School-based mindfulness intervention supports

International Journal of School & Educational Psychology

ISSN: 2168-3603 (Print) 2168-3611 (Online) Journal homepage: http://www.tandfonline.com/loi/usep20

School-based mindfulness intervention supports adolescent resiliency: A randomized controlled pilot study Joshua C. Felver, Adam J. Clawson, Melissa L. Morton, Erica Brier-Kennedy, Pamela Janack & Robert A. DiFlorio To cite this article: Joshua C. Felver, Adam J. Clawson, Melissa L. Morton, Erica Brier-Kennedy, Pamela Janack & Robert A. DiFlorio (2018): School-based mindfulness intervention supports adolescent resiliency: A randomized controlled pilot study, International Journal of School & Educational Psychology, DOI: 10.1080/21683603.2018.1461722 To link to this article: https://doi.org/10.1080/21683603.2018.1461722

Published online: 15 Aug 2018.

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INTERNATIONAL JOURNAL OF SCHOOL & EDUCATIONAL PSYCHOLOGY https://doi.org/10.1080/21683603.2018.1461722

ARTICLE

School-based mindfulness intervention supports adolescent resiliency: A randomized controlled pilot study Joshua C. Felvera, Adam J. Clawsona, Melissa L. Mortona, Erica Brier-Kennedyb, Pamela Janackc, and Robert A. DiFlorioc a Syracuse University, Syracuse, New York, USA; bContact Community Services, Syracuse, New York, USA; cSyracuse City School District, Syracuse, New York, USA

ABSTRACT

This research evaluated the effects of a seven-session mindfulness intervention, Learning to BREATHE, on an ethnically diverse at-risk high school student sample. Two classrooms were randomly assigned to intervention or normal health-education programming. Results indicated significant effects to self-reported psychosocial resilience, with students receiving the intervention reporting stable levels of resilience over time and students in the control condition reporting significant reductions. Intervention groups did not evidence change to self-reported psychosocial problem behavior, school attendance, and quarterly academic grades. Findings suggest that MBI may offer an effective strategy for enhancing student dispositional resilience, and suggestions for further research are offered.

Adolescence is a crucial transitional period in which an individual undergoes considerable changes in physical, behavioral, emotional, and cognitive development (Blakemore, Den Ouden, Choudhury, & Frith, 2007; Bluth et al., 2016; Boxer, Tobin-Richards, & Petersen, 1983; Goddings, Heyes, Bird, Viner, & Blakemore, 2012). In addition to typical developmental changes, contemporary adolescents are often faced with stress across multiple domains of life (Rew, Johnson, & Young, 2014). Adolescents may experience stress related to school, social settings, family and home life, uncertainty of the future, and other variables such as finances and occupations (LaRue & Herrman, 2008; Rew et al., 2014). Stress on adolescents is related to a plethora of unfavorable outcomes that include impaired academic functioning (Suldo, Shaunessy, Thalji, Michalowski, & Shaffer, 2009), executive functioning deficits (Agoston & Rudolph, 2016), increased risk of maladaptive behaviors, and lower life satisfaction (McKight et al., 2002). While adolescents face life stressors across multiple domains that can impair healthy development, resilience is an important collection of individual dispositions that may serve as a protective variable in aiding individuals to overcome adversity (Ayyash-Abdo, Sanchez-Ruiz, & Barbari, 2016; Tan & Martin, 2016). Resilience refers to the complex interaction of individual characteristics and external supports that

KEYWORDS

mindfulness; adolescent; resiliency; contemplative; psychosocial functioning

provide protective factors to counter the effects of adverse situations that place individuals at risk of negative outcomes (Prince-Embury, 2015a; 2015b). Previous research has indicated that adolescents who are more dispositionally resilient demonstrate better academic performance (Ayyash-Abdo et al., 2016), decreased risky behavior (Prince-Embury, 2015b), and fewer mental health problems when faced with severe stressors (Kim, Cho, & Kim, 2015). Further, previous empirical studies have demonstrated that resilience may protect individuals from the deleterious effects of stressful events through providing a buffer between academic stress and anxiety (Cole et al., 2015; Kleiman, Liu, & Riskind, 2013). Luthar and colleagues (1993, 2000) have expanded on the construct of resilience by elaborating upon how protective factors of resilience can be broken down into separate categories. They describe how protective factor categories of resilience include protective-stabilizing, protective-enhancing, and protective-reactive. (Luthar, 1993; Luthar et al., 2000). Protective-stabilizing factors provide stability in competencies despite increasing or cumulating risk. Protective-enhancing factors assist individuals to engage with ongoing stressors, thus their competencies are augmented with increasing risk. Finally, protective-reactive factors

CONTACT Joshua C. Felver [email protected] College of Arts and Sciences, Psychology Department, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244, USA. Color versions of one or more figures in the article can be found online at www.tandfonline.com/USEP. © 2018 International School Psychology Association

