Saturday, November 4, 2017

New Articles Again Debunk “Mindfulness” in Schools



Teaching Emotional and Behavioral Self-Management through Cognitive-Behavioral Science and The Stop & Think Social Skills Program

Don’t We Really Just Want Students to “Stop & Think”? [Part I of III]


Dear Colleagues,

Introduction

   It is a simple fact that how students feel, feel about themselves, behave, and get along with others strongly predicts their interactions and even their achievement in school. 

   Indeed: 

   * If students feel pressured, bullied, or unsafe, they focus more on these emotional conditions than on academic instruction and learning. 

   * If they are unsure of themselves, lack self-confidence, or are self-conscious, they may not believe that they can succeed. 

   * If they do not have the behavioral skills to pay attention, work independently, or organize themselves, their academic work may suffer. 

   * If they cannot relate to others, work cooperatively in a group, and prevent or resolve conflicts, they will not socially survive.
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   We have also known for decades that students’ social, emotional, and behavioral competency and self-management in school is essential to their academic and interpersonal success.  And that a cognitive-behavioral approach that uses instruction grounded by social learning theory (Teach, Model, Provide Feedback, and Apply the Training to Real-life) is the best social, emotional, and behavioral approach when (a) teaching all students interpersonal and interactional skills, and (b) addressing the serious, extreme, and complex needs of emotionally disturbed and behaviorally disruptive students.

   This science-to-practice approach has not changed in its school and clinical use and effectiveness.
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And yet . . . The Mindfulness Bandwagon Persists

   Despite established and effective cognitive-behavioral approaches (like social skills training—see below), districts and schools across the country continue to jump on the Mindfulness bandwagon.

   Moreover, they continue this pattern despite knowing (and, presumably, valuing) the importance of implementing scientifically- and research-based practices in our schools.

   I have tried to assist by reviewing the Mindfulness research, and by documenting my concerns about the Mindfulness “wave of popularity.”

   Specifically, I have discussed Mindfulness and . . .

   * Its lack of research support

   * The number of schools wasting precious professional development and classroom time and money on this fad

   * The potential harm to students—who need an evidence-based approach to address their social, emotional, and behavioral needs—who are getting this approach instead

. . . in three previous Blogs:

   June 4, 2017.  “Effective School-wide Discipline Approaches: Avoiding Educational Bandwagons that Promise the Moon, Frustrate Staff, and Potentially Harm Students

Implementation Science and Systematic Practice versus Pseudoscience, Menu-Driven Frameworks, and ‘Convenience Store’ Implementation”

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   January 30, 2016.  “Reviewing Mindfulness and Other Mind-Related Programs: Have We Just Lost our Minds? (Part I)

Why Schools Sometimes Waste their Time and (Staff) Resources on Fads with Poor Research and Unrealistic Results”

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   February 13, 2016.  “Reviewing Mindfulness and Other Mind-Related Programs: More Bandwagons that Need to be Derailed? (Part II)

Why are Schools Wasting their Time and Resources on Fads with Poor Research and Unrealistic Results?

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Psychoeducational Researchers Continue to Caution Against the Large-Scale Use of Mindfulness

   On October 11, 2017 (less than three weeks ago), an article in Scientific American (“Where’s the Proof that Mindfulness Meditation Works?”) referenced an article published the day before in Perspectives on Psychological Science, as well as other research and psychologists, stating:

The concept of mindfulness involves focusing on your present situation and state of mind. This can mean awareness of your surroundings, emotions and breathing—or, more simply, enjoying each bite of a really good sandwich. Research in recent decades has linked mindfulness practices to a staggering collection of possible health benefits.

Yet many psychologists, neuroscientists and meditation experts are afraid that hype is outpacing the science. In an article released this week in Perspectives on Psychological Science, 15 prominent psychologists and cognitive scientists caution that despite its popularity and supposed benefits, scientific data on mindfulness is woefully lacking. Many of the studies on mindfulness and meditation, the authors wrote, are poorly designed—compromised by inconsistent definitions of what mindfulness actually is, and often void of a control group to rule out the placebo effect.

The new paper cites a 2015 review published in American Psychologist reporting that only around 9 percent of research into mindfulness-based interventions has been tested in clinical trials that included a control group. The authors also point to multiple large placebo-controlled meta-analyses concluding that mindfulness practices have often produced unimpressive results. A 2014 review of 47 meditation trials, collectively including over 3,500 participants, found essentially no evidence for benefits related to enhancing attention, curtailing substance abuse, aiding sleep or controlling weight.

