Skip to main content

Mindfulness-Based Interventions for Adolescents with Mental Health Conditions: A Systematic Review of the Research Literature

Abstract

Objectives

Although research investigating Mindfulness-based interventions (MBIs) for adults has increased exponentially, the evidence of the effects of MBIs on adolescents with mental health problems is only beginning to emerge. Our aim is to systematically review the current state of the MBI research literature across the range of mental health conditions in adolescents, and to identify some key research questions yet unanswered.

Methods

MEDLINE, CINAHL, PsycINFO and Scopus were searched, as well as the references of retrieved articles. Of 754 articles, 17 met the inclusion criteria. Of these, only a few studies implemented a manualized intervention for adolescents, five featured interventions adapted from the classical Mindfulness models (MBSR and MBCT), while the remaining studies used a combination between these models while incorporating also other components. In terms of research design, only three of the studies were RCTs, seven pilot studies, five design studies and the rest were feasibility studies. Moreover, only three of the seventeen studies used validated measures of mindfulness in gauging the impact of the interventions.

Results

We identified the following four categories of mental health conditions in studies of MBIs among adolescents: Neurodevelopmental and Behavioral Disorders; Mood and Anxiety Disorders; Substance Abuse Disorders, and Heterogeneous Disorders.

Conclusions

The evidence so far suggests that MBIs are both feasible and well accepted, although study populations and methods varied so much that precise estimates of impact on clinical outcomes needs further research. Guided by our systematic review, we summarize ways to adapt MBIs for adolescents with mental health problems.

This is a preview of subscription content, access via your institution.

References

  1. Reviewed articles are marked by an*

  2. Abujaradeh, H., Safadi, R., Sereika, S. M., Kahle, C. T., & Cohen, S. M. (2018). Mindfulness-based interventions among adolescents with chronic diseases in clinical settings: a systematic review. Journal of Pediatric Health Care, 32(5), 455–472.

    PubMed  Article  Google Scholar 

  3. Ali, A., Weiss, T. R., Dutton, A., McKee, D., Jones, K. D., Kashikar-Zuck, S., & Shapiro, E. D. (2017). Mindfulness-based stress reduction for adolescents with functional somatic syndromes: a pilot cohort study. Journal of Pediatrics, 183, 184–190.

    PubMed  Article  Google Scholar 

  4. *Ames, C. S., Richardson, J., Payne, S., Smith, P., & Leigh, E. (2014). Innovations in practice: mindfulness-based cognitive therapy for depression in adolescents. Child and Adolescent Mental Health, 19(1), 74–78.

    Article  Google Scholar 

  5. Baer, J. S., & Peterson, P. (2002). Motivational interviewing with adolescents and young adults. In W. R. Miller & S. Rollnick (Eds), Motivational interviewing: preparing people for change. New York, NY: Guilford Press.

    Google Scholar 

  6. Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143.

    Google Scholar 

  7. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.

    PubMed  PubMed Central  Article  Google Scholar 

  8. Baer, R. A., Walsh, E., & Lykins, E. L. R. (2010). Assessment of mindfulness. In F. Didonna & F. Didonna (Eds), Clinical handbook of mindfulness (pp. 153–168). New York, NY: Springer.

    Google Scholar 

  9. Barnert, E. S., Himelstein, S., Herbert, S., Garcia‐Romeu, A., & Chamberlain, L. J. (2014). Exploring an intensive meditation intervention for incarcerated youth. Child and Adolescent Mental Health, 19(1), 69–73.

    Article  Google Scholar 

  10. Barrera, M. E., Rapoport, A., & Daniel, K. S. (2018). Easing psychological distress in pediatric cancer. In J. Wolfe, B. Jones, U. Kreicbergs & M. Jankovic (Eds), Palliative Care in Pediatric Oncology (pp. 159–187). Cham, Switzerland: Springer.