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allow individuals to demonstrate competencies when risk levels are high rather than low (Luthar et al., 2000). Due to the multiple domains of stressors and risk factors that many adolescents face, there is a high need for intervention strategies that specifically target dispositional protective factors and thus bolster adolescent resilience. A growing body of empirical studies indicates that mindfulness-based intervention (MBI) generally promotes positive mental health indicators (Schoner-Reichl & Roeser, 2016; Tan & Martin, 2016). Mindfulness has been operationally defined as “the self-regulation of attention so that it is maintained on immediate experience” and “an orientation that is characterized by curiosity, openness, and acceptance” (Bishop et al., 2004, p. 232). Core components of mindfulness include presentmoment awareness and a nonjudging attitude toward the acceptance of experiences (Tan & Martin, 2016). Practices that utilize mindfulness training, broadly termed MBI, have been shown to be generally effective for a wide range of psychosocial difficulties (Khoury, Lecomte, Gaudiano, & Paquin, 2013). The mindfulnessbased stress reduction program (MBSR; Kabat-Zinn, 1990) has been researched in many randomized-controlled trials (Keng, Smoski, & Robins, 2011) and results have been aggregated into several meta-analyses (e.g., Chiesa & Serretti, 2009); the existing literature suggests that the program may help alleviate a variety of mental health problems as well as improve psychological functioning (Baer, 2003; Chiesa & Serretti, 2009). Shapiro and colleagues (2006) have provided a theoretical model of the putative mechanisms behind MBI, suggesting that a cyclic process of intention, attention, and attitude occurs simultaneously during mindfulness practice. The authors suggest that a significant shift in perspective occurs that is defined as reperceiving, and is believed to lead to changes in self-regulatory ability, and cognitive, emotional, and behavioral flexiblity (Shapiro et al., 2006). Put another way, it is hypothesized that MBI provides individuals with the ability to develop a distanced relationship between internal and external experiences, which in return may assist with decreasing emotional reactivity (Hayes & Feldman, 2004) and support one’s resilience to cope with stressful life events. Connecting this theoretical work with the empirical evidence suggesting that students benefit from MBI, Meiklejohn et al. (2012) elaborates that these same putative mechanisms outlined by Shapiro et al. (2006) may also be conceptualized as a means of enhancing student stress resiliency. Meiklejohn and colleagues (2012) argue that, because of the high levels of stress faced by many children and adolescents, the provision of MBI in school settings may offer effective strategies (e.g., enhanced

ability to self-regulate emotional responses to stressors) for enhancing student resilience to stressors and thus mitigating the deleterious effects of environmental stressors on their development. Within a school context, empirical research has demonstrated that MBI is a generally safe and effective intervention modality that supports psychosocial wellbeing (Felver, Celis-DeHoyos, Tezanos, & Singh, 2016), and may also be an effective strategy for more specific targeted outcomes such as aggressive and problematic behaviors (Felver, Doerner, Jones, Kaye, & Merrell, 2013; Singh et al., 2007), executive functioning skills (Parker, Kupersmidt, Mathis, Scull, & Sims, 2014), emotion-regulation (Carvalho, Pinto, & Marôco, 2016), and reductions in depressive symptoms (Bluth et al., 2016). Additionally, previous MBI research suggests that trait-level mindfulness is a significant predictor of student resilience (Keye & Pidgeon, 2013). Specifically, Zenner, Herrnleben-Kurz, and Walach (2014) completed a systematic review of school-based MBIs, and observed that mindfulness interventions are generally an effective strategy to increase student resilience (g = 0.36). Schonert-Reichl and Roeser (2016) describe one specific school-based MBI, Learning to BREATHE (L2B; Broderick, 2013), as an empirically supported strategy that may increase adolescents’ ability to regulate difficult emotional states. Given that emotion regulation is highly related to one’s ability to cope with stressful life events (Tugade & Fredrickson, 2007), L2B may provide adolescents an opportunity to develop targeted resilience skills to better manage adverse situations. In particular, Broderick and Jennings (2012) indicate L2B may increase student resilience via the development of developing a mindful attitude marked by curiosity, patience, and nonjudgment. Specifically, the authors postulate that student resilience can be strengthened by the continued practice of tolerating experiences simply as they occur, thus gaining self-regulatory capacity over behavioral or emotional reactions to stressful experiences. L2B is a mindfulness training and a universal prevention program that can be integrated into secondary education settings. The program aims to increase emotion regulation, stress management, compassion, and executive functioning skills to promote well-being and learning (Broderick, 2013; Schonert-Reichl & Roeser, 2016). L2B uses concepts from Kabat-Zinn’s (1990) MBSR program. The L2B intervention includes six major thematic foci that are delivered across group sessions, including body awareness, understanding and working with feelings, increasing awareness of thoughts, feelings, and bodily sensations, reducing harmful self-judgments, cultivating positive emotions

