The evidence base with children and young people
The evidence base for work on mindfulness and youth can be described as “promising.” There are to date eight reviews of the quantitative studies of mindfulness and the young, the most recent of which are two meta-analyses by Zoogman et al. (2015) and Zenner et al. (2014). Both concluded that mindfulness had an overall effect size in the small to moderate range and found no examples of adverse (harmful) effects. There is also a growing literature of qualitative work, on mindfulness for the young in health contexts, on mindfulness for the adults who work with youth, on the theories behind mindfulness, and on the neuroscience of mindfulness. Interventions amenable for robust evaluation tend to be relatively short, with six to eight sessions being common, although many are part of wider and more diffuse programs and frameworks. They are diverse but tend to be in schools rather than health settings, and more with adolescents than with younger students. Twice as many are targeted as universal programs, and a growing number in teacher education and in the community.
All reviews comment on the methodological weaknesses of existing studies (e.g., Greenberg and Harris 2012), as would be expected in a young field. Studies are generally underpowered, being mostly small pilots and exploratory studies. There are few RCTs. There are a number of studies that show some element of control (mostly wait-list), but many are before and after studies with no controls. Few studies have adequate follow-up. Measurement is underdeveloped, with few measures designed specifically for young people, no standardization or even much overlap in the use of measures, and a good deal of emphasis on self-report rather than more “objective” measures. Studies cover a diverse range of age groups, contexts, problems, and conditions, with little replication, which undermines claims for generalizability. There is frequent use of the same teams to design, deliver, and evaluate programs with the consequent problem of bias.
Calls for better quality and more robust research are being heeded and many teams are currently addressing the methodological concerns in newer research; meanwhile, there is reason to believe that all of this activity is proving to be worthwhile. The hard evidence that has emerged so far is positive and promising. Interventions tend to be highly “acceptable,” that is popular with staff and students, with no reported adverse effects. The outcomes, which will be discussed later, are very much in line with the outcomes that have emerged in research with adults. The same broad processes and mechanisms are at work for children and adults, although some teams are now examining the developmental aspects of mindfulness; for example, how mindfulness skills and the nature of appropriate interventions may change across the age range.