    Chapter  Google Scholar 

  11. Bawa, F. L., Mercer, S. W., Atherton, R. J., Clague, F., Keen, A., Scott, N. W., & Bond, C. M. (2015). Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. British Journal of General Practice, 65(635), e387–400.

    PubMed  Article  Google Scholar 

  12. *Beauchemin, J., Hutchins, T. L., & Patterson, F. (2008). Mindfulness meditation may lessen anxiety, promote social skills, and improve academic performance among adolescents with learning disabilities. Complementary Health Practice Review, 13(1), 34–45.

    Article  Google Scholar 

  13. *Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 77(5), 855–866.

    Article  Google Scholar 

  14. *Bogels, S., Hoogstad, B., van Dun, L., de Schutter, S., & Restifo, K. (2008). Mindfulness training for adolescents with externalizing disorders and their parents. Behavioural and Cognitive Psychotherapy, 36(2), 193–209.

    Article  Google Scholar 

  15. Bögels, S., & Restifo, K. (2013). Mindful parenting: A guide for mental health practitioners. New York, NY: Springer.

  16. Bootzin, R. R., & Stevens, S. J. (2005). Adolescents, substance abuse, and the treatment of insomnia and daytime sleepiness. Clinical Psychology Review, 25(5), 629–644.

    PubMed  Article  Google Scholar 

  17. Borum, R., & Verhaagen, D. A. (2006). Assessing and managing violence risk in juveniles. New York, NY: Guilford Press.

    Google Scholar 

  18. Britton, W. B., Lepp, N. E., Niles, H. F., Rocha, T., Fisher, N. E., & Gold, J. S. (2014). A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children. Journal of School Psychology, 52(3), 263–278.

    PubMed  PubMed Central  Article  Google Scholar 

  19. Broderick, P. C., & Jennings, P. A. (2012). Mindfulness for adolescents: a promising approach to supporting emotion regulation and preventing risky behavior. New Directions for Youth Development, 2012(136), 111–126.

    PubMed  Article  Google Scholar 

  20. Broderick, P. C., & Metz, S. (2009). Learning to BREATHE: a pilot trial of a mindfulness curriculum for adolescents. Advances in School Mental Health Promotion, 2(1), 35–46.

    Article  Google Scholar 

  21. Bylund, D. B., & Reed, A. L. (2007). Childhood and adolescent depression: why do children and adults respond differently to antidepressant drugs? Neurochemistry International, 51(5), 246–253.

    PubMed  PubMed Central  Article  Google Scholar 

  22. Chadi, N., McMahon, A., Vadnais, M., Malboeuf-Hurtubise, C., Djemli, A., Dobkin, P. L., & Haley, N. (2016). Mindfulness-based intervention for female adolescents with chronic pain: a pilot randomized trial. Journal of the Canadian Academy of Child and Adolescent Psychiatry (Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent), 25(3), 159–168.

    Google Scholar 

  23. Chronis, A. M., Gamble, S. A., Roberts, J. E., & Pelham, W. E. (2006). Cognitive-behavioral depression treatment for mothers of children with attention-deficit/hyperactivity disorder. Behavior Therapy, 37(2), 143–158.

    PubMed  Article  Google Scholar 

  24. Coffman, J. K., Guerin, D. W., & Gottfried, A. W. (2006). Reliability and validity of the parent-child relationship inventory (PCRI): evidence from a longitudinal cross-informant investigation. Psychological Assessment, 18(2), 209–214.

    PubMed  Article  Google Scholar 

  25. Collishaw, S., Maughan, B., Goodman, R., & Pickles, A. (2004). Time trends in adolescent mental health. Journal of Child Psychology and Psychiatry and Allied Disciplines, 45(8), 1350–1362.

    Article  Google Scholar 

  26. *Cotton, S., Luberto, C. M., Sears, R. W., Strawn, J. R., Stahl, L., Wasson, R. S., & Delbello, M. P. (2016). Mindfulness-based cognitive therapy for youth with anxiety disorders at risk for bipolar disorder: a pilot trial. Early Intervention in Psychiatry, 10(5), 426–434.

