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Posts Tagged ‘Dr Stan Kutcher’

Mindfulness has enjoyed a tremendous boom in the past decade and has recently begun to spring up in Canadian school systems. Two provinces, Ontario and British Columbia, are hotbeds for promoting “student well being” through broad application of ‘mindfulness training’ and its step-child ‘self-regulation ‘ beginning in the earliest grades. Under the former Liberal Government of Kathleen Wynne, the heavily promoted Student Well Being Strategy’ attempted to integrate ‘mindfulness’ through what is known as the MINDUP curriculum.  The recent change in government presents a rare opportunity to critically examine the whole initiative, its assumptions, research base, and actual impact upon schoolchildren.

“Student Well Being” has acquired something of an exalted status in Ontario schools ever since the appearance of a fascinating November 2016 policy paper,’ entitled “Well Being in Our Schools, Strength in Our Society.’ The whole concept of  Student Well Being was rationalized using a popular narrative promoted by its leading Ontario advocates, Dr. Jean Clinton, a McMaster University clinical psychiatrist, and Dr Stuart Shanker, a York University psychologist who doubles as the CEO of the MEHRIT Centre, a Peterborough-based organization holding a patent on the term “Self-Reg” and marketing “self-regulation’ in schools.  While labelled an “engagement paper,” the educators and the public were invited to “provide your insights and considerations on how best to promote and support student well-being throughout Ontario’s education system.

Promoting “Student Well Being” sounds like the educational equivalent of motherhood, so it has, to date, attracted little close scrutiny. That may explain why the whole provincial strategy sailed through the normal process of review and was immediately embraced by educators, particularly in elementary schools. Few Ontario educators, it seemed, were troubled by the initiative and parents were, as usual with curriculum initiatives, presented with a fait accompli.

Growing concerns among leading researchers in the United States, the U.K., and the Netherlands about the widespread adoption of positive psychology, the implementation of the Goldie Hawn Foundation’MINDUP program, and the mindfulness and happiness movement. failed to register.  Judging from Ontario Ministry of Education and school board conferences held in 2016-17 and 2017-18, the provincial school system was totally enamoured with an approach that promised salvation and relief from stress, anxiety, depression, bullying, and today’s frenetic school life.

What could possibly be wrong with making Student Well Being a system-wide priority? It sounded harmless enough until you bore down into what it actually entails and begin to examine the promotional videos and classroom resources generated by the initiative. An early warning was issued by British Columbia teacher Tina Olesen  in November of 2012 on the Scientific American Blog. Her concerns about the potentially harmful effects of Hawn’s MINDUP program were prophetic. Early studies in British Columbia (K.A. Schonert-Reichel 2008 and 2010) extolling the virtues of MINDUP curriculum have now come in for heavy criticism, challenging the validity of the findings.

Mindfulness and meditation recently took a big hit in “Mind the Hype,” a January 2018 peer-reviewed article in Perspectives on Psychological Science. An interdisciplinary team of scholars, led by N.T. Van Dam, found that the benefits of “mindfulness and meditation” have been over-hyped and that the research evidence to support its widespread use is mostly shoddy. They are very critical of the “misinformation and propagation of poor research methodology” that pervade much of the evidence behind the benefits of mindfulness. They focus in particular on the problem of defining the word mindfulness and on how the effects of the practice are studied.

“Mindfulness has become an extremely influential practice for a sizable subset of the general public, constituting part of Google’s business practices, available as a standard psychotherapy via the National Health Service in the United Kingdom and, most recently, part of standard education for approximately 6,000 school children in London,” the authors wrote. They also pinpointed a number of flaws in the supporting research, including  using various definitions for mindfulness, not comparing results to a control group of people who did not meditate and not using good measurements for mindfulness.

“I’ll admit to have drank the Kool-Aid a bit myself. I’m a practicing meditator, and I have been for over 20 years,” David Vago told Newsweek. A research director at the Osher Center for Integrative Medicine at Vanderbilt University, he is one of the study’s authors. “A lot of the data that’s out there is still premature,” he said. Educators are not the only ones overstating the benefits of mindfulness.  “You go into Whole Foods today, and there will be three magazines with some beautiful blonde meditating on the cover,” Vago said. “And they’re labeled ‘Mindfulness, the New Science and Benefits’ in some shape or form.”

