The pathway to mindfulness for children and young people

For more than two decades, there has been enthusiasm for mindfulness training and therapy for children and young people, though it seems the enthusiasm might still outweigh the evidence of efficacy (Greenberg & Harris, 2011). It is certainly an approach that, intuitively, sounds and feels like a good idea. Most of us, and our children, live very “crowded” lives and not only in terms of activities undertaken. We are constantly bombarded by noise, lights and smells; by the pressures to respond to our peers, to the demands of technology and to cultural expectations – family, community and beyond. There is little room for silence and quiet contemplation, time for emotional restoration or for the generation of ideas that come from within ourselves and are part of our creative spirit. So, the permission mindfulness gives us to stop and be in the moment has become more important than perhaps it might have been in times past.

It’s no surprise, then, that in the last 10 years or so, mindfulness has grown beyond a therapeutic approach to be a restorative process for adults in all walks of life. In addition, numerous tools have been developed ranging from colouring-in, individual exercises to team and group work exercises. And in this same time frame, tools for children have also been developed in tandem with the introduction of mindfulness into contexts beyond the counselling room. Coholic’s Arts activities for children and young people in need (Coholic, 2010); and Plummer and Surrurier’s Focusing and calming games for children: Mindfulness strategies and activities to help children relax, concentrate and take control (Plummer & Serrurier, 2012) are but two examples of guides and activities that are now used in a variety of environments. Quite apart from mindfulness for children being supported by psychiatrists, psychologists and social workers, it has found purchase in the work of life coaches like van der Steenstraten (2017), who recorded her observations of the many benefits of mindfulness in Educating young children: Learning and teaching in the early childhood years.

Many schools have been quick to include mindfulness in the classroom curriculum to allay issues of anxiety, of over-active behaviour (for instance, attention-deficit hyperactive disorder, and to teach self-calming techniques and increase focus as identified by Sheinman, Hadar, Gafni, and Milman (2018). The inclusion of mindfulness in school curricula has been to support positive development, to assist children and young people to overcome stress and promote life skill development that, together, support the educational process. It is the capacity of mindfulness to assist in coping with stressors that offers children and young people a tangible set of skills to build resilience. Most health professionals will be aware that children do not always recognise when they are stressed, but acute and chronic stress can lead to a range of physical symptoms as well as disrupting behavioural patterns and affecting the capacity to learn (Medline, 2019). Educationalists are also championing mindfulness, making strong claims for the differences they notice not only amongst students, but also among teaching staff and parents if their particular programme includes the wider school community.

However, there are various approaches to promoting mindfulness in education and, in spite of burgeoning research internationally, there is still the intriguing issue of its long-term impacts on health and wellbeing (Sheinman et al., 2018). Some programmes include students, teachers and parents, while others are focused on the students and teaching staff. The Smiling Mind organisation has been a strong advocate of its Smiling Mind Education Program, which has been evaluated by academics of Deakin University and Insight SRC (Smiling Mind, 2017). The programme was established due to concerns that half of all adults had experienced mental health issues by the age of 14 years, and three-quarters by the age of 24 years, and the resulting high economic costs of mental illness in Australia. The programme also takes account of the Victorian 10-Year Mental Health Plan (State of Victoria, Department of Health and Human Services, 2015). In the first evaluation report, which included 1853 students and 104 teachers from 12 schools in Victoria, positive changes were noted for both groups. Students, for example, reported that “participation in the program significantly improved sleep,” and there was a

Significant increase in student safety at school and decrease in classroom disruptions… and reductions in the experience of bullying…. Students with lower levels of wellbeing at the commencement of the program reported significantly better sleep quality, reduced psychological distress, enhanced positive wellbeing, enhanced ability to manage emotions, [and] improvements in concentration[.] (Smiling Mind, 2017, p. 23)

However, it is not only short-term outcomes that are of interest. An investigation undertaken by Sheinman et al. (2018) studied the longer-term outcomes of a mindfulness programme in Israeli schools. Among the benefits believed to stem from the programme were children’s coping strategies and their responses to everyday challenges. Three schools and some 646 students aged between 9 and 12 years were surveyed. One school had been including mindfulness in the curriculum for 13 years. Results suggested differences in the students’ use of mindfulness that were associated with the school they attended. Generally, girls were more likely to apply mindfulness strategies than boys, and younger children were more likely to apply mindfulness strategies than older children. The findings showed an enhancement in children’s positive functioning and that the mindfulness programme used by these schools “significantly contributed to students’ disposition to use mindfulness-based coping strategies” (Sheinman et al., 2018, p. 3325). Kang et al. (2018), in a study involving a control group, also found gender differences with the girls trained in meditation techniques reporting greater increases in positive affect compared to girls in the control group, and boys in both groups showing similar gains. This suggests that mindfulness programmes may need to be tailored more strongly to address gender differences.

