The contribution of mindfulness-based therapies for children and families and proposed conceptual integration

The Effectiveness of Mindfulness-Based Interventions in Improving the Mental Health of Parents of Children with Intellectual or Developmental Disabilities: A Systematic Review and Meta-Analysis

This review aims to evaluate the effectiveness of mindfulness-based interventions in improving the mental health of parents of children with intellectual and developmental disabilities (IDDs), specifically focusing on outcomes such as parental stress, anxiety, depression, and parent-child relationships. A systematic search was conducted across multiple databases, including Web of Science, PubMed, Embase, and others, up to December 2024. Two reviewers independently screened studies, extracted data, and assessed bias risk using the Cochrane Risk of Bias tool. Studies involving parents of children with intellectual or developmental disabilities who received mindfulness-based interventions and reported psychological outcomes were included. The meta-analysis was conducted using Review Manager 5.4 software, with a random effects model applied. This systematic review included 15 studies (1124 participants), of which 14 were used for meta-analysis (1078 participants). The results indicate that mindfulness-based interventions reduced the stress levels [SMD = - 0.26, 95% CI (- 0.49, - 0.04)], depressive symptoms [SMD = - 0.37, 95% CI (- 0.66, - 0.08)], distress [SMD = - 0.26, 95% CI (- 0.43, - 0.09)] and anxiety symptoms[SMD = - 0.35, 95% CI (- 0.66, - 0.04)] of parents of children with IDDs, while also improving parent-child relationships [SMD = - 0.32, 95% CI (- 0.05, - 0.58)], although the effects were moderate. Subgroup analyses revealed that interventions lasting 8 weeks or more [SMD =- 0.41, 95% CI (-0.67, -0.14)] and those targeting only the parents [SMD = - 0.26, 95% CI (- 0.44, - 0.08)] showed some positive effects in improving parent-child relationships or parent stress. Mindfulness-based interventions appear to have a positive effect on improving the mental health of parents of children with IDDs. However, the evidence of their effectiveness in enhancing parental mindfulness remains inconclusive. Future studies should consider the key factors influencing intervention implementation and optimize the design of large-scale randomized controlled trials to systematically and comprehensively assess the effectiveness and applicability of mindfulness-based interventions.

Mindfulness in paediatric occupational therapy practice: a phenomenological inquiry

PURPOSE

While research into mindfulness practices is on the rise across populations, there is evidence to suggest that clinical practice has outpaced the literature with regard to mindfulness in pediatric rehabilitation. The aim of this study was to explore the perceptions of occupational therapists who opt to incorporate mindfulness into their clinical practices with children and youth.

METHODS

Hermeneutic phenomenology was the methodology of the study. The theoretical framework employed a Heideggerian-informed phenomenology of practice. Eight occupational therapists practicing in Canada and the United States participated in 90-120 min semi-structured interviews that elicited first-hand accounts of mindfulness in pediatric occupational therapy practice. Interviews were transcribed verbatim and analyzed using Finlay's four-step approach.

RESULTS

Six salient themes were identified in the data: drawing from personal practice, enhancing participation, fostering healthy habits, adapting for children, keeping it playful, and doing with.

CONCLUSION

The findings of this study offer insights for therapists who are considering incorporating mindfulness into their practices with children and youth. Further, this research highlights a number of research priorities that require further inquiry.

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents

BACKGROUND

Emotional and behavioural difficulties (EBD) in children are common, characterised by externalising or internalising behaviours that can be highly stable over time. EBD are an important cause of functional disability in childhood, and predictive of poorer psychosocial, academic, and occupational functioning into adolescence and adulthood. The prevalence, stability, and long-term consequences of EBD highlight the importance of intervening in childhood when behavioural patterns are more easily modified. Multiple factors contribute to the aetiology of EBD in children, and parenting plays an important role. The relationship between parenting and EBD has been described as bidirectional, with parents and children shaping one another's behaviour. One consequence of bidirectionality is that parents with insufficient parenting skills may become involved in increasingly negative behaviours when dealing with non-compliance in children. This can have a cyclical effect, exacerbating child behavioural difficulties and further increasing parental distress. Behavioural or skills-based parenting training can be highly effective in addressing EBD in children. However, emotional dysregulation may intercept some parents' ability to implement parenting skills, and there is recognition that skills-based interventions may benefit from adjunct components that better target parental emotional responses. Mindful parenting interventions have demonstrated some efficacy in improving child outcomes via improvements in parental emotion regulation, and there is potential for mindfulness training to enhance the effectiveness of standard parent training programmes.

OBJECTIVES

To assess the effectiveness of mindfulness-enhanced parent training programmes on the psychosocial functioning of children (aged 0 to 18 years) and their parents.

SEARCH METHODS

We searched the following databases up to April 2023: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL Plus, PsycINFO, Sociological Abstracts, Social Sciences Citation Index, Conference Proceedings Citation Index - Social Science & Humanities, AMED, ERIC, ProQuest Dissertations & Theses, Cochrane Database of Systematic Reviews, Campbell Collaboration Library of Systematic Reviews, as well as the following trials registers: ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also contacted organisations/experts in the field.

SELECTION CRITERIA

We included randomised and quasi-randomised trials. Participants were parents or caregivers of children under the age of 18. The intervention was mindfulness-enhanced parent training programmes compared with a no-intervention, waitlist, or attentional control, or a parent training programme with no mindfulness component. The intervention must have combined mindfulness parent training with behavioural or skills-based parent training. We defined parent training programmes in terms of the delivery of a standardised and manualised intervention over a specified and limited period, on a one-to-one or group-basis, with a well-defined mindfulness component. The mindfulness component must have included mindfulness training (breath, visualisation, listening, or other sensory focus) and an explicit focus on present-focused attention and non-judgemental acceptance.

DATA COLLECTION AND ANALYSIS

We followed standard Cochrane procedures.