Lead author of the report Nicholas Van Dam, a clinical psychologist and research fellow in psychological sciences at the University of Melbourne, contends potential benefits of mindfulness are being overshadowed by hyperbole and oversold for financial gain. Mindfulness meditation and training is now a $1.1-billion industry in the U.S. alone. “Our report does not mean that mindfulness meditation is not helpful for some things,” Van Dam says. “But the scientific rigor just isn’t there yet to be making these big claims.”

He and his co-authors are also concerned that as of 2015, less than 25 percent of meditation trials included monitoring for potential negative effects of the intervention, a number he would like to see grow as the field moves forward.

Van Dam acknowledges that some good evidence does support mindfulness. The 2014 analysis found meditation and mindfulness may provide modest benefits in anxiety, depression and pain. He also cites a 2013 review published in Clinical Psychology Review for mindfulness-based therapy that found similar results.

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   This article echoes virtually all of the concerns that I have addressed in previous Blogs.

   But a few more points are important:

   * Those studies that have shown “good evidence” have focused on the treatment of clinically significant mental health issues (anxiety, depression, and pain). 

   Sound research demonstrating that Mindfulness prevents these issues (for example, at Tier 1 in schools) has not yet been established.  Moreover, there is virtually no research that has differentially investigated Mindfulness versus Cognitive-Behavioral Therapy approaches in controlled, randomly-selected, and double-blind samples.
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   * As noted above, most of the Mindfulness research has either not been methodologically sound, or it has not produced objective and demonstrable success.

   Thus, rather than use the few studies that have shown “good evidence” to rationalize the use of Mindfulness in schools (or worse, someone’s personal testimony), educators need to look at the substantial body of research that contraindicates its consideration—much less use.

   By way of analogy, college football players do not win the Heisman Trophy based on one or two exemplary games.  They win the award based on a consistent “body of work” or evidence of excellence over an entire football season.
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   * Finally, most of studies that have shown “good evidence” have focused on adults, not on school-aged students.

   BUT. . . a recent article has again summarized the research on Mindfulness with students . . . once again, questioning the efficacy of this approach.
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Recent ResearchWith StudentsAgain Debunks Mindfulness

   Yet another Scientific American article (“Mindfulness Training for Teens Fails Important Test”), published this week on October 31, 2017, began as follows:

Over the past several decades, the practice of mindfulness has evolved into a booming billion-dollar industry, with growing claims that mindfulness is a panacea for host of maladies including stress, depression, failures of attention, eating disorders, substance abuse, weight gain, and pain.

Not all of these claims, however, are likely to be true. A recent critical evaluation of the adult literature on mindfulness identifies a number of weaknesses in the extant research, including a lack of randomized control groups, small sample sizes, large attrition rates, and inconsistent definitions of mindfulness.

Moreover, a systematic review of intervention studies found insufficient evidence for a benefit of mindfulness on attention, mood, sleep, weight control, or substance abuse.

That said, there is empirical evidence that mindfulness offers a moderate benefit for anxiety, depression, and pain, at least in adults.

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   This article then asks whether Mindfulness can effectively address depression and anxiety in teens.  It notes that some research suggests that Mindfulness can be useful, but it again reinforces the critique above regarding the shortcomings in the research.

   Finally, the article summarizes a large-scale study with 308 middle and high school students who were randomly assigned to a Mindfulness training or Control group (published in Behavior Research and Therapy in 2016).

The students were enrolled in 17 different classes across 5 different schools. Students opted in to the study, and were randomly assigned to the control group or the mindfulness training group. Students in the control group received no mindfulness training but instead participated in community projects or received lessons in pastoral care. Students in the mindfulness group completed 8 weeks of training in the.b (“Dot be”) Mindfulness in Schools curriculum, which is based on the “gold standard” Mindfulness Based Stress Reduction (MBSR) intervention for adults.

The training sessions varied in length from 35 to 60 min and were administered once a week. All mindfulness training was conducted by the same certified instructor. Beyond the weekly training sessions, teens in the mindfulness group were encouraged to practice mindfulness techniques at home and were given manuals to assist in this practice.

All participants were assessed at three different time points: a baseline taken one week before the intervention, a post-test measure taken a week after the sessions were over, and a follow-up assessment administered about 3 months later. The study included measures of anxiety and depression, weight and shape concerns, well-being, emotional dysregulation, self-compassion, and mindfulness. Participants were also asked to report their compliance with home practice, and to provide an evaluation of the intervention. Attrition rates were low (just 16 percent at follow up) and comparable for both groups.

