Posted 12.04.2018 | by AMRA

While there is a fairly extensive research literature evaluating the benefits of Mindfulness Based Stress Reduction (MBSR) for adults with depression and anxiety, research into the benefits of MBSR for adolescents with mental health problems is sparse.

Vohra et al. [Child and Adolescent Mental Health] conducted a controlled trial of MBSR as an adjunctive treatment for adolescents attending an intensive residential mental health treatment program.

The researchers studied 85 non-psychotic adolescent patients (average age = 14 years; 59% male; 73% Caucasian) residing in an intensive residential mental health treatment program. Half of the residents received standard residential care and half received standard residential care plus adjunctive MBSR. Assignment to condition was based on the time of year that patients resided in the treatment program, rather than on individual randomization.

Standard residential care consisted of a structured program including daily group therapy, medication, education, recreation, and weekly family therapy. Adjunctive MBSR was offered in eight two-hour weekly sessions with a three-hour retreat in week eight. The standard MBSR protocol was modified for the age group and homework was less demanding.

Outcome measures assessed at baseline, 10 weeks, and 3 months included parent, teacher, and self-ratings using the Behavioral Assessment System for Children System (BASC) as well as self-ratings on perceived stress, mindfulness (using the Child Acceptance and Mindfulness Measure), and emotional regulation. During the course of the study, 4 participants were discharged early and one participant declined further participation. Average MBSR session attendance was 88%.

BASC teacher ratings showed significant improvements for the adjunctive MBSR group on measures of internalizing problems (depression, anxiety, somatization) and adaptive skills (social skills, study skills, leadership) compared to standard care alone. Average ratings of internalizing problems in the MBSR group decreased from 53 to 51, whereas standard care alone ratings increased from 56 to 63.

Average MBSR adaptive skills ratings improved from 44.7 to 45.5, whereas standard care alone ratings improved from 44.4 to 44.6. Effect sizes for adaptive skills were not indicated, but appear small. There were no significant differences on any other rating scales. In a post-hoc analysis, the MBSR group had a significantly shorter length of stay in the program (133 vs.151 days).

The results of this study show that adjunctive MBSR can improve teacher-reported internalizing problems and adaptive skills among adolescents attending an intensive residential mental health program. These same improvements were not found for participant self-report or parental ratings, but as this was a residential program, parents had only minimal contact with their children.

The study was limited by its lack of individual random assignment, as well as the fact that teachers performing ratings were not blind to condition, introducing the possibility of evaluation bias.

Reference:

Vohra, S., Punja, S., Sibinga, E., Baydala, L., Wikman, E., Singhal, A., . . . Van Vliet, J. (2018). Mindfulness-based stress reduction for mental health in youth: A cluster randomized controlled trial. Child and Adolescent Mental Health.

[Link to abstract]