Case Study

Case study on implementing the MBSR Programme in Mountjoy Prison

Introduction 

The 8-week course took place from April to June 2019 onsite in Mountjoy Prison. The MBSR course is a scientifically critiqued course that provides the tools to help manage everyday stress and anxiety.

During the course participants learned about the mechanics of stress and how negative thoughts and emotions if not managed spirals into patterns of automatic negative behaviors that erode wellbeing.

The MBSR course is not meant to be a substitute for clinical interventions.  All participants completed a health questionnaire, and where appropriate sought advice from their doctor before participation. 

The objective of the MBSR programme is to introduce participants to mindful techniques, provide theory on the principles underpinning the mindfulness based stress reduction programme, and to immerse participants in the practice of mindfulness.  Over 50% of the MBSR course consists of practice.  Participants received weekly audios meditations to encourage daily practice and were required to attend eight weekly two-hour sessions.

Participants were also required to attend a retreat day that provided a forum to bring together skills learned over the previous weeks and practice the different mindfulness techniques taught. The retreat day provides a time for reflection and creates a trusting space to explore challenges.   The feedback from the retreat day was positive with participants reporting it reaffirmed what was learned in the weakly sessions.

Pre-Evaluation

In addition to the health questionnaire all participants were asked to complete a pre-evaluation survey course.   The objective of the pre-evaluation survey was to get the pulse on the thinking in the group prior to commencement of the MBSR course.

The output from this pre-evaluation survey provides an insight into participants’ expectations and into their stress profile and coping mechanisms.

Before you start the training can you reflect on your expectations for the MBSR course.

‘Hoping to be calm’

‘To help to learn to relax more’

‘I would hope that it would help to calm my mind and possibly stop it racing as  well as to stop me over thinking past and future things that may or may not happen’

‘Hope to understand my mindset better and to be more tolerant and relaxed’

‘I hope to better learn how to mind my own head as well as being supportive with the people in my life that need help’

‘I hope to learn how to be more self aware and how to take time for myself’’

‘… I hope to further learn and experience meditation from this course..’

‘I find myself not distressing after a difficult day and tend to bring this home and I can be short with family members.  This upsets me as I’ve hurt people..’’

‘Hoping to gain the ability to relax the overthinking mind and deal more proactively with life.  Slow down and take the time out that I need for myself

Twelve participants started the course and one person dropped out after week 2. 70% of the group indicated they are mentally fit with a further 60% of the group finding meaning and value in the work they do.   However when asked ‘do you cope well with stress’, only 30% of respondents agreed.   90% of respondents indicated they over think things with only 20% reporting that they create space for themselves.

These findings and the recent ESRI recent report on job stress suggest there is a need to explore a tool such as mindfulness to encourage employees to create mental space and nurture healthy habits to enhance mental wellbeing.

During group discussions most participants reported they are ‘always on high alert’.  Participants reported that ‘being on high alert’ is the norm due to the work they do.   This translates as the body being in constant fight or flight mode, which puts stress on the body.  Constantly being on high alert erodes wellbeing.   Mindfulness nurtures self-awareness and as the group engaged more in meditation practices they learned to differentiate between ‘being on high alert’ and standing back and learning to switch off. 

Post Evaluation of the MBSR Course

Over 80% of participants completed the post evaluation questionnaire. The objective of the post evaluation questionnaire was to assess if expectations were met and if changes in knowledge, skills and attitudes accrued as a result of the training.   The commentary below is a snapshot of the reflections on the course. Twelve participants started the course and one person dropped out after week 2. 

During group discussion participants reported they were ‘always on high alert’ which they felt was the norm due to the work they do.  

This has implication for the individuals’ health and wellbeing.  Constantly in fight or flight mode, stresses and erodes wellbeing.  Particiants reported after the MBSR course that mindfulness helps us to be more self-aware and as the group engaged more in meditation practices they learned to differentiate between ‘being on high alert’ and standing back and learning to switch off.  

Reflections on the course

‘…the course was fabulous self-development, self-understanding mind opening and a mind as well as body relaxing experience…’

‘…never realised how much mindfulness can help with your attitudes and approach to different situations…”

‘…as a result of the skills I learnt I have mindfully accepted that for my home and professional life to excel I need to deal with recent trauma I experienced and have started to do so…I’ve learned not to be so hard on myself and be more accepting of others…’

‘…Learning to control breathing and calming the body during anxiety…’

‘…the retreat day was excellent, and that was when I really got it…I believe it has made me a more calm person…given the job I am in …this is hugely beneficial to me…’

‘…I found it helps me clear my mind and aids my sleep patterns..’

‘…it was good to talk with colleagues about the stresses of work in a very open and honest way and feel that Susan created an atmosphere of trust which allowed this communication

Over 80% of participants completed the post evaluation questionnaire. The objective of the post evaluation questionnaire was to assess if expectations were met and if changes in knowledge, skills and attitudes accrued as a result of the training.   The above commentary is a snapshot of the reflections on the course.  All participants reported changes in knowledge and skills, with many indicating that at first they were skeptical about mindfulness.  88% reported changes in attitudes, which is a precursor to behavioral changes.  All participants found the training relevant to their job and reported that they are applying the mindfulness skills to their job and life in general.  

Many participants reported being more kind to themselves, and valued making time to create headspace through meditation practice.   Some respondents indicated mindfulness helped them become more tolerant of others, which is as an essential skill required particular in the prison environment.   Breaking down biases and negative attitudes builds trust and enhances the working environment.

Challenge

Finding time to practice was the biggest challenge reported which is a universal challenge for all in the fast pace environment we live in.  All participants reported participating in home practiced, but the length varied and this is to be expected.  Mindfulness is a habit, and like all habits it takes time to anchor. 

To help build momentum and encourage a wider body of participation encourage employees to participate in retreat days and continue to organise mindfulness training.  Such actions encourage long-term commitment to mindfulness.  Holzel et al. found that as little as ten minutes mindful-breathing daily increases prefrontal cortex activation.  This part of brain has been referred to as the orchestra of the brain and is responsible a range of functions including decision-making and mood regulation.

The Way Forward

 

“Weave your parachute every day, rather than leaving it to the time you jump out of the plane”

Jon Kabat-Zinn

Creating a safe and trusting environment is pivotal to the success of the MBSR programme.  It allows for openness and participants to talk without judgment.  This group excelled in this area.

Another factor contributing to the success of the course was management’s commitment to the project.  Participants were released from duty to attend the two-hour weekly session and the retreat day.

Mindfulness needs to be practiced regularly to accrue its benefits. Individual responsibility plays a big factor in this, however where an employer creates an environment in which practice is openly encouraged, this helps spread its impact.  Creating a compassionate mindful work environment can only benefit employees and the prisoner population.  This will not happen over night, it takes time planning and commitment from leadership to encourage a broad population of employees (and prisoners) to participate the MBSR training.

As part of an organizational wellbeing strategy, creating a space for employees to practice creates headspace even for short periods and encourages a culture that promotes a mindful approach to work.