223. A Quality Improvement Project Aimed At Integrating An Adapted Mindfulness Based Stress Reduction (MBSR-AH) Programme Into A Paediatric Psychology Service

Abstract

This project used quality improvement methods to pilot the introduction of mindfulness-based stress reduction (MBSR) groups to a clinical psychology service for young people aged between 15 and 19. Quality improvement methods were used and three "Plan, Do, Study, Act” (PDSA) cycles were deployed, utilising both data on uptake and adherence together with qualitative feedback at each cycle to plan the next stage. Step 1: Taster sessions, designed to include didactic information about mindfulness, provide the opportunity for participants to experience some short meditations and also experience being in a group situation. Step 2: MBSR groups of 4 weeks in duration were rolled out into the service. A priori targets for uptake and adherence were set at 50% (i.e. at least 50% of people approached would take up the offer of joining the group and at least 50% should complete at least 75% of the sessions). Step 3: The development of MBSR-AH, an adapted MBSR programme specifically for adolescents. This was modelled on the traditional MBSR programme with adaptations to the session format, meditations used and an adolescent friendly manual was also developed. Step 1: Uptake was good and 18/25 (72%) of people referred attended the sessions. Qualitative feedback indicated that this was indeed an approach that could be acceptable to young people. Step 2: Uptake and treatment adherence were 65% (17/26) and 82% (14/17) respectively. This compared well against our a priori targets of 50% for both. Qualitative feedback indicated that these four week courses were too short and therefore we aimed to introduce a group programme of 8 weeks in duration, in line with the standard MBSR format, adapted for adolescents. Step 3: For practical reasons it was not possible to run 8 weeks courses and therefore courses of lasting 7 weeks took place. Uptake of the extended groups fell short of target at 35 % (8/22), although treatment adherence remained high with the majority of participants (6/8) completing at least 75% of the course. A mindfulness based stress reduction programme does appear to be faesible and acceptable to young people with chronic health problems. In this pilot the traditional MBSR programme has been adapted to be more adolescent friendly and these adaptations are described. The traditional 8 week course format posed some recruitment challenges and methods to address this are discussed.