    PubMed  Article  Google Scholar 

  27. Counsell, C. (1997). Formulating questions and locating primary studies for inclusion in systematic reviews. Annals of Internal Medicine, 127(5), 380–387.

    PubMed  Article  Google Scholar 

  28. Dahl, R. E., & Gunnar, M. R. (2009). Heightened stress responsiveness and emotional reactivity during pubertal maturation: implications for psychopathology. Development and Psychopathology, 21(1), 1–6.

    Article  PubMed  Google Scholar 

  29. *de Bruin, E. I., Blom, R., Smit, F. M., van Steensel, F. J., & Bogels, S. M. (2015). MYmind: mindfulness training for youngsters with autism spectrum disorders and their parents. Autism, 19(8), 906–914.

    PubMed  Article  Google Scholar 

  30. *Edelen, M. O., Cerully, J. L., Verni, K. A., Tucker, J. S., & Fox, E. (2013). Implementation of mindfulness training for adolescent residential clients. Therapeutic Communities, 34(2–3), 96–103.

    Google Scholar 

  31. Follette, V., Palm, K. M., & Pearson, A. N. (2006). Mindfulness and trauma: Implications for treatment. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 24(1), 45–61.

    Article  Google Scholar 

  32. Goodman, T. A., & Greenland, S. K. (2010). Mindfulness with children: working with difficult emotions. In F. Didonna & F. Didonna (Eds), Clinical handbook of mindfulness (pp. 417–429). New York, NY: Springer.

    Google Scholar 

  33. Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., & Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357–368.

    PubMed  PubMed Central  Article  Google Scholar 

  34. Grabovac, A. D., Lau, M. A., & Willett, B. R. (2011). Mechanisms of mindfulness: a Buddhist psychological model. Mindfulness, 2(3), 154–166.

    Article  Google Scholar 

  35. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta- analysis. Journal of Psychosomatic Research, 57(1), 35–43.

    PubMed  Article  Google Scholar 

  36. Guo, S., Wu, Q., Smokowski, P. R., Bacallao, M., Evans, C. B., & Cotter, K. L. (2015). A longitudinal evaluation of the positive action program in a low-income, racially diverse, rural county: effects on self-esteem, school hassles, aggression, and internalizing symptoms. Journal of Youth and Adolescence, 44(12), 2337–2358.

    PubMed  Article  Google Scholar 

  37. *Haydicky, J., Shecter, C., Wiener, J., & Ducharme, J. M. (2015). Evaluation of MBCT for adolescents with ADHD and their parents: impact on individual and family functioning. Journal of Child and Family Studies, 24(1), 76–94.

    Article  Google Scholar 

  38. Hayward, C., Varady, S., Albano, A. M., Thienemann, M., Henderson, L., & Schatzberg, A. F. (2000). Cognitive-behavioral group therapy for social phobia in female adolescents: results of a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 39(6), 721–726.

    PubMed  Article  Google Scholar 

  39. Himelstein, S. (2011). Mindfulness-based substance abuse treatment for incarcerated youth: a mixed method pilot study. International Journal of Transpersonal Studies, 30(1–2), 1–10.

    Article  Google Scholar 

  40. *Himelstein, S., Saul, S., & Garcia-Romeu, A. (2015). Does mindfulness meditation increase effectiveness of substance abuse treatment with incarcerated youth? A pilot randomized controlled trial. Mindfulness, 6(6), 1472–1480.

    Article  Google Scholar 

  41. Holzel, B. K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S. M., Gard, T., & Lazar, S. W. (2011). Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging, 191(1), 36–43.

    PubMed  Article  Google Scholar 

  42. Hunsley, J., & Lee, C. M. (2007). Research-informed benchmarks for psychological treatments: efficacy studies, effectiveness studies, and beyond. Professional Psychology: Research and Practice, 38(1), 21–33.

