A Sc Rvie Ar‑B M Interven f C Youth - Springer › content › pdf › 10.1007 ›...
Transcript of A Sc Rvie Ar‑B M Interven f C Youth - Springer › content › pdf › 10.1007 ›...
Vol.:(0123456789)1 3
Child and Adolescent Social Work Journal https://doi.org/10.1007/s10560-020-00657-5
A Scoping Review of Arts‑Based Mindfulness Interventions for Children and Youth
Diana Coholic1 · Nicholas Schwabe1 · Kenneth Lander1
© The Author(s) 2020
AbstractMindfulness-Based Interventions (MBIs) hold promise for building resilience in children/youth. We were interested in understanding why some MBIs incorporate arts-based methods, and what key findings were identified from the study of these MBIs. We used a scoping review to address our research questions. Scoping reviews can help us better understand how different types of evidence can inform practice, policy, and research. Steps include identifying research questions and relevant studies, selecting studies for analysis, charting data, and summarizing results. We identified 27 research articles for analysis. MBIs included the use of drawing, painting, sculpting, drama, music, poetry, and karate. Rationales included both the characteristics of children/youth, and the benefits of the methods. Arts-based MBIs may be more relevant and engaging especially for youth with serious challenges. Specific focus should be paid to better understanding the development and benefits of these MBIs.
Keywords Mindfulness · Arts-based · Youth · Scoping review
Mindfulness is a holistic philosophy and way of being in the world, and it can be both a state (an experience) and a trait (a personality characteristic or disposition) (Kabat-Zinn, 2003). Mindfulness-Based Interventions (MBIs) can help people learn to focus their attention, and with regular practice, they can learn to be aware of their present thoughts, feelings, and bodily sensations without negative judgements (Kabat-Zinn, 1990). With this nonjudgmental awareness, an individual can develop the ability to choose a response to distressing situations and emotions instead of reacting with unhealthy behaviors and interpretations (Horesh & Gordon, 2018). Indeed, emotion regulation is an important component in treating a variety of complex mental health challenges including anxiety (Chambers, Gullone, & Allen, 2009). As a way of being in the world, mindfulness represents an inner-resource that contributes to resilience, which is the ability to recover from tumultuous circumstances (Bajaj & Pande, 2016). Thus, youth facing a variety of psychosocial stressors may find mindfulness a helpful strategy for mitigating chal-lenges and building resilience.
MBIs have been developed for a range of conditions in both clinical and healthy adult populations. Well established MBIs include Mindfulness Based Stress Reduction (MBSR) (Kabat-Zinn, 1990), Mindfulness Based Cognitive Therapy (MBCT) (Segal, Williams, & Teasdale, 2002), and Accept-ance and Commitment Therapy (ACT) (Hayes, Strosahl, & Wilson, 1999). There is evidence that MBSR improves mental health and reduces symptoms of stress, anxiety and depression, and MBCT prevents depressive relapse (Fjor-back, Arendt, Ornbol, Fink, & Walach, 2011). MBIs have also been found to be helpful in reducing symptoms of anxi-ety (Vollestad, Birkeland Nielsen, & Hostmark Nielsen, 2012). ACT combines mindfulness and cognitive therapy with an emphasis on treating anxiety and depression but is typically delivered in a traditional one-on-one counselling setting. Most other MBIs are facilitated via group delivery making them cost-effective, and providing the additional benefit of developing social competencies (Klatt, Buck-worth, & Malarkey, 2009).
A wide variety of MBIs, often adapted from programs developed for adults, have also been investigated for use with children and youth in clinical settings and in schools with promising results. It appears that MBIs in schools may improve resilience (Zenner, Herrnleben-Kurz, & Walach, 2014). Others have found that youth with serious
* Diana Coholic [email protected]
1 School of Social Work, Laurentian University, Sudbury, ON P3E 2C6, Canada
D. Coholic et al.
1 3
mental health challenges who participated in MBSR developed improved attention and mood, self-concept, and interpersonal relationships (Van Vliet et al., 2017). A review of the evidence for MBCT for improving self-regulation in teenagers indicated that youths reported bet-ter self-regulation and coping (Perry-Parrish, Copeland-Linder, Webb, Shields, & Sibinga, 2016). Similarly, a review of MBIs for youth with anxiety reported that MBIs are effective for the treatment of anxiety disorders in youth (Borquist-Conlon, Maynard, Esposito Brendel, & Farina, 2017).
Tan and Martin (2013) summarized the mechanisms that are thought to contribute to the effectiveness of practicing mindfulness. These include improved atten-tional capacity, which is important in learning processes; increased self-awareness and the ability to notice thoughts as transitory experiences that are not necessarily true (flexible thinking); and reduced distress and/or distress tolerance through the process of accepting thoughts and feelings rather than repressing or trying to control them. These mechanisms of change and consequent benefits can build on each other. For example, with improved attention and focus, self-awareness can be developed so that a youth can understand and express their feelings. With improved emotion regulation, they can cope better with challenges, which can affect overall mood and self-esteem (Coholic et al., 2019). However, this is a developing field and some have argued that findings should be considered tentatively promising (Zenner et al., 2014), while others argued that we need more research that examines the mechanisms of change that participants experience and/or self-report (Alsubaie et al., 2017; Chiesa, Fazia, Bernardinelli, & Morandi, 2017), that is, learning mindfulness may not be the only factor implicated in change.
When MBIs are adapted from adult programs for use with children and youth, modifications are often made to make the programs more relevant for young people, for example, shortened meditation exercises and the addi-tion of experiential activities, but typically, the structure of the program adheres to the original adult program. Some researchers have argued that there is a need to bet-ter understand the factors contributing to changes in chil-dren’s behaviours, feelings, and thoughts as a result of having participated in an MBI (Harnett & Dawe, 2012). In our own work, we have found that the enjoyment cre-ated through the use of arts-based methods engages our target population and is consistently reported as one of the most favorite aspects of our arts-based MBI (Coholic & Eys, 2016). Thus, we were interested in better understand-ing what research exploring arts-based MBIs has been completed and why arts-based approaches were used by researchers and facilitators. With this information, future areas for research and practice can be identified.
Scoping Reviews
Scoping reviews have been successfully used to aid in the design of research, inform best policies/practices, and locate research gaps in the literature (Pham et al., 2014). Various definitions have been proposed to describe scoping reviews including to identify key concepts and sources of available evidence (Arksey & O’Malley, 2005); to synthesize and analyze diverse research and non-research material (Davis, Drey, & Gould, 2009); and to map the literature on a spe-cific topic so that we can better understand how different types of evidence can inform practice, policy making, and research (Pham et al., 2014). Scoping reviews are most com-monly used to rapidly develop a description and analysis of available literature in a specific area (Grant & Booth, 2009). Study quality is not assessed, thus, more studies tend to be included compared to systematic reviews/meta-analyses. Therefore, the scoping review was selected as a methodol-ogy well suited to quickly, and with limited resources, map the emerging literature with regards to the use of arts-based group MBIs with children and youth. In a scoping review of scoping reviews, Pham et al. (2014) indicated that Arksey and O’Malley’s (2005) framework was the most common methodological framework employed. We also used their five-stage framework to guide our work with the following steps: (1) identifying research questions, (2) identifying rel-evant studies, (3) study selection, (4) charting the data, and (5) collating and summarizing. Consultation is listed as an optional component (Arksey & O’Malley, 2005).
Method
Research Questions
We were interested in exploring the existent research per-taining to arts-based group MBIs with children and youth aged 8–18 years old. The research questions were: (1) What are the MBIs that primarily use arts-based methods to facili-tate mindfulness with children and youth? (2) Why do these MBIs focus on using arts-based methods? and (3) What are the key findings from these programs?
Selection Criteria
We focused on research published from 2000–2017 because studying MBIs with children and youth is an emergent area of research, and beginning with the year 2000 ensured a comprehensive search. Literature published in English was the focus as we did not have the resources to translate papers written in other languages. Criteria was also related
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
to type of intervention including MBIs with children and youth aged 8–18 years old including all types of challenges and rationales for participation in the MBI; group delivery; and any group size and mix of genders. Importantly, for the purposes of our review, the MBI had to have a major focus on arts-based methods. We understood arts-based methods to include a variety of creative and experiential approaches such as drawing, painting, sculpting, games, movement such as karate or tai chi, drama, music, and poetry/journaling. We agreed that the MBIs had to be primarily focused around teaching mindfulness-based practices and concepts by way of arts-based activities so that arts-based activities were facilitated in every session serving as the context for the delivery of the mindfulness-based practices. We included all cultures, practitioner-types, and geographical/physical locations.
