Skip to main content
×
×
Home

Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study

  • Willem Kuyken (a1), Katherine Weare (a1), Obioha C. Ukoumunne (a1), Rachael Vicary (a1), Nicola Motton (a1), Richard Burnett (a2), Chris Cullen (a2), Sarah Hennelly (a3) and Felicia Huppert (a4)...
Extract
Background

Mindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have evaluated their effectiveness among young people.

Aims

To assess the acceptability and efficacy of a schools-based universal mindfulness intervention to enhance mental health and well-being.

Method

A total of 522 young people aged 12–16 in 12 secondary schools either participated in the Mindfulness in Schools Programme (intervention) or took part in the usual school curriculum (control).

Results

Rates of acceptability were high. Relative to the controls, and after adjusting for baseline imbalances, children who participated in the intervention reported fewer depressive symptoms post-treatment (P = 0.004) and at follow-up (P = 0.005) and lower stress (P = 0.05) and greater well-being (P = 0.05) at follow-up. The degree to which students in the intervention group practised the mindfulness skills was associated with better well-being (P<0.001) and less stress (P = 0.03) at 3-month follow-up.

Conclusions

The findings provide promising evidence of the programme's acceptability and efficacy.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study
      Available formats
      ×
Copyright
Corresponding author
Willem Kuyken, Exeter Mindfulness Network, University of Exeter, EX4 4QG, UK. Email: w.kuyken@exeter.ac.uk.
Footnotes
Hide All

Declaration of interest

R.B. is Co-Founder and Director and C.C. is Co-Founder of the Mindfulness in Schools Project.

Footnotes
References
Hide All
1 Luthar, SS. Vulnerability and resilience – a study of high-risk adolescents. Child Dev 1991; 62: 600–16.
2 Ford, T, Goodman, R, Meltzer, H. The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 2003; 42: 1203–11.
3 Durlak, JA, Wells, AM. Primary prevention mental health programs for children and adolescents: a meta-analytic review. Am J Community Psychol 1997; 25: 115–52.
4 Cuijpers, P, van Straten, A, Smit, F, Mihalopoulos, C, Beekman, A. Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions. Am J Psychiatry 2008; 165: 1272–80.
5 Weare, K, Nind, M. Mental health promotion and problem prevention in schools: what does the evidence say? Health Promot Int 2011; 26: 129–69.
6 Durlak, JA, DuPre, EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol 2008; 41: 327–50.
7 Williams, JMG, Kuyken, W. Mindfulness-based cognitive therapy: a promising new approach to preventing depressive relapse. Br J Psychiatry 2012; 200: 359–60.
8 Harnett, PH, Dawe, S. Review: The contribution of mindfulness-based therapies for children and families and proposed conceptual integration. Child Adolesc Ment Health 2012; 17: 195208.
9 Huppert, FA. A new approach to reducing disorder and improving well-being. Perspect Psychol Sci 2009; 4: 108–11.
10 Bishop, SR, Lau, M, Shapiro, S, Carlson, L, Anderson, ND, Carmody, J, et al Mindfulness: a proposed operational definition. Clin Psychol Sci Prac 2004; 11: 230–41.
11 Kabat-Zinn, J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Prac 2003; 10: 144–56.
12 Meiklejohn, J, Phillips, C, Freedman, ML, Griffin, ML, Biegel, GM, Roach, A, et al Integrating mindfulness training into K-12 education: fostering the resilience of teachers and students. Mindfulness 2012 (Epub March 14).
13 Goldstein, J, Kornfield, J. Seeking the Heart of Wisdom. Shambhala Publications, 1987.
14 Kabat-Zinn, J. Full Catastrophe Living: How to Cope with Stress, Pain and Illness using Mindfulness Meditation. Delacorte, 1990.
15 Segal, ZV, Williams, JMG, Teasdale, JD. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. Guilford Press, 2002.
16 Stewart-Brown, SL, Tennant, A, Tennant, R, Platt, S, Parkinson, J, Weich, S. Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey. Health Qual Life Outcomes 2009; 7: 15.
17 Stewart-Brown, SL, Platt, S, Tennant, A, Maheswaran, H, Parkinson, J, Weich, S, et al The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS): a valid and reliable tool for measuring mental well-being in diverse populations and projects. J Epidemiol Community Health 2011; 65: A389.
18 Tennant, R, Hiller, L, Fishwick, R, Platt, S, Joseph, S, Weich, S, et al The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 2007; 5: 63.
19 Cohen, S. Contrasting the Hassles Scale and the Perceived Stress Scale – who's really measuring appraised stress. Am Psychol 1986; 41: 716–8.
20 Hewitt, PL, Flett, GL, Mosher, SW. The perceived stress scale – factor structure and relation to depression symptoms in a psychiatric sample. J Psychopathol Behav 1992; 14: 247–57.
21 Pbert, L, Doerfler, LA, Decosimo, D. An evaluation of the Perceived Stress Scale in 2 clinical populations. J Psychopathol Behav 1992; 14: 363–75.
22 Jacobs, PD, Thornton, JW. Scale sensitivity of perceived stress index. Percept Motor Skill 1970; 30: 944.
23 Coyle, CP, Roberge, JJ. The psychometric properties of the Center for Epidemiologic Studies-Depression Scale (CES-D) when used with adults with physical-disabilities. Psychol Health 1992; 7: 6981.
24 Radloff, LS. The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults. J Youth Adolesc 1991; 20: 149–66.
25 Fendrich, M, Weissman, MM, Warner, V. Screening for depressive disorder in children and adolescents – validating the center for epidemiologic studies depression scale for children. Am J Epidemiol 1990; 131: 538–51.
26 Bracke, P, Levecque, K, Van de Velde, S. The psychometric properties of the CES-D 8 depression inventory and the estimation of cross-national differences in the true prevalence of depression. University of Leuven, 2008 (http://soc.kuleuven.be/ceso/dagvandesociologie/papers/CESD8%20in%20comparative%20perspective%20Vandevelde-Bracke-Levecque.pdf).
27 Burke, CA. Mindfulness-based approaches with children and adolescents: a preliminary review of current research in an emergent field. J Child Fam Stud 2010; 19: 133–44.
28 Biegel, GM, Brown, KW, Shapiro, SL, Schubert, CA. Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. J Consult Clin Psychol 2009; 77: 855–66.
29 Huppert, FA, Johnson, DM. A controlled trial of mindfulness training in schools: the importance of practice for an impact on well-being. J Posit Psychol 2010; 5: 264–74.
30 Rao, U, Ryan, ND, Birmaher, B, Dahl, RE, Williamson, DE, Kaufman, J, et al Unipolar depression in adolescents – clinical outcome in adulthood. J Am Acad Child Adolesc Psychiatry 1995; 34: 566–78.
31 Stallard, P, Sayal, K, Phillips, R, Taylor, JA, Spears, M, Anderson, R, et al Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial. BMJ 2012; 345: e6058.
32 Crane, RS, Kuyken, W, Williams, JMG, Hastings, RP, Cooper, L, Fennell, M. Competence in teaching mindfulness-based courses: concepts, development and assessment. Mindfulness 2012; 3: 8.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 1
Total number of PDF views: 621 *
Loading metrics...