MAIN RESULTS

Eleven studies met our inclusion criteria, including one ongoing study. The studies compared a mindfulness-enhanced parent training programme with a no-treatment, waitlist, or attentional control (2 studies); a parent training programme with no mindfulness component (5 studies); both a no-treatment, waitlist, or attentional control and a parent training programme with no mindfulness component (4 studies). We assessed all studies as being at an unclear or high risk of bias across multiple domains. We pooled child and parent outcome data from 2118 participants to produce effect estimates. No study explicitly reported on self-compassion, and no adverse effects were reported in any of the studies. Mindfulness-enhanced parent training programmes compared to a no-treatment, waitlist, or attentional control Very low certainty evidence suggests there may be a small to moderate postintervention improvement in child emotional and behavioural adjustment (standardised mean difference (SMD) -0.46, 95% confidence interval (CI) -0.96 to 0.03; P = 0.06, I2 = 62%; 3 studies, 270 participants); a small improvement in parenting skills (SMD 0.22, 95% CI 0.06 to 0.39; P = 0.008, I2 = 0%; 3 studies, 587 participants); and a moderate decrease in parental depression or anxiety (SMD -0.50, 95% CI -0.96 to -0.04; P = 0.03; 1 study, 75 participants). There may also be a moderate to large decrease in parenting stress (SMD -0.79, 95% CI -1.80 to 0.23; P = 0.13, I2 = 82%; 2 studies, 112 participants) and a small improvement in parent mindfulness (SMD 0.21, 95% CI -0.14 to 0.56; P = 0.24, I2 = 69%; 3 studies, 515 participants), but we were not able to exclude little to no effect for these outcomes. Mindfulness-enhanced parent training programmes compared to parent training with no mindfulness component Very low certainty evidence suggests there may be little to no difference postintervention in child emotional and behavioural adjustment (SMD -0.09, 95% CI -0.58 to 0.40; P = 0.71, I2 = 64%; 5 studies, 203 participants); parenting skills (SMD 0.13, 95% CI -0.16 to 0.42; P = 0.37, I2 = 16%; 3 studies, 319 participants); and parent mindfulness (SMD 0.11, 95% CI -0.19 to 0.41; P = 0.48, I2 = 44%; 4 studies, 412 participants). There may be a slight decrease in parental depression or anxiety (SMD -0.24, 95% CI -0.83 to 0.34; P = 0.41; 1 study, 45 participants; very low certainty evidence), though we cannot exclude little to no effect, and a moderate decrease in parenting stress (SMD -0.51, 95% CI -0.84 to -0.18; P = 0.002, I2 = 2%; 3 studies, 150 participants; low certainty evidence).

AUTHORS' CONCLUSIONS

Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.

A Reliability Generalization Meta-Analysis of the Child and Adolescent Mindfulness Measure (CAMM)

We carried out the present meta-analysis study to secure the reliability generalization of the Child and Adolescent Mindfulness Scale (CAMM) based on its reliability findings in different studies. The study only considered full-text papers in English that were indexed in Web of Science, PubMed, ProQuest, and Scopus and presented a Cronbach's alpha value of the measurements with the CAMM (209 alpha values out of 155 papers). Using the random effects model and the Bonnet transformation, the relevant analyses yielded the transformed Cronbach's alpha value of the CAMM to be 0.80 (CI = 0.79-0.81). The present meta-analysis study concluded that the CAMM is rather reliable to be utilized in child and adolescent populations. Besides, moderator analyses to scrutinize the alpha values yielded significant differences in favor of the origin continent of the research and the CAMM-short version (25-item/10-item). Yet, it was not the case with the publication type and the adaptation status of the scale. In a nutshell, future research may confidently employ the 10-item short form of the CAMM to assess mindfulness among children and adolescents.

Tübinger Training for Autism Spectrum Disorders (TüTASS): a structured group intervention on self-perception and social skills of children with autism spectrum disorder (ASD)

In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants' self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD.

Examining the Mediating Role of Mindful Parenting: A Study on the Relationship Between Parental Emotion Regulation Difficulties and Problem Behaviors of Children with ASD

Parental emotion regulation plays a vital role in the parent-child relationship. This study examines the mediating role of mindful parenting in the relationship between parental emotion regulation difficulties and problem behaviors of children with autism spectrum disorder (ASD). The study was conducted with 273 parents of children with ASD in Istanbul. The study findings revealed a significant yet negative correlation between mindful parenting and emotion regulation difficulty and problem behaviors. The study model highlighted that emotion regulation difficulties significantly predicted mindful parenting and the child's problem behavior, whereas mindful parenting significantly predicted the child's problem behavior. Additionally, the study findings indicated that mindful parenting was a partial mediator.

Mindfulness and Imagery Enhanced Behavioral Parenting: Effectiveness Pilot of the Confident Carers Cooperative Kids Program

Mindfulness is increasingly offered to parents of children presenting with behavioral problems, either as a stand-alone intervention, or integrated within existing behavioral parenting interventions. There is relatively modest support for mindful parenting, with small to medium effect size improvements demonstrated across child and parent outcome measures. Here we introduce a mindfulness and imagery enhanced behavioral parenting program. We argue blending mindfulness, imagery and behavioral skills could produce improved parenting engagement and perseverance, leading to stronger outcomes. Pilot data is presented from two contrasting real world clinical settings. Parents attending the 8-week Confident Carers Cooperative Kids (CCCK) group program in a university clinic setting were invited to be included in the study (n = 20). Permission was also gained to use archival data from a community organisation offering CCCK groups to parents who were at risk of child welfare involvement (n = 14). Pre- and post-intervention measures were completed across both groups on parent-reported child behavior, parent wellbeing, adaptive parenting, and mindful parenting. Parents from both groups achieved significant pre- to post-intervention improvements in child behavior problems, parent wellbeing, adaptive parenting, and mindful parenting, with large effect sizes. Larger improvements in child behavior problems were reported by parents from the community group compared with the university group. The CCCK intervention appears beneficial across child and parent outcomes, including for families most in need. A larger sample is required to replicate and extend these promising findings.

Mindful Parenting Intervention MinUTo App for Parents of Preschool Children: Study Protocol of a Randomised Controlled Trial

BACKGROUND

Mindful parenting and the use of technology for parenting intervention have expanded separately from one another with promising results, but their relationship is underexplored. The current study protocol proposes a new universal intervention via app, MINd Us TOghether (MinUTo), based on mindful parenting for parents of typically developing children of 4-5 years of age.

METHODS

The effect of the intervention is evaluated using a randomised controlled trial. Around 2000 parents are enrolled and randomised to the intervention and control groups. Data are collected in three different waves from parents at baseline and endline; APP usage data allow for the analysis of intervention adherence. The MinUTo app proposes contents and activities for five dimensions of mindful parenting. Each dimension is presented within a two-week distance, explaining its importance, providing information, and offering activities for parents and children.

EXPECTED RESULTS

We hypothesise a positive effect of the intervention on primary outcomes (mindful parenting, parenting stress, parent behaviours and parental time investment), increasing parents' skills and promoting a positive parent-child relationship. We also test possible effects on secondary outcomes (parenting attitudes and beliefs) at an explorative level.

CONCLUSIONS

The study will add new considerations about the psychological and economic impact of technologies in implementing parenting interventions in non-clinical populations.