Despite the numerous outcome measures employed in the study, there was no evidence of any benefit for the mindfulness group at either the immediate post-test or the follow up. In fact, anxiety was higher at the follow up for males in the mindfulness group relative to males in the control group. The same was true for participants with low baseline depression and low baseline weight concerns; mindfulness training led to an increase in anxiety in these individuals over time.

   While there were some limitations noted in the students’ Mindfulness practice at home and the fact that the length and number of sessions needed to be adapted for school use, the methodological strengths of this study, and the negative effects are notable.
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Cognitive-Behavioral Interventions and Social Skills Training Still Remain

   So . . . given these consistent cautions and research results, why are districts and schools still jumping aboard the Mindfulness Express?

   And what are the alternatives?
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   The alternative is a focus on teaching students’ social, emotional, and behavioral self-management . . . that is, interpersonal, social problem-solving, conflict prevention and resolution, and emotional control and coping skills.

   While this certainly takes time in the classroom, we recommend that these skills be embedded in a Health, Mental Health, and Wellness “curriculum” that involves a preschool through high school scope and sequence of units and instruction.

   Consistent with the cognitive-behavioral and social learning theory points in the Introduction to this Blog, research reviews of over 200 studies of school-based programs [CLICK HERE FOR ABSTRACT] revealed that classroom time spent on addressing the social, emotional, and behavioral skills and needs of students helped to significantly increase their academic performance and their social and emotional skills, and that the students involved were better behaved, more socially successful, less anxious, more emotionally well-adjusted, and earned higher grades and test scores. 
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   And so, while social skills training is needed by all students in the schools, it also facilitates the classroom management process for teachers, and it is especially essential for students demonstrating social, emotional, and behavioral challenges.

   Indeed, if the primary goal of a Mindfulness program is to help students to be more aware and in control of their emotions, thoughts, and behavior, why would we not focus on the same goals—but use a research-based approach that has a 30-year track record of success?
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Summary . . . and Prelude to Part II

   When critiquing some of the current practices in our schools (while also recommending that some be avoided, and others be discontinued), it is equally important to suggested well-researched and effective alternatives.

   That, in essence, is what I have tried to do in this Blog.

   Indeed, I have tried to emphasize that we:

   * Know and have well-researched approaches to help children and adolescents progressively develop social, emotional, and behavioral self-awareness, self-management, self-evaluation, and self-correction and reinforcement skills;

   * Need to invest our school-based social, emotional, and behavioral training and application time in approaches that have demonstrated their student-specific benefits—including academic benefits—and “return on investment”; and

   * Need to discriminate the “marketing, social media, and testimony-based” hype from the “objective, science-driven, and professionally-refereed” facts that bombard educators, and make critical decisions more difficult than they need to be.
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   In Part II of this three-part “series,” I will use the evidence-based Stop & Think Social Skills Program as an exemplar of a social skills approach to teaching students social, emotional, and behavioral self-management.

   In doing this, I will identify the scientific foundations of a sound social skills program, and use the Stop & Think Program to provide examples of how that science is translated into practice.

   The Stop & Think Social Skills Program is written for classroom teachers with implementation at the preschool to Grade 1, Grades 2/3, Grades 4/5, and Grades 6 through 8.  At the same time, the Program has been implemented strategically at the high school level, in alternative and juvenile justice facilities with students who are 18 years old and beyond, and in residential and day treatment programs for students with emotional and behavioral disabilities.  There also is a Stop & Think Program for parents—to help guide them on how to teach and reinforce prosocial skills at home from preschool through early adolescence. 
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   Meanwhile, I hope that this review of the recent Mindfulness research and thought has been helpful to you, and that the information will assist you in making the sometimes-confusing decisions that are relevant to your school discipline, classroom management, and student self-management program.

   I always look forward to your comments. . . whether on-line or via e-mail.

   If I can help you in any of the student support and intervention areas discussed in this message, I am always happy to provide a free one-hour consultation conference call to help you clarify your needs and directions on behalf of your students.

Best,

Howie

1 comment:

  1. Howie,

    Thanks for drafting this outline of your concerns with mindfulness programs. I recently saw this post that laid out the challenges that researchers are having with mindfulness programs - https://www.mindful.org/science-mindfulness-needs/. It's interesting to see that the field is having a moment of self-reflection as well.

    Dr. Ari Yares

    ReplyDelete