Abstract
Objectives
The implementation of mindfulness-based programming/interventions (MBP) for youth, and corresponding research, has proliferated in recent years. Although preliminary evidence is promising, one pressing concern is that the heterogeneity of MBP for youth makes it difficult to infer the essential constituent program elements that may be driving specified outcomes (i.e., core program components (CPCs)).
Methods
This research employed the Delphi method to survey expert MBP scientists and instructors to identify consensus of CPCs of MBP for youth.
Results
The study’s advisory board identified scientists based on topical publication record and peer nomination. Delphi Round 1 surveyed scientists (n = 19) to name and define potential CPCs of MBP for youth; responses were qualitatively analyzed yielding 22 MBP categorical codes. Delphi Round 2 recruited MBP instructors (n = 21) identified by scientist participants and peer instructor nomination. In Rounds 2 and 3, the full participant sample (scientists and instructors) were asked to consider the preceding Round’s results and whether each of the 22 identified codes were an essential CPC of MBPs for youth. Final Round 3 results indicated consensus (≥ 75% endorsement) of 9 of the 22 identified codes as CPCs of MBP for youth, including self-awareness, non-judging, focused attention, orienting to present moment, acceptance, compassion, somatic awareness, non-reacting, and decentering. Two additional codes (skillful responding and loving-kindness) were indicated by the instructor subgroup only.
Conclusions
These findings are the first to report expert consensus of identified CPCs of MBP for youth, and results have significant implications for future youth MBP evaluation, implementation, and curriculum development.
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Data Availability
Research data in this study is not shared publicly because participant’s written responses to open-ended questions could lead to de-identification of participants and thus violate expectations for confidentiality as described in the consent document.
References
Arch, J. J., Brown, K. W., Dean, D. J., Landy, L. N., Brown, K., & Laudenslager, M. L. (2014). Self-compassion training modulates alpha-amylase, heart rate variability, and subjective responses to social evaluative threat in women. Psychoneuroendocrinology, 42, 49–58. https://doi.org/10.1016/j.psyneuen.2013.12.018
Baelen R. N., Gould, L. F., Felver, J. C., Schussler, D. L., & Greenberg, M. T. (2022). Implementation reporting recommendations for school-based mindfulness programs. Mindfulness. Advance of Print.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. https://doi.org/10.1177/1073191107313003
Baminiwatta, A., & Solangaarachchi, I. (2021). Trends and developments in mindfulness research over 55 years: A bibliometric analysis of publications indexed in Web of Science. Mindfulness, 12, 2099–2116. https://doi.org/10.1007/s12671-021-01681-x
Bennett, M. P., Knight, R., Patel, S., So, T., Dunning, D., Barnhofer, T., Smith, P., Kuyken, W., Ford, T., & Dalgleish, T. (2021). Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: A narrative review and insight report. Translational Psychiatry, 11(1), 288. https://doi.org/10.1038/s41398-021-01397-5
Benzo, R. P., Anderson, P. M., Bronars, C., & Clark, M. (2018). Mindfulness for healthcare providers: The role of non-reactivity in reducing stress. Explore, 14(6), 453–456. https://doi.org/10.1016/j.explore.2018.03.008
Burke, C. A. (2010). Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19(2), 133–144. https://doi.org/10.1007/s10826-009-9282-x
Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Sage Publishing.