    Article  Google Scholar 

  43. Huppert, F. A., & Johnson, D. M. (2010). A controlled trial of mindfulness training in schools: the importance of practice for an impact on well-being. Journal of Positive Psychology, 5(4), 264–274.

    Article  Google Scholar 

  44. Jastrowski Mano, K. E., Salamon, K. S., Hainsworth, K. R., Anderson Khan, K. J., Ladwig, R. J., Davies, W. H., & Weisman, S. J. (2013). A randomized, controlled pilot study of mindfulness-based stress reduction for pediatric chronic pain. Alternative Therapies in Health and Medicine, 19(6), 8–14.

    PubMed  Google Scholar 

  45. Jonkman, E. J. (1997). The role of the electroencephalogram in the diagnosis of dementia of the Alzheimer type: an attempt at technology assessment. Clinical Neuropsychology, 27(3), 211–219.

    Google Scholar 

  46. Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47.

    Article  Google Scholar 

  47. Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday life. New York, NY: Hyperion.

    Google Scholar 

  48. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62(6), 593–602.

    Article  Google Scholar 

  49. Kuyken, W., Weare, K., Ukoumunne, O. C., Vicary, R., Motton, N., Burnett, R., & Huppert, F. (2013). Effectiveness of the mindfulness in schools programme: non-randomised controlled feasibility study. The British Journal of Psychiatry, 203(2), 126–131.

    Article  PubMed  Google Scholar 

  50. Lee, J., Semple, R. J., Rosa, D., & Miller, L. (2008). Mindfulness-based cognitive therapy for children: results of a pilot study. Journal of Cognitive Psychotherapy, 22(1), 15–28.

    Article  Google Scholar 

  51. Ludwig, D. S., & Kabat-Zinn, J. (2008). Mindfulness in medicine. JAMA, 300(11), 1350–1352.

    PubMed  Article  Google Scholar 

  52. *Sams, D. P., Handley, E. D., & Alpert-Gillis, L. J. (2018). Mindfulness-based group therapy: impact on psychiatrically hospitalized adolescents. Clinical Child Psychology and Psychiatry, 23(4), 582–591.

    PubMed  Article  Google Scholar 

  53. Schonert-Reichl, K. A., & Lawlor, M. S. (2010). The effects of a mindfulness-based education program on pre- and early adolescents’ well-being and social and emotional competence. Mindfulness, 1(3), 137–151.

    Article  Google Scholar 

  54. Schwartz, S. W. (2009). Adolescent mental health in the United States: facts for policymakers. http://www.nccp.org/publications/pub_878.html.

  55. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York, NY: Guilford Press.

    Google Scholar 

  56. Semple, R. J. (2010). Does mindfulness meditation enhance attention? A randomized controlled trial. Mindfulness, 1(2), 121–130.

    Article  Google Scholar 

  57. Semple, R. J., & Lee, J. (2008). Treating anxiety with mindfulness: mindfulness-based cognitive therapy for children. In L. A. Greco & S. C. Hayes (Ed.), Acceptance and mindfulness treatments for children and adolescents: a practitioner’s guide (pp. 63–87). Oakland, CA: New Harbinger Publications.

  58. Semple, R. J., & Lee, J. (2011). Mindfulness-based cognitive therapy for anxious children: a manual for treating childhood anxiety. Oakland, CA: New Harbinger Publications.

    Google Scholar 

  59. Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness-based cognitive therapy for children: promoting mindful attention to enhance social-emotional resiliency in children. Journal of Child and Family Studies, 19(2), 218–229.

    Article  Google Scholar 

  60. 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.

    Article  Google Scholar 

  61. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.

    PubMed  Article  PubMed Central  Google Scholar 

  62. Sibinga, E. M., Kerrigan, D., Stewart, M., Johnson, K., Magyari, T., & Ellen, J. M. (2011). Mindfulness-based stress reduction for urban youth. Journal of Alternative and Complementary Medicine, 17(3), 213–218.

