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The Power of Surfing, as Therapy

The Power of Surfing, as Therapy

Surf therapy programs often focus on children with autism or anxiety, or groups like veterans or cancer survivors.

 

Agatha Wallen’s son, Mason, has autism, and when he was 7, she heard about an initiative in San Diego aimed at children with special needs. It involved an unlikely tool: a surf board.

She wasn’t sure how it would work for her son, who struggled with behavioral and sensory issues. “Even getting the wet suit on was difficult for him because it was a brand-new sensory sensation,” she recalled. “From the beach I could see the surf instructors calmly speaking to him, and his whole body seemed to change and relax,” Ms. Wallen said. “He was able to stand up and catch a wave, with a big smile on his face, and ran up to shore and said ‘Mommy, I want to do it again.’”

Mason has been surfing for five years, and now his younger brother, Trevor, 9, is also an active participant in the same program, A Walk on Water. It is a California-based surf therapy nonprofit that primarily focuses on children with special needs — mostly with neurological disabilities. Ms. Wallen serves as an ambassador for the program, helping explain surf therapy to other parents.

“In the ocean there are no cars or planes or people shouting or things buzzing around,” she said.

“It might be the calmness of the waves, but it’s also being with instructors that he could trust and who were patient with him as well.”

A Walk on Water’s executive director, Sean Swentek, points to the importance of serving the whole family, including the child’s siblings, while also offering respite for parents.

“Surf therapy often provides bonding time for them, and our events are meant to be a full day of healing for the whole family,” Mr. Swentek said. The group recently released a short documentary about the role of surf therapy in the lives of three children with special needs.

“In a nutshell, surf therapy is a structured method of surfing utilizing elements of ocean and using its therapeutic benefits for those in need,” said Kris Primacio, the chief executive of the International Surf Therapy Organization, which acts as an umbrella organization to bring together surf therapy programs and researchers. “We tend to focus on underserved populations and exposing surf therapy to those who wouldn’t otherwise have access to an instructor.”

Each surf therapy organization develops its own program. In general, groups meet on the sand before a surf lesson, discuss ocean safety and often discuss mental health struggles as a form of group therapy. They then surf for a few hours and have a debriefing session.

In Britain, children with referrals for anxiety can participate in a free six-week program called The Wave Project. The program, which has received National Health Service funding in the past, gathers data before and after through questionnaires using the Stirling Children’s Well-being Scale and the Rosenberg Self-Esteem Scale.

“We focus on children who have anxiety disorders or are at risk of developing issues. Some may have autism or A.D.H.D. and are at risk of developing more series mental health problems, and most of these children feel isolated,” said Joe Taylor, the program’s chief executive. “Our approach is similar to an occupational therapy approach, and we don’t see ourselves as an alternative to support for care, but part of a package of mental health care.”

In 2014, John Newkirk started Salt Water Therapy L.A., which emphasizes mindfulness as well as surfing. As a certified drug and alcohol counselor with his own history with addiction, Mr. Newkirk wanted to share a mindfulness practice while also structuring the program with ocean safety and surf instruction.

“What happens with mental struggles, including addiction, is that there is an element of self-medicating. Surfers have called it ocean therapy for decades, because of the spiritual benefits. It’s a high with dopamine, but a safer healthier kind,” Mr. Newkirk said.

Surf therapy is not a substitute for medical care, and surfers can still struggle with mental illness. Indeed, the surf legend Sunny Garcia talked about his depression and has been hospitalized since attempting suicide this spring.

However, the evidence for surf therapy seems to validate what we know about movement and exercise, therapeutic effects of water and mindfulness. For instance, two years ago, a paper out of California State University described that just one 30-minute surf session improved mood, but the researchers didn’t distinguish the impact of surfing compared to other sports.

A qualitative study of 22 youths participating in The Wave Project, published in June in the International Journal of Environmental Research and Public Health, noted that surf therapy may work through offering a safe physical and emotional space, peer mentoring and positive reinforcement. Similarly, in 2017 a British study looked at the effectiveness of a three-month surfing program for youth and found that some elements of self-reported well-being improved. However neither study matched participants with a control group.

