Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial

Kuyken, Willem; Ball, Susan; Crane, Catherine; Ganguli, Poushali; Jones, Benjamin; Montero-Marín, Jesús; Nuthall, Elizabeth; Raja, Anam; Taylor, Lewis; Tudor, Kate; Viner, Russell; Allwood, Matt; Aukland, Louise; Dunning, Darren L.; Casey, Tríona; Dalrymple, Nicola; Wilde, Katherine De; Farley, Eleanor-Rose; Harper, Jennifer; Hinze, Verena; Kappelmann, Nils; Kempnich, Maria; Lord, Liz; Medlicott, Emma; palmer, lucy; Petit, Ariane; Philips, Alice; Pryor-Nitsch, Isobel; Radley, Lucy; Sonley, Anna; Shackleford, Jem; Tickell, Alice; Team, Myriad; Blakemore, Sarah‐Jayne; Ukoumunne, Obioha C; Greenberg, Mark T.; Ford, Tamsin; Dalgleish, Tim; Byford, Sarah; Williams, James

doi:10.1136/ebmental-2022-300424

Cited by 23 publications

(23 citation statements)

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“…The MYRIAD trial premises were that there is an urgent need to prioritise mental health in early adolescence, as early/mid-adolescence is a developmental window when many mental health problems emerge; and schools may play an important role in fostering mental health by teaching foundational abilities such as mindfulness skills and executive function. As reported elsewhere, 9 there was no effect on any of the primary outcomes of SBMT versus TAU in students. The present study explored for whom SBMT does/does not work, what implementation context influences SBMT’s effectiveness, and how SBMT works.…”

Section: Discussionsupporting

confidence: 72%

“…22 Schoolteachers can benefit from mindfulness training, 23 and this can potentially benefit students through improvements in teacher well-being, classroom instruction, and school climate. 9 In the absence of compelling evidence, our on July Child and adolescent mental health results do not support the universal roll-out of SBMT, at least in the form of this curriculum. Our data suggest that adolescents at different developmental stages may require benefit from different approaches.…”

Section: Discussionmentioning

confidence: 83%

“…In the main analyses, we found no support for the SBMT’s effectiveness compared with TAU on student mental health and well-being outcomes 8. There were, however, short-term effects of SBMT versus TAU on teacher burnout and school climate 9. This large trial provides an invaluable opportunity to drive innovation and generate hypotheses for future research.…”

Section: Introductionmentioning

confidence: 75%

“… 8 There were, however, short-term effects of SBMT versus TAU on teacher burnout and school climate. 9 This large trial provides an invaluable opportunity to drive innovation and generate hypotheses for future research.…”

Section: Introductionmentioning

confidence: 99%

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School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?

Montero-Marín

Allwood

Ball

et al. 2022

Evid Based Mental Health

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BackgroundPreventing mental health problems in early adolescence is a priority. School-based mindfulness training (SBMT) is an approach with mixed evidence.ObjectivesTo explore for whom SBMT does/does not work and what influences outcomes.MethodsThe My Resilience in Adolescence was a parallel-group, cluster randomised controlled trial (K=84 secondary schools; n=8376 students, age: 11–13) recruiting schools that provided standard social–emotional learning. Schools were randomised 1:1 to continue this provision (control/teaching as usual (TAU)), and/or to offer SBMT (‘.b’ (intervention)). Risk of depression, social–emotional–behavioural functioning and well-being were measured at baseline, preintervention, post intervention and 1 year follow-up. Hypothesised moderators, implementation factors and mediators were analysed using mixed effects linear regressions, instrumental variable methods and path analysis.FindingsSBMT versus TAU resulted in worse scores on risk of depression and well-being in students at risk of mental health problems both at post intervention and 1-year follow-up, but differences were small and not clinically relevant. Higher dose and reach were associated with worse social–emotional–behavioural functioning at postintervention. No implementation factors were associated with outcomes at 1-year follow-up. Pregains−postgains in mindfulness skills and executive function predicted better outcomes at 1-year follow-up, but the SBMT was unsuccessful to teach these skills with clinical relevance.SBMT as delivered in this trial is not indicated as a universal intervention. Moreover, it may be contraindicated for students with existing/emerging mental health symptoms.Clinical implicationsUniversal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

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School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?

Montero-Marín

Allwood

Ball

et al. 2022

Evid Based Mental Health

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“…Our scoping review sets out a conceptual model with testable hypotheses 7. In a parallel paper we report MYRIAD Trial effects on teacher-level (mental health and functioning) and school-level (eg, climate) outcomes 28. In a further paper, we explore potential moderators (eg, student age), mechanisms (eg, participants’ engagement) and implementation facilitators (eg, teacher competency) 29…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial

Kuyken

Ball

Crane

et al. 2022

Evid Based Mental Health

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BackgroundSystematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health.ObjectiveThe My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU).MethodsMYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11–14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included.FindingsAnalysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI −0.05 to 0.06) for risk for depression; 0.02 (−0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (−0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed.ConclusionsFindings do not support the superiority of SBMT over TAU in promoting mental health in adolescence.Clinical implicationsThere is need to ask what works, for whom and how, as well as considering key contextual and implementation factors.Trial registrationCurrent controlled trials ISRCTN86619085. This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z).

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Mindfulness in education: Critical debates and pragmatic considerations

Lee,

McCaw,

Van Dam

2024

British Educational Res J

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Mindfulness has all but become a mainstay in modern education. Yet despite the incredible enthusiasm and increased application in schools, there remains significant divergence between advocates and critics. Advocates assert that mindfulness practice promotes individual and societal health and well‐being. Meanwhile, critics question the intention and the social and political implications of promoting these ancient practices in schools, arguing that the Buddhist ethics underlying mindfulness remain incompatible with the neoliberal ideology and instrumentalism of contemporary schooling. As mindfulness has been commodified, instrumentalised and used as a therapeutic tool for acute coping, its broader potential for human growth and development may be undermined. Furthermore, scholars caution that the fledging nature of mindfulness research leaves critical questions unanswered, especially the potential for adverse effects. The work herein examines these critiques, presenting three critical considerations for mindfulness in education, and articulates practical recommendations for educational leaders, policy makers and stakeholders. We aim to empower educators and others to make judgements about the promotion and integration of mindfulness into educational settings, considering context‐specific factors such as developmental needs and capacities, as well as recommendations to support effective and ethical practice of mindfulness in education.

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Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial

Cited by 23 publications

References 25 publications

School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?

School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?

Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial

Mindfulness in education: Critical debates and pragmatic considerations

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