A structured group intervention (TüTASS) with focus on self-perception and mindfulness for children with autism spectrum disorder, ASD. A pilot study

Autism spectrum disorders (ASD) represent a set of long-lasting severe neurodevelopmental conditions and effective therapeutic interventions are needed. Recent research points to the importance of including mindfulness-based elements to improve emotion and body perception in the psychotherapy of patients with ASD. Therefore, we developed a structured group psychotherapy program The Tübinger Training for Autism Spectrum Disorders (Tübinger Training für Autismus-Spektrum-Störungen; TüTASS) which focuses on mindfulness-based training elements. This pilot study accompanying the TüTASS reports the first results on the feasibility of the program with a pre-post comparison of 25 treated children with ASD. The psychometric assessment comprised five standardized questionnaires/ scales evaluating on the basis of parents and patients self-reports the child's social responsiveness, behavior, strengths and difficulties, quality of life, and depressive symptoms before and after training completion. The results indicated that upon training completion, symptoms with respect to emotional and social problems, externalizing behavior, and attentional and schizoid-compulsive behavior substantially declined. In a questionnaire assessing feasibility and quality of the group training, patients and parents found the therapy highly beneficial, especially as to the focus on emotions and body, and strengths and failures. This training program was developed to bridge the gap of lacking mindfulness-based interventions with the aim to optimize the course of ASD, especially with respect to behavioral disturbances and social-emotional problems.

The Parents under Pressure parenting programme for families with fathers receiving treatment for opioid dependence: the PuP4Dads feasibility study

Background

The impact of parental drug use on children is a major public health problem. However, opioid-dependent fathers have been largely ignored in parenting research.

Objective

To implement and test the feasibility and acceptability of the Parents under Pressure programme (PuP4Dads) for opioid-dependent fathers and their families, and to determine whether or not a full-scale evaluation could be conducted.

Design

A mixed-methods feasibility study.

Setting

Two non-NHS family support services for parents who use drugs in Scotland.

Participants

Fathers prescribed opioid substitution therapy (n = 25), their partners (n = 17) and children, as well as practitioners, supervisors, service managers and referrers.

Intervention

A home-visiting programme, including an integrated theoretical framework, case formulation, collaborative goal-setting and modules designed to improve parenting, the caregiving environment and child welfare. The programme was delivered flexibly over 6 months by accredited practitioners.

Main outcome measures

Feasibility progression criteria included the recruitment target (n = 24 fathers), acceptability of PuP4Dads, father engagement in the study (including a minimum of 66% of fathers completing PuP and a minimum of 10 fathers completing baseline and post-treatment research interviews), engagement in qualitative interviews (including a minimum of 10 fathers and 90% practitioner uptake and 80% manager uptake), focus groups (with a minimum of 80% referrer uptake), adequate fidelity and no adverse events.

Data sources

The following researcher-administered validated questionnaires were used: the Brief Child Abuse Potential Inventory, the Parenting Sense of Competence Scale, the Difficulties in Emotion Regulation Scale, the Paternal Antenatal Attachment Scale, the Maternal Antenatal Attachment Scale, the Emotional Availability Scale, the Brief Infant Toddler Social and Emotional Assessment, the Strengths and Difficulties Questionnaire, the Conflict Tactics Scale, Treatment Outcome Profile and the EuroQol-5 Dimensions, five-level version. Other sources included parent-completed service use (an economic measure), social work child protection data, NHS opioid substitution therapy prescription data and practitioner-reported attendance data. We also conducted interviews with fathers (n = 23), mothers (n = 14), practitioners (n = 8), supervisors (n = 2) and service managers (n = 7); conducted focus groups with referrers (n = 28); and held an ‘expert event’ with stakeholders (n = 39).

Results

The PuP4Dads was successfully delivered within non-NHS settings and was considered acceptable and suitable for the study population. Referrals (n = 44) resulted in 38 (86%) eligible fathers, of whom 25 (66%) fathers and 17 partners/mothers consented to participate. Most fathers reported no previous parenting support. A total of 248 sessions was delivered to the 20 fathers and 14 mothers who started the intervention. Fourteen fathers (and 10 mothers) completed ≥ 6 sessions and six fathers (and four mothers) completed ≤ 5 sessions. Father and mother attendance rates were equal (mean 71%). Median length of engagement for fathers was 26 weeks and for mothers it was 30 weeks. Twenty-three fathers completed interviews at baseline, 16 fathers completed interviews at follow-up 1 and 13 fathers completed interviews at follow-up 2. Outcome measures were well tolerated; however, the suitability of some measures was dependent on family circumstances. The researcher-administered questionnaires had few missing data. The perceived benefits of PuP4Dads reported by parents, practitioners and managers included the following: the therapeutic focus on fathers improved parental emotion regulation, there was improved understanding and responding to child’s needs, there was better multiagency working and the programme was a good fit with practice ‘ethos’ and policy agenda. Learning highlighted the importance of service-wide adoption and implementation support, strategies to improve recruitment and retention of fathers, managing complex needs of both parents concurrently, understanding contextual factors affecting programme delivery and variables affecting intervention engagement and outcomes.

Limitations

Lack of emotional availability and economic (service use) data.

Conclusions

A larger evaluation of PuP4Dads is feasible.

Future work

Further work is required to demonstrate the effectiveness of PuP4Dads and the cost implications. A better understanding is needed of how the intervention works, for whom, under what circumstances and why.

Trial registration

Current Controlled Trials ISRCTN43209618.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.

Self-Compassion and Rumination Type Mediate the Relation between Mindfulness and Parental Burnout

The COVID-19 lockdown increased the day-to-day challenges faced by parents, and thereby may have increased parental burnout risk. Therefore, identifying parental burnout protection factors is essential. This study aimed to assess the protective role of the following factors which can be increased through mindfulness practice: trait mindfulness, self-compassion, and concrete vs. abstract ruminations. A total of 459 parents (M_age = 40; 98.7% female) completed self-reported questionnaires at two-time points to assess the predictive role of mindfulness on parental burnout, self-compassion and rumination type, and the mediating role of self-compassion and rumination type in the relation between mindfulness and parental burnout. Results showed that trait mindfulness, self-compassion, and rumination type at Time 1 predicted levels of parental burnout at Time 2. Self-compassion (indirect effects: b = − 22, 95% CI = [−38, −05], p < 0.01), concrete ruminations (indirect effects: b = −20, 95% CI = [−32, −09], p < 0.001), and abstract ruminations (indirect effects: b = −0.54, 95% CI = [−71, −37], p < 0.001) partially mediated the relation between trait-mindfulness and parental burnout. These findings showed that trait mindfulness, self-compassion, and concrete (vs. abstract) ruminations may help prevent parental burnout in the context of the COVID-19 pandemic. These results contribute to the field of research on parental burnout prevention and will allow for the development of effective approaches to mental health promotion in parents.

