Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a “mental health” approach feels pathologizing. Nevertheless, these youth have suffered maltreatment and interventions to improve their ability to cope with past trauma and their often uncertain present are clearly needed. Cognitively-Based Compassion Training (CBCT) provides an alternative perspective on suffering and can be framed as a wellness intervention that is appropriate for all humans. The present study examined whether a 6-week CBCT intervention would improve psychosocial functioning among adolescents in foster care. Seventy adolescents were randomized to CBCT (twice weekly) or a wait-list condition. Youth were assessed at baseline and after 6 weeks. Groups did not differ on measures of psychosocial functioning following training; however practice frequency was associated with increased hopefulness and a trend for a decrease in generalized anxiety. Qualitative results indicated that participants found CBCT useful for dealing with daily life stressors. Adolescents in care were willing to engage in CBCT. The majority reported CBCT was very helpful and almost all reported they would recommend CBCT to a friend. Participants reported specific instances of using CBCT strategies to regulate emotion, manage stress, or to respond more compassionately towards others. Standardized self-report measures were not sensitive to qualitative reports of improved functioning, suggesting the need for measures more sensitive to the positive changes noted or longer training periods to demonstrate effects. Practical issues surrounding implementation of such programs in high-risk youth populations are identified. Recommendations are provided for further development.
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Achenbach, T. M., Dumenci, L., & Rescorla, L. A. (2003). DSM-oriented and empirically based approaches to constructing scales from the same item pools. Journal of Clinical Child and Adolescent Psychology, 32(3), 328–340.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington: University of Vermong, Research Center for Children, Youth, and Families.
American Academy of Pediatrics, Committee on Early Childhood, Adoption, and Dependent Care. (2002). Health Care of Young Children in Foster Care. Pediatrics, 109, 536–541.
Bernstein, D. P., Ahluvalia, T., Pogge, D., & Handelsman, L. (1997). Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child and Adolescent Psychiatry, 36(3), 340–348.
Black, D. S., Milam, J., & Sussman, S. (2009). Sitting-meditation interventions among youth: A review of treatment efficacy. Pediatrics, 124(3), e532–e541.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.
Brown, K. W., West, A. M., Loverich, T. M., and Biegel, G. M. (2011). Assessing adolescent mindfulness: Validation of an adapted mindful attention awareness scale in adolescent normative and psychiatric populations. Psychological Assessment.
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. The Journal of Alternative and Complementary Medicine, 15(5), 593–600.
Essau, C. A., Sasagawa, S., & Frick, P. J. (2006). Callous-unemotional traits in a community sample of adolescents. Assessment, 13(4), 454–469.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.
Fink, L. A., Bernstein, D., Handelsman, L., & Foote, J. (1995). Initial reliability and validity of the childhood trauma interview: A new multidimensional measure of childhood interpersonal trauma. The American Journal of Psychiatry, 152(9), 1329–1335.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.
Greco, L. A., Baer, R. A., and Smith, G. T. (2011). Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (camm). Psychological Assessment.
Guertin, T., Lloyd-Richardson, E., Spirito, A., Donaldson, D., & Boergers, J. (2001). Self-mutilative behavior in adolescents who attempt suicide by overdose. Journal of the American Academy of Child and Adolescent Psychiatry, 40(9), 1062–1069.
Hishinuma, E. S., Miyamoto, R. H., Nishimura, S. T., Goebert, D. A., Yuen, N. Y. C., Makini, G. K., et al. (2001). Prediction of anxiety disorders using the state-trait anxiety inventory for multiethnic adolescents. Journal of Anxiety Disorders, 15(6), 511–533. doi:10.1016/S0887-6185(01)00079-2.
Kimonis, E. R., Frick, P. J., Skeem, J. L., Marsee, M. A., Cruise, K., Munoz, L. C., et al. (2008). Assessing callous-unemotional traits in adolescent offenders: Validation of the inventory of callous-unemotional traits. International Journal of Law and Psychiatry, 31(3), 241–252.
Kohlberg, L. (1976). Moral stages and moralization: The cognitive-developmental approach. In T. Lickona (Ed.), Moral development and behavior: Theory, research, and social issues. Holt: Rinehart and Winston.
Kraus, S., & Sears, S. (2009). Measuring the immeasurables: Development and initial validation of the Self-other four immeasurables (SOFI) scale based on buddhist teachings on loving kindness, compassion, joy, and equanimity. Social Indicators Research, 92(1), 169–181.
Kuo, H.-K., Yen, C.-J., Chang, C.-H., Kuo, C.-K., Chen, J.-H., & Sorond, F. (2005). Relation of C-reactive protein to stroke, cognitive disorders, and depression in the general population: systematic review and meta-analysis. Lancet Neurology, 4(6), 371–380.
Lau, M. A., Bishop, S. R., Segal, Z. V., Buis, T., Anderson, N. D., Carlson, L., et al. (2006). The toronto mindfulness scale: development and validation. Journal of Clinical Psychology, 62(12), 1445–1467.
Lloyd, E. E., Kelley, M. L., and Hope, T. (1997). Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates. Paper presented at the Society for Behavioral Medicine.
Lloyd-Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristic and functions on non-suicidal self-injury in a community sample of adolescents. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 37(8), 1183–1192.
Mehl, M. R., & Pennebaker, J. W. (2003). The sounds of social life: A psychometric analysis of students’ daily social environments and natural conversations. Journal of Personality and Social Psychology, 84(4), 857–870.