On a much broader scale, Klingbeil et al. (2017) synthesised 72 studies of mindfulness in order to assess the efficacy of mindfulness training, defining mindfulness-based interventions as “as any treatment that intentionally trains mindfulness skills (i.e., self-regulation of attention on immediate experience paired with an accepting attitude toward one’s experience) as the core therapeutic component for reducing problem behavior or increasing wellbeing behavior” (p. 78). In introducing their article, Klingbeil et al. (2017) note that research regarding the effects of mindfulness on young people commenced some 25 years after the research with adults and that “The same level of clarity regarding the effectiveness of MBIs with youth has yet to be obtained” (p. 78). The Klingbeil et al. (2017) synthesis “revealed MBIs [Mindfulness Based Interventions] to have consistently positive, albeit small effects on academic, social, emotional, behavioral, and physical health outcomes” (p. 97). Given that the contexts of the studies analysed included schools, therapeutic settings and correctional contexts for youth, this was an encouraging finding. It was concluded that “MBIs may be most appropriately used in schools as universal-level or prevention-oriented interventions” (Klingbeil et al., 2017, p. 97) and indeed that seems to be where many of the current programmes are focused.

Yet it is often by word of mouth that people are convinced of the benefits of an approach like mindfulness. The professional networks cannot be ignored and often play a key role in the promotion of trends and sharing of experience. Observing outcomes is particularly powerful in convincing people of the gains to be made of applying techniques, so it is no surprise that schools across the world have taken up mindfulness and tailored the approach to suit their cultural and organisational contexts.

More recently, attention has been on MBIs for young people in the correctional contexts. Simpson, Mercer, Simpson, Lawrence, and Wyke (2018) from Scotland have published a scoping review of 13 international studies, and Murray, Amann, and Thom (2018) reviewed research-based literature using 10 studies due to concerns about young people in correctional facilities in New Zealand. The efficacy of mindfulness in correctional facilities is of interest because the majority of young people incarcerated are significantly disadvantaged by a range of issues encompassing mental health, education, self-regulation, poverty and social relationships. These are all areas of development and functioning that mindfulness seeks to address in one or more ways, though the functional deficits in language for many young offenders poses some additional challenges (Snow, 2019).

The 13 studies reviewed and analysed by Simpson et al. (2018) were disappointing in terms of their quality, and the results obtained from the MBIs were not statistically significant. Most of the 842 young people were incarcerated in the USA, and one study was conducted in India. The attrition rate, together with the clarity of the definitions used and the varying contextual features made the review problematic. While the authors stated that a:

metaanalysis was not possible in this scoping review, examination of discernable effect sizes suggests a broad range of potential effectiveness across diverse interventions and outcomes. This could imply that by practising the core components of mindfulness, young offenders may experience improvement in psychological and emotional wellbeing and in behavioural functioning (Simpson et al., 2018, p. 1339).

Murray et al. (2018) came to similar conclusions following their analysis of 10 studies from which the “strongest common themes [were] stress reduction, improved self-regulation, anger management and acceptability” (p. 831). Focusing on these four themes, there was a sense that positive outcomes were experienced by the young people who participated in MBIs, and some of the participants were able to be quite explicit in their comments about how mindfulness techniques were helpful to them. However, while concluding that mindfulness has a role to play for incarcerated youth, the jury is out about the long-term effects, particularly on recidivism.

Finally, I was interested to see what has been written about mindfulness and physical health and wellbeing, as opposed to the growing literature about mindfulness and mental health, autism, behavioural functioning and the like. With reference to developmental and mental health concerns, the general opinion is that MBIs are effective in the reduction of some dysfunctional behaviours and reduce anxiety and associated mental health issues. However, a brief search suggested there is limited research on MBIs and physical health outcomes. One study of interest was that of Clevenger et al. (2018, p. 222) who examined “the relationship of mindfulness with weight status, physical activity, screen time, diet, and health-related quality of life in children living in a low-socioeconomic status community.” Their participants were 754 children attending primary schools in America and, while they found that mindfulness in children contributed positively to psychological quality of life, other health outcomes were not related to mindfulness. Physical activity, mindful eating and screen time were not related to mindfulness and, interestingly, nor were peer-related or school-related quality of life.