Mindfulness-Based Versus Story Reading Intervention in Public Elementary Schools: Effects on Executive Functions and Emotional Health

Introduction

In this study we compared the effects of a mindfulness-based intervention (MBI) with a story reading intervention (SI) on the executive functions and psychological profile of children in two different public schools in São Paulo, Brazil.

Methods

In this controlled clinical trial, 207 children aged 8 to 9 years old responded to the Five-Digit Test (FDT), stress levels, depression, anxiety, positive and negative affect, at baseline (T0) and 8 weeks later (T1). From T0 to T1, school 1 participated in MBI classes and school 2 in IS classes.

Results

In school 1 (MBI), children improved their scores on all tests except reading (errors) and counting (errors) compared with school 2. No differences were observed between groups in terms of emotional health.

Conclusion

It is feasible to implement MBI or SI in Brazilian public schools. Students in the MBI group presented broader effects in executive functions, while students in the SI group showed a trend toward reduced negative affect and depression symptoms.

A Community-Based Mindfulness Intervention Among Latino Adolescents and Their Parents: A Qualitative Feasibility and Acceptability Study

Few studies have evaluated the effectiveness of mindfulness-based meditation interventions (MBMIs) among Latino youth. Furthermore, joint parent-child participation in such programs is rare. Utilizing a community-based participatory research approach, this study evaluated the feasibility of a pilot bilingual MBMI among Latino adolescents and their parents in Los Angeles. Qualitative interviews were conducted to assess the practicality, implementation, and acceptability of the program. Challenges to attendance included health issues or conflicts with work. Several adolescents struggled with distractions from peers. However, overall responses suggest that parents and children found the program convenient and enjoyable, and perceived benefits from the curriculum. This study supports the feasibility of a MBMI among Latino family dyads.

Effectiveness of a Web-Based Intervention on Parental Psychological Flexibility and Emotion Regulation: A Pilot Open Trial

"Parenting Forest" is an informed contextual therapy parenting program for improving parental emotion regulation strategies and psychological flexibility. The aim of this study was to evaluate the preliminary effectiveness of a self-guided web-based intervention of the Parenting Forest program. The intervention program consists of six self-applied sequential modules that use strategies from contextual therapies for providing a parenting style open to experience, mindful and committed to its actions. A pilot controlled open trial was conducted. Eligible parents (n = 12) enrolled in the web-based intervention completed baseline (T1) and post-intervention (T2) assessment instruments. Parental psychological flexibility, avoidance, emotional regulation, parental stress, satisfaction with life, children's psychological adjustment and client satisfaction were measured to assess the effects of the intervention. Mood, coping, and value-related actions were assessed as measures of progress. The results showed positive effects on the parents' psychological flexibility and emotion regulation. Parents' mood and coping skills improved throughout the intervention program. These results provide preliminary evidence of the web-based Parenting Forest's efficacy, although further research is needed to assess its effectiveness for prevention and in clinical populations.

Risk Assessment and Crisis Intervention for Youth in a Time of Telehealth

For the last decade, there has been growing concern regarding the rising rates of youth engagement in self-injury and suicide. The worldwide outbreak of the coronavirus disease 2019 (COVID-19) has elevated these concerns due to increased risk factors pertaining to social, family, economic, and health stressors, in addition to changes to typical routines and support systems. Unfortunately, there are many barriers to at-risk youth being able to access evidence-based mental health services including cost, lack of trained providers, transportation issues, and physical distancing due to the pandemic. Providing school-based prevention and intervention programs that promote social, emotional, and behavioral well-being helps to address many of these barriers. This article highlights important considerations to providing these services in a school-based telehealth modality. Symptom clusters that put youth at risk of harm to self are described. Best practice therapeutic modalities that can be disseminated in a school-based telehealth modality, such as cognitive behavior therapy, dialectical behavior therapy, and mindfulness-based approaches, are reviewed. Although there is growing empirical literature for these school-based prevention and intervention approaches, additional research is needed to determine how to best support at-risk youth remotely.

A live-online mindfulness-based intervention for children living with epilepsy and their families: protocol for a randomized controlled trial of Making Mindfulness Matter©

BACKGROUND

Epilepsy extends far beyond seizures; up to 80% of children with epilepsy (CWE) may have comorbid cognitive or mental health problems, and up to 50% of parents of CWE are at risk for major depression. Past research has also shown that family environment has a greater influence on children's and parents' health-related quality of life (HRQOL) and mental health than epilepsy-related factors. There is a pressing need for low-cost, innovative interventions to improve HRQOL and mental health for CWE and their parents. The aim of this randomized controlled trial (RCT) is to evaluate whether an interactive online mindfulness-based intervention program, Making Mindfulness Matter (M3), can be feasibly implemented and whether it positively affects CWE's and parents' HRQOL and mental health (specifically, stress, behavioral, depressive, and anxiety symptoms).

METHODS

This parallel RCT was planned to recruit 100 child-parent dyads to be randomized 1:1 to the 8-week intervention or waitlist control and followed over 20 weeks. The intervention, M3, will be delivered online and separately to parents and children (ages 4-10 years) in groups of 4-8 by non-clinician staff of a local community epilepsy agency. The intervention incorporates mindful awareness, social-emotional learning skills, and positive psychology. It is modeled after the validated school-based MindUP program and adapted for provision online and to include a parent component.

DISCUSSION

This RCT will determine whether this online mindfulness-based intervention is feasible and effective for CWE and their parents. The proposed intervention may be an ideal vector to significantly improve HRQOL and mental health for CWE and their parents given its low cost and implementation by community epilepsy agencies.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04020484 . Registered on July 16, 2019.

