Compassion Meditation for Therapists of Individuals with ASD: Effects on Stress and Cultural Competence

Background:

Health care workers are at a higher risk of experiencing severe distress, burnout, and mental and physical illness than employees of any other industry (McVicar, 2003). This risk has been directly linked to adverse consequences for the quality of care that is provided to patients (Irvin et al., 2009). Comparatively, very little is known about the experience of health workers in ASD. Whereas the practice of mindfulness meditation is reportedly associated with stress reduction in several populations, including health care professionals (Goodman Schorling, 2012). We are not aware of any studies describing mindfulness or compassion based interventions for therapists of individuals with ASD.

Objectives:

The goal of this research is to pilot-test Cognitively Based Compassion Training (CBCT), a mindfulness and compassion meditation protocol developed at Emory University and empirically validated in other populations, with therapists of children with ASD in order to reduce stress and burnout and icrease their social competence.

Methods:

Participants were 22 healthy volunteers working with individuals with ASD at the Marcus Autism Center. The experimental group consisted of 12 participants (Age: M±SD = 26.33±1.16; 10 females) who received CBCT over the course of 8 weeks and the control group included 10 participants (Age: M±SD = 31.60±5.72; 10 females) who were on a wait list and received no intervention. They all completed several measures pre- and post-test: stress and burnout (Perceived Stress Scale or PSS, Maslach Burnout Inventory or MBI, and Brief Symptom Inventory or BSI-18), acceptance (Acceptance and Action Questionnaire or AAQ), empathy and compassion (Interpersonal Reactivity Index or IRI), behavioral flexibility (Mindful Attention Awareness Scale or MAAS, and Behavior Rating Inventory of Executive Function or BRIEF-A), and relational competence (Cultural Competence Checklist or CCC).

Results:

Paired t-tests were utilized to evaluate pre- to post-test changes in scores at the .05 significance level. At post-test, the experimental group reported significant improvements on the PSS [T1: M±SD = 22.33±8.14; T2: M±SD = 13.17±6.37; t(5) = 5.33], IRI Personal Distress Scale [T1: M±SD = 18.17±3.19; T2: M±SD = 15.50±3.15; t(5) = 3.16], and CCC [T1: M±SD = 60.67±20.62; T2: M±SD = 58.00±18.61; t(5) = 2.61]. The experimental group also reported a marginally significant improvement at post-test on the AAQ [T1: M±SD = 16.33±3.50; T2: M±SD = 11.67±3.27; t(5) = 2.47, p= .057]. There were additional significant improvements on the raw scores corresponding to the BRIEF-A Shift, Initiate, and Working Memory subscales and in the BSI Depression and Anxiety subscales (p< .05). The control group reported no significant changes from pre- to post-test on all measures.

Conclusions:

These results highlight the vulnerability of those professionals, with a potential impact on individuals under their care, and the need to address such vulnerability and its effects using a systematic empirically-based approach. CBCT may be a feasible training for therapists of children with ASD, as it has been demonstrated for the parents of these children elsewhere, with potential benefits on their stress and cultural competence. A randomized controlled trial should test its efficacy under controlled conditions.