Feasibility and acceptability of a mindfulness-based intervention for temper outbursts in Prader–Willi syndrome

The intervention is called Meditation on the Soles of the Feet (SOF). It is a mindfulness-based training program designed for people with an intellectual disability. SoF teaches the person to recognise the precursors to their aggression, disengage attention from the emotionally arousing situation and redirect their attention to the soles of their feet. The primary caregiver will be trained by a member of the research team to personally use and to teach SoF to the person with PWS. Individual training sessions will be conducted via video conference over two half days in the two weeks prior to baseline. Each primary caregiver will be provided with a copy of the trainer’s manual (Singh et al., 2011), which includes step-by-step instructions for their own training and for training the person with PWS. During the intervention period, the primary caregivers will use the 6-week training program, outlined in the trainer’s manual, to the person with PWS to implement SoF. Training will occur in the person’s home. Participants will be asked to participate in the training as many days as possible over the six weeks. Ideally, once a day. The training program breaks the intervention down into five steps. Participants are advised to work through each step at their own pace and to only progress through the steps when each one is successfully completed So, how often they do each step will vary across participants. The training session will take anywhere from 5 to 20 minutes, depending on how well the person is grasping the content. The five steps include: learning how to draw attention to their breath, learning how to draw attention to the soles of their feet, switching attention from a positive memory to the soles of their feet and then from a negative memory to their soles and finally how to redirect attention to the soles of their feet during times of anger. The primary caregivers will be assessed by an expert SoF trainer (via video conferences) to ensure that they are competent in teaching the technique before the trial begins. Primary caregivers will then be asked to video record three training sessions that they conduct with the person with PWS at weeks one, three and six of the intervention period. A member of the research team will use the recordings to assess fidelity through a checklist. Caregivers will participate in weekly phone calls with the research team where they will be given feedback about their training and have an opportunity to ask questions. Caregivers will also be asked to keep a record of the number and length of the sessions and how many times they practised each step. Singh, N. N., Singh, J., Singh, A. D. A., Singh, A. N. A., & Winton, A. S. W. (2011). Mediation of the Soles of the Feet for Anger Management: A Trainers Manual. Raleigh, NC: Fernleaf Publishing.