INTERNATIONAL JOURNAL OF SCHOOL & EDUCATIONAL PSYCHOLOGY

and mindfulness training in daily life, and cultivating emotional balance and empowerment through meditation practice (Broderick, 2013; Schoner-Reichl & Roeser, 2016). Previous empirical applications of L2B in secondary education settings have demonstrated that the full 18-session intervention may reduce levels of perceived stress and psychosomatic complaints and increase levels of efficacy in affective regulation (Metz et al., 2013), and that the abbreviated 6- to 11-session L2B intervention may improve emotion regulation, decrease levels of tiredness (Broderick & Metz, 2009), and reduce depressive symptoms (Bluth et al., 2016). Although the aforementioned literature suggests that the L2B curriculum may bolster general psychosocial functioning, there has not been a study to date that has specifically examined the program’s impact on psychosocial resiliency. The present study aims to build upon existing literature exploring the benefits of school-based MBI by evaluating the effects of the L2B curriculum on secondary student’s psychosocial functioning generally, and on student’s psychosocial resiliency in particular in order to address this specific gap in the literature. Specifically, the current study has three a priori hypotheses, which include: (a) students who receive the L2B intervention will demonstrate improvements in psychosocial resiliency, (b) students who receive the L2B intervention will demonstrate a reduction in psychosocial problem behavior, and (c) students who receive the L2B intervention will demonstrate increased school attendance and overall academic grades.

Method Setting The participating high school was selected because of its ethnically diverse student body, high proportion of atrisk adolescents (i.e., low graduation rate and high rates of economically disadvantaged students), and proximity to the first author’s university. The participating high school’s administrator identified a general education health teacher who was subsequently recruited for this project. This teacher identified two classes that were comparable in class size and time of day (consecutive morning classes). These two classes met during every school day for the entire marking period. This public high school was located in an urban neighborhood of a small city in the state of New York. According to 2015–2016 data (New York Stated Education Department 2016), 1,906 students were enrolled at grade levels 9 through 12; the 4-year graduation rate was 61%; 17% of students were identified

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as having a disability; 14% of the students were English Language Learners; and 72% of the students were classified as economically disadvantaged (e.g., receiving free or reduced-price lunch). The ethnic composition of this school was 2% American Indian, 43% African American, 12% Hispanic, 10% Asian, 31% White, and 2% multiracial. Participants and recruitment Details concerning participant enrollment in this study are provided in Figure 1. Legal guardians of students from these two classrooms (n = 40) of high school students (mixed grade levels 9 through 12) were approached for consent directly (i.e., home mailings addressed to legal guardians) and indirectly (i.e., students bringing home consent forms). Students were offered extra credit in the health education class for signed returned consent documents, regardless of whether this indicated agreeing or not agreeing to participate. Inclusion criteria included student receiving general education services in a public high school and the ability to comprehend written and spoken English language (as appraised by the general education instructor). Exclusion criteria included being 18 years of age or older. All students in the participating classrooms met inclusion criteria and no students met exclusion criteria. After obtaining guardian consent, students were asked for their assent. No guardian returned a consent form indicating that they did not want their child to participate, and one student did not give assent to participate in this research. In total, 29 students from the two classrooms (i.e., 73% of eligible students) were consented to participate in this research, although two students stopped attending school entirely after returning their guardians’ consent forms. Details concerning student demographics in the two classrooms are presented in Table 1. Student demographic information was representative of this high school, the two classrooms did not differ statistically significantly in terms of age, grade level, gender, disability status, ethnic composition (i.e., White compared to non-White), or English as a Second Language status (ps > 0.05). Research design and sampling To ascertain the effects of L2B intervention on student psychosocial characteristics, self-report questionnaires were administered pre–post delivery of the L2B curriculum. To determine intervention effects on student attendance and academic grades, student data during the quarterly marking period immediately prior to the

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All parents of students approached for consent (n = 40)

Excluded (n = 11) Parents did not return consent (n = 8) Adolescent did not assent (n = 1) On roster but not attending school (n = 2)

Two classrooms randomized (n = 29) (students n = 30)

Classroom allocated to intervention (n =18)

Classroom allocated to control (n = 11)

Completed questionnaires (n = 15) Did not attend school this week (n = 1) Stopped attending school entirely (n = 2)

Completed questionnaires (n = 11)

Completed questionnaires (n = 12) Did not attend school this week (n = 1) Stopped attending school entirely (n = 2)

Completed questionnaires (n = 11)

Completed questionnaires pre- and postintervention (n = 11)

Completed questionnaires pre- and postintervention (n = 11)

Figure 1. Diagram of participant enrollment. Table 1. Demographic characteristics of student participants.