Cheang, R., Gillions, A., & Sparkes, E. (2019). Do mindfulness-based interventions increase empathy and compassion in children and adolescents: A systematic review. Journal of Child and Family Studies, 28(7), 1765–1779. https://doi.org/10.1007/s10826-019-01413-9
Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67(4), 404–424. https://doi.org/10.1002/jclp.20776
Chimiklis, A. L., Dahl, V., Spears, A. P., Goss, K., Fogarty, K., & Chacko, A. (2018). Yoga, mindfulness, and meditation interventions for youth with ADHD: Systematic review and meta-analysis. Journal of Child and Family Studies, 27(10), 3155–3168. https://doi.org/10.1007/s10826-018-1148-7
Cullen, M. (2011). Mindfulness-based interventions: An emerging phenomenon. Mindfulness, 2(3), 186–193. https://doi.org/10.1007/s12671-011-0058-1
Diamond, I. R., Grant, R. C., Feldman, B. M., Pencharz, P. B., Ling, S. C., Moore, A. M., & Wales, P. W. (2014). Defining consensus: A systematic review recommends methodologic criteria for reporting of Delphi studies. Journal of Clinical Epidemiology, 67(4), 401–409. https://doi.org/10.1016/j.jclinepi.2013.12.002
Dimidjian, S., & Linehan, M. M. (2003). Defining an agenda for future research on the clinical application of mindfulness practice. Clinical Psychology: Science and Practice, 10(2), 166–171. https://doi.org/10.1093/clipsy.bpg019
Domitrovich, C. E., Bradshaw, C. P., Poduska, J. M., Hoagwood, K., Buckley, J. A., Olin, S., Romanelli, L. H., Leaf, P. J., Greenberg, M. T., & Ialongo, N. S. (2008). Maximizing the implementation quality of evidence-based preventive interventions in schools: A conceptual framework. Advances in School Mental Health Promotion, 1(3), 6–28. https://doi.org/10.1017/cbo9781139013949.017
Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). The effects of mindfulness-based interventions on cognition and mental health in children and adolescents—A meta-analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 60(3), 244–258. https://doi.org/10.1111/jcpp.12980
Dymnicki, A., Trivits, L., Hoffman, C., & Osher, D. (2020). Advancing the use of core components of effective programs: Suggestions for researchers publishing evaluation results. Office of Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services. https://www.aspe.hhs.gov/sites/default/files/migrated_legacy_files/195646/ASPE-Brief-Core-Components.pdf
Elsevier (n.d.). Scopus. https://www.scopus.com/search/form.uri?display=basic#author
Engert, V., Kok, B. E., Papassotiriou, I., Chrousos, G. P., & Singer, T. (2017). Specific reduction in cortisol stress reactivity after social but not attention-based mental training. Science Advances, 3(10), e1700495. https://doi.org/10.1126/sciadv.1700495
Felver, J. C., Hoyos, C. E. C., Tezanos, K., & Singh, N. N. (2016). A systematic review of mindfulness-based interventions for youth in school settings. Mindfulness, 7(1), 34–45. https://doi.org/10.1007/s12671-015-0389-4
Felver, J. C., Clawson, A. J., Ash, T. L., Martens, B. K., Wang, Q., & Singh, N. N. (2022). Meta-analysis of mindfulness-based program Soles of the Feet for disruptive behaviors. Behavior Modification. Advance online publication. https://doi.org/10.1177/01454455211073738
Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473. https://doi.org/10.1007/s12671-019-01134-6
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353–379. https://doi.org/10.1002/cpp.507
Gould, L. F., Mendelson, T., Dariotis, J. K., Ancona, M., Smith, A. S., Gonzalez, A. A., Smith, A. A., & Greenberg, M. T. (2014). Assessing fidelity of core components in a mindfulness and yoga intervention for urban youth: Applying the CORE Process. New Directions for Youth Development, 2014(142), 59–81. https://doi.org/10.1002/yd.20097
Gould, L. F., Dariotis, J. K., Greenberg, M. T., & Mendelson, T. (2016). Assessing fidelity of implementation (FOI) for school-based mindfulness and yoga interventions: A systematic review. Mindfulness, 7(1), 5–33. https://doi.org/10.1007/s12671-015-0395-6
Greenberg, M. T., & Harris, A. R. (2012). Nurturing mindfulness in children and youth: Current state of research. Child Development Perspectives, 6(2), 161–166. https://doi.org/10.1111/j.1750-8606.2011.00215.x
Hasson, F., Keeney, S., & McKenna, H. (2000). Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32(4), 1008–1015. https://doi.org/10.1046/j.1365-2648.2000.t01-1-01567.x
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.
Helminen, E. C., Scheer, J. R., & Felver, J. C. (2021). Gender differences in the associations between mindfulness, self-compassion, and perceived stress reactivity. Mindfulness, 12(9), 2173–2183. https://doi.org/10.1007/s12671-021-01672-y
Hirsch, J. E. (2005). An index to quantify an individual’s scientific research output. Proceedings of the National Academy of Sciences, 102(46), 16569–16572. https://doi.org/10.1073/pnas.0507655102
Johnson, E. A., & O’Brien, K. A. (2013). Self-compassion soothes the savage EGO-threat system: Effects on negative affect, shame, rumination, and depressive symptoms. Journal of Social and Clinical Psychology, 32(9), 939–963. https://doi.org/10.1521/jscp.2013.32.9.939
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy.bpg016
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Dell.
