Classroom-Based Mindfulness Training Reduces Anxiety in Adolescents: Acceptability and Effectiveness of a Cluster-Randomized Pilot Study.

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 (=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 (=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, ≤0.001; 95% CI=-0.12, -0.02). No significant between group differences were found for depression or stress (>0.4). Students' satisfaction with the mindfulness intervention they received withstood baseline credibility and expectancy effects: =0.21, =67, =0.17 for credibility; =-0.001, =67, 0.99 for expectancy. However, students' satisfaction with the wellness intervention they received was positively correlated with their pre-intervention expectations, =0.42, =47, >0.001. Fifty-two percent of the 68 students assigned to mindfulness (=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.