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Mindfulness-Based Cognitive Therapy for Children (MBCT-C) for Prevention of Internalizing Difficulties: a Small Randomized Controlled Trial with Australian Primary School Children

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Abstract

Objectives

The use of mindfulness-based programs (MBP) with children is rapidly growing, but calls for well-designed randomized controlled trials (RCTs) of existing programs. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) has preliminary evidence for targeting internalizing symptoms in children. Within MBCT-C (and MBPs more broadly), attention is thought to be a key component of change, but mediation has been relatively unexplored. The overall aim of this small RCT was to compare MBCT-C to cognitive behavior therapy (CBT), as a preventive program for children experiencing internalizing difficulties.

Methods

A mixed factorial design was used, with 2 (program group) by 2 (pre- and post-intervention) conditions. Children from 3 primary schools were randomized to MBCT-C (n = 45) or CBT (n = 44) using random permuted blocks, with stratification by school, gender, and age. Main analyses were multi-level mixed models.

Results

Contrary to the hypotheses, only limited differences were found between programs. Both programs had small effects on symptoms of anxiety and depression, quality of life, attention control, and parent- and teacher-SDQ Total Difficulties, as well as moderate-large effects on shifting attention. There were no statistically significant changes in mindfulness or sustained attention.

Conclusions

This RCT provides a robust test of MBCT-C in a “real life” setting, demonstrating that it may be used as a clinically oriented preventive program in schools to reduce internalizing symptoms. The results challenge whether attention (as measured in this study) is a unique component of change for MBCT-C.

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Acknowledgments

Carol Holden and Alasdair Wright assisted with reviewing the manuscript. Teegan Hart assisted with data entry.

Role of the Funding Source

This research was conducted as part of a PhD in Psychology within The University of Adelaide. No other funding was received.

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Authors and Affiliations

  1. The University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia

    Kathleen M. Wright, Rachel Roberts & Michael J. Proeve

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  1. Kathleen M. Wright
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  2. Rachel Roberts
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  3. Michael J. Proeve
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Contributions

KW: Designed, planned, and implemented the research, completed the statistical analysis, and wrote the paper. RR and MP: supervisors of the PhD research program, oversaw the research idea conceptualization and planning, provided training and clinical supervision to the program facilitators, collaborated in developing the content and structure of the publication manuscript, and reviewing drafts. All authors approved the final version of the manuscript for submission.

Corresponding author

Correspondence to Kathleen M. Wright.

Ethics declarations

Approvals were provided by The University of Adelaide’s Human Research Ethics Committee, the South Australian Department of Education and Child Development, and the Catholic Education Office. All adult participants provided informed written consent. Parents/Guardians provided consent for their child, and children provided assent. Registration of this trial was not required, as it formed part of a PhD student’s thesis, and data collection was conducted in 2014.

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The authors declare that there are no conflicts of interest.

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Wright, K.M., Roberts, R. & Proeve, M.J. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) for Prevention of Internalizing Difficulties: a Small Randomized Controlled Trial with Australian Primary School Children. Mindfulness 10, 2277–2293 (2019). https://doi.org/10.1007/s12671-019-01193-9

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