Mean (SD) student agea Mean (SD) student grade levela Student gender b Female Male Student ethnicity Black or African American White Asian or Pacific Islander Hispanic or Latino American Indian School identified IEPb School identified ESLb

Total (n = 27) 16.39 (1.04) 9.85 (0.82)

Intervention (n = 16) 16.15 (0.90) 9.81 (0.75)

Control (n = 11) 16.74 (1.17) 9.91 (0.94)

67% 33%

69% 31%

64% 34%

48%

50%

46%

30% 15%

38% 6%

18% 27%

4% 4% 11% 30%

6% 0% 6% 20%

0% 9% 18% 46%

Independent samples t-tests yielded no significant difference (p > 0.05) between experimental and control conditions. b Chi-square test of independence yielded no significant difference (p > 0.05) between intervention and control conditions.

completion of L2B. In the event of student absence during the date that measures were being completed, the health teacher had students complete the forms the next time they were in attendance in her class. In the intervention classroom (n = 18), four students stopped attending school entirely during the time period that this study took place and two students were absent from class during the week before and after the L2B program was delivered, resulting in a total of 11 students who had completed forms at both time points. All of the control classroom’s students (n = 11) were present during both data collection dates. Subject enrollment and attrition are provided in Figure 1.

a

L2B intervention was compared to attendance during the quarter when L2B was delivered. The two classrooms were randomly assigned to receive either the L2B curriculum (i.e., intervention condition) or typical health education material (i.e., control condition). Students were administered study measures in class during the week prior to the L2B intervention commencing, and during the week following the

Measures Psychosocial resiliency Among the myriad of available self-report resilience scales (for a review see Windle, Bennett, & Notes, 2011), the Social-Emotional Assets and Resilience Scales (SEARS-SF; Merrell) offers several unique benefits for applied school-based research: (a) it was developed specifically for youth in school settings, (b) it evidences strong test–retest reliability, (c) it can be completed by parents, teachers, or students, (d) it targets social-emotional resiliency characteristics, and (e) it was designed specifically for screening and progress monitoring purposes. Students


completed the 12-item SEARS-SF. This self-report scale yields a single total score index of student social and emotional strengths, assets, and positivistic dispositional resiliency characteristics. Items on the SEARS-SF include a variety of positivistic social-emotional statements, such as “I stay in control when I get angry.” Evidence of scale reliability and validity has been reported (Merrell, 2011), including good test–retest reliability (r = 0.80). Internal consistency (i.e., Cronbach’s alpha) coefficients for the total sample were 0.79 at Time 1 and was 0.86 at Time 2, indicating acceptable and good (respectively) internal reliability (Cronbach, 1951). Psychosocial problem behavior Students completed the 28-item Behavior Assessment System for Children, third edition, Behavioral and Emotional Screening System (BASC-3 BESS; Kamphaus & Reynolds, 2015). The BASC-3 BESS is a commonly used instrument in school settings, and it was included to replicate previous findings of L2B and school-based MBI that found intervention effects to psychosocial problem behavior. This self-report scale yields separate indices of student risk in domains of internalizing behavior, externalizing behavior, and adjustment. However, the current study evaluated the BASC-3 BESS total scores as a robust measure of psychosocial problem behavior, and subscales were not analyzed in this pilot research. Items on the BASC-3 BESS include a variety of mostly negativistic socialemotional statements, such as, “I worry about what is going to happen.” Evidence of scale reliability and validity has been reported (Kamphaus & Reynolds, 2015), including good test–rest reliability (r = 0.88). Internal consistency coefficients (i.e., Cronbach’s alpha) for the total sample was 0.84 at Time 1 and 0.90 at Time 2 indicating good internal reliability (Cronbach, 1951).

Intervention and control conditions Students assigned to the intervention condition were delivered the six-session version of the L2B curriculum over the course of nine weeks during the fourth quarter of the school year. The six-session version of L2B was chosen as this shorter curriculum better matched the participating school’s limited availability for scheduling programming. An outline of the L2B curriculum is presented in Table 2, and content elements of a singleexample session are shown in Table 3; more details can be found in the published manual (Broderick, 2013). L2B was delivered by the first and fourth authors, both of whom have extensive training and experience in the delivery of MBI to youth and are licensed mental health providers. In reviewing the curriculum, the decision was made to deliver the third session, “Emotions,” over two sessions, as we felt that there was too much content to cover in a single class period; details on how this session was divided are provided in Table 2. Sessions were delivered weekly, with two weeks being skipped due to school vacation and state-mandated standardized testing. Content was delivered during a single 48-min class period once per week. The intervention condition was delivered asnormal health education programming Table 2. Overview of Learning to BREATHE curriculum. Session and theme 1 – Body

2

3

4

Student attendance The total number of unexcused student absences was totaled during the quarterly marking period preceding L2B and the marking period in which L2B was implemented.