Kalill, K. S., Treanor, M., & Roemer, L. (2014). The importance of non-reactivity to posttraumatic stress symptoms: A case for mindfulness. Mindfulness, 5(3), 314–321. https://doi.org/10.1007/s12671-012-0182-6
Kallapiran, K., Koo, S., Kirubakaran, R., & Hancock, K. (2015). Effectiveness of mindfulness in improving mental health symptoms of children and adolescents: A meta-analysis. Child and Adolescent Mental Health, 20(4), 182–194. https://doi.org/10.1111/camh.12113
Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A meta-analysis of compassion-based interventions: Current state of knowledge and future directions. Behavior Therapy, 48(6), 778–792. https://doi.org/10.1016/j.beth.2017.06.003
Klingbeil, D. A., Renshaw, T. L., Willenbrink, J. B., Copek, R. A., Chan, K. T., Haddock, A., Yassine, J., & Clifton, J. (2017). Mindfulness-based interventions with youth: A comprehensive meta-analysis of group-design studies. Journal of School Psychology, 63, 77–103. https://doi.org/10.1016/j.jsp.2017.03.006
Linehan, M. M., Heard, H. L., & Armstrong, H. E. (1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry, 50(12), 971–974. https://doi.org/10.1001/archpsyc.1993.01820240055007
Lucena, L., Frange, C., Pinto, A. C. A., Andersen, M. L., Tufik, S., & Hachul, H. (2020). Mindfulness interventions during pregnancy: A narrative review. Journal of Integrative Medicine, 18(6), 470–477. https://doi.org/10.1016/j.joim.2020.07.007
Martens, B. K., & Witt, J. C. (2004). Competence, persistence, and success: The positive psychology of behavioral skill instruction. Psychology in the Schools, 41(1), 19–30. https://doi.org/10.1002/pits.10135
Mazza, J. J., Dexter-Mazza, E. T., Miller, A. L., Rathus, J. H., & Murphy, H. E. (2016). DBT skills in schools: Skills training for emotional problem solving for adolescents. Guilford Publications.
Morton, M. L., Helminen, E. C., & Felver, J. C. (2020). A systematic review of mindfulness interventions on psychophysiological responses to acute stress. Mindfulness, 11(9), 2039–2054. https://doi.org/10.1007/s12671-020-01386-7
Roeser, R. W., Greenberg, M. G., Frazier, T., Galla, B. M., Semenov, A. & Warren, M. T. (2022a). Envisioning the next generation of science on mindfulness and compassion in schools. Mindfulness. Advance of Print.
Roeser, R. W., Galla, B. M. & Baelen, R. N. (2022b). Mindfulness in the schools: Evidence on the impacts of school-based mindfulness programs on student outcomes in P-12 educational settings. Policy Brief for Robert Wood Johnson Foundation. https://doi.org/10.31234/osf.io/ascpv
Roeser, R. W., & Pinela, C. (2014). Mindfulness and compassion training in adolescence: A developmental contemplative science perspective. New Directions for Youth Development, 142, 9–30. https://doi.org/10.1002/yd.20094
Santorelli, S. F., Meleo-Meyer, F., & Koerber, L. (2017). Mindfulness-Based Stress Reduction (MBSR) authorized curriculum guide. University of Massachusetts Medical School Center for Mindfulness in Medicine, Health Care & Society.
Schuman-Olivier, Z., Trombka, M., Lovas, D. A., Brewer, J. A., Vago, D. R., Gawande, R., Dunne, J. P., Lazar, S. W., Loucks, E. B., & Fulwiler, C. (2020). Mindfulness and behavior change. Harvard Review of Psychiatry, 28(6), 371–394. https://doi.org/10.1097/HRP.0000000000000277
Schutt, M. K. & Felver, J. C. (2020). Mindfulness in education. In N. N. Singh & S. D. Singh Joy (Eds.), Mindfulness-based interventions with children and adolescents: Research and practice (pp. 57–73). Routledge. https://doi.org/10.4324/9781315563862
Segal, Z. V., Williams, M., & Teasdale, J. (2018). Mindfulness-based cognitive therapy for depression. Guilford Publications.