    PubMed  PubMed Central  Article  Google Scholar 

  63. Sibinga, E. M., Webb, L., Ghazarian, S. R., & Ellen, J. M. (2016). School-based mindfulness instruction: an RCT. Pediatrics, 137(1), 4–6.

  64. Siegel, R. D., Germer, C. K., & Olendzki, A. (2009). Mindfulness: what is it? Where did it come from? In F. Didonna & F. Didonna (Eds), Clinical handbook of mindfulness (pp. 17–35). New York, NY: Springer.

    Chapter  Google Scholar 

  65. *Singh, N. N., Lancioni, G. E., Joy, S. D., Winton, A. S., Sabaawi, M., Wahler, R. G., & Singh, J. (2007). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15(1), 56–63.

    Article  Google Scholar 

  66. *Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. S., Singh, A. N., Singh, J., & Singh, A. D. (2011a). A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Research in Autism Spectrum Disorders, 5(3), 1153–1158.

    Article  Google Scholar 

  67. *Singh, N. N., Lancioni, G. E., Singh, A. D., Winton, A. S., Singh, A. N., & Singh, J. (2011b). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control their aggressive behavior. Research in Autism Spectrum Disorders, 5(3), 1103–1109.

    Article  Google Scholar 

  68. *Tan, L., & Martin, G. (2013). Taming the adolescent mind: preliminary report of a mindfulness-based psychological intervention for adolescents with clinical heterogeneous mental health diagnoses. Clinical Child Psychology and Psychiatry, 18(2), 300–312.

    PubMed  Article  Google Scholar 

  69. *Tan, L., & Martin, G. (2015). Taming the adolescent mind: a randomised controlled trial examining clinical efficacy of an adolescent mindfulness-based group programme. Child and Adolescent Mental Health, 20(1), 49–55.

    Article  Google Scholar 

  70. Tan, L. B. G. (2015). A critical review of adolescent mindfulness-based programmes. Clinical Child Psychology and Psychiatry, 21(2), 193–207.

    PubMed  Article  Google Scholar 

  71. Teasdale, J. D., Segal, Z., & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy, 33(1), 25–39.

    PubMed  Article  Google Scholar 

  72. *van de Weijer-Bergsma, E., Formsma, A. R., Bruin, E. I., & Bogels, S. M. (2012). The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. Journal of Child and Family Studies, 21(5), 775–787.

    PubMed  Article  Google Scholar 

  73. van der Oord, S., Bogels, S. M., & Peijnenburg, D. (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child and Family Studies, 21(1), 139–147.

    PubMed  Article  Google Scholar 

  74. *Van Vliet, K. J., Foskett, A. J., Williams, J. L., Singhal, A., Dolcos, F., & Vohra, S. (2017). Impact of a mindfulness-based stress reduction program from the perspective of adolescents with serious mental health concerns. Child & Adolescent Mental Health, 22(1), 16–22.

    Article  Google Scholar 

  75. Williams, M., Teasdale, J., Segal, Z., & Kabat-Zinn, J. (2007). The mindful way through depression. New York, NY: Guilford.

  76. Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness Interventions with youth: a meta-analysis. Mindfulness, 6(2), 290–302.

    Article  Google Scholar 

Download references

Authors Contributions

ZK contributed to the design of the study, the study selection, performed the data extraction, quality assessment and drafted the manuscript. LL contributed to literature search and study selection, data extraction, and the drafting and editing of the final manuscript. BL and DZ contributed to the design of the study, and drafting and editing of the final manuscript.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Zlatina Kostova.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kostova, Z., Levin, L., Lorberg, B. et al. Mindfulness-Based Interventions for Adolescents with Mental Health Conditions: A Systematic Review of the Research Literature. J Child Fam Stud 28, 2633–2649 (2019). https://doi.org/10.1007/s10826-019-01477-7

Download citation

Keywords

  • Mindfulness
  • Adolescents
  • Mental health conditions
  • Clinical disorders
  • Clinical settings