Identifying Relevant Studies
As academic journals are increasingly web-based we decided to conserve our limited resources by solely searching elec-tronic databases. Our search was limited to English language articles published between January 2000 and March 2017. To identify relevant studies a number of search terms were selected in consultation with one of our university’s librar-ians and based on the research questions. For instance, an article’s abstract or title would require the term mindfulness and synonyms for children/youth, groups, and arts-based/creative interventions. These terms were separated by
Boolean operator ‘AND,’ whilst synonyms were separated by ‘OR.’ Terms with varying suffixes were truncated with the asterisk symbol to yield more studies. The terms were then used to search the abstracts and titles of articles in their respective databases (see Table 1 for list of keyword search terms). The second and third authors, who were senior social work students training in the first author’s research program, independently searched 22 databases which were expected to yield the most relevant results using the same set of search terms (see Table 2 for a list of the databases searched).
Study Selection
The initial search yielded 4363 articles. This number was reduced when 2116 duplicates were removed. The second and third authors then independently reviewed the titles and abstracts to identify articles that did not meet the inclusion criteria; this eliminated an additional 1365 articles. Another 674 articles were eliminated following the abstract review leaving 208 articles. The description of interventions in the remaining articles were then independently reviewed by the second and third authors to assess whether the interventions met the inclusion criteria. When there was a lack of consen-sus between these two authors, discussions were held with the first author regarding the inclusion of an article in order to resolve the discrepancies. The flow chart in Fig. 1 depicts the process of searching and screening the articles. Addition-ally, we found that our search yielded several dissertations but they were eliminated during the intervention description
Table 1 Database keyword search terms
Search terms and Boolean operators
(mindfulness) AND (youth* OR teen* OR child* OR laten* OR adolescen* OR kid* OR boy* OR girl* OR juvenile* OR minor* OR young* OR preteen* OR pubescent* OR prepubescent* OR junior* OR student* OR immature*) AND (program* OR creativ* OR art* OR activit* OR non-traditional* OR recreation* OR experiential* OR expressi* OR adventur* OR outdoor* OR play*) AND (group* OR class* OR club* OR circle* OR team* OR program* OR company* OR cast* OR gang* OR band* OR squad* OR crew* OR clan* OR collectiv* OR troop*)
Table 2 Databases searched Databases
Academic OneFile PsycINFOCINAHL PubMedDirectory of Open Access Journals REHABDATA JSTOR Sage JournalsLiterature Resource Center Scholars PortalMedline (Ovid) ScienceDirectNative Health Database Social Work AbstractsOVID Nursing Journals Sociological AbstractsPublished International Literature on Traumatic Stress Springer LINKProject MUSE Taylor & Francis OnlineProQuest Nursing & Allied Health Source Wiley Online Library
D. Coholic et al.
1 3
review due to time and resource constraints. Ultimately, 27 studies were selected for inclusion and analysis.
Charting the Data
The second and third authors charted the 27 articles accord-ing to the following extraction fields: publication year, authors, title, country, purpose/research questions, popula-tion characteristics, sample size, study design, intervention duration and description, facilitator qualifications, compara-tor description, outcome measures, outcomes, and research-ers’ rationales for the use of arts-based MBIs (see Table 3 for a list of included articles and relevant extraction data).
Results
The analysis phase of a scoping review should include three steps: analyzing the data, reporting results, and applying meaning to the results. Analysis typically involves a descriptive numerical summary and a thematic analysis (Levac, Colquhoun, & O’Brien, 2010).
Characteristics of Arts‑Based MBIs
Of the 27 studies, 10 were based in Canada, eight were based in the United States of America, and five were based in Australia. One study was from South Korea, Norway, and Kosovo respectively. One article reported on two stud-ies, one from Australia and another from Sweden evalu-ating the same MBI. Studies included children/youth between the ages of 7–27 years, with the highest minimum age requirement being 16 years. Twenty-one of the MBIs were offered to boys and girls. Most of the studies targeted specific populations that included youth with chronic pain and illness, low income, placement in foster care, incarcer-ation, learning disabilities, anxiety, eating disorders, post-traumatic stress disorder, depression, disruptive behaviors, and other mental health challenges. Six studies recruited youth from schools or the general population.
Eight studies employed solely qualitative designs. Nine of the remaining studies had primarily quantitative designs whilst also featuring qualitative methods. Six studies iden-tified themselves as randomized controlled trials (RCTs) compared to 14 intervention trials that were non-RCTs. Eight of the non-RCT designs included control groups. Twenty-three of the studies had total sample sizes of less than 100, but one RCT included 347 participants. New programs usually require preliminary evidence of benefits before being studied more widely. Thus, many of the stud-ies were pilot projects (Jee et al., 2015), feasibility studies (Klatt, Harpster, Browne, White, & Case-Smith, 2013) or exploratory studies (Milligan, Badali, & Spiroiu, 2015). Research investigating arts-based MBIs is emergent, which may account in part for the heterogeneity of the MBIs and the study designs.
Integra Mindfulness Mixed Martial Arts (MMA) (Milli-gan et al., 2015, 2016), Taming the Adolescent Mind (Tan & Martin, 2013, 2015), and the Holistic Arts-Based Pro-gram (Coholic & Eys, 2016; Coholic, Eys, & Lougheed, 2012) were the only MBIs reported in multiple studies. Briefly, MMA aims to decrease challenging behaviors, increase self-awareness, control, and adaptability, and improve social and self-defence skills. The 20-week pro-gram consists of weekly 1.5-h sessions that include mind-fulness, cognitive behavioral therapy (CBT), and mixed
Database search(n=4363)
Articles after duplicates removed(n=2247)
Articles after title review (n=882)
Articles after abstract review
(n=208)
Articles included in review(n=27)
Articles excluded based on intervention description
(n=181)
Articles excluded based on abstracts(n=674)
Articles excluded based on title
(n=1365)
Duplicates removed
(n=2116)
Fig. 1 Article search flowchart
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
Tabl
e 3
List
of i
nclu
ded
artic
les a
nd e
xtra
cted
dat
a
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Atk
inso
n an
d W
ade
(201
5)A
ustra
lia14
–18
Girl
sYo
uths
at r
isk
of
deve
lopi
ng a
n ea
ting
diso
rder
Feat
ured
vid
eos,
mirr
or
exer
cise
s, ro
le-p
layi
ng,
and
disc
ussi
on to
con
vey
non-
judg
emen
tal p
rese
nt
mom
ent a
war
enes
s fo
cuse
d on
bod
y re
late
d se
nsat
ions
and
thou
ghts
- opt
iona
l hom
ewor
k w
as
prov
ided
to p
ract
ice
skill
s le
arne
d in
-ses
sion
n = 34
7C
luste
r ran
d-om
ized
con
trol
trial
with
follo
w
up a
nd p
ost-
inte
rven
tion
writ
ten
prog
ram
fe
edba
ck
EDE-
Q, P
AN
AS-
X, D
EBQ
-R,
SATA
Q-3
, C
IA, a
nd
prog
ram
ac
cept
abili
ty
Like
rt sc
ales
The
inte
rven
tion
prod
uced
impr
oved
scor
es o
n w
eigh
t/sha
pe c
once
rns,
nega
tive
affec
t, di
etar
y re
strai
nt, t
hin-
idea
lizat
ion,
soci
o-cu
ltura
l pre
s-su
res,
eatin
g di
sord
er sy
mpt
oms,
and
psyc
ho-
soci
al im
pairm
ents
thro
ugh
follo
w u
p bu
t no
stat
istic
ally
sign
ifica
nt e
ffect
was
foun
d fo
r stu
dy
cond
ition
or c
ondi
tion
x tim
e in
tera
ctio
n. M
BI
parti
cipa
nts r
epor
ted
the
low
est i
nter
vent
ion
acce
ptab
ility
scor
es w
ith st
atist
ical
ly si
gnifi
cant
di
ffere
nces
for t
he u
nder
stan
ding
of c
once
pts a
nd
likel
ihoo
d to
con
tinue
the
use
of sk
ills
Bur
ckha
rdt e
t al.