Cognitive Fusion Mediates the Relationship between Dispositional Mindfulness and Negative Affects: A Study in a Sample of Spanish Children and Adolescent School Students

Nowadays, mindfulness-based interventions (MBI) have experienced a remarkable development of studies among childhood and adolescent interventions. For this reason, dispositional mindfulness (DM) measures for children and adolescents have been developed to determine the effectiveness of MBI at this age stage. However, little is known about how key elements of DM (for example, cognitive de/fusion or experiential avoidance that both confirm psychological inflexibility) are involved in the mechanisms of the children and adolescents' mental health outcomes. This research examined the mediating effect of cognitive fusion between DM and anxiety and other negative emotional states in a sample of 318 Spanish primary-school students (aged between 8 and 16 years, M = 11.24, SD = 2.19, 50.8% males). Participants completed the AFQ-Y (Avoidance and Fusion Questionnaire for youth), which is a measure of psychological inflexibility that encompasses cognitive defusion and experiential avoidance; CAMM (DM for children and adolescents), PANAS-N (positive and negative affect measure for children, Spanish version of PANASC), and STAIC (an anxiety measure for children). The study accomplished ethical standards. As MBI relevant literature has suggested, cognitive defusion was a significant mediator between DM and symptoms of both negative emotions and anxiety in children and adolescents. However, experiential avoidance did not show any significant mediating relationship. Probably, an improvement of the assessment of experiential avoidance is needed. MBI programs for children and adolescents may include more activities for reducing effects of the cognitive defusion on their emotional distress.

Mindfulness-Based Program Embedded Within the Existing Curriculum Improves Executive Functioning and Behavior in Young Children: A Waitlist Controlled Trial

There is a growing evidence base for mindfulness-based interventions in educational settings. Notably, there has been little investigation of the potential benefits of classroom-based mindfulness programs in children in the early school years (Preparatory/Kindergarten, Grades 1 and 2) despite early childhood being a period characterized by the development of self-regulation and executive functions. The present study investigated the effects of a mindfulness program that was embedded within a school curriculum. This waitlist controlled trial investigated the effects of a mindfulness program, CalmSpace, delivered by classroom teachers across two school terms. A total of 55 students, M age = 76.4 months, SD = 8.62, were allocated to participate in CalmSpace in Terms 3 and 4. Thirty-six students in the waitlist control condition, M age = 80.53 months, SD = 13.04, participated in the intervention in Term 4. The start of Term 3 served as baseline (Time 1), and measures were obtained at the end of Term 3 (Time 2) and the end of Term 4 (Time 3). Direct measures of executive functioning using the Flanker Inhibitory Control and Attention Test (Flanker Task) and Dimensional Change Card Sort Task (DCCS) from the National Institute of Health Toolkit were obtained. Teachers' report of children's behavior was also obtained using the Strengths and Difficulties Questionnaire (Teacher version) at the beginning and at the end of Term 3, and at the end of Term 4. Children who received the CalmSpace program showed improvements on the DCCS relative to waitlist control at Time 2 (Cohen's d = 0.48) and Time 3 (Cohen's d = 1.10). Similar results were found on the Flanker Task with greater improvements found at Time 2 (Cohen's d = 0.77) and Time 3 (Cohen's d = 1.33). Teachers reported improvements for those receiving CalmSpace at Time 2 on total SDQ scores, Emotional Symptoms, Conduct Problems, Hyperactivity/Attention (Cohen's d = 0.32, 0.14, 0.46, 0.30, 0.33, and 0.53, respectively) compared to waitlist control and at Time 3 (Cohen's d = 0.85, 0.37, 0.48, and 0.90, respectively). The findings demonstrate that implementing the CalmSpace program can lead to improvements in EF and attention for young children. Despite limitations, this study provides promising evidence that the inclusion of focused, targeted mindfulness activities throughout the day may represent a value-added component to the regular school curriculum that can result in benefits for the students.

The Role of Compassion and Mindfulness in Building Parental Resilience When Caring for Children With Chronic Conditions: A Conceptual Model

Compassion- and mindfulness-based interventions (CMBIs) and therapies hold promise to support parent resilience by enabling adaptive stress appraisal and coping, mindful parenting, and perhaps crucially, self-compassion. These contemplative modalities have recently been expanded to parents of children with chronic illness, building on successful applications for adults facing stress, chronic pain, or mental illness, and for healthcare professionals in response to caregiver burnout resulting from their work. The design and adaptation of interventions and therapies require a conceptual model of parent resilience in the context of childhood chronic illness that integrates mindfulness and compassion. The objective of this paper is to propose and describe such a model. First, we review the need for parent support interventions for this population. Second, we introduce a Model of Compassion, Mindfulness, and Resilience in Parental Caregiving. We highlight the mindful parenting approaches, guiding theories for adaptive coping, and family resilience frameworks that informed our model. Third, we describe a case of a parent to illustrate a practical application model. Finally, we outline future directions for intervention development and research to examine the impact of CMBIs on parent resilience.

Implementation of a Mindfulness Intervention for Women in Treatment for Opioid Use Disorder and Its Effects on Depression Symptoms

Background: Many women in treatment for opioid use disorder (OUD) also experience mental health co-morbidities. Mindfulness intervention has demonstrated effectiveness for improving mental health in the general population, but has not been tested with female populations in OUD treatment. The purpose of this study was to describe characteristics associated with participation in a mindfulness intervention provided to women in treatment for OUD, and also to evaluate the effectiveness of a mindfulness intervention on depression symptoms. Aims: To evaluate participation characteristics associated with a mindfulness intervention and to assess the impact of a mindfulness intervention on depression symptoms for women with OUD. Methods: A secondary data analysis of a mindfulness intervention with women in treatment for OUD was accomplished. Bivariate analysis was conducted to determine any sociodemographic variables associated with intervention participation. Depression scores were assessed pre and post intervention using paired samples t tests for the intervention group (n = 65) and the control group (n = 8). Results: A 45% of women in the study reported moderate to severe depression symptoms at baseline, and 63% reported high levels of childhood trauma. There was a significant decrease in depression scores (M = 3.6 [1.2,6.1]) following the mindfulness intervention for the intervention group (t(64) = 3.1, p = .003). Participants entering the intervention group with moderate to severe depression scores experienced the most significant decrease in depression symptoms (M = 6.6, SD = 13.5), (t(64) = -2.1, p < .05). Conclusions: Women in treatment for OUD experience high levels of depression symptoms and past trauma, and mindfulness is a feasible intervention for OUD populations which may improve depression symptoms.

