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16 / COMMUNIQUÉ / TOME 17 / NUMÉRO 2 / AUTOMNE 2016
From Muddy Water
to Blue Skies Using
BreathingRoomTM
by Patricia Kostouros, Deb Bennett, and Kandi McElary
The Mount Royal University strategic plan, Learning
and Leading Together, has within its pages a goal
pertaining to student achievement. In particular,
this goal is related to reducing barriers to academic
success. In addition, the Okanagan Charter of Health
Promoting University and Colleges has a call to action
and suggestion that health promotion can be accomplished
when health aspects are embedded into all areas of campus
culture, across the administration, operations, and academic
mandates. Responding to the call to action required
collaboration across an institution and finding ways to
meet student needs in a variety of ways, including in their
classrooms. To engage faculty, it is vital that they are aware
of the demographics of who is in their classrooms, which
includes health and wellness statistics about those students.
When faculty are aware of student needs, they are better
equipped to support the students who often approach faculty
when they are struggling.
National College Health Assessment
One of the ways that faculty become informed about students is to share the data
that is collected from the National College Health Assessment (American College
Health Assessment Canadian reference 2016). Mount Royal University has been
collecting information from students about students for a number of years. Doing
so informs strategic direction and assists with planning for funds as well as activities
to support student needs. For the purpose of the research described herein, the most
relevant statistics taken from the NCHA are related to the mental health concerns of
students on our campus. Shared below is the most recent data from the NCHA (2016):
Students stated that these health
concerns impacted the following
academic areas: received a lower
grade on an exam or an important
project; received a lower grade in the
course; received an incomplete or
dropped the course; or experienced
a significant disruption in thesis,
dissertation, research or practicum work. Given this impact on academic work, two
faculty who were already using stress-relieving tools in their classes decided to adopt
one particular tool for use and collect data from students on its impact to reduce
stress and build resilience.
BreathingRoomTM
The BreathingRoomTM, formerly known as the Leap Project (Paccagnan, et al.,
2012), is an award-winning mental health program developed by the Canadian
Institute for Natural and Integrative Medicine (CINIM). This tool was originally
developed for young people 13-24 years of age who were experiencing symptoms of
depression. The BreathingRoomTM tool was found to be effective with the population for
which it was first devised. What was also noted was that this tool could not only reduce
depression symptoms and stress, but it was found to have resiliency factors as well.
The program consists of eight online modules all containing a variety of activities
and speakers. For example, most modules contain a piece of music, poetry, a joke
of the day, someone talking about his or her experiences, and a variety of activities
such as deep breathing, muscle relaxation, or mindfulness. The modules can be
completed in one sitting, which might take two to three hours, or spread out over a
week by completing small 20 to 30-minute sections within the modules. The concepts
within the program build upon each other over time.
The Research
The faculty researchers who used this tool were already discussing self-care and
mental health wellness strategies with students in their classes. These researchers
chose to use the BreathingRoomTM since it was already being used on the campus and
being offered to students from Wellness Services. It made sense to use a tool students
had access to and was being supported by the institution. Additionally, by researching
the impact of the existing tool, we were able to provide feedback from students about
their experience to Wellness Services.
The classes that were engaged for this research were quite different in nature
and structure, but each course had two sections. One was two sections of a child and
youth care counselling course that had 20 students in each section, and the other was
two sections of an undergraduate studies course that had about 30 students in each
section. The counselling courses included the topic of self-care and the undergraduate
studies courses were mostly focused on student wellness. The researchers created an
assignment by which the students were to engage in the BreathingRoomTM tool on a
weekly basis and journal about their experiences. What is important to note is that
assignments related to self-care already existed in these courses but were less focused
on a particular tool.
Methodology
Two sources of data were collected from students. The course assignment related
to this research asked students to keep a journal. Students were asked to submit their
journals as one data source. The other data source was participant interviews. Ten
students agreed to be interviewed. It is important to note that each researcher gathered
and anonymized the student participant data from the other researcher’s classes
ensuring that the teacher of that class did not know whether students were participating
in the research or not. Researchers also interviewed students from the other teacher’s
classes again, ensuring that participants were unidentifiable. In addition, journals
were not gathered and interviews not completed until final grades were submitted.
Researchers used a qualitative interpretive inquiry method for interviewing
as well as journal data analysis. According to Merriam (2002), asking students
about their perspectives and collecting data via interviews matches an interpretive-
phenomenological methodology. According to Fleming et al. (2002), the purpose
in using an interpretive approach is to create deep understanding and “lead to the
opening up of possibilities for this understanding” (p. 117). By reading and re-reading,
we deepened our understanding of the data and then compared and contrasted our
findings with each other. We began the interviews with one overarching question,
“What was your experience having the BreathingRoomTM used as a self-care tool in
your class?” Establishing an appropriate research question allows the researcher
to maintain a focus and direction that will guide the research (Creswell, 2014). In
Academic Impacts MRU %
Stress 39.9
Anxiety 30.8
Sleep Difficulties 28.2
Cold/Flu/Sore Throat 20.2
Depression 18.1
COMMUNIQUÉ / VOLUME 17 / ISSUE 2 / FALL 2016 / 17
this method, one would not want to truncate the interview process by staying too
aligned with any particular line of questioning, instead remaining open to use the
participant voice as fodder for the direction of the interview (Cohen, Khan & Steeves
2000). There were three journals submitted over the term, two of which focused
on integration of the BreathingRoomTM strategies with the fi nal journal asking for
specifi c feedback about the tool.