(201
7)A
ustra
lia14
–16
Mix
edPr
ivat
e sc
hool
stu
dent
sIn
clud
ed th
e us
e of
vid
eos,
liste
ning
min
dful
ly
to a
udio
tape
s, m
ock
deba
tes,
and
actin
g in
a
play
abo
ut th
ough
ts
n = 48
Clu
ster r
and-
omiz
ed c
ontro
l tri
al w
ith fo
llow
up
DA
SS-2
1, F
S,
and
custo
m
prog
ram
eva
lu-
atio
n qu
estio
n-na
ire w
ith
Like
rt sc
ales
The
inte
rven
tion
impr
oved
scor
es o
n bo
th th
e D
ASS
-21
(dep
ress
ion,
anx
iety
, and
stre
ss) a
nd
FS (fl
ouris
hing
) but
thes
e w
ere
not s
igni
fican
tly
diffe
rent
from
the
cont
rol g
roup
, tho
ugh
the
pre
to fo
llow
-up
effec
t siz
es w
ere
mod
erat
e to
larg
e.
On
the
prog
ram
eva
luat
ion
scal
es, p
artic
ipan
ts
belie
ved
they
wer
e m
ore
confi
dent
, im
pact
ed
less
by
nega
tive
thou
ghts
, hap
pier
, fou
nd th
e w
orks
hop
help
ful,
mor
e co
mfo
rtabl
e w
ith
nega
tive
emot
ions
and
anx
iety
, und
ersto
od th
eir
valu
es, h
ad b
ette
r rel
atio
nshi
ps, a
nd a
pplie
d th
e w
orks
hop
to d
aily
life
Coh
olic
(201
1)C
anad
a8–
15M
ixed
—si
ngle
ge
nder
gro
ups
Chi
ldre
n re
ceiv
-in
g m
enta
l he
alth
or c
hild
w
elfa
re se
rvic
es
Mul
timod
al (p
aint
, pas
tels
, sa
nd, e
tc.)
arts
-bas
ed
min
dful
ness
exe
rcis
es
that
requ
ire th
e pr
actic
e of
pre
sent
mom
ent a
war
e-ne
ss a
nd n
onju
dgem
ent
with
par
ticul
ar a
ttent
ion
to e
mot
iona
l aw
aren
ess
n = 31
Qua
litat
ive
post-
inte
rven
tion
inte
rvie
ws
N/A
Yout
h fo
und
the
inte
rven
tion
fun
and
this
aid
ed in
th
e de
velo
pmen
t of s
elf-
awar
enes
s, em
otio
nal
regu
latio
n, h
ealth
y em
otio
nal e
xpre
ssio
n, c
opin
g sk
ills,
and
self-
este
em
Coh
olic
and
Eys
(2
016)
Can
ada
Ran
ge n
ot
repo
rted
( x =
10.34
± 1.
71)
Mix
ed—
sing
le
gend
er g
roup
sC
hild
ren
rece
iv-
ing
men
tal
heal
th o
r chi
ld
wel
fare
serv
ices
See
Coh
olic
(201
1)n =
77N
on-e
quiv
alen
t gr
oups
qua
si-
expe
rimen
tal
trial
with
pos
t-in
terv
entio
n in
terv
iew
s
PHC
SCS
and
RSC
AYo
uth
foun
d th
e gr
oup
enjo
yabl
e an
d re
ques
ted
it be
leng
then
ed. T
hey
also
foun
d th
e M
BI f
un a
nd
enjo
yed
mak
ing
frie
nds a
nd d
oing
art.
Per
ceiv
ed
bene
fits i
nclu
ded
emot
iona
l reg
ulat
ion,
moo
d,
soci
al/c
opin
g sk
ills,
confi
denc
e/se
lf-es
teem
, em
path
y, a
nd im
prov
ed a
ttent
ion.
Sta
tistic
ally
si
gnifi
cant
impr
ovem
ents
wer
e fo
und
for s
elf-
conc
ept
Coh
olic
et a
l. (2
012)
Can
ada
8–14
Mix
ed—
sing
le
gend
er g
roup
sC
hild
ren
rece
iv-
ing
men
tal
heal
th o
r chi
ld
wel
fare
serv
ices
See
Coh
olic
(201
1)n =
21N
on-e
quiv
alen
t gr
oups
qua
si-
expe
rimen
tal
trial
PHC
SCS
and
RSC
ASt
atist
ical
ly si
gnifi
cant
impr
ovem
ents
wer
e fo
und
for e
mot
iona
l rea
ctiv
ity fo
llow
ing
the
MB
I
D. Coholic et al.
1 3
Tabl
e 3
(con
tinue
d)
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Coh
olic
, Lo
ughe
ed, a
nd
Cad
ell (
2009
)
Can
ada
8–15
Mix
ed—
sing
le
gend
er g
roup
sC
hild
ren
rece
iv-
ing
men
tal
heal
th o
r chi
ld
wel
fare
serv
ices
See
Coh
olic
(201
1)n =
38Q
ualit
ativ
e po
st-in
terv
entio
n in
terv
iew
s and
se
ssio
n ob
serv
a-tio
ns
N/A
Youn
g pe
ople
enj
oyed
the
grou
p, w
ould
like
to
cont
inue
atte
ndin
g be
yond
the
initi
al p
rogr
am,
and
coul
d no
t ide
ntify
any
are
as fo
r im
prov
emen
t. Pa
rtici
pant
s des
crib
ed th
e gr
oup
as fu
n an
d pl
ace
to d
evel
op se
lf-es
teem
. Gua
rdia
ns w
ere
sup-
porti
ve o
f the
pro
gram
and
wer
e gl
ad to
see
the
child
ren
expr
essi
ng e
xcite
men
t, se
lf-aw
aren
ess,
and
impr
oved
scho
ol o
utco
mes
. The
you
ths f
ound
th
ey u
sed
thei
r im
agin
atio
n m
ore
and
min
dful
ness
ex
erci
ses t
o re
lax
and
regu
late
em
otio
nC
ohol
ic,
Loug
heed
, an
d Le
Bre
ton
(200
9)
Can
ada
8–12
Mix
ed—
sing
le
gend
er g
roup
sC
hild
ren
rece
iv-
ing
child
w
elfa
re se
rvic
es
See
Coh
olic
(201
1)n =
35N
on-c
ontro
lled
pre-
post
trial
w
ith p
ost-
inte
rven
tion
inte
rvie
ws
PHC
SCS
Qua
ntita
tive
resu
lts w
ere
not r
epor
ted.
For
qua
lita-
tive
resu
lts se
e C
ohol
ic, L
ough
eed,
and
Cad
ell
(200
9)
Dia
z et
al.
(201
2)U
SA7–
12N
/ASu
mm
er st
uden
ts
with
em
otio
nal
reac
tivity
cha
l-le
nges
The
use
of th
e ga
me
head
s-up
/sev
en-u
p to
teac
h m
indf
ulne
ss
N/A
Qua
litat
ive
jour
n-al
ing
durin
g se
ssio
ns a
nd
focu
s gro
ups
N/A
Parti
cipa
nts n
oted
that
min
dful
ness
was
abo
ut
quie
tnes
s, de
coru
m, a
nd k
indn
ess.
The
child
ren
enjo
yed
play
ing
the
gam
e an
d in
tegr
atin
g m
indf
ulne
ss. F
ocus
gro
ups a
t firs
t hel
ped
deve
lop
the
gam
e ru
les.
They
als
o re
veal
ed th
at th
e ga
me
help
ed th
e yo
uths
lear
n ab
out m
indf
ulne
ss in
w
ays t
hey
coul
dn’t
in c
lass
Gor
don
et a
l. (2
008)
Kos
ovo
14–1
8M
ixed
Stud
ents
with
PT
SDEx
pres
sive
arts
incl
ud-
ing
writ
ing,
dra
win
g,
imag
ery,
gen
ogra
ms,
spok
en w
ord,
and
dan
ce
n = 82
Ran
dom
ized
wai
t-lis
t con
trol t
rial
with
follo
w u
p
HTQ
Trau
ma
sym
ptom
s wer
e si
gnifi
cant
ly re
duce
d af
ter t
he in
terv
entio
n w
hen
com
pare
d w
ith th
e w
aitli
st co
ntro
l and
at f
ollo
w-u
p. A
void
ance
and
re
expe
rienc
ing
sym
ptom
s wer
e si
gnifi
cant
ly
redu
ced
imm
edia
tely
afte
r the
inte
rven
tion
whe
n co
mpa
red
with
the
wai
tlist
cont
rol,
how
ever
, hy
pera
rous
al sy
mpt
oms w
ere
not
Hay
dick
y et
al.
