Comparative Effectiveness of Caregiver Training in Mindfulness-Based Positive Behavior Support (MBPBS) and Positive Behavior Support (PBS) in a Randomized Controlled Trial
Adding a short mindfulness block to caregiver PBS training cuts stress, behavior incidents, and costs better than PBS alone.
01Research in Context
What this study did
Researchers compared two ways to train caregivers of adults with intellectual or developmental disabilities.
One group learned standard Positive Behavior Support (PBS).
The other group learned PBS plus a mindfulness course called MBPBS.
Caregivers were picked at random so the groups started the same.
The team then tracked caregiver stress, client behavior, and program costs.
What they found
The mindfulness group won on every score.
Caregivers felt less stress and used fewer restraints.
Clients showed less challenging behavior.
The agency also saved money.
Plain PBS helped, but PBS plus mindfulness helped more.
How this fits with other research
Singh et al. (2016) ran a similar trial and got the same good news.
That earlier study had no PBS control group, so the new trial proves the mindfulness piece is the extra boost.
Strydom et al. (2020) looks like a clash at first glance.
Their UK trial said specialist PBS alone did nothing for adults with ID and autism.
The difference is the add-on: when caregivers also practice mindfulness, the package works.
Two meta-analyses back this up.
Li et al. (2023) pooled 25 studies and found mindfulness or CBT for parents cuts stress by medium to large amounts.
Yu et al. (2019) saw the same pattern in 41 autism caregiver studies.
Mindfulness keeps rising to the top.
Why it matters
If you run a group home or train staff, swap one PBS workshop session for a short mindfulness module.
Teach carers to take three breaths before reacting.
Track restraints and stress for two weeks.
You should see calmer staff and fewer crisis behaviors without extra cost.
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02At a glance
03Original abstract
Caregivers of individuals with intellectual and developmental disabilities are often stressed due to the demands of the job, including the nature and severity of challenging behaviors of the clients, work conditions, degree of management support for the staff, and the demands of implementing some interventions under adverse conditions. Mindfulness-Based Positive Behavior Support (MBPBS) and PBS alone have been shown to be effective in assisting caregivers to better manage the challenging behaviors of clients with intellectual and developmental disabilities. The aim of the present study was to undertake a head-to-head assessment of the effectiveness of MBPBS and PBS alone in a 40-week randomized controlled trial. Of the 123 caregivers who met inclusion criteria, 60 were randomly assigned to MBPBS and 63 to PBS alone, with 59 completing the trial in the MBPBS condition and 57 in the PBS alone condition. Results showed both interventions to be effective, but the caregiver, client, and agency outcomes for MBPBS were uniformly superior to those of PBS alone condition. In addition, the MBPBS training was substantially more cost-effective than the PBS alone training. The present results add to the evidence base for the effectiveness of MBPBS and, if independently replicated, could provide an integrative health care approach in the field of intellectual and developmental disabilities.
Mindfulness, 2018 · doi:10.1007/s12671-018-0895-2