Early adolescence is a developmental period during which many mental health problems emerge. It is a period of heightened vulnerability associated with reduced attentional, emotional, and behavioural regulation. For that reason, researchers have been testing programs to help adolescents learn self-regulation skills to reduce the risk of mental health problems and to promote well-being. Typically, such programs are delivered in school settings because of schools’ central role in the lives of children and families. One such program is the school-based mindfulness therapy program (SBMT) in the United Kingdom, which trains teachers to roll out the program in their classrooms. The program was developed as a mindfulness training for the general population. Participants are encouraged to develop a daily mindfulness practice. Montero-Marin and colleagues enrolled 84 schools and 8,376 adolescents (11-13 years) in this large randomized controlled study. Half of the schools’ students received SBMT, while the other half received the standard social, health, and economic education curriculum. The study aimed to assess if SBMT could be adequately implemented on a large scale and if it was more effective than the standard curriculum in reducing mental health problems and promoting resilience. The authors found that most students attended 9 out of 10 SBMT sessions and that the teachers faithfully delivered the content 83% of the time. However, student engagement with mindfulness practice during and after the intervention was very low, suggesting that they did not practice mindfulness outside the classroom. About 30% of students were at high risk for depression or social-emotional problems. High-risk students who received SBMT reported significantly worse depression and social-emotional functioning at post-intervention and at one-year follow-up compared to those who received the standard curriculum. These worsening effects were small and opposite to what was expected.
Practice Implications
Low-intensity psychological programs are sometimes touted as a means of reducing the risk of mental health problems in the population. However, findings like these suggest that broadly implementing such a program without sufficient support may lead to unexpected negative outcomes. Younger adolescents may be unable to reflect on the nature of their conscious awareness required to apply mindfulness skills. Those in late adolescence may not fully engage in mindfulness or other interventions when they do not choose to but are required to do so. Also, as the authors suggest, low-intensity programs may bring into awareness upsetting thoughts, feelings and mental difficulties without sufficient support. And perhaps most importantly, these programs do not address the very real social and societal difficulties that at-risk adolescents face.
Montero-Marin, J., Allwood, M., Ball, S., Crane, C., DeWilde, K., Hinze, V., … Kuyken, W. (2022). School-based mindfulness training in early adolescence: What works, for whom and how in the MYRIAD trial? Child and Adolescent Mental Health, 25, 117-124. http://dx.doi.org/10.1136/ebmental-2022-300439.
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