(201
2)C
anad
a12
–18
Boy
sYo
uths
with
le
arni
ng d
is-
abili
ties
Mix
ed m
artia
l arts
incl
ud-
ing
the
Bus
hido
Way
of
the
War
rior a
nd a
bel
t sy
stem
rew
ardi
ng m
artia
l ar
ts p
rofic
ienc
y, h
ome
prac
tice,
and
pro
soci
al
beha
vior
n = 60
Non
-ran
dom
ized
w
aitli
st co
ntro
l tri
al
WA
SI, W
J-II
I, C
PRS,
BR
IEF,
C
BC
L, a
nd
CB
CL-
YSR
With
in th
e A
DH
D/L
earn
ing
disa
bilit
y su
b-gr
oup,
si
gnifi
cant
tim
e x
grou
p (in
terv
entio
n v.
con
trol)
effec
ts w
ere
foun
d fo
r opp
ositi
onal
defi
ant a
nd
cond
uct p
robl
ems o
n th
e C
BC
L. W
ithin
the
hype
ract
ive/
impu
lsiv
e su
b-gr
oup
sign
ifica
nt
time
x gr
oup
(inte
rven
tion
v. c
ontro
l) eff
ects
w
ere
foun
d fo
r met
acog
nitiv
e m
onito
ring
on th
e B
RIE
F. W
ithin
the
inat
tent
ive
sub-
grou
p, si
gnifi
-ca
nt ti
me
x gr
oup
(inte
rven
tion
v. c
ontro
l) eff
ects
w
ere
foun
d fo
r soc
ial p
robl
ems o
n th
e C
BC
L.
With
in th
e an
xiet
y su
b-gr
oup,
sign
ifica
nt ti
me
x gr
oup
(inte
rven
tion
v. c
ontro
l) eff
ects
wer
e fo
und
for D
SM a
nxie
ty o
n th
e C
BC
L-Y
SRH
imel
stein
et a
l. (2
012)
USA
14–1
8B
oys
Yout
hs in
carc
er-
ated
in a
ju
veni
le h
all
Expe
rient
ial e
xerc
ises
(e.g
., ic
eber
g ac
tivity
, bag
of
rese
ntm
ents
, and
be
a m
an b
ox),
story
telli
ng,
and
visu
aliz
atio
n
n = 23
Post-
inte
rven
tion
qual
itativ
e in
terv
iew
s with
pa
rtici
pant
s
N/A
Parti
cipa
nts r
epor
ted
incr
ease
d re
laxa
tion,
self-
este
em, s
elf-
cont
empl
atio
n, e
mot
iona
l and
ph
ysic
al aw
aren
ess,
pres
ent—
mom
ent a
war
enes
s, em
otio
nal r
egul
atio
n, c
ogni
tive
regu
latio
n, a
nd
beha
vior
al re
gula
tion.
The
y al
so re
porte
d re
duce
d str
ess,
impr
oved
slee
p, in
terv
entio
n ac
cept
ance
, an
d po
sitiv
e gr
oup
expe
rienc
es
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
Tabl
e 3
(con
tinue
d)
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Jee
et a
l. (2
015)
USA
14–2
1M
ixed
Yout
h in
foste
r or
kins
hip
care
Arts
and
cra
fts a
ctiv
ities
an
d pl
ayin
g m
usic
n = 42
Ran
dom
ized
co
ntro
l tria
l w
ith p
artic
ipan
t fo
cus g
roup
s at
the
seco
nd
last
sess
ion
and
follo
w u
p in
terv
iew
s with
gu
ardi
ans/
case
-w
orke
rs
PSC
-17,
CA
MM
, ST
AIT
/STA
IS,
and
HRV
Two
adve
rse
even
ts (fi
ghts
bet
wee
n pa
rtici
pant
s)
wer
e re
porte
d. N
o st
atist
ical
ly si
gnifi
cant
im
prov
emen
ts w
ere
foun
d fo
r ext
erna
lizin
g sy
mpt
oms,
inte
rnal
izat
ion,
atte
ntio
n pr
oble
ms,
min
dful
ness
, or a
nxie
ty. E
CG
resu
lts in
dica
ted
stat
istic
ally
sign
ifica
nt h
ighe
r hea
rt ra
tes p
ost-
inte
rven
tion
for a
ctiv
e gr
oup
parti
cipa
nts
Kla
ssen
(201
7)U
SA10
–13
Girl
sSi
xth-
grad
e stu
dent
sJo
urna
ling,
min
dful
m
ovem
ent,
and
phot
o el
icita
tion
N/A
Qua
litat
ive
desc
riptiv
e ca
se
study
N/A
The
case
stud
y re
ports
the
impe
tus f
or th
e cr
eatio
n of
the
prog
ram
(i.e
., an
incr
ease
in c
once
rn th
at
fem
ale
stude
nts w
ere
self-
criti
cal a
nd h
ighl
y co
m-
petit
ive)
and
a n
arra
tive
acco
unt o
f the
inte
rven
-tio
n im
plem
enta
tion
but q
ualit
ativ
e in
terv
entio
n or
pro
cess
out
com
es w
ere
not r
epor
ted
Kla
tt et
al.
(201
3)U
SA ~
9M
ixed
Yout
hs li
ving
in
low
-inco
me
fam
ilies
Gui
ded
visu
aliz
atio
n,
colo
ring
and
draw
ing,
ex
pres
sive
writ
ing,
and
co
llage
mak
ing
n = 49
Non
-ran
dom
ized
co
ntro
lled
trial
w
ith fo
llow
up
and
post-
inte
r-ve
ntio
n te
ache
r in
terv
iew
s
CTR
S-R
:SQ
ualit
ativ
ely,
teac
hers
repo
rted
stude
nts l
earn
ed to
re
lax,
shor
t ses
sion
s wer
e us
eful
for i
nteg
ratio
n in
the
scho
ol d
ay, t
he in
terv
entio
n im
prov
ed
clas
s atte
ndan
ce, i
ncre
ased
ale
rtnes
s dur
ing
clas
ses a
fter t
he in
terv
entio
n, th
e in
corp
orat
ion
of m
usic
was
hel
pful
, and
that
the
inte
rven
tion
was
acc
epta
ble
and
feas
ible
. AD
HD
, hyp
erac
tiv-
ity, a
nd c
ogni
tive
atte
ntio
n w
ere
all s
tatis
tical
ly
sign
ifica
ntly
impr
oved
afte
r the
inte
rven
tion
and
thes
e im
prov
emen
ts w
ere
mai
ntai
ned
at fo
llow
up
and
the
effec
t siz
es w
ere
mod
erat
e. O
ppos
ition
al
beha
vior
scor
es w
ere
not s
igni
fican
tly im
prov
edLa
gor e
t al.
(201
3)U
SA8–
12M
ixed
Stud
ents
with
a
chro
nic
illne
ssV
isua
l im
ager
y, m
indf
ul
touc
hing
gam
es, u
sing
op
tical
illu
sion
s, lis
teni
ng
to m
usic
, dra
win
g, a
nd
assi
gnin
g co
lour
and
so
und
to e
mot
ions
n = 15
Non
-con
trolle
d pr
e-po
st tri
al
with
pos
t-in
terv
entio
n in
terv
iew
s
CAM
M, P
edsQ
L,
and
BYI-
IIA
maj
ority
of s
tude
nts l
iked
the
inte
rven
tion,
43%
of
stud
ents
pre
ferr
ed e
xper
ient
ial a
ctiv
ities
, on
e ev
en b
roug
ht in
terv
entio
n el
emen
ts to
thei
r fa
mily
, but
mul
tiple
stud
ents
foun
d th
e ac
tiviti
es
diffi
cult
or b
orin
g an
d on
e w
as fr
ustra
ted
that
m
indf
ulne
ss d
oes n
ot re
duce
em
otio
n in
tens
ity.
Hal
f of t
he st
uden
ts re
porte
d m
indf
ulne
ss a
s a
tool
for b
ehav
iora
l reg
ulat
ion
and
21%
repo
rted
that
min
dful
ness
is m
eant
to in
crea
se aw
aren
ess.
Stud
ents
wou
ld h
ave
pref
erre
d gr
oups
bas
ed o
n ag
e. A
mon
g tre
atm
ent c
ompl
eter
s, an
xiet
y w
as
stat
istic
ally
sign
ifica
ntly
redu
ced.
