Classroom-Based Mindfulness Training Reduces Anxiety in Adolescents: Acceptability and Effectiveness of a Cluster-Randomized Pilot Study
Jeanette M. Johnstone, PhD
National University of Natural Medicine, Helfgott Research Institute, 2220 SW 1st Ave, Portland, OR, 97201, USA
Amanda Ribbers, MS
David Jenkins, BA
Rachel Atchley, PhD, MCR
Hanna Gustafsson, PhD
Joel T. Nigg, PhD
Helané Wahbeh, ND, MCR
Barry Oken, MD, PhD


Stress reduction
High school


Objective: Many high school students experience a high degree of anxiety and perceived stress. This study examined whether a classroom-based mindfulness program or a wellness program were acceptable and effective as anxiety and stress reduction interventions based on students’ self-reports.

Design, setting, and participants: Thirteen health education classes (n=285 students, aged 14–16 years) were randomized by classroom to one of three conditions: mindfulness, wellness, or usual health class only (passive control/waitlist), for 8 weeks.

Outcomes: Pre- and post-intervention scores compared self-reported measures of depression, anxiety and stress.

Results: Complete data were available from nine classes (n=202 students). Post-intervention anxiety scores were reduced in students who received the mindfulness intervention compared to those who received only their usual health class (β=−0.07, SE=0.03, P≤0.001; 95% CI=−0.12, −0.02). No significant between group differences were found for depression or stress (P>0.4). Students’ satisfaction with the mindfulness intervention they received withstood baseline credibility and expectancy effects: r=0.21, n=67, P=0.17 for credibility; r=−0.001, n=67, P=0.99 for expectancy. However, students’ satisfaction with the wellness intervention they received was positively correlated with their pre-intervention expectations, r=0.42, n=47, P<0.001. Fifty-two percent of the 68 students assigned to mindfulness (n=35) used the iPad app for mindfulness home practice at least once; of those, 10% used it 10 or more times.

Conclusion: Eight weeks of classroom-based mindfulness, with limited home practice, reduced self-reported anxiety compared to usual health class, and withstood baseline expectancy effects in this group of high school students, a majority who come from high income families.

Clinical implications: School- or community-based mindfulness may be an appropriate recommendation for adolescents who experience anxiety.



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