5

6

Student academic grades On a 100-point scale, students’ average academic grades across all of their classes were calculated during two quarterly marking periods, namely the marking period preceding L2B implementation and the marking period during L2B implementation.

5

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Description Introducing L2B program, BREATHE acronym, and concept of mindfulness. Discussing how mindfulness is related to well-being and overall health and explaining how stress is typically stored in the body. – Reflections Increasing student awareness of inner self-talk and highlighting how self-talk can affect attention and performance. Discussing the relationship between cognitions and emotions, and introducing the concept of letting go. – Emotions Increasing student knowledge of how emotional states (part a) can influence overall health or wellness. Discussing how mindfulness is a tool to provide power over our emotions and behavior. – Emotions Explaining the tendency for students to avoid (part b) unpleasant emotions, and defining the concept of nonjudgment. Increasing student ability to observe the rising and falling of emotions nonjudgmentally. – Attention Increasing student knowledge concerning common life stressors and how stress builds up in the body. Integration of previously discussed material to highlight the need to pay attention to thoughts, body, and emotions to prevent the buildup of stress. – Tenderness Explaining that the mind can be trained, thus mindfulness can increase empowerment over thoughts, feelings, and behaviors. Reviewing concept of self-care and kindness and practicing making kind statements to self and others. – Habits Reviewing major concepts and themes of L2B curriculum. Discussing how students can incorporate mindfulness practice in daily lives and develop personal practice.

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Table 3. Example content “Learning to BREATHE” class (Lesson 5). Topic covered Review and brief practice Introduce new theme

Minutes devoted 5 5

Case study activity

10

Universality activity

5

Stress buildup activity

2–3

Yoga practice

10

Closing

2–3

Description Review content from previous classes. Students practice mindful breathing by focusing on somatic sensations of breath. Brief explanation of theme for class; paying attention to body, thoughts, and emotions may be useful for stress reduction. Interventionist reads a brief story and students are asked to identify potential life stressors. Class discussion on what stress is and the differences between acute and chronic stress. Students are asked to make a list of 5–10 stressors. Some stressors are anonymously read aloud. One student is chosen to complete many tasks at once. Class discussion highlights how it is difficult and stressful to complete many tasks at once. Group discusses the first step in stress management is becoming aware of stress and antecedent variables that exist prior. Class practices guided movement activities, including gentle stretching. During yoga practice, the students focus on somatic sensations, thoughts, and feelings. Review key concept that mindfulness can be a viable strategy to reduce stress or unpleasant emotions and cognitions. Class is reminded about the importance of daily practice.

research assistants and this data entry was compared and verified by the first author to ensure accuracy. To determine whether the L2B intervention had significant effects on dependent variables of interest, we selected the repeated-measures 2 × 2 ANOVA test to determine whether there was a significant interaction between the within-subject (i.e., pre–post L2B implementation) and the between-subject (i.e., random assignment to intervention condition). If the interaction term was statistically significant, post-hoc t-tests would explore the nature of the differences.

Results Fidelity of implementation Fidelity forms were independently completed by both interventionists, and by the classroom health teacher who was present during all sessions but was not involved in L2B instruction. These data indicated that there was 100% agreement (i.e., no disagreements) between all raters and that the intervention was implemented with 100% fidelity. Overview of inferential results

during the four days of the week when they were not receiving the L2B curriculum, and during most of these four days (66.7%) they listened to a brief ~5-min audio recording of a mindfulness practice that corresponded to the L2B curriculum and was provided by the L2B publisher. Students were instructed to practice mindfulness exercises between sessions as per the L2B manual and were asked to report their home practice frequency at the end of intervention; however, only four students indicated that they had practiced at all outside of class and as such this data was not included in quantitative analyses. Fidelity of L2B was monitored by the two interventionists and the health teacher (who was not involved in the delivery of the L2B content) independently completing a form of whether the intervention content (see Table 3) was or was not delivered. Put another way, fidelity was measured as an intervention adherence measure. The control condition received normal health education programming delivered by the general education health teacher (fifth author).

Statistical methods Data were coded and analyzed using SPSS version 23 (IBM Corp., 2015). Paper questionnaires were entered electronically twice by two different undergraduate