In June, research with 74 active duty military personnel from the Naval Health Research Center in San Diego found that depression, anxiety and PTSD symptoms decreased after surf therapy, but all participants were simultaneously receiving another form of therapy, making it hard to measure the impact of surfing alone.

Naturally, surfing is not without dangers: drowning, rip currents, sharks, just to name a few.

“The ocean is unpredictable, but leading organizations try to mitigate the risks by making sure staff are C.P.R.-certified and know how to prevent and deal with emergencies,” Mr. Swentek told me. “I think part of the reason it’s so powerful is because of those risks. It is not easy to do, so when these kids for instance are able to surf a wave and overcome their fear, there’s huge growth.”

Is the trend of surf therapy meaningfully different from exercise or mindfulness techniques? The evidence isn’t quite there. But its popularity is a sign of broader interest in a variety of tools that might improve mental fitness. Notably, a Los Angeles-based study from 2014 found that surfing may have a positive effect when delivered in combination with other forms of exercise, medication if needed, and group or individual therapy.

In Jon Kabat-Zinn’s book on mindfulness “Wherever You Go, There You Are,” he writes, “You can’t stop the waves, but you can learn to surf.” Dr. Kabat-Zinn, a physicist by training, was one of the first academics to standardize and research mindfulness approaches. In surfing, much of the challenge involves facing a real wave and pushing forward anyway, even when the easy thing to do is back away.

When I reached out to Dr. Kabat-Zinn to say that one of his best-known sayings was being taken quite literally, he replied in an email:

“The beauty of mindfulness is that you can bring it into anything, and then everything becomes your mindfulness teacher and contributes to waking you up fully. Surfing is no exception. When you are really present, the world (and the wave) can wake you up, and bring you into the timeless present moment, even in the midst of complex, unpredictable, dynamical circumstances.”

**Originally published in the New York Times**

The Doctor is Cooking

The Doctor is Cooking

Here we were, 80 eager physicians from across North America in a large teaching kitchen in Northern California.

 

Surgeons have the best knife skills.

That might sound obvious in the operating room, but here we were, 80 eager physicians from across North America in a large teaching kitchen in Northern California in February.

Our white coats had been traded in for white aprons as we learned the first lesson of the day: The best way to dice an onion is to keep the root intact.

The veteran surgeon from Alaska was encouraging as I attempted to chop the onion into even cubes, as he had humbly done in less than 15 seconds flat. No tears were involved.

Next we went on to preparing grains like farro and cooking plant-based proteins like quinoa and lentils.

Much of the day was also spent addressing nutrition myths (for instance, low-fat diets don’t necessarily lead to weight loss), learning motivational interviewing techniques to help patients identify their readiness to make diet and lifestyle changes, reading nutrition labels, and most important, cooking nutritious meals on a budget — all with the aim of teaching doctors so that they can better educate their patients.

This wasn’t exactly cooking school — it was a three-day “culinary medicine” conference, which just completed its 15th year this past spring. Called Healthy Kitchens, Healthy Lives, there are several others that work along similar lines: Nutrition and Health ConferenceFood as Medicine Conference, and most recently the Health Meets Food Conference.

Culinary medicine is an emerging field that teaches doctors to cook while also imparting practical nutrition information, and is defined as “a new evidence-based field in medicine that blends the art of food and cooking with the science of medicine.”

A 2008 study found that doctors coming out of medical schools in the United States lacked the knowledge to effectively counsel patients about nutrition. Similar findings have been reported among Canadian medical students and European residents. Even specialties like gastroenterology and cardiology, which often deal with diseases that have a large dietary component, include little training in nutrition.

I can relate: once in clerkship and residency, it struck me that what I thought I knew about nutrition was totally inadequate to address the questions patients would ask, and left me unprepared to understand and decipher the myriad new nutrition research and ever-changing recommendations that patients get bombarded with everyday.

