Neuroscience has revealed in recent years that trauma resulting from adverse childhood events can actually change the brain — for the worse — of a developing child. And their thought processes and behaviors can become impaired as a result. They may be less able to control their emotions than youth who have not been traumatized, and they may experience reinjury and disturbing flashbacks.
With about 17 million young people with a mental health disorder of some kind, according to the Child Mind Institute — and with this greater awareness about the lifelong effects of trauma — anxiety grows among youth workers who wonder how best to get help for their charges.
A growing number of experts, including psychologists, social workers and physicians, have found a new tool in their kits for treating young people: mindfulness.
“There’s been an explosion of interest and studies,” said Dr. Jill Emanuele, director of training for the Child Mind Institute in New York City and a clinical psychologist. Therapists are becoming trained in using mindfulness, or paying attention to what is happening in one’s own environment with care and attention, to treat their young patients.
Mindfulness reduces reactivity
Mindfulness is used in addition to other, more conventional therapies in clinical settings, and is also being used in wider groups of youngsters before signs of depression or anxiety appear.
Young people are taught to “observe and not respond in a way that is counterproductive,” Emanuele said. For example, if a young person is experiencing anger, he or she would be taught to observe their emotion, “to sit with it and let it ride out,” Emanuelle said, instead of screaming at one’s parents or, worse, self-harming.
The young person would be instructed to name the feeling and to experience it, such as “I’m feeling angry, and I’m feeling the urge to punch somebody,” but then not to act on the feeling, Emanuele said.
Amy Saltzman, M.D., was trained as an internist and has devoted her life to helping people, particularly young people, live healthier lives. The author of two books on mindfulness and young people, she has taught mindfulness to young people for 15 years.
“Basically, what I’m seeing is that kids are stressed, depressed, anxious, suicidal,” said Saltzman, also a professor at Stanford University and director of the Association for Mindfulness in Education. “I’ve worked with a broad spectrum of kids, and it does help kids be less stressed and anxious, and improves their ability to cope and be more engaged with their lives.”
Saltzman has recently co-edited a book, “Teaching Mindfulness Skills to Kids and Teens,” drawing on the expertise of many professionals working with youth in a wide variety of settings — music, sports, drug and alcohol rehabilitation and juvenile justice.
She also has a workbook coming out in November that guides professionally trained mindfulness experts. “Stress Ed” is geared toward fifth graders and high school freshmen, and is designed to help them learn to be with their feelings rather than react to them.
Evidence for mindfulness
Studies about the benefits of mindfulness have for years shown benefit to adults, but research into the benefits for youth is still in its infancy, Saltzman said. While hundreds of studies at dozens of research centers across the country are underway, few so far have been conducted with the rigor that the medical and scientific communities like to see before they make recommendations for treatment.
Still, advocates believe firmly that smaller studies and anecdotal evidence show mindfulness helps young people, and wellconducted studies are beginning to show significant benefits for youth with depression and anxiety.
“The data for the kids is 20 years behind the adults,” said Saltzman. But, from studies completed so far, “the data for kids is mimicking the data for adults.”
A particularly impressive study was completed in Belgium in 2013, Saltzman said, with 400 students from five high schools. The control group — those receiving no mindfulness training — and the study group — those who were to receive mindfulness training — had similar rates of depression before the study began.
The rate of depression in the mindfulness group was half that in the control group after six months, or 16 percent for the mindfulness group compared to 31 percent for the control group.
Because studies, such as those pioneered by Jon Kabat-Zinn as far back as the 1970s, have shown that mindfulness reduces stress, schools and out-of-school settings are offering it to reduce stress in the general youth population. For example, a study conducted in Augusta, Ga., by what was known as the Medical College of Georgia (now Mercer University School of Medicine) showed high school biology students who practiced mindfulness had lower blood pressure than their peers.
Meditation & compassion training
Emory University School of Medicine in Atlanta now teaches meditation to medical students, helping them to decrease stress.
“In many ways, it’s a psychological intervention,” said Timothy Harrison, assistant director of the Emory-Tibet Partnership for Cognitively-Based Compassion Training. Emory’s program takes mindfulness training a step further by incorporating compassion training, which also seems to help lower stress.
“We’re not having a problem teaching these kids studying medicine. They’re smart. They get that,” Harrison said. “What they’re having problems with is stress.”
Emory has conducted research on the effectiveness of mindfulness training on children, and, while results are only just starting to come in, Harrison said he has been encouraged by what he and others have seen. For example, one research project indicated that young children could be taught to be more inclusive, which in turn helps other youth feel less stressed.
As for young adult medical students, the stakes can be even higher.
Training to train others
Therapists and those who use mindfulness in after-school settings should be trained and should practice mindfulness themselves, experts said.
“Someone can’t just pick it up and start doing it,” Emanuele said. “Any therapist who uses it should have mindfulness training.”
Saltzman said mindfulness training could be most helpful before youth become distressed and find themselves in therapy. And while much of her focus has been on the in-school environment, she wholeheartedly supports mindfulness training in the out-ofschool environment.
“I think [mindfulness training] is important for everybody, and I love to teach kids before they are diagnosed,” she said.
Saltzman lives in the Palo Alto, Calif., area, where several teens have killed themselves by jumping in front of a Caltrain train in recent years. She wonders what might have happened to them had they been able to stop and think for a moment about a different response to the pain that led them to take their lives.
“If any of the teenagers who stood in front of the train had been taught to be with intense feelings, perhaps some of them might have chosen differently,” she said. “I’m not saying that mindfulness would have made a difference or that it’s a cure-all, but I do wonder if just giving them a moment to stop and choose would have made a difference.”
The city and Caltrain have placed more security cameras at the tracks, but Saltzman thinks that spending money on mindfulness training could be more productive.
“It teaches you to have your feelings without your feelings having you,” she said. “That’s really important for kids.”
— Lynne Anderson writes about health and wellness from Atlanta.
More mindfulness resources
- ACES Too High (acestoohigh.org) offers user-friendly articles and tools, such as this video: “Just Breathe.” http://bit.ly/1R635qN
- American Mindfulness Research Association (goamra.org) offers a monthly newsletter and other resources to members.
- Mindful Schools (mindfulschools.org) publishes resources and offers training and certification for professionals working with youth, including a sample lesson.
- “Meditate or Medicate? Teens and Hypertension,” an article published by Yoga International, describes the impact of meditation on teens. http://bit. ly/1Pow8aJ
- “Teaching Mindfulness Skills to Kids and Teens,” edited by by Christopher Willard, Psy. D., and Amy Saltzman M.D., includes research review, lesson plans and scripts, case studies and more.
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