Mindfulness has spawned a completely new “mental health and happiness” industry. Mindfulness and meditation are a popular practice that brings in around $1 billion US annually, according to Fortune. The booming industry includes apps, classes and medical treatments.  That’s what concerns Canadian mental health researchers such as Dr. Stan Kutcher, the Sun Life Chair of Teen Mental Health, at Dalhousie University. “Being happy all the time without feeling any stress,” he reminds teachers, is not normal.  Contrary to the claims of Mindfulness promoters, Kutcher points out that  “Anxiety Disorder is not the same as being stressed before an exam.  Handling such normal stress is, in fact, essential to being in good mental health.”

Where’s the research to support mass application of Student Well Being training based upon mindfulness?  Two leading University of Wisconsin  researchers , Richard J. Davidson and Alfred W. Kaszniak, addressed the problem squarely in their October 2015 American Psychologist research review.  Mindfulness meditation and mindfulness-based interventions, they found, lack a proper research base. “There are still very few methodologically rigorous studies, ” they concluded,  that demonstrate the efficacy of mindfulness-based interventions in either the treatment of specific diseases or in the promotion of well-being.”

Studying the effectiveness of Canadian social and emotional learning (SEL) school programs is still in its infancy. One of the first such studies, conducted by Dr. John LeBlanc of Dalhousie Medical School and a team of researchers, systematically assessed over a dozen school-based SEL programs, including both “evidence-based” and “non-evidence based” programs. Five evidence-based programs (PATHS, Second Step, Caring School Community, Roots of Empathy, The Fourth R), and 6 non-evidence-based programs (DARE, Lion’s Quests: Skills for Adolescence, Options to Anger, Room 14: A Social Language Program, Stop Now and Plan (SNAP), Tribes) were identified.

A systematic literature search was conducted for all evidence-based programs, and each program underwent qualitative analysis using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Implementation recommendations were then developed for all 13 programs. PATHS and Second Step received the strongest recommendations for school-based implementation, due to high quality empirical evaluations of the positive outcomes of these programs. Caring School Community, Roots of Empathy, and The Fourth R showed promise and received provisional recommendations for implementation. Those five programs were recommended for use in Nova Scotia public schools. Eight other noteworthy programs were discussed. but deemed to require empirical evaluation before evidence-based recommendations can be made. Based upon the evidence gathered in subsequent Dalhousie Medical School studies, MINDUP would also fall into that category – not yet suitable for school implementation. The research study or toolkit for educators underlined the critical need for proper program evaluation to ensure that such SEL programs are “cost effective and yield maximal benefits for students’ behaviour.”

Why did the Ontario Ministry of Education adopt Social Well-Being in January 2017 as a system-wide priority?  Where is the evidence to support the implementation of a mindfulness-based initiative in schools across Ontario? Were Ontario parents ever properly consulted on this provincial curriculum initiative?  Given the recent research findings, is it time to halt the Student Well Being Strategy and to seriously look at the wisdom of proceeding on the current set of assumptions? 

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Seeing some 400 teachers and school service providers flooding into the Halifax West High School auditorium on July 20, 2017 was an eye-opening experience. In the middle of the summer, they committed time to a two-day conference focusing on child and teen mental health. Led by Dr. Stan Kutcher, the Mental Health Academy was filling a real need in the school system.

With the news full of stories warning of a “mental health crisis,” teachers in the K-12 system are feeling anxious and more conscious than ever of their role in the front lines of education.  What Dr. Kutcher’s Academy offered was something of a tranquilizer because he not only rejects the “crisis” narrative, but urges classroom practitioners to develop “mental health literacy” so they can “talk smart” with students and their parents.

The fifth edition of the Mental Health Academy, initiated in 2006 by Dr. Kutcher, studiously avoided adding further to the noise and sought to advance teacher education in mental health using evidence-based research and programs.  Stress can be good and bad, Kutcher reminded us, and we need to be able to distinguish among the three types of stress responses identified by the Harvard Center for the Developing Child: positive (daily), tolerable (regularly) and toxic (extremely rare).  Instead of pathologizing “stress” as “anxiety,” what children and youth need most is “inoculation” to help build a more robust stress immune system.