The movement is gaining ground across North America as well as around the world, with researchers looking into how it could improve health outcomes for chronic diseases such as diabetes, obesity and heart disease.

As physicians themselves aren’t typically the best models for nutrition — long hours and on-the-run meals are common — bringing doctors into the kitchen may also be a way to encourage self-care as well, both through the mindfulness inherent in food preparation and the consumption of wholesome foods.

There are at least 10 culinary programs in the United States that are backed by a hospital, medical school or school of public health. As part of the medical education curriculum, they reach more than 2,500 doctors and other health professionals each year.

Each school approaches the field slightly differently. For instance, since 2012, Tulane University School of Medicine has offered a compulsory culinary medicine curriculum for its medical students while also reaching over a thousand medical residents through online courseware it has licensed to seven American residency programs. Dartmouth School of Medicine provides culinary medicine workshops to medical staff members, patients and the community through teaching kitchens. And Baylor College of Medicine’s Choosing Healthy, Eating Fresh (CHEF) program is a medical student led elective course which facilitates nutrition and cooking workshops for medical students and patients at Texas Children’s Hospital.

Stanford is one of the latest medical schools to jump on board. Co-founded by Dr. Julia Nordgren, “The Doctor is In … The Kitchen” program began last spring. The group meets one evening a week to learn about how culinary medicine is implicated in a real clinical story — for instance, a busy mother with a toddler who is a picky eater, or a patient with diabetes who is on a tight food budget. To be effective, culinary medicine cannot ignore the issue of food insecurity, which affects 12.7 percent of Americans.

My alma mater, the University of Toronto, started a mandatory culinary medicine program for medical students last year under the direction of Dr. John Sievenpiper. It involves an interactive cooking class, open-access lectures and a grocery store tour led by registered dietitians and chefs, where students learn to read labels and prepare simple meals. Late last year, more experienced physicians eager to advance their nutrition knowledge were offered a chance to enroll in an “update” on clinical nutrition which, among other things, will help separate fact from fiction with respect to popular diets for chronic diseases.

“Nutrition evidence is protean; it changes as we learn more,” said Dr. David Jenkins, a professor in the department of nutritional sciences at the University of Toronto whose research played a key role in the development of the glycemic index. “We need to allow students to critically think about nutrition, and extending this teaching into the kitchen could be one good way to do that.”

Studies show that physician beliefs about the role of food in preventive medicine, and cooking specifically, can translate to effective nutrition counseling for patients, leading to better dietary choices. In 2013, researchers reported that participants in a culinary medicine program reported a higher comfort level with cooking and were better able to assess patients’ nutritional status and advise them regarding nutrition changes, and in 2015, a culinary program at New York University reported improved culinary skills and budget-appropriate meal preparation.

Some medical educators question the effectiveness of nutrition counseling at a time when doctors are so pressed for time, or whether the 10 to 15 minutes allotted to a patient visit can cover the primary medical concerns and additional information about diet and cooking. But Dr. Nordgren notes, “it doesn’t take any more time to discuss a technique to cook a vegetable than it does to write a prescription.”

Still, she acknowledges it’s an imperfect system. She and others have reported that nutrition science is an emerging and difficult to research field. Programs across the country would do well to standardize objectives and curriculums. Recently, the European Society for clinical Nutrition and Metabolism and the American College of Lifestyle Medicine have called for a standardized nutrition curriculum in medical schools.

If Hippocrates really did say, “let food be thy medicine and medicine be thy food,” the culinary medicine movement takes it one step further with a nontraditional take on the traditional medical education adage: ‘see one, do one, teach one.’ And perhaps bringing more doctors into the kitchen could lead to fewer patients being brought into the hospital. Wouldn’t this be the sweetest of ironies?

**Originally published in the New York Times**

Protecting Sleep in the Hospital, for Both Patients and Doctors

Protecting Sleep in the Hospital, for Both Patients and Doctors

What if sleep were considered a continuous infusion of a medication that helped patients heal faster?

