types of meditation practices, which they apply in class and at home to routine aspects of daily life such as eating, driving, walking, washing the dishes, and interacting with others.

Key elements of the program include:

  • group format;
  • emphasis upon a non-goal orientation;
  • expectation of relief (or placebo effect);
  • sense of active engagement in the process and responsibility for outcomes;
  • demand characteristics (a significant time commitment and amount of home practice);
  • variation of meditation techniques (body scan, sitting and walking meditation, and hatha yoga);
  • didactic material (i.e., the relationship of stress to illness);
  • finite duration (long enough to practice skills, yet short enough not to become dependent upon the group); 
  • a long-term perspective (continued practice is encouraged after the group is terminated)
     

Major Achievements

Participants completed assessments before and after the course. Their scores showed significant improvements in perceived stress and total mood disturbance including subscales on tension, anger, fatigue, confusion and vigor.  While the change in depression scores was not statistically significant, the scores did improve. Since the depression scores were not elevated at the start of the course however, a significant improvement was not expected.

 

Metric

Result

Detail  (t statistic)

Percieved Stress

Before program: 17.66 (6.9)

After program: 13.50 (5.8)

3.78*

Total Mood Disturbance

Before program: 19.09 (14.9)

After program: 6.23 (12.1)

4.64*

Tension

Before program: 5.34 (2.9)

After program: 3.39 (2.6)

3.89*

Depression

Before program: 3.24 (2.5)

After program: 2.24 (2.3)

1.90*

Anger

Before program: 4.80 (3.0)

After program: 2.94 (2.4)

3.85*

Fatigue

Before program: 8.52 (4.4)

After program: 4.23 (3.2)

5.12*

Confusion

Before program: 4.54 (2.3)

After program: 3.09 (1.9)

3.46*

Vigor

Before program: 6.36 (3.8)

After program: 10.28 (4.0)

-5.63*

(*Indicates that value is significant at p < .001.  Decreases in mean scores indicate improvement on all measures with the exception of “Vigor” where increased values indicate improvement.)