No
sign
ifica
nt
resu
lts w
ere
foun
d fo
r sel
f-co
ncep
t, de
pres
sion
, an
ger,
disr
uptiv
e be
havi
ors,
qual
ity o
f life
, or
min
dful
ness
D. Coholic et al.
1 3
Tabl
e 3
(con
tinue
d)
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Livh
eim
et a
l. (2
015)
Aus
tralia
and
Sw
eden
12–1
8/14
–15
Mix
ed—
sing
le
gend
er g
roup
sSt
uden
ts
expe
rienc
ing
sym
ptom
s of
depr
essi
on/
Stud
ents
with
m
enta
l hea
lth
chal
leng
es
Pain
ting,
role
-pla
ys, fi
nger
-tra
ps, c
harc
oal c
olou
ring,
cl
ay sc
ulpt
ing,
poe
m
writ
ing,
and
map
dra
win
g
n = 66
/ n =
32R
ando
miz
ed c
on-
trol t
rial w
ith a
po
st-in
terv
en-
tion
feed
back
qu
estio
nnai
re/
Ran
dom
ized
co
ntro
l tria
l w
ith fo
llow
up
and
pos
t-in
terv
entio
n fe
edba
ck
ques
tionn
aire
RA
DS-
2, A
FQ-
Y8,
and
SD
QIn
the
Aus
tralia
n stu
dy, t
here
wer
e m
oder
ate
to
larg
e st
atist
ical
ly si
gnifi
cant
tim
e x
grou
p eff
ects
fo
r the
RA
DS-
2 ov
eral
l (in
clud
ing
dysp
horia
, ne
gativ
e aff
ect,
and
nega
tive
self-
eval
uatio
n su
bsca
les b
ut n
ot so
mat
ic c
ompl
aint
s) a
nd th
e A
FQ-Y
8 (a
void
ance
and
fusi
on).
In th
e Sw
edis
h stu
dy, t
here
wer
e la
rge
to m
ediu
m si
gnifi
cant
and
m
argi
nally
stat
istic
ally
sign
ifica
nt ti
me
x gr
oup
effec
ts fo
r per
ceiv
ed st
ress
, min
dful
ness
, and
an
xiet
y. A
dditi
onal
ly, s
tress
, dep
ress
ion,
anx
iety
, an
d qu
ality
of l
ife w
ere
sign
ifica
ntly
cor
rela
ted
amon
g in
terv
entio
n pa
rtici
pant
s with
the
num
ber
of se
ssio
ns a
ttend
edPa
rtici
pant
s in
the
Aus
tralia
n stu
dy re
porte
d le
arni
ng a
bout
feel
ings
, lea
rnin
g ‘e
very
one
was
th
e sa
me’
, had
fun,
nor
mal
ized
feel
ings
, and
le
arni
ng th
at ‘t
houg
hts a
nd fe
elin
gs d
o no
t nee
d to
rule
my
life’
. Par
ticip
ants
als
o co
mm
ente
d th
at
ther
e w
as n
othi
ng th
ey w
ould
cha
nge
abou
t the
pr
ogra
m, b
ut it
was
too
shor
t and
was
occ
asio
n-al
ly c
onfu
sing
. Sw
edis
h pa
rtici
pant
s rep
orte
d th
at
the
prog
ram
was
val
uabl
e an
d ov
er 9
1% p
rovi
ded
posi
tive
feed
back
Loug
heed
and
C
ohol
ic (2
016)
Can
ada
15–1
7M
ixed
—si
ngle
ge
nder
gro
ups
Yout
h ag
ing
out
of fo
ster c
are
See
Coh
olic
(201
1)n =
8D
escr
iptio
n of
the
grou
p pr
ogra
m
and
prel
imin
ary
qual
itativ
e re
sults
N/A
Yout
hs re
port
impr
oved
em
otio
nal r
egul
atio
n, o
pti-
mis
m, a
nd sl
eep
hygi
ene.
The
y al
so re
port
feel
ing
acce
pted
by
peer
s. Re
sear
cher
s bel
ieve
that
the
crea
tive
inte
rven
tions
are
eng
agin
g, p
rovi
de
flexi
bilit
y, a
nd o
ffer t
he o
ppor
tuni
ty to
wor
k w
ith
a ra
nge
of st
reng
ths.
Add
ition
ally
, the
rese
arch
ers
iden
tify
norm
aliz
ing
expe
rienc
es, c
olla
bora
tion,
an
d m
utua
l aid
as k
ey b
enefi
ts to
the
grou
p fo
rmat
Mea
gher
et a
l. (2
018)
Aus
tralia
7–11
Mix
edSt
uden
ts e
xper
i-en
cing
anx
iety
A m
ultis
enso
ry le
arni
ng a
id
that
pro
vide
s a ta
ctile
and
vi
sual
repr
esen
tatio
n of
m
indf
ulne
ss
n = 14
Ran
dom
ized
ac
tive
and
inac
-tiv
e co
ntro
l tria
l w
ith p
ost-i
nter
-ve
ntio
n w
ritte
n fe
edba
ck
ques
tionn
aire
PSW
Q-C
, SC
AS,
AFQ
-Y,
CAM
M, S
DQ
, an
d PE
Q
Sam
ple
size
s wer
e to
o sm
all t
o an
alyz
e in
activ
e co
ntro
l gro
up d
iffer
ence
s. St
atist
ical
ly si
gnifi
cant
la
rge
pre-
post
effec
ts w
ere
foun
d fo
r chi
ld
repo
rted
wor
ry a
nd p
aren
t-rep
orte
d an
xiet
y w
ithin
the
inte
rven
tion
grou
p. N
o si
gnifi
cant
eff
ects
wer
e fo
und
for t
he a
ctiv
e co
ntro
l. N
o si
g-ni
fican
t res
ult w
ere
foun
d fo
r avo
idan
ce, f
usio
n,
acce
ptan
ce, a
nd m
indf
ulne
ssM
illig
an e
t al.
(201
6)C
anad
a13
–17
Mix
edRu
ral h
igh
scho
ol
stude
nts w
ith
self-
regu
latio
n ch
alle
nges
Mix
ed m
artia
l arts
, phy
sica
l ch
alle
nges
, sto
ryte
lling
, an
d po
ints
-bas
ed sy
stem
fo
r pro
soci
al b
ehav
ior
and
hom
e pr
actic
e
n = 35
Non
-ran
dom
ized
w
aitli
st co
ntro
l tri
al
PCS-
C, S
CS-
C,
and
CN
CEQ
Posi
tive
smal
l-mod
erat
e st
atist
ical
ly si
gnifi
cant
tim
e x
grou
p eff
ect s
izes
(in
favo
r of t
he in
terv
entio
n)
wer
e fo
und
for p
artic
ipan
ts’ se
cond
ary
cont
rol
and
cogn
itive
err
or sc
ores
but
not
prim
ary
cont
rol
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
Tabl
e 3
(con
tinue
d)
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Mill
igan
et a
l. (2
015)
Can
ada
12–1
7M
ixed
Yout
hs w
ith a
le
arni
ng d
is-
abili
ty
See
Mill
igan
et a
l. (2
015)
n = 29
Post-
inte
rven
tion
qual
itativ
e fe
edba
ck q
ues-
tionn
aire
and
in
terv
iew
s
N/A
Yout
h re
porte
d at
tend
ing
to im
prov
e re
latio
n-sh
ips,
fitne
ss/m
artia
l arts
skill
s, an
d em
otio
nal
regu
latio
n. M
ost y
outh
s rep
orte
d ac
hiev
ing
thei
r go
als.
Like
wis
e, p
aren
ts re
porte
d go
als t
hat t
he
parti
cipa
nts w
ould
impr
ove
emot
iona
l reg
ulat
ion,
be
havi
oral
con
trol,
fitne
ss, a
nd sc
hool
per
for-
man
ce. T
he m
ost f
avor
ed c
ompo
nent
s of t
he
inte
rven
tion
wer
e th
e gr
oup
form
at a
nd m
artia
l ar
ts fo
llow
ed b
y m
edita
tion
and
min
dful
self-
talk
. G
ener
ally
, stu
dent
s enj
oyed
the
use
of st
orie
s, cl
ass s
umm
arie
s, th
e po
ints
syste
m, a
nd th
e in
clu-
sion
of p
aren
ts. H
owev
er, t
he u
se o
f wor
kshe
ets
rece
ived
less
supp
ort.
