Effects of Mindful Engagement and Attention on Reciprocal Caregiver and Client Interactions: A Behavioral Analysis of Moment-to-Moment Changes During Mindfulness Practice

Objectives: The objective of this study was to examine the effects of Mindfulness-Based Positive Behavior Support (MBPBS) training on the nature of caregiver and client reciprocal interactions at a moment-by-moment level using behavior analytic methodology. Specifically, we compared the behavior of caregivers and clients before and after MBPBS training for the caregivers in terms of caregiver-client engagement, percent of learning and leisure interactions during caregiver-client engagement, and percent of the clients’ challenging behaviors and socially acceptable behaviors during learning and leisure interactions. In addition, we examined the effects of specific conditionality of attentional responses of the caregivers to the clients’ challenging or socially acceptable behavior in terms of frequency, latency, duration, and quality. Method: Caregiver and client engagements were videotaped before and after MBPBS training for the caregivers. The percent of caregiver-client engagement was analyzed using partial-interval recording for overall engagement and the clients’ challenging behaviors and socially acceptable behaviors during learning and leisure interactions. The effects of the caregivers’ attentional responses to the clients’ challenging behaviors and socially acceptable behaviors were analyzed using whole-interval recording. Results: Training caregivers in MBPBS significantly increased caregiver-client engagement during learning and leisure activities, which resulted in the clients exhibiting fewer challenging behaviors and more socially appropriate behaviors. Furthermore, an analysis of the effects of different types of caregiver attention showed differential effects on the clients’ challenging behaviors and socially acceptable behaviors. Conclusions: The results indicated that behavior analytic methods can be used as an objective and reliable way of capturing the nature of changes in predefined behaviors of both caregivers and clients at a moment-by-moment level following training of the caregivers in a mindfulness-based program. Using such an analytic method may provide an effective way of objectively measuring some experiential processes involved in mindfulness training.