A relatively new group of therapies has emerged over the past two decades, known as mindfulness or third-wave cognitive behavioral therapies. Different from traditional cognitive-behavioral therapy (CBT), the mindfulness component seeks to alter the context and relationship one has with their thoughts and behaviors rather than simply focusing on altering the behavior, thoughts, or content. Mindfulness therapies have gained considerable attention recently in empirical literature and revealed promise in the reduction of a variety of psychological and physiological symptoms among adults. Studies have offered promising results regarding the efficacy of Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MSBR) with problems such as depression, anxiety disorders, borderline personality traits, internalizing and externalizing problems, chronic pain, psychosis, and epilepsy. Only in recent years have researchers begun to investigate the impact of mindfulness therapies on adolescent illnesses. To date, however, no synthesis of research on mindfulness therapies with adolescents exists. Therefore the purpose of this study is to offer an overview of each third wave therapy, their utility with adolescents, and corresponding empirical support by calculating effect sizes for treatment effect.
Method
Authors searched the following databases: CINHAL, Dissertation Abstracts International, ERIC, MEDLINE, and PsycINFO using four groups of search terms : 1)“Acceptance and Commitment Therapy” and “adolescen* or youth or teenage*”, 2) “Dialectical Behavior Therapy or Dialectical Behavioral Therapy” and “adolescen* or youth or teenage*”, 3) “Mindfulness-Based Cognitive Therapy” and “adolescen* or youth or teenage*”, and 4) “Mindfulness-Based Stress Reduction” and “adolescen* or youth or teenage*.” The search yielded 296 articles (46 ACT, 209 DBT, 14 MBCT, and 27 MBSR). Articles employing randomized controlled trial, quasi-experimental, or one-group pre-posttest designs utilizing one the mindfulness therapies with adolescents (age 12-18) were included in the final sample of 15 (2 ACT, 12 DBT, 0 MBCT, and 1 MBSR). Effect sizes (Hedges' g) were calculated for all outcome measures using Comprehensive Meta-Analysis 2.0 software when not reported in the articles. When studies reported multiple follow-up points, the first follow-up point was selected to help calculate effect sizes.
Results
The majority of included studies reflected moderate to very large effect sizes regarding the impact of the mindfulness therapies on outcome variables; however, only particular variables were significant. Psychological variables significantly impacted by the mindfulness therapy were depression symptoms, internalizing and externalizing symptoms, suicidal ideation, borderline personality traits, aggression, and oppositional defiant disorder symptoms. Mindfulness therapies had moderate to large significant effects on some physiological symptoms as well, such as somatization (g=0.45, p<.05), pain intensity (g=1.15, p<.001), and pain related discomfort (g=0.99, p<.01). Large significant effects were also found for school attendance (g=1.06, p<.001).
Conclusions
Findings from this study offer a first step toward understanding the impact of mindfulness therapies with adolescents. Additional research is needed to truly offer insight into the efficacy of mindfulness therapies with adolescents; however, taken with caution, these therapies may offer social worker practitioners a promising therapeutic alternative when working with clients with challenging psychological and physiological illnesses.