The
clas
s tim
ing,
leng
th,
and
freq
uenc
y w
ere
repo
rted
as a
ppro
pria
te b
y pa
rtici
pant
s. Pa
rent
s app
reci
ated
the
parti
cipa
nts’
m
edita
tion
prac
tice
and
mee
tings
with
par
ents
but
so
me
foun
d w
orks
heet
s the
leas
t hel
pful
Parti
cipa
nt-r
epor
ted
bene
fits i
nclu
ded
incr
ease
d ca
lmne
ss, m
aste
ry a
nd p
ride,
em
otio
nal w
ell
bein
g, p
eer r
elat
ions
hips
, ‘th
inki
ng b
efor
e ac
t-in
g’, t
oler
ance
of d
isco
mfo
rt, c
omm
unic
atio
n,
self-
unde
rsta
ndin
g, a
nd b
ehav
iora
l reg
ulat
ion.
Pa
rent
s and
you
ths r
epor
ted
prog
ram
del
iver
y fo
rmat
ben
efits
incl
uded
the
expe
rient
ial f
eatu
res
of in
tegr
ated
mar
tial a
rts a
nd th
erap
y, le
arni
ng
acco
mm
odat
ions
, and
a sa
fe a
nd su
ppor
tive
envi
-ro
nmen
t. N
egat
ive
feat
ures
as r
epor
ted
by p
aren
ts
wer
e tim
ing,
dist
ance
, and
cos
ts. T
wo
yout
hs
repo
rted
the
med
itatio
n an
d yo
ga a
s bor
ing
and
pain
ful r
espe
ctiv
ely
Rusk
in e
t al.
(201
7)C
anad
a12
–18
Mix
edYo
uth
with
ch
roni
c pa
inFi
nger
trap
s, ic
e-cu
be
med
itatio
n, a
nd o
ther
ex
perie
ntia
l act
iviti
es
n = 21
Non
-con
trolle
d pr
e-po
st tri
al
with
follo
w u
p,
acce
ptab
ility
as
sess
men
t, an
d po
st-in
ter-
vent
ion
focu
s gr
oups
with
pa
rtici
pant
s
AH
IF, P
CQ
, FD
I, M
ASC
, CD
S,
PCS,
CA
MM
, C
PAQ
-R,
MSP
SS, a
nd
custo
m p
ost-
sess
ion
and
satis
fact
ion
ques
tionn
aire
s
Ave
rage
satis
fact
ion
with
the
inte
rven
tion
was
ra
ted ~
8/10
. Tw
o of
the
twen
ty-o
ne p
artic
ipan
ts
wer
e no
n-co
mpl
eter
s. Pa
rtici
pant
s’ d
isab
ility
in
dex
and
pain
acc
epta
nce
stat
istic
ally
sig-
nific
antly
incr
ease
d. N
o si
gnifi
cant
resu
lts w
ere
foun
d fo
r anx
iety
, pai
n ca
tastr
ophi
zing
, soc
ial
supp
ort,
pain
, min
dful
ness
, or d
epre
ssio
n
Tan
and
Mar
tin
(201
5)A
ustra
lia13
–18
Mix
edYo
uths
with
m
enta
l hea
lth
chal
leng
es
Min
dful
scul
ptin
g, v
isu-
aliz
atio
n, d
raw
ing,
and
m
indf
ul m
usic
liste
ning
n = 91
Ran
dom
ized
con
-tro
l tria
l with
fo
llow
up
DA
SS-2
1, R
SES,
R
SCA
, AFQ
-Y
8, C
AM
M,
CB
CL
Sign
ifica
nt ti
me
x gr
oup
effec
ts w
ere
foun
d fo
r ov
eral
l men
tal h
ealth
(DA
SS-2
1), m
indf
ulne
ss,
psyc
holo
gica
l infl
exib
ility
, sel
f-es
teem
, and
tota
l be
havi
oral
out
com
es (C
BC
L) in
favo
r of t
he
min
dful
ness
inte
rven
tion.
Bet
wee
n-gr
oup
men
tal
heal
th o
utco
me
diffe
renc
es w
ere
med
iate
d by
ch
ange
s in
min
dful
ness
D. Coholic et al.
1 3
Tabl
e 3
(con
tinue
d)
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Tan
and
Mar
tin
(201
3)A
ustra
lia13
–17
Mix
edYo
uths
dia
gnos
ed
with
a m
enta
l ill
ness
See
Tan
and
Mar
tin (2
015)
n = 10
Pre-
post
trial
with
fo
llow
up
and
open
resp
onse
po
st-in
terv
en-
tion
feed
back
qu
estio
nnai
re
DA
SS-2
1, R
SES,
CA
MM
, AFQ
-Y
8, C
BC
L,
and
custo
m
post-
inte
rven
-tio
n pr
ogra
m
satis
fact
ion
scal
e
Smal
l sta
tistic
ally
sign
ifica
nt e
ffect
s wer
e fo
und
for s
tress
, anx
iety
, dep
ress
ion,
self-
este
em,
psyc
holo
gica
l infl
exib
ility
, beh
avio
ral o
utco
mes
(C
BC
L), a
nd a
larg
e eff
ect f
or m
indf
ulne
ss. B
ene-
fits i
nclu
ded
bette
r sle
epin
g, le
ss a
nger
, inc
reas
ed
rela
xatio
n, b
ette
r em
otio
nal r
egul
atio
n, re
duce
d str
ess a
nd te
nsio
n, le
arni
ng to
be
mor
e aw
are,
th
ink
mor
e cl
early
, inc
reas
ed a
ccep
tanc
e, a
nd
lear
ning
to d
o on
e th
ing
at a
tim
e. P
artic
ipan
ts
foun
d th
e pr
ogra
m u
sefu
l, he
lpfu
l, an
d re
laxi
ng.
They
als
o re
porte
d th
at th
ey w
ould
reco
mm
end
the
grou
p to
frie
nds a
nd w
ante
d m
ore
sess
ions
or
wou
ld c
hang
e no
thin
g. E
ight
y-ni
ne p
erce
nt w
ere
high
ly sa
tisfie
d w
ith th
e pr
ogra
mTh
aral
dsen
(2
012)
Nor
way
16–2
7M
ixed
Hig
h sc
hool
stu
dent
sRo
le-p
layi
ng, s
tory
telli
ng,
visu
aliz
atio
n, a
nd c
omic
str
ips
n = 81
Non
-ran
dom
ized
co
ntro
l pre
-pos
t tri
al w
ith fo
llow
up
and
pos
t-in
terv
entio
n in
terv
iew
s
MC
S, S
CL-
90-R
, an
d SW
LSSt
atist
ical
ly si
gnifi
cant
diff
eren
ces e
xiste
d in
th
e pr
e-fo
llow
-up
chan
ges i
n lif
e sa
tisfa
ctio
n w
ith d
eter
iora
ting
life
satis
fact
ion
with
in th
e in
terv
entio
n gr
oup.
The
re w
as a
lso
a st
atist
ical
ly
sign
ifica
nt p
re-p
ost r
educ
tion
in aw
aren
ess i
n th
e co
ntro
l gro
up. P
artic
ipan
ts re
porte
d th
at m
indf
ul
brea
thin
g sk
ills w
ere
usef
ul a
s wer
e in
crea
sed
awar
enes
s, as
serti
vene
ss, a
nd se
lf-di
strac
tion.
Fe
w p
artic
ipan
ts re
porte
d th
e be
nefit
s of p
re-
vent
ing
nega
tive
emot
ions
. Som
e pa
rtici
pant
s re
porte
d di
fficu
lty le
arni
ng se
lf-di
strac
tion
and
awar
enes
s but
mos
t had
thei
r exp
ecta
tions
of t
he
prog
ram
met
Wal
l (20
05)
USA
11–1
3M
ixed
—si
ngle
ge
nder
gro
ups
Mid
dle
scho
ol
stude
nts
Tai-c
hiN
/AQ
ualit
ativ
e st
ate-
men
ts c
olle
cted
th
roug
hout
the
proc
ess
N/A
Ane
cdot
al re
ports
sugg
est p
artic
ipan
ts fe
lt m
ore
calm
, les
s rea
ctiv
e, m
ore
self-
awar
e, im
prov
ed
slee
p, m
ore
rela
xed,
incr
ease
d fe
elin
gs o
f int
er-
conn
ecte
dnes
s, m
ore
peac
eful
, and
exp
erie
nced
in
crea
sed
wel
l bei
ng a
fter e
ach
sess
ion.
Som
e pa
rtici
pant
s stru
ggle
d w
ith th
e ph
ysic
al d
eman
ds.