While the incidence of teen mental health problems is not appreciably different than it was fifty years ago, we are far better equipped to respond to the challenges in and around schools. The MH Academy amply demonstrated how much more we know today about adolescent brain development, school staff self-care, anxiety, depression, eating disorders, substance addictions, and teen suicide.  Educating teachers about that research is the real purpose of the Academy.

Mental health disorders are serious and teachers are well-positioned to assist in early identification. About 1 in 5 people may experience a mental disorder during adolescence. If left unrecognized and untreated, they can lead to substantial negative outcomes in physical and mental health, academic and vocational achievement, interpersonal relationships, and other important life experiences. Despite this tremendous burden of mental health disability, youth requiring proper care still do not receive it from childhood through to adulthood.  Lack of knowledge, presence of stigma, and limited access to care all serve as barriers to addressing mental disorders and alleviating the daily challenges.

Promoting Mental Health Literacy (MHL) is Dr. Kutcher’s mission because it is an essential component of improving individual and population health and mental health outcomes. As most mental disorders can be identified by age 25, schools provide the ideal location in which to implement interventions that can be demonstrated to improve mental health and life outcomes.  Good MHL programs tend to exhibit four components: : understanding how to obtain and maintain good mental health; understanding mental disorders and their treatments; decreasing stigma; and enhancing help seeking efficacy (knowing when, where, and how to obtain proper care.

A recent Canadian study of some 10,000 educators, cited by  IWK Health researcher Dr. Yifeng Wei at the Academy, found that over 90 per cent of teachers lacked adequate preparation for responding to mental health issues.  That is startling when one considers the fact that the survey uncovered some 200 different mental health programs being implemented in over 1,000 Canadian schools.

Systematic evidence-based reviews of the most popular mental health programs are not that encouraging.  Four such programs, including two based upon “mindfulness, “Learning to Breathe,” and “Mind Up,” analyzed using the GRADE System, were found to be mostly ineffective and judged not ready for widespread implementation in schools. “Good intentions,” Dr. Wei stated,” do not translate into beneficial outcomes for children and teens.”

One curriculum resource, the Mental Health and High School Curriculum Guide, researched and developed by Kutcher and his research team at Dalhousie’s Medical School, shows more promising results. It’s not a “packaged program,” but rather a full curriculum taught by the usual classroom teachers in Canadian secondary schools. Survey data collected before, immediately after, and 2 months after implementation of The Guide showed that students’ knowledge improved significantly when the program was delivered by their regular teachers.  Embedding a classroom resource, delivered by usual classroom teachers in usual school settings is proving to be far better than utilizing any number of the commercially-marketed mental health programs.

What’s contributing to the widespread public perception that we are experiencing a “mental health crisis” in and around our schools?  Why are classroom teachers so motivated and committed to responding to mental health issues?  Why are education authorities and school districts so quick to snap up the latest program in mental health, student behaviour modification, and suicide prevention?  What’s the secret of the recent success of the the Canadian Teen Mental Health Curriculum Guide? 

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Principal Daniel Villeneuve of Saints-Anges Catholic Elementary School in North Bay, Ontario, is among the first wave of Canadian school leaders to take a stand against fidget spinners, the latest craze among children and teens world-wide. On May 23, 2017, he visited class after class to advise his students that the hand-held gadgets were being banned from school grounds. Marketed as a “stress reliever” for anxious or hyperactive kids, the spinners had become a “major distraction” interfering with teaching and learning affecting everyone in the classroom.

FidgetSpinnerCloseUpThe North Bay principal’s letter to parents, issued May 24, 2017, directly challenged the claim of the commercial product’s marketers that a fidget spinner “helps people focus and concentrate.”  He was crystal-clear about the real “issues with this toy”: 1) it makes noise; 2) it attracts attention; 3) most kids require two hands to make it spin; and 4) it distracts the user and others. For this reason, it was “banned from the school and the day care” and “must remain in the student’s school bag at school.”  What he didn’t say was perhaps obvious – it was driving teachers crazy and making teaching almost intolerable.

Most Canadian school authorities and far too many principals were simply asleep at the switch, compared to their counterparts in the United Kingdom, New York State, Southern California, and New Zealand.  By May 10, 2017, 32 per cent of America’s 200 top rated high schools had banned the spinners from their premises. With the exception of a few Western Canadian school boards, provincial educational leaders seemed to be taken-in by the latest student pacifier and the pseudoscience offered in support of such panaceas. How and why did it get so advanced, and take so long, before a few courageous school principals saw fit to weigh in to put a stop to the classroom disruption?