Shonin, E., Van Gordon, W., Compare, A., Zangeneh, M., & Griffiths, M. D. (2015). Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review. Mindfulness, 6(5), 1161–1180. https://doi.org/10.1007/s12671-014-0368-1
Stein, E., & Witkiewitz, K. (2020). Dismantling mindfulness-based programs: A systematic review to identify active components of treatment. Mindfulness, 11(11), 2470–2485. https://doi.org/10.1007/s12671-020-01444-0
Thomas, D. R. (2006). A general inductive approach for analyzing qualitative evaluation data. American Journal of Evaluation, 27(2), 237–246. https://doi.org/10.1177/1098214005283748
Whitehead, D., Dilworth, S., & Higgins, I. (2016). Common qualitative methods. In Z. Schneider, D. Whitehead, G. LoBiondo-Wood, & J. Haber (Eds.), Nursing and midwifery research: Methods and appraisal for evidence-based practice (5th ed., pp. 94–109). Elsevier.
Whitehead D. & Schneider Z. (2013) Mixed-methods research. In Z. Schneider, D. Whitehead, G. Lo Biondo-Wood, & J. Haber (Eds.), Nursing & Midwifery Research: Methods and Appraisal for Evidence-Based Practice (4th ed., pp. 263–284). Elsevier.
Winders, S. J., Murphy, O., Looney, K., & O’Reilly, G. (2020). Self-compassion, trauma, and posttraumatic stress disorder: A systematic review. Clinical Psychology & Psychotherapy, 27(3), 300–329. https://doi.org/10.1002/cpp.2429
Zeng, X., Chiu, C. P., Wang, R., Oei, T. P., & Leung, F. Y. (2015). The effect of loving-kindness meditation on positive emotions: A meta-analytic review. Frontiers in Psychology, 6(1693), 1–14. https://doi.org/10.3389/fpsyg.2015.01693
Zhang, D., Lee, E. K., Mak, E. C., Ho, C., & Wong, S. Y. (2021). Mindfulness-based interventions: An overall review. British Medical Bulletin, 138(1), 41–57. https://doi.org/10.1093/bmb/ldab005
Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: A meta-analysis. Mindfulness, 6(2), 290–302. https://doi.org/10.1007/s12671-013-0260-4
Acknowledgements
The authors would like to express gratitude for all members of this study’s Delphi panel who contributed their wisdom and time to this collaborative group effort. Panel members who elected to be de-identified and acknowledged include Vernon Anthony Barnes, Mark Bertin, Karen Bluth, Ravid Bogaire, Matthew Brensilver, Patricia C. Broderick, Brian Galla, Andres A. Gonzalez, Matthew Goodman, Susan Kaiser Greenland, Sat Bir Singh Khalsa, Siri Krishna Kaur Khalsa, Molly Stewart Lawlor, James K. Luiselli, Catherine Malboeuf-Hurtubise, Jacqueline Maloney, Helen Marsh, Tamar Mendelson, Moriya Rosenberg, Randye J. Semple, Nirbhay N. Singh, Ricardo Tarrasch, Katleen Van der Gucht, and Betsy L. Wisner. The first author would like to express special thanks to Sarah Felver for helpful feedback on earlier drafts of this manuscript.
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JCF: conceptualized, designed, and executed the study, analyzed the data, and wrote the paper. ELC, ECH, and MKS: assisted with the data analyses and writing of the paper. LFG partnered on the original conceptualization and design of the study, served as an advisory board, and assisted with editing the final manuscript. MTG and RWR: served as an advisory board, collaborated with the study design, and assisted with editing the final manuscript. RNB and DLS: assisted with conceptualization of the draft manuscript and editing the final manuscript.
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This research was approved by the Syracuse University Institutional Review Board (IRB# 20–043).
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Felver, J.C., Cary, E.L., Helminen, E.C. et al. Identifying Core Program Components of Mindfulness-Based Programming for Youth: Delphi Approach Consensus Outcomes. Mindfulness 14, 279–292 (2023). https://doi.org/10.1007/s12671-022-02015-1
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DOI: https://doi.org/10.1007/s12671-022-02015-1
Keywords
- Mindfulness-based Program
- Components
- Delphi
- Children
- Adolescents