All study variables at both time points were evaluated prior to statistical analyses using visual analysis and the Shapiro-Wilk Test of Normality. Total scores on the SEARS-SF at both time points, and BASC-BESS data at Time 2, were all normally distributed (ps > 0.05). BASC-BESS data at Time 1 was somewhat positively skewed and student attendance and academic grade data were not normally distributed (ps < 0.05). Although ANOVA is robust to violations of normal distribution, both parametric and nonparametric procedures were utilized in statistical analysis of BASCBESS, and student attendance and academic grade data. Means and standard deviations for the self-report variables are presented in Table 4. Psychosocial resiliency To determine the effects of the mindfulness-based intervention (L2B) on student psychosocial resiliency (i.e., SEARS-SF scores), a repeated-measures 2 × 2 ANOVA was conducted using the intent-to-treat group assignment as the between-subject factor (i.e., intervention or control) and the pre-L2B and post-L2B assessments time points as the within-subject factor (i.e., Time 1 and Time 2). Results indicate a statistically significant interaction between intervention assignment and time, F(1,20) = 4.81, p = 0.040, ηp2 = 0.19, which is considered a large effect based on


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Table 4. Means (standard deviations) of the study variables. Intervention

Psychosocial resiliencea Psychosocial problemb behavior Attendance Academic grades

Control

Time 1 (n = 15)

Time 2 (n = 12)

Time 1 (n = 11)

Time 2 (n = 11)

23.93 (5.69) 28.00 (11.46)

24.50 (5.07) 27.08 (11.31)

23.27 (5.16) 30.55 (14.71)

19.82 (5.06) 30.00 (10.39)

16.00 (14.93) 76.24 (19.46)

12.18 (10.94) 75.34 (18.36)

7.00 (6.47) 75.23 (12.48)

7.91 (10.93) 74.47 (15.29)

a

Assessed with the Social-Emotional Assets and Resilience Scales–Short Form (SEARS-SF). Assessed with the Behavior Assessment System for Children, Behavioral and Emotional Screening System (BASC-3, BESS).

b

Cohen (1988) recommendations. A graphical depiction of these mean scores on the SEARS-SF is provided in Figure 2. To further explore these psychosocial resiliency data, post-hoc t-test analyses were utilized to explore differences between time points and groups. All available data was utilized to best explore these data (see Figure 1 for details on subject sizes at each time point). These results indicate that there were no significant differences between intervention and control groups at Time 1 (t [24] = 0.30, p = 0.76), and that there were significant differences between groups at Time 2 (t[21] = 2.22, p = 0.038). Analyses of separate group differences over time indicate that students assigned to the mindfulnessintervention condition did not change significantly over time (t[10] = 0.079, p = 0.94) and that students in the control condition had significantly lower scores at the second time point (t[10] = 3.03, p = 0.013). Psychosocial problem behavior, attendance, and academic grades Student psychosocial problem behavior (i.e., BASCBESS scores), quarterly attendance, and quarterly academic grades were analyzed using repeated measures

ANOVA procedures. The between-subject factor was group assignment, and the within-subject factor was the data obtained pre- and post-L2B for the BASCBESS, and during the quarterly marking period prior to and during the L2B implementation for attendance and academic grade data. Results indicated that there was not a statistically significant interaction between group assignment and time for any of these variables (ps > 0.05). Following recommendations for nonparametric analyses (Conover, 1999), data were rankordered and reanalyzed using the same procedure with similar statistically nonsignificant results.

Discussion The central aim of this study was to build upon the existing literature to examine whether a school-based MBI, namely L2B, delivered in a general education context, could support student psychosocial functioning and resilience. In particular, this research contributes and builds upon the existing L2B literature by evaluating the effects of the abbreviated 7-session intervention, including a control condition, and including a self-report measure designed to directly assess student resilience.

Figure 2. Significant time-by-condition interaction effect for student self-reported SEARS-SF total score.

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This research also addresses a notable limitation in the field of school-based MBI by using random assignment and a valid control condition (Felver et al., 2016). The results of the current study did not support our first a priori hypothesis, which postulated that students who received the L2B intervention would demonstrate improvements related to their psychological resilience; however, L2B did demonstrate significant unexpected intervention results. Students in the MBI group did not demonstrate a significant change to their psychosocial resilience over the course of this study; however, the control group demonstrated significantly lower levels of psychosocial resilience from the onset of the intervention to postintervention. The results obtained from this study suggest that there may be protective-stabilizing factors (Luthar, 1993) imbued in the delivery of the L2B curriculum that can play a role in minimizing the deleterious effects of stress for adolescents over time. Contrary to our hypotheses, the intervention group did not demonstrate a reduction in psychosocial problem behavior, and students who received the L2B intervention did not demonstrate increased school attendance and overall course academic grades as hypothesized a priori. Contextually, it is important to note that the date of the first assessment occurred during a typical school week, and that the date of the second assessment occurred during a week that state standardized testing was taking place. Virtually all of the participants anecdotally reported that these high-stakes state tests were a source of considerable stress. Our data indicates that students in both conditions reported comparable levels of psychosocial resiliency during the first assessment date; however, only students in the control condition had decreased levels of psychosocial resilience during the second high-stress assessment date. We believe that these findings are supportive of enhanced resiliency consistent with Luthar’s (1993) conceptualization of protective-stabilizing factors (Luthar, 1993). Specifically, students receiving MBI may have gained protective attributes via the L2B curriculum that buffered against the deleterious effects of acute increased risk (i.e., additional stress students experienced from high-stakes standardized testing during the post-MBI assessment period). As previously mentioned, Luthar (1993) outlined that protective-stabilizing factors assist individuals with the maintenance of stability of competences with increasing levels of risk. Participants who received the L2B curriculum may have demonstrated protective-stabilizing performances in which scores of psychosocial resiliency were not significantly different across time, but were significantly higher than the active control condition during the second assessment. The results of the current study appear to be in