Fem
ale
parti
cipa
nts r
eque
sted
the
grou
p co
ntin
ue
but m
ale
parti
cipa
nts w
ere
less
inte
reste
d. T
here
w
as in
tere
st in
the
use
of n
ovel
aid
s suc
h as
m
edita
tion
cush
ions
Wal
tman
et a
l. (2
012)
USA
14–1
7B
oys
Yout
h w
ith d
is-
rupt
ive
beha
v-io
r dis
orde
rs
and
expo
sure
to
min
dful
ness
Stor
ytel
ling
and
read
ing,
w
ritin
g ex
erci
ses,
and
Stan
ford
mar
shm
allo
w
expe
rimen
t rep
licat
ion
n = 7
Non
-con
trolle
d pr
e-po
st tri
al
with
follo
w u
p
MQ
and
PC
ITh
ere
was
a sm
all p
ost-t
est e
ffect
of t
he in
terv
en-
tion
on m
indf
ulne
ss a
nd a
larg
e eff
ect a
t fol
low
-up
—st
atist
ical
sign
ifica
nce
was
not
repo
rted.
A
larg
e th
en m
oder
ate
effec
t was
repo
rted
at
post-
test
then
follo
w-u
p fo
r fac
ility
pro
gram
co
mpl
ianc
e. O
nly
four
of t
he se
ven
parti
cipa
nts
finis
hed
the
inte
rven
tion
and
wer
e in
clud
ed in
th
e an
alys
is
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
martial arts. Key mindfulness concepts emphasized are impermanence, nonjudgment, acceptance, letting go, and focusing on the moment (Haydicky, Wiener, Badali, Mil-ligan, & Ducharme, 2012). Taming the Adolescent Mind (Tan & Martin, 2013) is based on the adult MBSR but delivered over 5-weeks in 1-h group sessions. Modifica-tions to the adult MBSR include shorter meditations and a variety of activities such as mindful drawing, eating, listening to music, and sculpting given youths’ need for movement and familiar activities. Program goals include mastering attention regulation, improving internal and external awareness, nonjudgmental acceptance, and learn-ing how to be mindful. Finally, the Holistic Arts-Based Program (HAP) is a strengths-based group intervention with the following goals: teaching mindfulness in acces-sible and relevant ways; improving self-awareness and expression of feelings and thoughts; developing self-compassion and empathy; and recognizing and shoring up strengths. It was developed and refined through research with marginalized children and youth, and is traditionally offered over 12 weeks in weekly 2-h sessions (Coholic & Eys, 2016).
Rationales for an Arts‑Based Approach
While the rationales for the use of arts-based methods were not always well articulated, some rationales were connected with characteristics of the participants including that activi-ties had to be age appropriate, and the need to engage young people who can be noncompliant, have short attention capac-ities and a variety of interests, possess limited verbal fluency, and struggle with abstract reasoning. Himelstein, Hastings, Shapiro, and Heery (2012) noted the ability of their MBI to engage and retain incarcerated adolescents who are a par-ticularly difficult group to engage in helping processes. Also, Coholic (2011) argued that some marginalized youth may not have the capacities for, or interests in, learning mindful-ness by way of traditional practices such as sitting medi-tations. Another study noted that young people reported a desire to play during MBIs (Diaz, Liehr, Curnan, Brown, & Wall, 2012). Creative methods involving play were adopted in Diaz et al.’s (2012) work to improve retention. Similarly, Tan and Martin (2013) noted that MBIs for youths should incorporate a range of activities that involve physical activ-ity and pastimes already familiar to adolescents (drawing, listening to music, art, etc.). Yook, Kang, and Park (2017) reported physical activity was utilized because of its many benefits for psychological health in general. Thus, mindful-ness needs to be facilitated in a manner that engages youth in a strengths-based helping process that promotes success.
Other rationales were connected with the ability of arts-based methods to teach mindfulness-based practices and concepts including the processes of self-expression, Ta
ble
3 (c
ontin
ued)
Aut
hors
(Yea
r)C
ount
ryA
geG
ende
rPo
pula
tion
Cre
ativ
e in
terv
entio
n co
mpo
nent
sSa
mpl
e si
zeSt
udy
desi
gnQ
uant
itativ
e m
easu
res
Find
ings
Yook
et a
l. (2
017)
Sout
h K
orea
~ 11
Mix
edPr
imar
y sc
hool
stu
dent
sN
ovel
spor
t ‘K
inba
ll’n =
46C
ontro
lled
pre-
post
trial
RSE
S-K
, ER
89-K
, and
th
e K
orea
n Ps
ycho
logi
cal
Wel
l-bei
ng
Scal
e
Ther
e w
ere
stat
istic
ally
sign
ifica
nt ti
me
x gr
oup
effec
ts fo
r sel
f-es
teem
, res
ilien
ce, a
nd h
appi
ness
USA
Uni
ted
Stat
es o
f Am
eric
a, A
HIF
Ado
lesc
ent H
ealth
Info
rmat
ion
Form
, PC
Q P
ain
Cha
ract
erist
ics
Que
stion
naire
, FD
I Fun
ctio
nal D
isab
ility
Inde
x, M
ASC
Mul
tidim
ensi
onal
Anx
iety
Sca
le
for C
hild
ren,
CSD
Col
umbi
a D
epre
ssio
n Sc
ale,
PC
S Pa
in C
atas
troph
izin
g Sc
ale,
CAM
M C
hild
and
Ado
lesc
ent M
indf
ulne
ss M
easu
re, C
PAQ
-R C
hron
ic P
ain
Acc
epta
nce
Que
stion
naire
-Rev
ised
, M
SPSS
Mul
tidim
ensi
onal
Sca
le o
f Per
ceiv
ed S
ocia
l Sup
port,
PSC
-17
Pedi
atric
Sym
ptom
Che
cklis
t—17
, STA
IT/S
TAIS
Sta
te-T
rait
Anx
iety
Inve
ntor
y fo
r Chi
ldre
n, H
RV H
eart
Rat
e Va
riabi
lity,
D
ASS-
21 D
epre
ssio
n A
nxie
ty a
nd S
tress
Sca
le—
Shor
t For
m, F
S Fl
ouris
hing
Sca
le, M
Q M
indf
ulne
ss Q
uesti
onna
ire, P
CI P
erfo
rman
ce C
ompl
ianc
e In
dex,
RSE
-K R
osen
berg
Sel
f-Es
teem
Sca
le
Kor
ean
Vers
ion,
ER8
9-K
Ego
-Res
ilien
ce S
cale
Kor
ean
Vers
ion,
WAS
I Wec
hsle
r Abb
revi
ated
Sca
le o
f Int
ellig
ence
, WJ-
III W
oodc
ock-
John
son
Tests
of A
chie
vem
ent—
3rd
Ed.,
CPR
S C
onne
rs’
Pare
nt R
atin
g Sc
ale,
BRI
EF B
ehav
ior
Rat
ing
Inve
ntor
y of
Exe
cutiv
e Fu
nctio
n—Pa
rent
For
m, C
BCL-
YSR
Chi
ld B
ehav
ior
Che
cklis
t—Yo
uth
Self
Repo
rt, C
TRS-
R:S
Con
ner’s
Tea
cher
Rat
ing
Scal
e—Re
vise
d Sh
ort F
orm
, Ped
sQL
Pedi
atric
Qua
lity
of L
ife I
nven
tory
, BYI
-II
Bec
k Yo
uth
Inve
ntor
ies—
2nd
Ed.,
MC
S M
indf
ul C
opin
g Sc
ale,
SC
L-90
-R S
ympt
om C
heck
list-9
0-Re
vise
d,
SWLS
Sat
isfa
ctio
n W
ith L
ife S
cale
, PC
S-C
Per
ceiv
ed C
ontro
l Sca
le fo
r Chi
ldre
n, S
CS-
C S
econ
dary
Con
trol S
cale
for C
hild
ren,
CN
CEQ
Chi
ldre
n’s
Neg
ativ
e C
ogni
tive
Erro
rs Q
uesti
onna
ire,
EDE-
Q E
atin
g D
isor
der E
xam
inat
ion—
Que
stion
naire
, PAN
AS-X
Pos
itive
and
Neg
ativ
e A
ffect
Sch
edul
e Ex
pand
ed, D
EBQ
-R D
utch
Eat
ing
Beh
avio
ur Q
uesti
onna
ire—
Restr
aint
, SAT
AQ-3
Soc
io-
cultu
ral A
ttitu
des
Tow
ards
App
eara
nce
Scal
e, C
IA C
linic
al Im
pairm
ent A
sses
smen
t, RS
CA R
esili
ency
Sca
les
for C
hild
ren
and
Ado
lesc
ents
, AFQ
-Y8
Avo
idan
ce a
nd F
usio
n Q
uesti
onna
ire fo
r Yo
uth,
RAD
S-2
Reyn
olds
Ado
lesc
ent D
epre
ssio
n Sc
ale—
2, S
DQ
Stre
ngth
s an
d D
ifficu
lties
Que
stion
naire
, PSW
Q-C
Pen
n St
ate
Wor
ry Q
uesti
onna
ire—
Chi
ld A
dapt
atio
n, S
CAS-
C S
penc
e C
hil-
dren
’s A
nxie
ty S
cale
—C
hild
, PEQ
Pro
gram
Eva
luat
ion
Que
stion
naire
, HTQ
Har
vard
Tra
uma
Que
stion
naire
, and
PH
CSC
S Pi
ers-
Har
ris C
hild
ren’