The Effect of Mindfulness Interventions for Parents on Parenting Stress and Youth Psychological Outcomes: A Systematic Review and Meta-Analysis

Background: The psychological well-being of parents and children is compromised in families characterized by greater parenting stress. As parental mindfulness is associated with lower parenting stress, a growing number of studies have investigated whether mindfulness interventions can improve outcomes for families. This systematic review and meta-analysis evaluates the effectiveness of mindfulness interventions for parents, in reducing parenting stress and improving youth psychological outcomes. Methods: A literature search for peer-reviewed articles and dissertations was conducted in accordance with PRISMA guidelines in the PsycInfo, Medline, PubMed, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses databases. Studies were included if they reported on a mindfulness-based intervention delivered in person to parents with the primary aim of reducing parenting stress or improving youth psychological outcomes. Results: Twenty-five independent studies were included in the review. Eighteen studies used a single group design and six were randomized controlled trials. Within-groups, meta-analysis indicated a small, post-intervention reduction in parenting stress (g = 0.34), growing to a moderate reduction at 2 month follow-up (g = 0.53). Overall, there was a small improvement in youth outcomes (g = 0.27). Neither youth age or clinical status, nor time in mindfulness training, moderated parenting stress or overall youth outcome effects. Youth outcomes were not moderated by intervention group attendees. Change in parenting stress predicted change in youth externalizing and cognitive effects, but not internalizing effects. In controlled studies, parenting stress reduced more in mindfulness groups than control groups (g = 0.44). Overall, risk of bias was assessed as serious. Conclusions: Mindfulness interventions for parents may reduce parenting stress and improve youth psychological functioning. While improvements in youth externalizing and cognitive outcomes may be explained by reductions in parenting stress, it appears that other parenting factors may contribute to improvements in youth internalizing outcomes. Methodological weaknesses in the reviewed literature prevent firm conclusions from being drawn regarding effectiveness. Future research should address these methodological issues before mindfulness interventions for parents are recommended as an effective treatment option for parents or their children.

The Implementation of an mHealth Intervention (ReZone) for the Self-Management of Overwhelming Feelings Among Young People

Background

The association between mental health difficulties and academic attainment is well established. There is increasing research on mobile health (mHealth) interventions to provide support for the mental health and education of young people. However, nonadoption and inadequate implementation of mHealth interventions are prevalent barriers to such trials.

Objective

The aim of this study was to bridge this gap and examine the implementation of an mHealth intervention, ReZone, for young people in schools.

Methods

Preliminary data for 79 students collected as part of a larger trial were analyzed. We additionally conducted postimplementation consultations with teachers.

Results

ReZone was used 1043 times by 36 students in the intervention arm during the study period. Postimplementation teacher consultations provided data on implementation strategies, barriers, and facilitators.

Conclusions

Implementation strategies, barriers, and facilitators for digital interventions need to be considered to limit nonadoption and inadequate implementation in larger trials. Important considerations involve tailoring the characteristics of the intervention to the requirements of the intended user group, the technology itself, and the organization in which it is implemented.

Trial Registration

International Standard Randomised Controlled Trial Number: 13425994; http://www.isrctn.com/ISRCTN13425994

Physiological self-regulation and mindfulness in children with a diagnosis of fetal alcohol spectrum disorder

OBJECTIVE

To explore the differences in baseline respiratory sinus arrhythmia (RSA) between children with fetal alcohol spectrum disorder (FASD) and typically developing children (TDC) and to investigate whether children with FASD have the capacity to engage in a brief mindfulness exercise.

METHODS

Participants were 14 children with FASD and 20 TDC. RSA was measured at baseline, during, and following a mindfulness exercise. A mindfulness compliance checklist was completed to ascertain if children could follow the task instructions.

RESULTS

Both groups obtained high scores on the mindfulness compliance checklist. There was a trend for children with FASD to have lower baseline RSA compared to TDC. Children in both groups demonstrated an increase in RSA during the mindfulness task.

CONCLUSIONS

Children with FASD could engage in a mindfulness task, and both groups showed an increase in RSA. Further research is needed to establish whether prolonged mindfulness practice could be beneficial.

The effects of mindfulness training on suicide ideation among left-behind children in China: A randomized controlled trial

BACKGROUND

The population of left-behind children is growing rapidly in China in recent years. Without parents' company, left-behind children may develop severe emotional problems, which can trigger extreme behaviours such as self-harm and suicide. Previous literature suggests that mindfulness-based intervention could effectively alleviate a variety of sufferings such as anxiety and suicide ideation. The current study sought to examine the effectiveness of mindfulness-based intervention on suicide ideation among left-behind children in China.

METHODS

This study investigated the effects of an 8-week mindfulness training programme on suicide ideation of left-behind children in China. Forty-nine left-behind children completed a pretest and posttest on mindfulness level, social anxiety, self-esteem, and suicide ideation, with 21 in the mindfulness training group and 28 in the waitlist control group.

RESULTS

Adjusting for pretest differences analyses of covariance found that, compared with waitlist control group, the mindfulness training group showed a significant improvement in mindfulness level and decreases in social anxiety and suicide ideation after the 8-week mindfulness training.

CONCLUSION

The findings from this study support that the use of mindfulness-based intervention can effectively reduce the suicide ideation and social anxiety of left-behind children in China.

A randomized controlled trial and economic evaluation of the Parents Under Pressure program for parents in substance abuse treatment

BACKGROUND

There is growing interest in the provision of parenting support to substance misusing parents.

METHODS

This pragmatic, multi-center randomized controlled trial compared an intensive one-to-one parenting program (Parents under Pressure, PuP) with Treatment as Usual (TAU) in the UK. Parents were engaged in community-based substance misuse services and were primary caregivers of children less than 2.5 years of age. The primary outcome was child abuse potential, and secondary outcomes included measures of parental emotional regulation assessed at baseline, 6 and 12-months. A prospective economic evaluation was also conducted.

RESULTS

Of 127 eligible parents, 115 met the inclusion criteria, and subsequently parents were randomly assigned to receive PuP (n = 48) or TAU (n = 52). Child abuse potential was significantly improved in those receiving the PuP program while those in TAU showed a deterioration across time in both intent-to-treat (p < 0.03) and per-protocol analyses (p < 0.01). There was also significant reliable change (recovery/improvement) in 30.6% of the PuP group compared with 10.3% of the TAU group (p < 0.02), and deterioration in 3% compared with 18% (p < 0.02). The probability that the program is cost-effective was approximately 51.8% if decision-makers are willing to pay £1000 for a unit improvement in the primary outcome, increasing to 98.0% at a £20,000 cost-effectiveness threshold for this measure.

CONCLUSIONS

Up to one-third of substance dependent parents of children under 3-years of age can be supported to improve their parenting, using a modular, one-to-one parenting program. Further research is needed.

Psychometric Evaluation of the PROMIS® Pediatric Psychological and Physical Stress Experiences Measures

Objective

To provide psychometric evaluation of the PROMIS® Pediatric Psychological and Physical Stress Experiences measures.

