Singh, Nirbhay N., Lancioni, Giulio E., Hwang, Yoon-Suk, Myers, Rachel E., Townshend, Kishani, and Medvedev, Oleg N. (2023) Using Mindfulness to Improve Quality of Life in Caregivers of Individuals with Intellectual Disabilities and Autism Spectrum Disorder: Agency Outcomes for Caregivers and Clients. Advances in Neurodevelopmental Disorders, 7. pp. 604-615.

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Abstract

Objectives: Research suggests that the quality of life of professional caregivers of individuals with intellectual disabilities and autism spectrum disorder can be enhanced through mindfulness-based training. The effects of such training have been evidenced in terms of perceived psychological stress, compassion satisfaction, compassion fatigue (i.e., burnout, secondary traumatic stress), and symptoms of depression. In addition to changes in caregiver personal outcomes, mindfulness-based training may have effects on the quality assurance variables of the agency that employs these caregivers. The aim of the present study was to examine the changes from a systems perspective in terms of quality assurance variables related to caregivers and clients in community-based group homes.

Methods: Professional caregivers (n = 216) were randomized into three experimental conditions based on the training they received: mindfulness, psychoeducation, or inservice training-as-usual (control). The effects of the training were assessed in terms of quality assurance indices pertaining to caregivers (progressive discipline, call-ins, days absent, medical referrals, hospitalizations, and caregiver turnover) and clients (learning objectives, behavioral episodes, use of physical restraints, emergency medications [stat], medical emergencies, hospitalizations, aggression to staff, aggression to peers, and level of supervision).

Results: Overall, caregivers in the mindfulness group exhibited significantly fewer progressive discipline and call-ins when compared to the psychoeducation and control groups. Caregivers in both the mindfulness and psychoeducation groups exhibited significantly fewer days of absence from work, medical referrals, and caregiver turnover when compared to the control group. There was no difference across the three groups in terms of hospitalizations. Clients under the care of mindfulness-trained caregivers showed significantly greater improvement in completing learning objectives, fewer behavioral episodes, reduced need for physical restraints and stat medication for behavioral episodes, fewer episodes of aggression to peers, and lower levels of supervision when compared to those in the psychoeducation and control groups. Clients did equally well in terms of medical emergencies, hospitalizations, and aggression to staff in the mindfulness and psychoeducation groups when compared to those in the control group.

Conclusions: Differential effects of mindfulness training, psychoeducation, and inservice training-as-usual were evident in quality assurance variables related to caregivers and clients. The results suggest that training caregivers in different approaches to self-care may differentially affect not only their clinical status but also at a systems level in terms of quality assurance indices.

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