agreement with previous empirical investigations of the effects of MBI on student psychosocial outcomes. For instance, Bluth, Roberson, and Gaylord (2015) evaluated the effects of implementing L2B among an ethnically diverse sample of at-risk adolescents. Results indicated that the L2B participants demonstrated a significant difference in depressive symptoms as compared to the active control, and the authors point to the fact that depressive symptoms worsened to a greater degree for the active control participants as compared to the L2B group (Bluth et al., 2015). Interpreting these results in light of Luthar’s conceptualization of resilience, L2B participants appear to have been demonstrating protective-stabilizing performances across measures of depressive symptoms in this study as well, as students in the L2B condition evidence relatively stable scores, whereas the scores of the active control group decreased from pre- to postintervention. We believe the results obtained in our study are consistent with findings from Bluth and colleague’s (2015) work, indicating that students who receive L2B may be acquiring attributes that offer protection against high-risk stressful contexts frequently encountered by at-risk adolescent populations. Contrary to results found in other implementations of L2B among high-risk ethnic minority adolescent students (Bluth et al., 2016; Fung, Guo, Jin, Bear, & Lau, 2016), we did not find evidence for reductions to student’s psychosocial problem behavior. It is important to note that the aforementioned studies implemented the 12-session (Fung et al., 2016) or 11-session (Bluth et al., 2016) version of the L2B intervention. Unlike other similar L2B trials, our work elected to use the shorter version (i.e., 7 sessions) of this MBI rather than the longer (i.e., 11–18 session) version. Although there is evidence to suggest that the abbreviated version of the L2B intervention is effective to decrease depressive symptoms, perceived stress, and negative affect (Bluth et al., 2015; Broderick & Metz, 2009; Eva & Thayer, 2017; Shomaker et al., 2017), it may be that in the context of the current high-risk population, this abbreviated version of L2B did not provide sufficient “dosage” of MBI to change students’ rates of problem behavior, attendance, or academic grades. In addition, it may be that the generally low levels of self-reported psychosocial problems in our sample (e.g., the overall mean for Time 1 on the BASC-3, BESS was ~29 [raw score], which yields a T-score of 54) limited the amount of overall variance available to change via intervention (i.e., floor effect). Similarly, in a general education sample, the variability in the student’s academic grades and attendance may have also been constrained.


Shapiro and colleagues (2006) provided a theoretical model of the putative mechanisms behind MBI. Specifically, they postulated that MBI may induce a significant shift in perspective through intentionally attending to inner and outer experiences with an attitude of openness and nonjudgement. The significant shift in perspective, termed reperceiving, is believed to increase self-regulatory ability, and cognitive, emotional, and behavioral flexibility. For instance, reperceiving may increase the number of potential responses elicited by an individual in response to stress, as many MBI practices involve teaching individuals to see a situation and internal reactions with greater clarity and focus on reducing unhelpful automatic responses (Shapiro et al., 2006). In this work, it could be that reperceiving functioned as the mechanism of action behind the results obtained. The L2B curriculum may have functioned as a protective-stabilizing factor by facilitating students’ ability to reperceive their stress, that is, their ability to stand back and witness internal emotional states in response to external environmental stressors. This ability to stand back and observe strong internal states may have provided students an increased ability to respond to their stressors (e.g., using L2B coping strategies to reduce physiological arousal) in ways that were in their best long-term interests, as opposed to reacting to stressors in ways that may be effective in the short-term but harmful over time (e.g., substance use, distracting with social media). In the specific high-stress sample of the current study, it could be that the MBI participants were more able to step back from the ongoing internal and external stressors and thus demonstrated more stable psychosocial resilience scores over time, as opposed to the activecontrol participants who were not able to reperceive their experience in response to chronic and acute stressors and were thus more affected by stress and demonstrated a decrease in their psychosocial resiliency. Future research should consider specifically evaluating student ability to reperceive their experience in order to empirically evaluate this theoretically postulated mechanism of action. Clinical implications The relatively low-cost and low-time commitment required to implement this brief MBI may be favorable for school-based clinicians. The L2B intervention in the current study was delivered across seven 48-min sessions, which is far less than the programmatic requirements of the full 18-session version of L2B or the average MBI delivered in school settings (Felver et al., 2016). Given the time and resource constraints of many school systems,