Fidget spinners, since their invention in the 1990s, have been used with some success to assist in teaching students severely challenged with autism. “We call them fidget tools because they really are tools,” Edmonton autism specialist Terri Duncan told CBC News. “Sometimes it helps to tune out other sensory information. Sometimes it helps them calm and focus. Sometimes it helps them with their breathing and relaxing. It’s a little bit different for every child.” They are one of a series of such tools, including fidget cubes, squishy balls, fuzzy rings, tangle puzzles, putty and even chews — colourful, tactile objects to meet the special needs of ASD children.  Fidget spinners, she adds, “can prevent kids from chewing on their fingers, from picking at their hands, picking at their clothes” and actually help them to concentrate more in class.

Serious problems arise when the fidget spinners are employed to simply relieve everyday stress and anxiety. One leading clinical psychologist, Dr. Jennifer Crosbie of Toronto’s Sick Children’s Hospital, sees value in the gadgets for treating autistic children, but is not a fan of their widespread use in classrooms.  In her words, “it’s too distracting” and “draws attention” to the user, disrupting the class. She and many other clinicians now recommend that schools limit their use to special education classes or interventions.

School authorities in Maritime Canada appear to have initially accepted the claims of the marketers and been swayed by their special education program consultants.  Self-regulation, championed by Dr. Shanker, has made inroads in elementary schools, many of which embrace “mindfulness” and employ “stress-reduction” strategies.  In the region’s largest school district, Halifax Regional School Board, the policy decision was left up to individual schools and frustrated teachers took to social media to complain about the constant distraction and ordeal of confiscating spinners to restore order. New Brunswick’s Anglophone school districts seeking to accommodate learning challenged students in inclusive classrooms accepted spinners as just another pacifying tool to complement their wiggle stools. In rural school communities such as Nova Scotia’s Shelburne and Pictou counties and towns such as Summerside, PEI, the craze popped up in schools totally unprepared with policies to deal with students fixated with the gadgets.

Prominent education critics and teacher researchers are now having a field day exposing the pseudoscience supporting the introduction of fidget spinners into today’s regular classrooms.  A Winnipeg psychologist, Kristen Wirth, finds little evidence testifying to their positive results and claims that it is a “placebo effect” where “we feel something is helping, but it may or may not be helping.”  Canada’s leading teen mental health expert, Dr. Stan Kutcher, sees “no substantive evidence on spinners” and warns parents and teachers to be wary of the out-sized claims made by marketers of the toys.

British teacher Tom Bennett, founder of researchED, is more adamant about the “latest menace” to effective teaching and learning in our schools.  The latest fad – fidget spinners – he sees as symptomatic of “education’s crypto-pathologies.”  Teachers today have to contend with students purportedly exhibiting “every trouble and symptom” of anxiety and stress.  Misdiagnoses, he claims, can lead to children feeling they have some insurmountable difficulty in reading, when what it requires is tutorial help and ongoing support.

“Many children do suffer from very real and very grave difficulties,” Bennett points out, and they need intensive support. When it comes to “fidget spinners,” he adds, “we need to develop a finer, collective nose for the bullshit, for the deliberately mysterious, for the (purely invented) halitosis of the classroom.”  In spite of the inflated claims of the marketers, “magic bullets and magic beans” won’t provide the solutions.

Why are today’s schools so susceptible to the inflated claims of marketers promoting the latest educational gadget?  Do popular inventions like the fidget spinner answer some inner need in today’s fast-paced, high anxiety, unsettled popular culture?  To what extent have Dr. Stuart Shanker and his student behaviour theorists made us more receptive to tools which are said to relieve stress and promote “self-regulation” in children?  Why do so many education leaders and school principals go along with the latest trend without looking deeper at its research-basis and broader impact? 

 

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The public cries of “crisis” are in the air, especially when it comes to child/teen mental health in the schools. Britain’s government-appointed Mental Health Champion, Natasha Devon, rang the latest alarm bell in The Telegram (April 29, 2016) claiming that the “child mental health crisis is spinning out of control.” In issuing her “Mental Health Manifesto” for Britain’s schoolchildren, Devon frequently cites a scary figure to buttress her public claims — the statistic that “rates of depression and anxiety among teenagers have increased by 70 per cent in the past 25 years.”

