Session 8: Final Session: Taking the Practice Forward

This final session provides a time and space for reflection—reflecting on the retreat experiences the participants have just had, their experiences with the program as a whole, and also their plans to take the practice forward. This might include how participants could seek additional support (e.g., joining a local mindfulness group) or even support each other in continued practice. In particular, time is taken to troubleshoot potential difficulties in keeping up with practice, and participants are reminded that, much like exercise, benefits will continue only with continued practice. If the optional booster session(s) will take place, time is spent scheduling and preparing for this.

Common Cognitive Slip-Ups

At the core of Wisdom Mind is the premise that normal cognitive aging can be a source of distress for certain older adults, and that mindfulness practice can help to alleviate that distress. To that end, this chapter provides an overview of the major cognitive domains and how our abilities within those domains can change with age. This material will be particularly informative for those who have not worked with older adults or do not have a background in clinical neuropsychology. It will allow the reader to connect with some of the common cognitive slip-ups that group participants may spontaneously report, so that these slip-ups can be situated within the context of mindfulness as presented in this program.

Session 9: Booster Session

The standard for mindfulness training programs, including MBSR, is an 8-week, weekly format. This chapter provides the structure for an optional follow-up or booster session that can occur outside of the standard 8-week structure of the program. The booster can be scheduled for a one-month follow-up after the group ends. At the facilitator’s discretion, you may wish to schedule additional boosters, such as at 3 months or even 1 year (such as was done in the original Wisdom Mind study). A booster session can be used to enhance ongoing engagement by promoting continued connection between participants and to troubleshoot difficulties with the practices.

Session 7: Be Your Own Meditation Instructor and Daylong Retreat

Nearing the end of the program, participants are asked to reflect on how they will sustain their mindfulness practice going forward. This underscores the self-regulatory aspect of mindfulness, as one learns how to “become one’s own meditation instructor.” This chapter also contains information regarding the daylong retreat. Participants are given guidance on how to prepare for this silent day of group mindfulness practice, and time is spent in session addressing any questions or concerns about the retreat. The prior week’s experience tracking reacting versus responding in relationships is discussed, and the final new practice of Loving-Kindness is introduced as a way to cultivate compassion for ourselves and ultimately for others.

Wisdom Mind: Conceptual Foundations and Preparing to Deliver the Program

This chapter provides the background to the Wisdom Mind program—why it was developed, the conceptual foundations on which it is based, and the results from the original empirical evaluation of the program. While the program is broadly influenced by Jon Kabat-Zinn’s mindfulness-based stress reduction, Wisdom Mind stands on its own as a unique program that is grounded in principles of clinical neuropsychology (specifically, cognitive rehabilitation) as well as lifespan developmental psychology. This chapter orients the reader to the overall structure of the program, who the program is designed for, and how to appropriately screen participants and measure outcomes/response to the program.

Session 5: Reacting Versus Responding

In this session, a distinction is made between mindfulness (coming to the present moment) and awareness (what we find when we come to this moment). After a discussion of the prior week’s practices, participants are then introduced to Open Monitoring as a way to cultivate awareness and make space for our emotional reactivity. In this context, a discussion is raised about “falling down a hole”—when we have a sustained negative emotional reaction, for example, in response to a cognitive slip-up. Participants are assigned the practice “Emotional Weather” as a way to actively work with emotions. Walking meditation (“Aimless Wandering”) is also provided for home practice.

Session 4: Paying Attention to the Commentator

The main principle introduced in this session is the idea of a “commentator”, the voice of automatic thoughts that contributes to the emotional reactivity in response to cognitive slip-ups. Through the homework of tracking “slips and falls,” participants are invited to reflect on this aspect of their mind that is constantly commenting on their experience. This, in turn, is connected to the concept of mind-wandering; this is a core concept in most discussions of mindfulness practices, and may become even more of an issue as we age. Participants are given the second of two Mindful Yoga series, and the attention hierarchy is also reinforced and connected to increasing experience with the practice. Tracking unpleasant events is also assigned for homework.

Session 2: Noticing Slip-Ups

The second session involves taking a deeper dive into mindfulness practice. We begin by debriefing participants on their initial experience with mindfulness from the prior week. As this mindfulness might be quite novel for certain participants, there may have been strong opinions or emotional reactions elicited in response to the homework. This material provides a context for the discussion of the experience of cognitive slip-ups as we age and how mindfulness can be one way to offset those slips. The facilitator then introduces the concept of cognitive reserve as a “mental bank account” that can be enhanced through mindfulness.

Session 3: Noticing Slips and Falls

The main focus of the current session is to help participants see the connection between their cognitive slip-ups (which they were asked to track in the prior week’s homework) and the emotional reactions they have to those slip-ups (i.e., “falls,” as in “slips and falls”). Homework is reviewed to provide material for this discussion. This segues into providing psychoeducation on the hierarchy of attention, and Focused Attention mindfulness is again reinforced as a way to decrease slip-ups. Participants are introduced to the first of two Mindful Yoga series as another way to experience present-moment awareness, and as a complement to sitting meditation practice. Tracking pleasant events is also assigned for homework as a way to make the bridge between mindfulness practice and daily activities and life experiences.

Session 1: Introduction to the Program

This first session covers the introduction to the program. It establishes the group context and orients participants to what to expect for the remainder of the program. Participants may have had varying levels of exposure to mindfulness, so time is taken to talk about what mindfulness is in the context of this program, and specifically how it is relevant to older adults and late-life cognitive decline. The raisin exercise is used as an in-class example of mindfulness. Information is given on the “attitudes of mindfulness,” aspirational principles that people can bring to their experiences in the program. Participants are introduced to the first homework exercises, and time is taken to troubleshoot when participants will practice and how they will remember to engage in daily practice.