It was 11 p.m. and my 2-year-old patient was sleeping peacefully in her hospital bed, snuggled up with her mother and several stuffed animals. Her breathing was quiet and soft. Her bedside heart rate monitor, which glowed a faint yellow in the dark hospital room, was turned to “silent.”

“Sorry, I have to take a listen to her heart,” I whispered to her mother, tapping her shoulder lightly. Her mother and I had a good relationship: I had served as an advocate for her daughter several times during her seven-week stay in the ward. She had a rare disease that had been a medical mystery for many months, but she would be transferred to a more specialized center soon.

I hated to wake her, but recently, when I had offered to wait to examine a child until after a nap, my attending physician had scolded: “You can’t care about that. If you do, you’ll never examine them. They have to get used to it — they’re in the hospital, after all.”

But the poor girl was tired. She was poked three times a day for blood and taken to the M.R.I. or CT scanner at various times. I completed my exam: her vital signs, her heart, perfusion (how well her heart was pumping blood to her body), and palpated her abdomen to check her liver and spleen (which were enlarged, but no more than they had been). She seemed stable. I backed out slowly.

The next morning, the girl’s mother mentioned that it had taken another hour for her to fall asleep again. Was there anything that we could do to allow her to sleep through the night? Wouldn’t a good night’s sleep help with her condition? She had a point.

This is a fundamental question we have to ask about all of our patients, as research now shows that sleep disruption isn’t just inconvenient and doesn’t merely affect our moods or increase risk of disease. Disrupted sleep can in fact drastically affect how well patients heal from the condition that brought them into the hospital in the first place.

If sleep were regarded as a continuous infusion of a medication that helped a patient heal faster, provided them with emotional stability, and ensured they were in the best mind-set to understand the risks and benefits of that care, we would think twice about disrupting it.

Matthew Walker, a professor of psychology and neuroscience at the University of California, Berkeley, and the author of “Why We Sleep,” explored this issue in his research.

“Sleep is one of the most powerful, freely available health care systems you could ever wish for,” Dr. Walker told me. “But the irony is that the one place a patient needs sleep the most is the place they’re least likely to get it: in a hospital bed on the ward.” This year, his research found that a lack of sleep can worsen pain perception.

Recently, a study in Nature found that sleep disruption is directly linked to atherosclerosis, a buildup of plaque in blood vessels. As such, it doesn’t just increase the propensity for a heart attack or stroke, but in patients admitted for a condition related to clogged arteries, interrupted sleep could actually affect how well they heal in a hospital.

study published last year found that sleep affects wound healing, including wounds from surgery or any type of procedure. Using the Pittsburgh Sleep Quality Index score, the researchers looked at patients with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease. These diseases are characterized by wounds primarily in the bowel, treated most often by medications to suppress the immune system. The wounds took longer to heal among the patients who had lower sleep scores.

Similarly, researchers have hypothesized that the healing of diabetic foot ulcers may be affected by undiagnosed obstructive sleep apnea.

And recently, a study on sleep and healing published in the Journal of Applied Physiology concluded that wounds were less likely to heal when sleep was disrupted.

Sleep fragmentation or disruption is not just an issue for patients, of course. It also affects health care workers — particularly medical residents who may be on call for a 26-hour shift several times a week — or nurses and emergency medicine doctors who work irregular hours that often disrupt their circadian rhythms.

A recent study in the journal Anaesthesia found that sleep deprivation among health care workers was directly linked to DNA damage. Research has found that a lack of sleep among residents can be a predictor for depression. Sleep-deprived doctors are also over eight times more likely to omit a crucial patient-care issue. Extended shifts even put people at risk outside the hospital: They triple the risk of a hazardous driving event, with 40 percent of attending physicians reporting that they’ve fallen asleep while driving.

Dr. Michael Farquhar, a sleep expert based in Britain, writes that many hospitals remain unaware of the impact of this issue. Particularly for night shifts, he writes: “We are not evolved to be awake at night. Our circadian rhythm, the powerful drive that helps regulate wake and sleep, means that we are at a physiological low when working at night.” One London-based campaign, “HALT: Take a Break,” offers ways to reduce fatigue.