Methods

Across two studies, Psychological and Physical Stress Experiences items were administered to 2,875 children aged 8-17 years and 2,212 parents of children aged 5-17 years. Analyses included descriptive statistics, reliability, factor analysis, differential item functioning (DIF), and assessment of construct validity. Items were calibrated using item response theory to estimate item parameters representative of the United States. Recommended eight- and four-item short forms were constructed for child- and parent-report versions of the Psychological and Physical Stress Experiences item banks.

Results

Final item banks were unidimensional and items were locally independent and free from impactful DIF. Psychological Stress banks include 19 child-report and 12 parent-proxy items. Physical Stress banks include 26 child-report and 26 parent-proxy items. All instruments have strong internal consistency and retest-reliability, and provide precise estimates of varying stress levels. The instruments' construct validity was evidenced by known-group comparisons and convergence with legacy measures.

Conclusions

The Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Psychological and Physical Stress item banks and short forms provide efficient, precise, and valid assessments of children's stress experiences.

Parent Engagement in Online Mindfulness Exercises Within a Parent Training Program for Post-Deployed Military Families

Mindfulness has drawn increased attention in prevention programs targeting parents. Commonly, mindfulness-based programs are provided to reduce parental stress and improve child outcomes. Less often, researchers incorporate a mindfulness-informed approach, integrating a low dose of mindfulness exercises into an existing evidence-based parent training model. Little is known about participant engagement with mindfulness exercises in such programs. This non-experimental study focuses on families who are at risk for impaired parenting due to the unique stressor of a parent's deployment to war. The goal is to examine military parents' online engagement in mindfulness exercises and associations between engagement and dispositional mindfulness within a web-enhanced parent training program. Online tracking records and self-reported data were obtained from 370 military parents (207 families) who were assigned to the program; at 6-month follow-up, 68.6% of these parents were retained (at least one parent reported from 75.4% of families). Results showed that nearly half (44.6%) of the parents engaged with the exercises. Participants who attended face-to-face group sessions (i.e., attendees) engaged throughout the intervention period whereas participants who never attended group sessions (i.e., non-attendees) mostly engaged during the first month in the program. Attendees and mothers engaged more than non-attendees and fathers. While engaged parents self-reported increased dispositional mindfulness at 6-month follow-up compared to baseline, only mothers' engagement accounted for a significant proportion of the variance (3%) in dispositional mindfulness at 6-month follow-up, after controlling for covariates. Implications for incorporating online mindfulness exercises into parent training are discussed in the context of programming for military families.

The Child’s Voice in Determining Program Acceptability for a School-Based Mindfulness Intervention

School-based mindfulness interventions have been shown to be effective in reducing mental health symptoms. However, comparatively little research has investigated the acceptability of these programs from the perspective of the children. Program acceptability underpins engagement, and more engaging programs are also more efficacious (Cowan & Sheridan, 2003; Mautone et al., 2009) yet there is little literature which has considered the acceptability of school-based mindfulness programs. To address this gap, semi-structured interviews were conducted with upper primary aged children (N = 30) who had participated in a six week mindfulness program in four Australian primary schools. Thematic analysis of interviews revealed children found the program to be acceptable. Children reported that they enjoyed doing the mindfulness program, would recommend it to others, and learned about relaxing as well as felt relaxed while doing the program. Children also highlighted the use of culturally appropriate teaching materials and possible stigmatisation as threats to the acceptability of the program. The results of the study support the acceptability of mindfulness programs in school settings, grounded in the unique perspective of the child.

Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements

A combined mindfulness-based program for children and their parents (MYmind) was beneficial for adolescents with autism spectrum disorder (ASD). In this study, we investigated whether this program is also beneficial for younger children with ASD, whether effects last on the long-term, and whether it reduces common comorbid problems. Forty-five children referred with ASD aged 8 until 19 years old, and their parents participated. Repeated measures of children's and parents' social communication problems, emotional and behavioral functioning, mindful awareness, and of parenting were conducted pre-intervention, post intervention, 2-month follow-up, and 1-year follow-up. While children did not report significant changes in mindful awareness, their social communication problems decreased, and their emotional and behavioral functioning improved. Results were not consistent at each occasion; improvements reported by children were most substantial at a 2-month follow-up and only partly remained at a 1-year follow-up, while all children's improvements as reported by parents were present on all occasions. Parents themselves reported improved emotional and behavioral functioning, improved parenting, and increased mindful awareness on all occasions. Parents' social communication problems reduced only directly after the intervention. Most improvements were supported by the qualitative investigation of children's and parents' experienced change as reported on open-ended questions. This study suggests that children, including adolescents, with ASD and their parents can benefit from a mindfulness-based program with parallel sessions for children and parents.

Evaluation of a Mindfulness-Based Mobile App Aimed at Promoting Awareness of Weight-Related Behaviors in Adolescents: A Pilot Study

Background

Mindfulness-based interventions are reported to be highly acceptable and have positive effects on youth, yet most are clinic- or school-based aimed at emotional regulation or academic performance. To provide flexible program delivery, we developed and tested a standalone mindfulness-based app aimed at improving weight-related behaviors (eg, diet, physical activity, sleep) in adolescents.

Objective

Our objective was to assess the feasibility, acceptability, and utility of a mindfulness-based mobile app.

Methods

In a single-arm pilot study, 15 adolescents (14-18 years) were prompted to access the app once a day, every day for 6 weeks. Outcomes were measured by in-app and poststudy surveys, and descriptive statistical analyses were performed. Time within a mindfulness state was self-reported during weekly timed practices.

Results

The app was rated highly for content and encouraging the practice of activities to promote mindfulness states. Teens reported increased awareness of eating behaviors and high adherence, particularly during physically active practices. Average self-reported time spent in a mindfulness state increased 2.5 times by week 6 (78 [SD 17] seconds) compared to week 1 (31 [SD 21] seconds).

Conclusions

The high acceptability and utility ratings of the app, increases in reported time in mindfulness states, and high frequency of participation, including mindful eating and physical activity, suggest the mindfulness-based mobile app has the potential to improve awareness of weight-related behaviors.

Enhancing Visual Perception and Motor Accuracy among School Children through a Mindfulness and Compassion Program

The present study assessed the effects of the mindfulness/compassion cultivating program: "Call to Care-Israel" on the performance in visual perception (VP) and motor accuracy, as well as on anxiety levels and self-reported mindfulness among 4th and 5th grade students. One hundred and thirty-eight children participated in the program for 24 weekly sessions, while 78 children served as controls. Repeated measures ANOVA's yielded significant interactions between time of measurement and group for VP, motor accuracy, reported mindfulness, and anxiety. Post hoc tests revealed significant improvements in the four aforementioned measures in the experimental group only. In addition, significant correlations were obtained between the improvement in motor accuracy and the reduction in anxiety and the increase in mindfulness. Since VP and motor accuracy are basic skills associated with quantifiable academic characteristics, such as reading and mathematical abilities, the results may suggest that mindfulness practice has the ability to improve academic achievements.