TeenDepressionUKNot everyone accepts her public pronouncements at face value — and a few are looking more deeply into the nature, definition, and prevalence of the so-called “child public health crisis.” Devon’s further claim that it constitutes an “epidemic” has sparked even more skepticism. Is this the proverbial twenty-first century equivalent of “crying wolf” or just a manifestation of our contemporary tendency to ‘pathologize’ social-psychological trends?

One of Canada’s leading teen mental health experts, Dr. Stan Kutcher, devotes his life to educating teachers, students and families about mental health disorders, but he is very skeptical about overblown claims. When asked about the purported “crisis” at St. Francis Xavier University a few weeks ago, he startled a local newspaper reporter with this statement: “there is no mental health crisis for crying out loud.”

Dr. Kutcher was not minimizing  the severity of the problem, but rather questioning the veracity of some of the recent public claims. “We have the same proportion of mental illness in our society now that we had 40, 50, 60 years ago,” he explained. “There is no epidemic of illness, there is better recognition of illness, which is good but what we’re seeing now is an epidemic of ‘I think I have a mental disorder when I’m just really feeling unhappy,’ and that is a direct reflection of poor mental health literacy.”

Like many health professionals, Dr. Kutcher sees the popular media as contributing to the public misunderstanding about the nature and prevalence of mental disorders. He’s critical of those who exaggerate the “crisis” and equally concerned about others too quick to dismiss
it as a ‘teenage fad.’“Now the depression happens in adolescents and depression is a serious disease and if you have depression you need the proper treatment for depression, but feeling unhappy, that’s not depression,” he said.“So I think a lot of people have become confused with all the talk about mental health and mental illness without the literacy to understand what they’re talking about.”

TeenMentalHealthDrStanStress and distress is not all bad, according to Kutcher. “People do have daily distress, that is normal, ubiquitous, necessary and good for you,” he said.“And all of us are going to have a mental health problem like the loss of a loved one, moving to a new city, losing your job – those are substantive challenges in our lives and we need extra help for that. But those two things aren’t mental illnesses and they don’t need to be medicalized, they don’t need medications, they don’t need specialized psychotherapy, they don’t need access to the mental health care system.They can be dealt with, the first one, mental distress, by yourself with your friends. The second one with special support, sometimes counselors, sometimes your clergy, whoever.”

As the Sun Life Chair of Teen Mental Health at Dalhousie University Medical School, Kutcher’s assessment carries considerable weight and he makes the critical distinctions that the popular media tend to completely miss: “Mental illnesses are different; they need specialized treatment like a treatment for any illness. But one of the challenges we have is that socially we’re tending to confuse mental distress and mental health problems with mental illness. So, because I feel unhappy today I feel like I should have therapy, because I take umbrage at what you said to me I have an anxiety disorder, that’s not true at all.”

Dr. Kutcher seems to dispute the whole approach taken by Britain’s Mental Health czarina and ‘body health’ counsellor, Natasha Devon. While Devon and her Self-Esteem Team (SET) target standardized tests and exams as “stress-inducers,” Kutcher and other specialists, including Dr. Michael Ungar, see value in competitive activities in developing “resilience” in teens.  Dr. Kutcher puts it this way: “We have to be very careful to differentiate the slings and arrows of outrageous fortune in real life which we have to learn to deal with and overcome, and for which we don’t need treatment, and those things which actually require treatment.”

Mental health disorders are serious and providing more accessible, effective and sustainable services should be a top public policy priority, inside and outside of schools. “Teenage angst,” as Ella Whelan recently pointed out, “is not a serious mental health issue.” It is important to carefully consider all public claims for their veracity and to be skeptical of mental health charities seeking to “normalize mental illness.” We must also recognize that “not all of the kids are all right.” Nor are mental health services accessible or available when and where they are needed in and around the schools. Therein lies the real problem.

What ‘s driving the public call to address the “child mental health crisis” in schools? Are school authorities and educators equipped to make the critical distinction between normal ‘mental health stresses’ and serious disorders requiring treatment?  Is there a danger that those ringing the alarm bells are ‘pathologizing’ teenage anxieties and stress?  Is it possible to identify and support those in serious personal crisis while recognizing that competition and stress develops ‘resilience’ and is part of healthy preparation for life? 

 

 

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