As Austin Frakt noted in The Upshot last year, several hospitals are taking steps to address the problem. For example, nurses at Yale-New Haven Hospital try to give patients their medications before they go to sleep to minimize sleep disruptions.

Dr. Walker has suggested giving patients ear plugs and an eye mask if they stay overnight in a hospital, and having doctors be more mindful about when they wake patients for a question or an assessment.

As to the standard argument that American doctors have to work brutally long hours to be properly trained, Dr. Walker counters, “Countries such as France, Switzerland and New Zealand train physicians in the same amount of time despite limiting resident shifts to less than 16 hours, yet these countries continue to rank in the top 10 for quality of medical care and practice.”

He added: “It’s worthwhile remembering that after being awake for 22 hours straight, you are as cognitively impaired as if you were legally drunk. Nobody would accept medical care from an inebriated doctor. Yet we must accept medical care from doctors who are similarly impaired due to the lack of sleep the system imposes on them.”

As for my 2-year-old patient, she was transferred to a different hospital a few days later and eventually discharged. She is now getting outpatient care and is back on a regular sleep schedule at home.

Would she have healed faster if her sleep had been less frequently interrupted in the hospital? I can’t say. Maybe the sleep interruptions were justifiable for other reasons that could have improved her care. But the opportunity to have stretches of restorative sleep in a more comfortable environment at home will probably be a big part of keeping her well. And knowing that, I sleep better, too.

**Originally published in the New York Times**

 

Take a Walk in the Woods. Doctor’s Orders.

Take a Walk in the Woods. Doctor’s Orders.

“Forest bathing,” or immersing yourself in nature, is being embraced by doctors and others as a way to combat stress and improve health.

On a damp Saturday morning last August, I joined 10 others in the woods outside Ottawa, Canada, as part of a “forest bathing” session offered by a local wilderness resort.

First we sat in a circle on the leafy ground, each sharing a moment in nature from our childhood that filled us with joy. Next our guide, Kiki, a newly trained forest therapist who insisted we call her by her first name, led us on a mindful — and very slow — walk through the forest.

“What do you hear, smell, see?” Kiki asked, encouraging us to use all five senses to become deeply “immersed” in the experience.

An older woman in the group told us that she was undergoing a difficult and stressful period in her life, and that being among the trees felt “healing.” Others mentioned that the activity reminded them of walks they took as part of Boy Scouts or commented on the sounds: insects, birds, the rustling of leaves. I noticed the bright green acorns that dotted the forest floor, which reminded me of my childhood collection of acorns and chestnuts. Admittedly, I was also worried that the early morning rain was fertile ground for vicious mosquitoes (West Nile!) and ticks (Lyme!).

We ended the two-hour forest walk with a tea ceremony, sipping a concoction of white pine needles steeped in hot water.I left feeling relaxed and more at peace, though with at least two dozen bites from mosquitoes that seemed immune to DEET.

Kiki had been trained according to standards set by the Association of Nature and Forest Therapy, a professional group that has certified more than 300 people across North America to be forest therapy guides, among them psychotherapists, nurses and six M.D.s. The sessions are modeled after the Japanese tradition of shinrin-yoku,or forest bathing.

Over the years, I’ve had physician mentors recommend Richard Louv’s books, “The Nature Principle” and “Last Child in the Woods,” which describe the benefits of time spent in the wilderness, from stimulating creativity to reducing stress. Florence Williams’s best-selling book, “The Nature Fix,” has a chapter dedicated to the benefits of forest therapy. And now, it appears that more North American doctors are starting to incorporate spending time in forests into their practice.

Some small studies, many conducted in Japan and Korea, suggest that spending time in nature, specifically in lush forests, might decrease stress and blood pressure (especially in middle-aged men), improve heart-rate variability and lower cortisol levels while boosting one’s mood. An analysis of studies from 2010 that focused on exercising in nature found improvements in self-esteem, particularly among younger participants. Overall effects on mood were heightened when there was a stream or other body of water nearby.

