School-based mindfulness programs

Perhaps teenagers are too cynical to benefit from mindfulness, say authors of latest school trial

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In the UK, more and more children are learning mindfulness at school. The Mindfulness in Schools project claims that over 4000 of our teachers are now trained in the practice. However, some experts are concerned that the roll-out of mindfulness has raced ahead of the evidence base, which paints a mixed picture.

A research team led by Catherine Johnson at Flinders University has now reported in Behaviour Research and Therapy the results of their latest school trial, which included new features in the mindfulness intervention, such as parental involvement and better designed homework materials, intended to maximise the programme’s effectiveness. However, once again the mindfulness programme led to no observable benefits.

Full story via The British Psychological Society

Link to Journal abstract: Johnson, C et al.  A randomized controlled evaluation of a secondary school mindfulness program for early adolescents: Do we have the recipe right yet?  Behaviour Research and Therapy | Volume 99, December 2017 |  Pages 37-46

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Mindfulness in schools: what next?

Mindfulness holds great promise, but can it really improve children’s thinking and wellbeing? And if so, does that help children to behave well in class and do better in school? | by Jennifer Hanratty for The Mental Elf Blog

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Maynard and colleagues (2017) carefully reviewed the evidence for MBIs for children in schools. They did a very thorough search of databases, relevant websites and conference records and contacted experts. They found 65 relevant studies of MBIs. Out of all the evidence found, 44 studies were well designed; in that the researchers assigned children or whole classes to either get MBI or not. Those who didn’t get MBI were put on a waiting list or just continued with their normal school activities. This means that the two groups (“got MBI”, “didn’t get MBI”) can be compared to see what effect MBIs have independent of any changes that would happen anyway without MBI. This is especially important for children because they will naturally develop thinking skills and social skills as they get older and also learn and practice these skills at school.

The author’s conclusions are slightly different to my own. They conclude that:

There is some indication that MBIs can improve cognitive and socio-emotional outcomes, but no support for improvement in behavior or academic achievement.

My interpretation of the evidence presented is that, as the authors say, there is a small effect of MBIs on helping children to feel good and improve their thinking skills. However, based on the forest plots it seems, to me at least, that there may well be a small positive effect on behaviour and academics too, but these results were not statistically significant and studies were of low quality. Without more and better quality studies we can’t say for sure whether or not MBIs might help children behave better or do better in school tests.

Mindfulness facets and problematic Internet use

The aim of this study was to study the cross-sectional and longitudinal associations between mindfulness facets and problematic Internet use in adolescents | Addictive Behaviors

Highlights: 

  • Acting with awareness and non-judging are the dimensions of mindfulness that are most closely associated with all PIU components.
  • Non-judging is the only dimension of mindfulness that predicts a decrease in the preference for online social interactions over face-to-face relationships.
  • Conclusions are supported by the use of a longitudinal design.

Findings indicated that non-judging is the only dimension of mindfulness that predicts a decrease in preference for online social interactions over face-to-face relationships. Moreover, non-judging indirectly predicted reductions in the rest of the problematic Internet use components. The observing and acting with awareness dimensions of mindfulness directly predicted less deficient self-regulation of Internet use and indirectly predicted less negative outcomes through their impact on deficient self-regulation. Thus, these dimensions seem to act when the maladaptive use of the Internet is consolidated.

Full reference: Calvete, E. et al. (2017) Mindfulness facets and problematic Internet use: A six-month longitudinal study. Addictive Behaviors. Vol. 72 (September) pp. 57-63

Mindfulness-Based Interventions in Adolescents with Chronic Illness

Mindfulness-based interventions (MBIs) have emerged as a promising strategy for individuals with a chronic illness, given their versatility in targeting both physical and mental health outcomes. However, research to date has focused on adult or community-based populations | The Journal of Alternative and Complementary Medicine

Objectives: To systematically review and critically appraise MBIs in clinical pediatric samples living with chronic physical illness.

Results: Of a total 4710 articles, 8 articles met inclusion criteria. All studies were small , included only outpatient adolescent samples, and focused on feasibility and acceptability of MBI; only 1 study included a comparison group (n = 1). No studies included online components or remote attendance. All studies found that MBI was acceptable to adolescents, whereas feasibility and implementation outcomes were mixed. Many studies were underpowered to detect significant differences post-MBI, but MBI did demonstrate improvements in emotional distress in several studies.

Conclusions and Implications of Key Findings: The literature on MBIs is preliminary in nature, focusing on adapting and developing MBI for adolescents. Although MBIs appear to be a promising approach to coping with symptoms related to chronic illness in adolescents, future research with adequate sample sizes and rigorous research designs is warranted.

Full reference: Ahola Kohut, S. et al (2017) Mindfulness-Based Interventions in Clinical Samples of Adolescents with Chronic Illness: A Systematic Review. The Journal of Alternative and Complementary Medicine. Vol. 23(no. 8) pp. 581-589.

The role of trait mindfulness in quality of life and asthma control among adolescents with asthma

The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients | Journal of Psychosomatic Research

In this cross-sectional study, questionnaire data of 94 adolescents with asthma that were prescribed daily asthma medication were included. Two Structural Equation Models (SEMs), a direct model and an indirect model, were tested.

We found that trait mindfulness was directly related to asthma-related QoL, but not to asthma control. The relationship between trait mindfulness and asthma-related QoL was explained by asthma-specific, but not by general stress. Furthermore, an indirect relation from mindfulness to asthma control via asthma-specific stress was found.

Cross-sectional evidence for a relation between mindfulness and asthma-related QoL is found. These findings may point to the possibility that an intervention aimed at increasing mindfulness could be a promising tool to improve asthma-related QoL in adolescents via a decrease in asthma-specific stress.

Full reference: Cillessen, L. et al. (2017) The role of trait mindfulness in quality of life and asthma control among adolescents with asthma. Journal of Psychosomatic Research. Vol. 99 (August) pp. 143–148.

Integrating Mindfulness into Family Therapy with Adolescents

Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices | Family Process

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These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy.

This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated.

Full reference: Brody, J.L. et al. (2017) A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.  Family Process. Published online: 7 June 2017

School-Based Mindfulness Program and Depression in Adolescents

This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms.

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Based on theory and previous research, we identified the following potential moderators:

  1. severity of symptoms of depression at baseline
  2. gender
  3. age
  4. school track.

The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium.

We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.

Full reference: der Gucht, K.V. et al. (2017) Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents. Mindfulness. 8(797)