Mehl, M. R., Pennebaker, J. W., Crow, D. M., Dabbs, J., & Price, J. H. (2001). The Electronically Activated Recorded (EAR): A device for sampling naturalistic daily activities and conversations. Behavior Research Methods. Instruments & Computers, 33(4), 517–523.
Napoli, M., Krech, P. R., & Holley, L. C. (2005). Mindfulness training for elementary school students: The attention academy. Journal of Applied School Psychology, 21(1), 99–125.
Neumann, A., van Lier, P. A. C., Gratz, K. L., & Koot, H. M. (2010). Multidimensional assessment of emotion regulation difficulties in adolescents using the difficulties in emotion regulation scale. Assessment, 17(1), 138–149.
Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. JAMA: Journal of the American Medical Association, 295(13), 1549–1555.
Ozawa-de Silva, B., Dodson-Lavelle, B., Raison, C. L., and Negi, L. T. Compassion and ethics: Scientific and practical approaches to the cultivation fo compassion as a foundation for ethical subjectivity and well-being. The Journal of Healthcare, Sciences, and the Humanities (in press).
Ozawa-de Silva, B., & Dodson-Lavelle, B. (2011). An education of heart and mind: Practical and theoretical issues in teaching cognitive-based compassion training to children. Practical Matters, 1(4), 1–28.
Pace, T. W. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D., et al. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology, 34(1), 87–98.
Pace, T. W. W., Negi, L. T., Sivilli, T. I., Issa, M. J., Cole, S. P., Adame, D. D., et al. (2010). Innate immune, neuroendocrine and behavioral responses to psychosocial stress do not predict subsequent compassion meditation practice time. Psychoneuroendocrinology, 35(2), 310–315.
Pradhan, A. D., Manson, J. E., Rifai, N., Buring, J. E., & Ridker, P. M. (2001). C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA: The Journal Of The American Medical Association, 286(3), 327–334.
Ridker, P. M. (2007). Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity. Nutrition Reviews, 65(12 Pt 2), S253–S259.
Riggs, S. A. (2010). Childhood emotional abuse and the attachment system across the life cycle: What theory and research tell us. Journal of Aggression Maltreatment & Trauma, 19(1), 5–51.
Robbins, M. L., Mehl, M. R., Holleran, S. E., & Kasle, S. (2011). Naturalistically observed sighing and depression in rheumatoid arthritis patients: A preliminary study. Health Psychology, 30(1), 129–133.
Roose, A., Bijttebier, P., Decoene, S., Claes, L., & Frick, P. J. (2010). Assessing the affective features of psychopathy in adolescence: A further validation of the inventory of callous and unemotional traits. Assessment, 17(1), 44–57.
Rush, A. J., Bernstein, I. H., Trivedi, M. H., Carmody, T. J., Wisniewski, S., Mundt, J. C., et al. (2006). An evaluation of the quick inventory of depressive symptomatology and the hamilton rating scale for depression: a sequenced treatment alternatives to relieve depression trial report. Biological Psychiatry, 59(6), 493–501.
Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., et al. (2003). The 16-Item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. [erratum appears in Biol Psychiatry. (2003) Sep 1;54(5):585]. Biological Psychiatry, 54(5), 573–583.
Saltzman, A., & Goldin, P. (2008). Mindfulness-based stress reduction for school-age children. In L. A. Greco & S. C. Hayes (Eds.), Acceptance and mindfulness treatments for children and adolescents: A practitioner’s guide (pp. 139–161). Oakland, CA USA: New Harbinger Publications.
Salzberg, S. (2002). Lovingkindness: The revolutionary art of happiness. Boston: Shambhala Publications.
Semple, R. J., Reid, E. F. G., & Miller, L. (2005). Treating anxiety with mindfulness: An open trial of mindfulness training for anxious children. Journal of Cognitive Psychotherapy, 19(4), 379–392.
Shlonsky, A., Bellamy, J., Elkins, J., & Ashare, C. J. (2005). The other kin: Setting the course for research, policy, and practice with siblings in foster care. Children and Youth Services Review, 27(7), 697–716.
Slatcher, R. B., & Trentacosta, C. J. (2011). A naturalistic observation study of the links between parental depressive symptoms and preschoolers’ behaviors in everyday life. Journal of Family Psychology, 25(3), 444–448.
Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., et al. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570–585.
Spielberger, C. D., Gorsuch, R. L., Lushene, P. R., Vagg, P. R., & Jacobs, G. (1983). Manual for the State-Trait Anxiety Inventory: STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press Inc.
Vera-Villarroel, P., Buela-Casal, G., & Spielberger, C. D. (2007). Preliminary analysis and normative data of the state-trait anxiety inventory (STAI) in adolescent and adults of Santiago. Chile. Terapia Psicologica, 25(2), 155–162.
White, S. F., Cruise, K. R., & Frick, P. J. (2009). Differential correlates to self-report and parent-report of callous-unemotional traits in a sample of juvenile sexual offenders. Behavioral Sciences & the Law, 27(6), 910–928.
Zeidan, F., Johnson, S. K., Gordon, N. S., & Goolkasian, P. (2010). Effects of brief and sham mindfulness meditation on mood and cardiovascular variables. The Journal of Alternative and Complementary Medicine, 16(8), 867–873.
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Reddy, S.D., Negi, L.T., Dodson-Lavelle, B. et al. Cognitive-Based Compassion Training: A Promising Prevention Strategy for At-Risk Adolescents. J Child Fam Stud 22, 219–230 (2013). https://doi.org/10.1007/s10826-012-9571-7
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