But other studies have shown mixed results. A cross-sectional study from Korea found no change in blood pressure with forest bathing, and a systematic review from 2010 found that while time in the forest may boost mood and energy, any effects on attention, blood pressure and cortisol may not be statistically significant. Another recent review from Australia underscored the challenges of drawing causal links to disease prevention, with the authors calling for robust randomized controlled trials.

Several theories have been proposed as to why spending time in forests might provide health benefits. Some have suggested that chemicals emitted from trees, so-called phytoncides, have a physiological effect on our stress levels. Others suggest that forest sounds — birds chirping, rustling leaves — have a physiologically calming effect. Yet evidence to support these theories is limited.

On a recent visit to Japan, I met with Dr. Hiroko Ochiai, a surgeon based at Tokyo Medical Center, and her husband, Toshiya Ochiai, who is currently the chief executive of the International Society of Nature and Forest Medicine. Dr. Ochiai is trained in forest therapy and currently conducts most of her sessions with volunteers within a forest in Nagano, about three hours from Tokyo, with the help of a local guide, and plans to offer forest therapy soon at one of Tokyo’s largest hospitals.

“I usually encourage participants to sit or lie down on the forest ground and listen to the sounds,” she says. “The hypersonic natural world can be soothing, and things are always moving even while we are still. It can be very calming.”

Last June the Northside Hospital Cancer Institute in Atlanta began to formally offer forest therapy as part of a pilot project in collaboration with the Chattahoochee Nature Center. Twelve patients with newly diagnosed cancers recently signed up for a session, according to Christy Andrews, the executive director of Cancer Support Community Atlanta.

“It was a four-hour session that seemed to have an impact on the patients,” she said. “I remember one participant telling me afterward that it was a way to ‘steer away from cancer,’ and the group became very cohesive. I think it helped reduce the isolation in a way that’s different from a regular support group.”

Dr. Suzanne Bartlett Hackenmiller, an obstetrician-gynecologist based in Cedar Falls, Iowa, began guiding patients in her practice through the Prairie Woods in Hiawatha Iowa, though she has also led groups in forests around Des Moines. She became a certified guide through the Association of Nature and Forest Therapy three years ago and tries to tailor her offerings based on the group she is leading.

“I generally get a sense of where people are at. For some, it’s best for me to stick to the science, but others may literally want to hug a tree. The traditional tea ceremony at the end might turn some people off, so I’m conscious of that and adjust accordingly,” she says.

In one exercise, she has participants close their eyes as she guides them through experiencing the different senses, imagining feeling their feet growing into the ground like roots of a tree, for instance, listening to nearby sounds and observing how far they may extend, or smelling the air. It’s similar in many ways to a guided meditation.

“I recently held a session where four out of the 20 participants were in wheelchairs, so I found a local park that had plenty of trees and a paved sidewalk so everyone could enjoy it,” she says.

At the University of California, San Francisco, Benioff Children’s Hospital in Oakland, Dr. Nooshin Razani, a pediatric infectious disease doctor and director of the Center for Nature and Health, has offered a similar program for the past four years. The “Shine” program, linked to the East Bay Regional Parks District, offers “park prescriptions,” a movement that is growing in popularity, and aims to improve accessibility to nature for low income children.

One Saturday a month, Dr. Razani leads a group of up to 50 people through a lush forest of redwood trees and lakes on the outskirts of Oakland. The groups consist of patients ranging in age from a few months to 18 years, accompanied by at least one adult family member. A few of her medical colleagues — an orthopedic surgeon and primary care doctor — have also attended, and the Oakland-based pediatrics residency program at the medical centers invites doctors in training to join the group. Shine recently celebrated its 60th park outing.

“The accessibility part is huge for me. Many children don’t have access to green spaces in their community,” Dr. Razani says. “We also have evidence that supports the mental health aspects of spending time in forests, and for the resident doctors who participate, it’s a way to show them how children interact with nature based on the developmental stage. Sometimes the doctors’ need is just as much as the patients’.” In February, Dr. Razani published findings of a randomized trial that found that park visits — regardless of whether they were led by a guide or not — were associated with a decrease in stress three months after the visits.