"Happiness Inventors": Informing Positive Computing Technologies Through Participatory Design With Children

Background

Positive psychological interventions for children have typically focused on direct adaptations of interventions developed for adults. As the community moves toward designing positive computing technologies to support child well-being, it is important to use a more participatory process that directly engages children’s voices.

Objective

Our objectives were, through a participatory design study, to understand children’s interpretations of positive psychology concepts, as well as their perspectives on technologies that are best suited to enhance their engagement with practice of well-being skills.

Methods

We addressed these questions through a content analysis of 434 design ideas, 51 sketches, and 8 prototype and videos, which emerged from a 14-session cooperative inquiry study with 12 child “happiness inventors.” The study was part of a summer learning camp held at the children’s middle school, which focused on teaching the invention process, teaching well-being skills drawn from positive psychology and related areas (gratitude, mindfulness, and problem solving), and iterating design ideas for technologies to support these skills.

Results

The children’s ideas and prototypes revealed specific facets of how they interpreted gratitude (as thanking, being positive, and doing good things), mindfulness (as externally representing thought and emotions, controlling those thoughts and emotions, getting through unpleasant things, and avoiding forgetting something), and problem solving (as preventing bad decisions, seeking alternative solutions, and not dwelling on unproductive thoughts). This process also revealed that children emphasized particular technologies in their solutions. While desktop or laptop solutions were notably lacking, other ideas were roughly evenly distributed between mobile apps and embodied computing technologies (toys, wearables, etc). We also report on desired functionalities and approaches to engagement in the children’s ideas, such as a notable emphasis on representing and responding to internal states.

Conclusions

Our findings point to promising directions for the design of positive computing technologies targeted at children, with particular emphases on the perspectives, technologies, engagement approaches, and functionalities that appealed to the children in our study. The dual focus of the study on teaching skills while designing technologies is a novel methodology in the design of positive computing technologies intended to increase child well-being.

Mind-Body Therapies in Children and Youth

Mind-body therapies are popular and are ranked among the top 10 complementary and integrative medicine practices reportedly used by adults and children in the 2007-2012 National Health Interview Survey. A growing body of evidence supports the effectiveness and safety of mind-body therapies in pediatrics. This clinical report outlines popular mind-body therapies for children and youth and examines the best-available evidence for a variety of mind-body therapies and practices, including biofeedback, clinical hypnosis, guided imagery, meditation, and yoga. The report is intended to help health care professionals guide their patients to nonpharmacologic approaches to improve concentration, help decrease pain, control discomfort, or ease anxiety.

Cognitive Effects of Mindfulness Training: Results of a Pilot Study Based on a Theory Driven Approach

The present paper reports a pilot study which tested cognitive effects of mindfulness practice in a theory-driven approach. Thirty-four fifth graders received either a mindfulness training which was based on the mindfulness-based stress reduction approach (experimental group), a concentration training (active control group), or no treatment (passive control group). Based on the operational definition of mindfulness by Bishop et al. (2004), effects on sustained attention, cognitive flexibility, cognitive inhibition, and data-driven as opposed to schema-based information processing were predicted. These abilities were assessed in a pre-post design by means of a vigilance test, a reversible figures test, the Wisconsin Card Sorting Test, a Stroop test, a visual search task, and a recognition task of prototypical faces. Results suggest that the mindfulness training specifically improved cognitive inhibition and data-driven information processing.

A RCT Comparing Daily Mindfulness Meditations, Biofeedback Exercises, and Daily Physical Exercise on Attention Control, Executive Functioning, Mindful Awareness, Self-Compassion, and Worrying in Stressed Young Adults

Our Western society is characterized by multitasking, competition, and constant time pressure. Negative effects of stress for the individual (anxiety, depression, somatic complaints) and for organizations and society (costs due to work absence) are very high. Thus, time-efficient self-help interventions to address these issues are necessary. This study assessed the effects of daily mindfulness meditations (MM) versus daily heart rate variability biofeedback (HRV-BF) and daily physical exercise (PE) on attention control, executive functioning, mindful awareness, self-compassion, and worrying. Young adults (n = 75, age range 18 to 40) with elevated stress levels were randomized to MM, HRV-BF, or PE, and measurements were taken at pre-test, post-test, and follow-up. Interventions in all three groups were self-guided and lasted for 5 weeks. Generalized estimating equation analyses showed that overall, all three interventions were effective and did not differ from each other. However, practice time differed between groups, with participants in the PE group practicing much more than participants in the other two groups. Therefore, additional analyses were carried out in two subsamples. The optimal dose sample included only those participants who practiced for at least 70 % of the total prescribed time. In the equal dose sample, home practice intensity was equal for all three groups. Again, the effects of the three interventions did not differ. In conclusion, MM, HRV-BF, and PE are all effective self-help methods to improve attention control, executive functioning, mindful awareness, self-compassion, and worrying, and mindfulness meditation was not found to be more effective than HRV-biofeedback or physical exercise for these cognitive processes.

Mindfulness-Oriented Meditation for Primary School Children: Effects on Attention and Psychological Well-Being

Mindfulness-based interventions are increasingly being used as methods to promote psychological well-being of clinical and non-clinical adult populations. Much less is known, however, on the feasibility of these forms of mental training on healthy primary school students. Here, we tested the effects of a mindfulness-meditation training on a group of 16 healthy children within 7-8 years of age from an Italian primary school. An active control condition focused on emotion awareness was employed on a group of 15 age-matched healthy children from the same school. Both programs were delivered by the same instructors three times per week, for 8 total weeks. The same main teacher of the two classes did not participate in the trainings but she completed questionnaires aimed at giving comprehensive pre-post training evaluations of behavior, social, emotion, and attention regulation skills in the children. A children's self-report measure of mood and depressive symptoms was also used. From the teacher's reports we found a specific positive effect of the mindfulness-meditation training in reducing attention problems and also positive effects of both trainings in reducing children's internalizing problems. However, subjectively, no child in either group reported less depressive symptoms after the trainings. The findings were interpreted as suggestive of a positive effect of mindfulness-meditation on several children's psychological well-being dimensions and were also discussed in light of the discrepancy between teacher and children's reports. More generally, the results were held to speak in favor of the effectiveness of mindfulness-based interventions for healthy primary school children.