Abstract views

Total abstract views: 1258 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 23rd May 2018. This data will be updated every 24 hours.

Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study

  • Willem Kuyken (a1), Katherine Weare (a1), Obioha C. Ukoumunne (a1), Rachael Vicary (a1), Nicola Motton (a1), Richard Burnett (a2), Chris Cullen (a2), Sarah Hennelly (a3) and Felicia Huppert (a4)...
Submit a response

eLetters

Sustaining long-term practice is the real challenge in promoting mindfulness

Jean E Spencer, Mindfulness Teacher
20 August 2013

"Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study" by Kuyken et al in the August issue of the Journal (1) breaks important new ground in suggesting that mindfulness practice may have a role in the amelioration of teenage depression which, as they point out, is also a risk factor for adult depression.

Their finding that those who practise mindfulness more often reap thegreater benefit is consistent with other studies of mindfulness in adults (e.g. 2). However, the actual numbers of children continuing to practise mindfulness more than once a week after the end of the MiSP is much smaller than in adult reports: less than 10% practised daily or several times a week at 3 month follow-up. The majority (61%) practised 1-3 times only in all of that time, with a further 18% not using it at all.

Mindfulness is not suited to everyone. Motivation to practise on one's own is a key issue in the effectiveness of mindfulness approaches. Motivation to practise is generally higher amongst those who have some element of suffering that they wish to overcome. The outcome studies by Jon Kabat Zinn PhD, who designed the original adult Mindfulness-Based Stress Reduction Programme for hospital outpatients with residual untreatable medical conditions such as chronic pain, show excellent follow-up practice rates, for example "At follow-up, the improvements observed during the meditation training were maintained up to 15 months post-meditation training for all measures except present-moment pain. The majority of subjects reported continued high compliance with the meditation practice as part of their daily lives." (3)

The low take-up rate post-programme in the schools study raises questions about the planned future repetition of the approach the authors took in offering the programme across the board to all school children, albeit with excellent intentions. It would be interesting to know the moderator analysis of the 3month follow-up subgroups, to investigate whichchildren continued with their mindfulness practice, in an effort to identify motivating features and define a subgroup with the best potentialfor long-term benefit. A study to determine what is cost-effective in sustaining interest in mindfulness practice might be a useful preamble to the full RCT proposed on the back of this feasibility study.

To repeat the same trial in RCT format with such potential for demonstrating that the short-term benefits of the programme are not sustained would seem to be shooting oneself in the foot, especially in thecontext of an endeavour to establish Mindfulness in Schools as a programmeworthy of the attention of funding bodies. In terms of the economic burdenof depression, projected to be the second most frequent cause of disease burden worldwide by 2020 (4), this could be a major disservice to the reputation of mindfulness as a potential alleviator of some of that burden. The authors may have to set aside the ambition for a school-wide programme until more questions have been answered relating to motivation to continue mindfulness practice beyond the initial programme.

1. Kuyken W, Weare K, Ukoumunne O, Vicary R, Motton N, Burnett R, Cullen C, Hennellly S, Huppert F. Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feaibuility study. Br J Psychiatry 2013, 203, 126-131

2. Carmody J, Baer RA. Relationships between mindfulness practice andlevels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med. 2008, 31, 23-33.

3. Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985, 8, 163-90.

4. Centres for Disease Control and Prevention Morbidity and MortalityWeekly Report, October 2010, 59, no. 38

Dr Maya (J. E.) Spencer BA, MB BS, MRCPsych, Dip ClinHyp (UCL)

Retired Consultant Psychiatrist. Teacher of the Mindfulness-Based Stress Reduction Programme in Taunton and Yeovil, Somerset.

... More

Conflict of interest: None declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *