Classroom Mindfulness Put to the Test

In 1979, scientist and meditator Jon Kabat-Zinn conceived the first form of Mindfulness-Based Stress Reduction (MBSR). In 1990, he wrote the best seller Full Catastrophe Living, introducing mindfulness to a global audience. And the rest, as they say, is history. As a reliever of chronic pain, anxiety, depression, and more, mindfulness soon exploded into the mainstream, with research journals full of glowing results of what the Buddhist meditation technique, respun as various mindfulness-based interventions, could do for mental health, relationships, and general suffering. 

With such a solid base of scientific evidence for mindfulness as a tool for adults’ mental health, it was natural for those involved in its initial spread to think about what was next. In the early millennium, a cadre of advocates, from clinicians to traditional meditators to schoolteachers and educators, began considering how to keep extending mindfulness outward. The thinking was straightforward. Mindfulness works so well for adults. Why not teach it to kids? Especially to a generation of kids, as developing research was showing, that had unprecedentedly high levels of mental health problems?

Mindfulness-based programs, taught in schools, began cropping up in the United States, Europe, Australia, Israel, and other places. Just as they had for adults, researchers began testing the effects of mindfulness on adolescents of varying ages, but the results weren’t as clear. “It was mixed,” said Mark Greenberg, a longtime designer of randomized controlled trials (RCTs)—the gold standard of study design. 

Several studies showed positive effects on a host of concerns, ameliorating adolescents’ anxiety and stress and improving their ability to pay attention as well as their social behavior. But when stacked up against one another in meta-analyses, a tool researchers use to analyze results as a whole, many of the studies lacked methodological rigor, like large sample sizes and active control groups. Some of the effects were statistically insignificant or disappeared at follow-up. And there was evidence of publication bias—a typical finding when studies showing only positive results, rather than negative or null ones, are published.

In a meta-analysis of sixty-six RCTs published in 2022, the authors concluded that “While mindfulness-based programs show promising results for some outcomes, in general, the evidence is of low quality and inconclusive.” What the field really needed were well-designed RCTs that would test thousands of children at once. But that would be expensive.

Then came the My Resilience in Adolescence (MYRIAD) trial. With over $8 million in funding from the Wellcome Trust, a charitable foundation started by pharmaceutical businessman Henry Wellcome in 1936, a team of researchers would test, among other things, whether a mindfulness-based program would prevent mental health problems or promote well-being in early teens. Beginning in 2016, that study, the largest RCT ever run for a mindfulness-based intervention, taught mindfulness to more than eight thousand students ages 11–14 in eighty-five schools in the United Kingdom.

For some kids, mindfulness made them more aware of their issues without giving them any of the tools to address them.

The findings, published as a suite of papers in a special edition of the British Medical Journal–Evidence-based Mental Health (BMJ) in 2022, landed with all the excitement of a party canceled last-minute. The main study found that mindfulness, compared with other social-emotional learning programs already being taught in the schools (things like sex and phys ed), had no effect in promoting mental health or well-being. Students who received the mindfulness training actually reported higher levels of hyperactivity and inattention, and scored higher on panic disorder and obsessive-compulsive scales and lower on levels of mindfulness skills, compared with the control group. Teachers also reported higher levels of emotional symptoms in the students who were taught mindfulness. 

The MYRIAD researchers concluded that they could not recommend school-based mindfulness training as a universal approach for kids. It wasn’t only that the mindfulness program was ineffective. They found that it made the symptoms of those with emerging mental health issues worse.

Initially, Willem Kuyken, one of the leads on the trial and the director of the University of Oxford Mindfulness Research Centre, says he was disappointed by the results. “I had two identities,” he told me, one as a mindfulness advocate and one as a scientist. “When we had a null finding, I found my two identities in stark competition with each other,” he said. “And I realized that my scientist identity was more important to me than my mindfulness-advocate identity, and that the findings were important and interesting. And if you really look under the hood and ask questions, you can learn an awful lot.” 

How could the largest study ever of mindfulness for adolescents lead to such underwhelming results? How could mindfulness have been found not only to be ineffective but also potentially harmful, making some adolescents’ problems worse? To analyze the MYRIAD trial—not only its results and what they mean but also its setup, its assumptions, and, some would say, its missteps—is complex. The answers open up questions about whether it’s a good idea to teach kids mindfulness at all. And they also depend on whom you talk to.

One group are the kids themselves. As a commentary on the MYRIAD trial was wryly titled, “You Can Lead an Adolescent to Mindfulness, but You Can’t Make Them Mindful.” Despite enthusiasm about feeding kids their mindfulness vegetables, by and large, the kids in the MYRIAD trial were not especially interested. Around half the students rated the mindfulness program positively, at over a 5 on a 10-point scale, while the other half didn’t think it was helpful. As one student summed up, with that cutting quality so darling to teenagers, “The only part of these lessons that had any kind of effect on me, that was to experience the shear [sic] boredom these classes produced.”

It should perhaps not come as a surprise that adolescents were unimpressed by a practice that many adults also find boring, uninteresting, or difficult. Adults who practice mindfulness also do so of their own volition. In the same way that you wouldn’t expect much enthusiasm from an adult mandated to attend mindfulness classes—or do anything—so too did the students in the MYRIAD trial rebel against being forced into them. “Schools are like prisons,” said Greenberg. But even those taught mindfulness in prisons sign up to learn it.

Indeed, some have posited that mindfulness didn’t “work” in the MYRIAD trial because the kids weren’t really practicing mindfulness at all. More than 80 percent of the students did not do the required mindfulness practice homework, some because it required a computer that they didn’t have at home.

Another reason mindfulness practice may have fallen flat in the MYRIAD trial has to do with the fact that children are not just miniature adults. Mindfulness involves metacognitive awareness, the ability to be aware of your own thoughts. Science hasn’t given us a definitive answer to when that ability comes online, but the guesstimate is around the age of the MYRIAD trial participants (11–14), and it gets better with age. So while an 11-year-old may just be beginning to be aware of their internal processes, metacognitive awareness is much more developed in a 15- or 16-year-old—and a mindfulness program aimed at those 14 and under may be limited in what it can accomplish. This may be why, said Greenberg, studies that measured mindfulness’s effects in college students have had much more positive outcomes than MYRIAD did. 

Being taught mindfulness, then, may not make sense developmentally until we’re well into our teenage years. “The traditional adult practices are really inappropriate for anybody who is still just figuring out [metacognition],” said Tish Jennings, a professor of education at the University of Virginia and a leader in the field of social-emotional learning, who was not involved in the MYRIAD trial. “In fact, adolescents can become hyperfocused on their thoughts and sometimes very self-conscious, and that can lead to rumination and worry about yourself.”

While the question of whether meditation can cause psychic harm has a long-standing literature in traditional texts, it’s a rather new consideration in Western discussion. Even in research on mindfulness in adults, it’s not common for adverse experiences, outside of severe ones like death, to be tracked. MYRIAD was unusual in that it did, so the answers as to how mindfulness could have made a child’s anxiety or depression worse are more clear. 

Consider one student’s journal entry, collected in a qualitative study connected to the MYRIAD trial called “Non-Positive Experiences Encountered by Pupils.”  The student described, the study says, feeling anxiety in a mall or walking down the hall at school, and trying to do a mindfulness practice to manage it. But it seemed to make the symptoms worse:

“I just feel like everybody is watching me and everything is very loud, and I can hear everyone. I feel like everybody is talking about me. So I just do that [mindfulness practice] and then it just makes me feel it more, it just makes me want to leave.”

There were also students who reported being triggered by difficult memories, like a grandmother who died “in a really bad way.” And there seemed to be a common misunderstanding that the point of mindfulness was to block out negative emotions and experiences. Suggestions to just let thoughts pass by, for instance, were interpreted as a suggestion to ignore problems: When a teacher asked what students could do about an email they were worried about, one of them responded, “Delete the email.”

These experiences did not represent all of the students, many of whom found the mindfulness course to be beneficial. But for some kids, mindfulness made them more aware of their issues without giving them any of the tools to address them. “If you are coming to school—and there were cases of this in our schools,” Kuyken said, referring to the MYRIAD trial, “and you can’t afford shoes, and you haven’t had breakfast, and you’ve watched your father beat the living daylights out of your mother before you even arrive at school . . . teaching that kid mindfulness is not the priority.” In those cases, Kuyken said, becoming more aware of challenging thoughts and feelings would need to be paired with access to basic safety and care, as well as mental health services.

Everyone I spoke to for this article, whose perspectives varied generally, agreed on the point that narrowing anyone’s focus onto a traumatic experience through mindfulness, particularly a child’s, was not advisable. Jennings, who says she was exposed to trauma as a child and was eventually diagnosed with PTSD, said that therapists have specifically told her not to meditate while experiencing intense feelings like grief. The field overall is adapting to these learnings; trauma-sensitive mindfulness is now being integrated into programs for adults as well.

Richard Burnett, cofounder of the UK-based Mindfulness in Schools Project (MiSP), whose curriculum was used for the MYRIAD trial as well as in several other mindfulness studies, said that teachers of their curriculum are usually aware of children who may be coming from dysfunctional home environments or passing through a traumatic experience, like a divorce or a death in the family. They may take measures to assess whether any of the children are having a hard time with the meditations, or let an individual student opt out. 

There was no opt-out option in the MYRIAD trial, and no announcement that the program may lead to some of the difficulties the students experienced. But even if there had been, expecting already overwhelmed teachers to be aware of each student’s interior landscape and home life seems like a big ask.

I asked Dr. Richard J. Davidson, founder and director of the Center for Healthy Minds at the University of Wisconsin-Madison, whether it’s even possible to identify children who are at risk of harm, from a psychiatric perspective, if they have emerging mental health symptoms and have yet to be diagnosed. “The most honest answer,” he responded, “is that we don’t know at this point in time.” Science also has yet to figure out, he said, whether there may be cognitive or emotional styles—not necessarily a psychiatric disorder but certain inclinations—that could make someone prone to, for example, rumination, when a person becomes preoccupied with their own distress, worsening it.

Negative outcomes, however, could be the case whether the kids were taught mindfulness or practically anything else. “There are always risks attached in a universal intervention,” said Davidson. Researchers have found that psychological interventions, generally speaking, can cause an adverse experience in 3 percent to 10 percent of people. More recently, scholars like Willoughby Britton have called attention to how often unintended negative consequences occur in meditators today. Few scientific resources have been devoted to the question. But early research has found that the proportion of meditators who have adverse experiences ranges from 8 percent to 22 percent, writes Miguel Farias, an associate professor at Coventry University, in the commentary Is it Ethically Wrong to Integrate Mindfulness into Public Health?

In my conversation with MiSP’s Burnett about these possibilities, he emphasized that the “dosage” of mindfulness that students would experience in school is “tiny.” And while he is aware of meditation’s risks, he said that “to compare what we’re doing in schools to ten-day vipassana retreats is like comparing chalk and cheese. . . . We are dipping children’s toes in very shallow puddles for a few minutes at a time.”

One other point of contention about the MYRIAD trial has to do with the quality of instruction. Unlike some mindfulness programs that are taught by experienced meditators, in the MYRIAD trial, the curriculum was taught by ordinary schoolteachers who had gone through an eight-week mindfulness-based cognitive therapy for life program, and then a four-day training on how to teach MiSP’s curriculum. They taught a trial run to a different group of students, before teaching it for the study.

While on average the teachers were rated as delivering the intervention competently, that the teachers were essentially amateurs is a sticking point for those who say that the MYRIAD trial didn’t test mindfulness’s efficacy at all, but only whether it could be scaled up rapidly as a public health intervention. Relying on classroom teachers with no meditation practice history was the trial’s “fatal flaw,” said Matthew Hirshberg, research assistant professor at the Center for Healthy Minds. “As a former teacher, developmental psychologist, and educational psychologist, I could have told you before you ran this study that it wasn’t gonna work.” The MYRIAD researchers did indeed find that the kids more interested in the mindfulness curriculum also had teachers who were rated as more competent.

What is somewhat ironic is that the teachers themselves were helped by the mindfulness training. Two additional studies from the MYRIAD trial found that, from the teachers’ perspective, school climate improved and their burnout was alleviated. Those results suggest one path forward for those invested in passing on mindfulness to kids. The idea is a kind of “trickle down mindfulness”—that if you could make all the adults in a school mindful, that they would be able to lead by example. In this view, mindfulness is somewhat like an infectious disease for beneficial qualities: “Mindfulness is caught, not taught,” explained Kuyken.

Another path is to test mindfulness as a universal intervention in schools once more, but to address all of the gripes of the MYRIAD trial—voluntary mindfulness training aimed at older adolescents and padded by additional mental health support for those who need it. Would spending the millions to see if it works be justified, though, with science that even before MYRIAD could be best described as mixed? In fact, other RCTs (randomized controlled trials)  of mindfulness-based school interventions, although not as large as MYRIAD, also showed disappointing results in Finland in 2020, in the UK again in 2022, and four times in Australia, in 2016, 2017, 2019, and in 2021.

There is also the work that Jennings and others are focusing on, which incorporates a kind of developmentally appropriate mindfulness into a more holistic social-emotional learning intervention. A recent study, led by Jennings, found that such a curriculum led to better behavior in students at high-poverty elementary schools. At the Center for Healthy Minds, the team is ditching a practice-first approach and testing whether it may be more efficacious to teach what Buddhists know as “view” and others might understand as a mindset or framework before diving into practice itself. 

Those within the industry don’t feel that it’s time to put the “mindfulness for kids” dream completely to bed, however. MYRIAD “is only one study,” said Greenberg. For his part, Burnett is concerned about throwing the baby out with the bathwater, and indeed whether mindfulness’s impact is even able to be measured by science. “How do you measure a seed that you’re sowing?” he asked. 

It’s the science, though, that protects the whole endeavor from smacking of evangelism. Farias, who has been banging the skepticism drum around mindfulness in schools for some time, sees the enthusiasm around it, without strong scientific evidence to back it, either as a religious or financially minded position, “a cheap way of trying to deal with kids’ mental health problems without really addressing what is driving the problems.” He also raised a valid, simple question: If the agreed-upon support for vulnerable children whom mindfulness may not help or even harm is to send them to a mental health professional, why wouldn’t it be best just to invest in more of them in schools?

While the intention to support kids through mindfulness is admirable, there’s also the fact that these efforts are a deviation from how traditional Buddhists have done things for thousands of years. Jennings recalls being in working groups convened by the contemplative science organization Mind & Life Institute to talk about teaching meditation to children. Naturally, they were curious about what is done in traditionally Buddhist countries like Tibet. “We thought that they must have a whole curriculum that we could modify and make appropriate for our culture,” she said. “No,” she continued, laughing. “It’s not there.”

While children in monastic settings may learn some basic contemplative skills by participating in group ritual practices, chanting, and so forth, even monks are not usually taught sitting meditation until their late teens, if at all. In the Mind & Life working groups, Jennings continued, it did make them think that if cultures where meditation is “deeply embedded are not doing these practices with young children, then why are we thinking about doing that?”