A few hours after my own forest walk, the woman in our group who had mentioned her stress emailed me to say that she had checked her blood pressure afterward and noticed it was lower than usual. “It would be nice to see if there was a meaningful change from before, if they collected that information,” she wrote.

She had hit on one of the biggest issues around guided forest walks and forest therapy. Is it an evidence-based activity with proven clinical benefits?

The science is still lacking to prove it. But there is some evidence — as well as good old common sense — to suggest that spending time in nature is good for both the mind and body, whether done as a group or alone. It may be something we all need more of.

**Originally published in the New York Times**

4 Mindfulness Practices Your Kids Can Try

4 Mindfulness Practices Your Kids Can Try

For youth and children, there is a plethora of scientific evidence for mindfulness practices in this group, allowing programs to develop evidence-based initiatives for schools, while also incorporating evaluation of their programs.

Mindfulness has been defined by Susan Kaiser Greenland as “the capacity to be alert and open to life experience as it occurs in a non-reactive, resilient, and compassionate way.” Popularized in the west by Dr. Jon Kabat-Zinn, mindfulness may also be described as “paying attention on purpose, in the present moment, nonjudgmentally.” While secular, it derives its origins from Hinduism and Buddhism and has gained popularity in recent years, both as a tool for self-care but also within structured initiatives to manage stress, anxiety, and depression.

There have been a number of studies looking at the effects of mindfulness for a variety of things — anything from stress, overeating (and eating disorders involving food restriction), memory, and self-esteem. In particular, for youth and children, there is a plethora of scientific evidence for mindfulness practices in this group, allowing programs to develop evidence-based initiatives for schools, while also incorporating evaluation of their programs.

New initiatives such as MindupMindfulness in Schools, and Mindfulness Without Borders have flourished, as they offer unique curricula that can be used in the classroom to improve mental health and coping strategies among students.

Over the last two years, books such as A Still and Quiet Place by Dr.Amy Saltzman and The Mindful Teen by Dr. Dzung Vo have provided teachers, parents, and healthcare providers with techniques to incorporate mindfulness practices with children and youth.

This past summer I had an opportunity to complete a facilitator workshop with Mindfulness Without Borders (MWB), a Canadian charity, that teaches youth, educators, professionals and parents essential skills and strategies to increase attention, regulate emotions, build resilience, and be more compassionate towards others in a high stress world. The workshop focused on their robust evidence-based curriculum on mindfulness techniques for youth, and prepares facilitators to lead what is traditionally a 12-session workshop in classrooms and other youth settings. MWB’s programs are active within the Toronto Catholic District School Board, YMCA Academy, select Toronto District School Board High Schools and the York Regional Police. There is an upcoming training in Toronto through the Applied Mindfulness and Meditation Program at the University of Toronto, and a number of online opportunities to learn more about mindfulness techniques for youth on the website.

Here are just four of the techniques we covered, that are described in more detail on the MWB website. They can be tools to use on yourself, or with a child or youth in your life who expresses interest. I have linked to an audio example of each practice below.

1.Mindful Listening: This technique brings awareness into the way we typically listen (usually with a purpose and agenda to formulate our own responses), and encourages us to stay open to the speakers perspective while releasing our own personal agendas.

2.Tuza: Tuza means “slow down and relax,” in a Rwandan dialect, and is a breathing technique used to restore a sense of calm and balance in challenging situations.

3.Take Five: This is a breathing technique intended to center our mind and our breath (both which tend to become frantic during stressful situations), bringing regularity to our breathing. It begins with a deep inhale, a pause, and a slow exhale, followed by another pause. This can be repeated at least four other times (hence “take five”) in overwhelming situations.

4.Body Scan: The body scan is a popular mindfulness technique used anytime during the day, and can be particularly helpful before sleep, in an effort to relax the mind and body. This tool involves “intentional attention” placed on one part of the body at a time, encouraging openness and curiosity.

 

**This blog was originally published on Huffingtonpost.ca**

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