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briefer MBI offers a unique benefit for school systems. However, there has yet to be an empirical investigation as to whether briefer MBI (e.g., 7-session L2B) yields the same clinical benefits relative to more lengthy programming (e.g., 18-session L2B), and future researchers should consider explicitly evaluating this question. Additionally, the intervention is standardized which increases the ease and fidelity of implementation. The intervention was implemented with 100% fidelity in the present study. However, it is important to note that the first and fourth authors who delivered the L2B intervention have extensive previous experience with mindfulness-based practices. Therefore, clinicians or teachers who are interested in implementing mindfulness interventions may find it useful if they develop fluency with the intervention and core concepts within their own lives. Although prerequisite experience with personal mindfulness practice is recommended in the L2B curriculum and in other standardized mindfulness-based interventions (e.g., MBSR), the feasibility of implementing L2B without such a background has not been systematically evaluated and should be studied in future research. The L2B curriculum also fit within the New York State education curriculum for health classes. The emphasis on self-care, stress management, and increased self-regulation found within the L2B curriculum closely relates to concepts discussed within the typical health education content. Although, in the current study, L2B was implemented within a general education health classroom, the use of this or another MBI may be incorporated within a tiered system of service delivery (Tilly, 2008). For example, MBI may be delivered for at-risk (i.e., Tier 2) students struggling with increased environmental stressors (Felver et al., 2013). Limitations There were several limitations in this current study. First, follow-up data to evaluate the long-term findings related to the protective-stabilizing factors was not collected. It would have been interesting to assess whether changes observed were maintained and stable across time. Intervention adherence to the L2B home practice recommendations was poor in this sample and prohibited any form of quantitative analysis; few participants (n = 4) reported any practice outside of school. This lack of home practice may have affected the fidelity of the L2B intervention and thus resulted in the obtained null findings. Future research should address this limitation by providing an information session prior to the implementation to enhance the motivation of participants from the onset to practice at home, or to yoke home practice to their academic grade in the health

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class. The sample size in this study was relatively small (n = 29) and was comprised of only two classrooms. As a result, the current study lacked the statistical sample size to account for the effects of students nesting within classrooms. Consequently, conducting research with a greater number of classrooms would enable future researchers to account statistically for heterogeneous classroom-group effects. This study also lacked an active control that included both experiential and didactic components, and future research should consider including such a comparison condition. This research also relied solely on student self-report, which is a noted limitation in the field of schoolbased MBI (Felver et al., 2016), and future work should consider utilizing multi-informant outcome measurement. Future research should also consider the inclusion of consumer satisfaction data, as this may provide interesting information that could inform future work with high-risk adolescent populations. Another limitation in this work was that we did not assess for students’ prior experience with MBI or L2B. Prior experience with MBI may have moderated the results obtained, and as such future research should consider assessing this student characteristic and including this information in quantitative analyses. Conclusions Taken as a whole, the results of this work contribute to the burgeoning literature base, suggesting the utility of school-based MBI. The current research contributes to the field of mindfulness-based research in the schools, as well as offers a unique aspect, as data suggests that MBI may support student resilience. In particular, to this work, results suggest that MBI may offer protective benefits to buffer against the deleterious effects of stress that all too frequently affect adolescents. Future research should seek to replicate, and expand upon, the results obtained to further explore the benefits that may be derived from school-based MBI. For example, it may be interesting to implement an MBI immediately before a period of high-stress standardized testing, and then to measure whether MBI meaningfully affected scores on these standardized tests. Such an undertaking would support the implementation of MBI and may encourage school stakeholders to invest in such programming in order to yield a measurable outcome that receives considerable attention in the current climate of public education. Future research should also focus on ensuring that students practice mindfulness exercises outside of school. Such practices would increase the fidelity of the L2B intervention, and may increase the dosage of mindfulness practice such that effects on psychosocial problem behavior and academic

behaviors could be observed. Future work with L2B should also consider research design elements that have been notably absent from the majority of school-based MBI research to date, such as collecting follow-up data, using multi-informant assessment procedures, and recruiting subjects with identified disabilities (Felver et al., 2016). School-based MBI appears to provide benefits to students, and the results from this study indicate that this programming should receive continued attention from clinicians and researchers, as MBI may offer novel and effective solutions to meeting the needs of today’s students.

About the authors Joshua Felver, PhD, is an Assistant Professor of Psychology at Syracuse University. Adam Clawson, BA, is a graduate student in school psychology at Syracuse University. Melissa Morton, MEd, is a graduate student in school psychology at Syracuse University. Erica Brier-Kennedy, MA, is a mental health professional in the Syracuse City School District. Pamela Janack, MS, is a health education teacher in the Syracuse City School District. Robert DiFlorio, EdD, is a high school principal in the Syracuse City School District.

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