Described Experiences
In essence, we uncovered three general categories of participant data. One category
included students as having their own lived experience of a mental health concern
that was either present or had existed in the past. Another group were students that
knew others who had suffered with a mental health concern that had touched their
lives in some way. The fi nal group that surfaced were those students who had not had
any connection to mental health concerns presently or in the past. These students
had a more diffi cult time understanding why they were participating in a self-care
assignment in general, while the other two groups of participants could understand
the importance of self-care and appreciated the tool. For example, one participant
remarked, “Although it is somewhat obvious, it is amazing how often people take
their emotional health and wellbeing for granted.” Comments from those who did
not have an experience with a mental health concern were more in line with “I just
did it for the marks.” That said, some students began with the same attitude that
shifted over time, and they found it more useful as they engaged more often: “I’ll
just do it for the marks, but upon doing it, I was like wow, these stories, I can relate.”
For those students who had an appreciation of the program we heard or read
comments that seemed to reinforce prior self-care tools that had been abandoned at
some point: “The messages really allowed you to say okay I’ll do it my way…I realized
she was talking about artistic stuff, and I haven’t done that in years, haven’t really
been balanced.” Students also came to understand they are not alone, and to some
degree participation in the BreathingRoomTM gave them some perspective: “A lot of
time I feel like I’m the only one that feels this way. The BreathingRoomTM made me
more comfortable sharing things…and I realized I’m not the only one struggling
with these kinds of things.”
Barriers and Facilitators
Initially, students participated in the BreathingRoomTM tool because it was
an assignment in their courses and they wanted their grades. However, over time
students appreciated that they were able to increase the number of strategies they
had for managing self-care and stressors. They also appreciated that the activities in
the modules could be modifi ed to their own liking. For those students who were in
counselling courses, it was clear that they could use the tools they were learning not
only for themselves but for their future counselling practice. Many students created
goals for themselves and intended to maintain their self-care practice.
In terms of the factors that made it diffi cult for students to participate, one major
point was the time it took to get through all of the content in the modules. Some
students waited until the last minute to engage in the module and therefore did not
receive the benefi t of the program in the same way as those who spread it out over the
week. In addition, and this is the main complaint by students, the BreathingRoomTM
was developed for individuals struggling with symptoms of depression and is the main
focus of the fi rst four modules. This does shift over time, but it became somewhat
of a turn-off for some students. In particular, there were some students who had
experienced depression as an adolescent and did not want to revisit those experiences.
Regardless, most students expressed appreciation that we were doing more than paying
lip-service for the need to reduce stress and care for self.
Researchers’ Experiences
As researchers we bumped up against some of our own realizations when using
particular tools in assignments. For instance, we wondered about the ethics of
privileging one particular tool over another. It did occur to us that privileging one
tool took away a certain amount of student choice and autonomy to manage stress
in their own way. We also encountered disclosures in the journals that we had not
anticipated and were inappropriate for the student-teacher relationship. Finally, we
realized that for some this created more stress rather than stress relief. While our
initial intentions were meant to support students based on the NCHA data and what
we knew about student stress, we did not want to assume we knew what the students
needed and certainly did not want to increase pressure.
References
American College Health Association. American Health Association-National College Health Assessment
II: Canadian Reference Group, Executive Summary (2016).
American College Health Association. American Health Association-National College Health Assessment
II: MRU Executive Summary (2016).
Cohen, M., Kahn, D., & Steeves, R. (2000). Hermeneutic phenomenological research: A practical guide
for nurse researchers. Thousand Oaks, CA: Sage Publications.
Creswell, J. (2014). Research design: Qualitative, quantitative and mixed method approaches. Thousand
Oaks, CA: Sage Publications.
Fleming, V., Gaidys, U., & Robb, Y. (2002). Hermeneutic research in nursing: developing a Gadamerian-
based research method. Nursing Inquiry, 10, 113-120.
Merriam, S. (2002). Qualitative Research in Practice. San Francisco CA: John Wiley and Sons
Paccagnan, P., Moritz, s., Rickhi, N., Dennis, C., Malhotra, S., Hart, C., Maser, R., Rickhi, B., Toews, J.,
& Cohen, J. (2012). Recruitment experiences from piloting the LEAP project: an online spirituality
based depression intervention for young adults. Scientifi c abstract presented at the International
Research Congress on Integrative Medicine and Health. 12(1). DOI: 10.1186/1472-6882-12-S1-P166.
Patricia Kostouros is an associate faculty member in the Department of Child
Studies and Social Work. Pat works to reduce stress in the lives of post-secondary
students in both teaching and research interests. Pat was one of the CACUSS co-
chairs of the post-secondary student mental health working group and community
of practice.
Deb Bennett is an associate faculty member in the Department of General
Education. Deb’s research interests include loss and grief, student wellness, and
the scholarship of teaching and learning.
Kandi McElary is the Director of Wellness Services. Kandi has worked in post-
secondary settings for over 30 years, is a member of CACUSS, and was on the
executive of the Canadian Organization for University and College Health. Kandi
is currently co-chair of the Alberta Post-Secondary Health Association.
All three authors are associated with Mount Royal University in Calgary, Alberta.