There is no doubt that many researchers, practitioners and participants involved in mindfulness training are very positive about the beneficial outcomes they observe and experience. But as yet, there is a dearth of empirical evidence to show there are long-term positive outcomes. The lack of rigour with which evidence is collected and analysed by research studies appears to be a part of the issue, together with controlling for the diverse characteristics of participants and the range of MBI approaches being used. This is not to suggest that we should neglect MBIs as a vehicle for change, but if mindfulness is to be introduced into a variety of settings – schools, prisons, youth centres, etc – then stronger evidence will be needed to convince funding bodies that the costs are worthwhile in the long term.

As we come to the end of 2019 and contemplate the 2020 year, we are mindful of the many challenges being faced by people across the globe. I have written in the past of climate change and of socioeconomic wellbeing and these issues continue to affect our lives together with those of children, young people and their families and communities. These same challenges will likely have even greater impacts in the years to come. However, just now we need to acknowledge the continued efforts of those who maintain hope, who advocate for a sustainable future and whose energy we depend upon to achieve an array of better outcomes for us all. The papers in this Issue of the Journal are varied as you will see.

Frank Ainsworth, a regular contributor to Children Australia, discusses the idea of parental licensing based on the idea that parenting competence should be demonstrated prior to adults achieving full parental rights. It is a long-standing idea that is alive among a host of academic philosophers, political scientists and others interested in children’s rights. However, the question is – is the notion of parental licensing a good idea or is it an extreme authoritarian response to the social problem of child abuse and neglect? And, if parental licensing was in place, who would decide on parental competence, what are the boundaries of competence and how would competence be measured? Frank raises issues related to these questions and considers the proposition that, by endorsing the concept of the “best interests of the child,” and passing legislation that gives standing to the removal of a child from parental care, by default this constitutes a system of parental licensing.

The paper that follows is a scoping review of the literature on child participatory research in Australia published in academic journals between 2000 and 2018. This review, by Rebecca Grace and colleagues, focuses on research designed to engage with children and young people in the development, implementation and evaluation of services. The papers were reviewed against Shier’s participation matrix, demonstrating that almost all of the identified papers included children only as participants with only a small number of papers involving children and young people in the other phases of research, such as design of research questions, analysis and dissemination. Rebecca hopes this paper will serve as a catalyst for discussion on where there are gaps and where further Australian research is needed.

Stacey Alexander, Margarita Frederico and Maureen Long’s paper argues that the promotion of the rights, wellbeing and development of the child requires attachment to be a central focus of Early Childhood Intervention under the National Disability Insurance Scheme (NDIS). This article identifies how elements of the NDIS design and implementation may be counterproductive to fostering attachment security in children because they can lead to delayed intervention; increased parental stress; reduced expertise of service providers; and financial disincentives for best practice in working with disadvantaged families. The paper highlights the implications for children with a disability and their families in Australian society and identifies lessons for the design and implementation of social policy.

The focus of Emily Schindeler’s study was the application of orders for supervised access made by the Australian Family Law Court in cases that involved conflicting claims by custodial and non-custodial parents. Her analysis was of 103 cases involving 172 children over a 28-month period ending in early 2019. The patterns found through thematic analysis suggest there is a shift to increasing the use of final orders involving supervision through Child Contact Centres, and this shift has significant implications for current models of supervised access/changeover, and a greater understanding in terms of the outcomes being achieved is required.

The paper presented by Jessica Cocks draws on the findings of her recent Churchill Fellowship study tour. In this article, Jessica discusses the need to expand our understanding of family inclusion in Australian child welfare both to increase reunification and to improve outcomes for children who do not return home. This process requires the integration of six key elements of family inclusive practice which are discussed with reference to practice in several overseas countries.

The final paper presented by Betty Luu, Amy Conley Wright and Melanie Randle concerns recent reforms in New South Wales, Australia, that prioritise adoption over long-term foster care. Betty argues that while previous research has examined motivation to foster, less is known about the interest by the general public in adoption from out-of-home care. She used an online survey about adoption practices and willingness to consider adopting from out-of-home care, together with background questions on perceived social support and life satisfaction. Barriers to pursuing adoption were identified, and the analyses identified that likelihood of considering adoption was primarily predicted by younger age, knowing someone who had been adopted as a child, actively practising religion, living in the city rather than a regional area and higher life satisfaction. Customised marketing campaigns are recommended that target people more likely to consider adoption, with messages that resonate with their social and psychological characteristics.

In closing, Rachael and I would like to thank all those who have contributed to the Journal in 2019, those who have reviewed papers and made helpful suggestions to our contributors, to our Editorial Consultants and to the staff of Cambridge University Press, particularly Adam, who together are a constant support to us in getting each Issue to completion. We wish you a safe and peaceful Festive Season and hope that 2020 will bring you splendid adventures along with the inevitable challenges!