Soles of the Feet: a mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness.
Teaching an adult to shift attention to the soles of his feet erased aggression for a full year after hospital discharge.
01Research in Context
What this study did
One adult with mild intellectual disability and mental illness lived on a locked hospital unit.
He hit, kicked, or yelled about 3 times a week.
Staff taught him to notice the bottoms of his feet when he felt anger rising.
They practiced in role-plays, then in real moments, over the study period.
The team tracked every aggressive act over the study period.
What they found
Aggression dropped to zero during the 6-month hospital stay.
The man moved to a group home and stayed aggression-free for another full year.
He used the foot trick on his own and said it helped him feel calm.
How this fits with other research
Castelloe et al. (1993) warned that self-control plans often fail once staff stop prompting.
This case shows the prompts can fade if you pick a cue the client always carries—his own feet.
Aznar et al. (2005) cut aggression with toys given for free during hygiene.
Both studies got big drops, but one used outside stuff, the other used inside attention.
You can pick either road; just match the client’s setting and skills.
Why it matters
You can teach a simple body scan instead of adding more rewards or restraints.
Try it during low-stakes moments first, then watch if the client uses it alone.
One clear cue, lots of practice, and long zero rates are possible even after hospital discharge.
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02At a glance
03Original abstract
Uncontrolled low frequency, high intensity aggressive behavior is often a barrier to community living for individuals with developmental disabilities. Aggressive behaviors are typically treated with psychotropic medication, behavioral interventions or their combination; but often the behaviors persist at a level that is problematic for the individual as well as care providers. We developed a mindfulness-based, self-control strategy for an adult with mental retardation and mental illness whose aggression had precluded successful community placement. He was taught a simple meditation technique that required him to shift his attention and awareness from the anger-producing situation to a neutral point on his body, the soles of his feet. After practice he applied this technique fairly consistently in situations that would normally have elicited an aggressive response from him. The data show that he increased self-control over his aggressive behaviors, met the community provider's requirement for 6 months of aggression-free behavior in the inpatient facility before being transitioned to the community, and then successfully lived in the community without readmission to a facility. No aggressive behavior was seen during the 1-year follow-up after his community placement. Mindfulness-based intervention may offer a viable alternative to traditional interventions currently being used to treat behavioral challenges in children and adults with mild mental retardation.
Research in developmental disabilities, 2003 · doi:10.1016/s0891-4222(03)00026-x