s Sel
f-C
once
pt S
cale
2nd
Ed
D. Coholic et al.
1 3
improved understanding of feelings and thoughts, and self-compassion and non-judgement. Arts-based methods included martial arts, tai chi, theatre/drama, drawing, sculpt-ing, painting, music, creative writing and more. For exam-ple, Klassen (2017) stated that journaling could improve participants’ self-awareness, and Milligan et al. (2016) com-mented that interventions utilizing movement can improve a youth’s ability to observe and accept distressing sensations and emotions. In our own MBI program, painting to different types of music helped participants to explore and express feelings and thoughts, and drawing oneself as a tree helped the participants to share about themselves and develop self-awareness (Coholic & Eys, 2016). Other experiential examples included Burckhardt, Manicavasagar, Batterham, Hadzi-Pavlovic, and Shand’s (2017) use of theatre to help participants practice thought diffusion, and Gordon, Staples, Blyta, Bytyqi, and Wilson’s (2008) use of dance to reduce physical tension and explore emotions. Creative interven-tions were also used in a didactic manner such as when Rus-kin et al. (2017) used finger traps to illustrate the concepts of acceptance and resistance. Meagher, Chessor, and Fogliati (2018) used a multi-sensory teaching aid to explain the tran-sient nature of thoughts.
Key Findings from the Arts‑Based MBIs
Diverse benefits were reported and included improved responses to stress and depressive symptoms (Livheim et al., 2015), increased comfort with challenging emotions (Burckhardt et al., 2017), and being able to think before act-ing and other metacognitive skills. For example, Haydicky et al. (2012) reported that boys with ADHD had significant improvements in parent-rated oppositional defiant problems and conduct problems. Improved self-concept (Coholic & Eys, 2016) and feelings of confidence and happiness (Yook et al., 2017) were noted as were feelings of general well-being and interconnectedness (Wall, 2005).
Most of the studies were focused on specific populations and findings were related to the goals of the MBIs and char-acteristics of these populations. For instance, Atkinson and Wade’s (2015) MBI was focused on the prevention of eat-ing disorders. They concluded that the MBI had a positive impact on weight and shape concerns, which are relevant in eating disorder prevention. They also concluded that the girls in their study indicated a strong preference for the increased use of visual and interactive activities. Lagor, Williams, Lerner, and McClure (2013) found that their MBI reduced anxiety in chronically ill youth, and Ruskin et al. (2017) found that youth with chronic pain reported learning mind-fulness helped them to cope better with their pain. Waltman, Hetrick, and Tasker (2012) studied adolescent males living in residential treatment with poor behavior control and noted that the largest self-reported change was in the ability to
notice feelings without having to react to them, which is a skill particularly important for these youth. Also, there were improvements noted in trauma symptoms in youth diagnosed with Post-Traumatic Stress Disorder (Gordon et al., 2008).
Several of the studies found mixed or unexpected results. For example, one study found participants’ heart rates, a measure of physiological stress, increased following the intervention (Jee et al., 2015). This was attributed in part to the population’s (traumatized youth-in-care) possible desen-sitization to stress, and the reality that practicing mindful-ness can raise awareness of difficult emotions. Tharaldsen (2012) explained that contradictory findings are valuable as they encourage re-examination of conceptual frameworks. They also pointed out that an increased awareness of diffi-cult feelings could lead to participants feeling worse than at the beginning of an intervention. Thus, they concluded that mixed methods research is most helpful as different types of data can help us understand research results in a more thorough manner.
Consultation with Youth
An optional step in a scoping review is consultation with appropriate stakeholders (Levac et al., 2010). We decided to invite youth (aged 11–17 years) who had recently par-ticipated in HAP groups to take part in a group discussion regarding our preliminary findings from the scoping review. Given these youths’ recent experiences in an arts-based mindfulness program, we thought it would be interesting to elicit their viewpoints regarding what we found in the literature regarding rationales for using arts-based methods. This also reflected our commitment to including youth in our research processes in meaningful ways. Six youth from three different HAP groups attended an hour-long meeting where we provided pizza and an opportunity to engage in some arts-based activities as incentives. At the beginning of the discussion, we asked the youth to think about their recent experiences in HAP and to compare these with the following rationales for using arts-based methods in MBIs, which were written on a white board: (1) engaging and inter-esting, (2) promote the development of self-awareness, (3) help participants pay attention, (4) help participants to stay with uncomfortable feelings, (5) address retention, (6) aid self-expression, and (7) address youth’s need for movement. Through our group discussion, we encouraged the youth to identify which of these seven rationales most resonated with them. They identified three factors that were most reflective of their own experiences in HAP: (1) arts-based methods were engaging/interesting and “not boring” (2) arts-based methods helped them pay attention and focus, and address their “wandering minds” and, (3) arts-based methods helped them express themselves. They added that the arts-based methods were “fun and different” and that they have been
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
able to carry on with some of the activities at home. They also appreciated the arts-based approaches to breathing, which helped them learn how to focus on their breath and meditate.
Discussion
This scoping review examined why and how arts-based methods were used in MBIs. A variety of approaches were studied with diverse youth populations with a variety of challenges. Because arts-based MBIs were often developed for a specific population, a good number of the studies were pilot projects investigating the suitability and benefits of the MBIs. Rationales for the use of arts-based methods included both the characteristics of children and youth, and benefits of the methods themselves. In our consultation with a small group of youth, they confirmed that arts-based methods were engaging, interesting, fun, and helpful. Participating in the MBIs helped the youth develop capacities such as self-awareness and non-judgment, and abilities to cope with challenges such as poor mood and emotion regulation.
There are sound rationales for using arts-based methods based both on participant characteristics and the benefits of creative approaches. One of the main reasons identified for the use of arts-based approaches was the ability of these methods to engage hard to reach youth and/or youth with challenging problems such as chronic pain or eating disor-ders. Thus, many of the creative MBIs were developed for specific youth populations including marginalized youth, youth with chronic pain, incarcerated youth, and youth with learning disabilities. The benefits reported in the studies indicated that mindfulness-based practices and concepts can be taught by way of arts-based methods, and can have benefits for youth who may not engage in a more traditional MBI such as MBSR. When working with youth, it is impor-tant to enable them to engage with methods that they find enjoyable, meaningful, and helpful for self-expression and learning. We should not diminish the importance of creativ-ity, fun, and play for children and youth learning new skills and concepts.
In fact, arts-based group modalities have a long history within helping practices with children and youth (Kelly & Doherty, 2017). In particular, they have been used exten-sively in non-deliberative social group work practice. Non-deliberative practice recognizes that there are multiple avenues for self-expression that do not rely on verbaliza-tion. Instead, the arts and creative processes act as analogs for situations and challenges that youths face outside of the group (Lang, 2016). Others have found that arts-based methods help people express their thoughts and feelings that would otherwise remain unidentified (Sinding, War-ren, & Paton, 2014). Indeed, youths with communication
challenges may find arts-based modalities more accessible and feasible than the high level of verbalization and cogni-tion required for more traditional talk-based interventions. Furthermore, group-based arts and crafts have been identi-fied as a source of enjoyment for marginalized youth who live in unstable environments (Punch, 2002). Thus, they are highly engaging and can become a refuge for children and youth. Moreover, they can be culturally competent practices. For example, crafting has been recognized as a holistic inter-vention appropriate for use with Indigenous peoples living in Canada (Archibald & Dewar, 2010).
Given the promising benefits of MBIs and arts-based interventions with youths, a combined approach may make more sense especially for children and youth dealing with serious problems. The practices may work synergistically, for instance, the art-making process provides children an in vivo opportunity to not only explore analogous situa-tions but to additionally practice mindful awareness and acceptance. Mindfulness is a complicated concept to teach didactically; it may require experiential activities such as those found in arts-based social work groups (Thompson & Gauntlett-Gilbert, 2008). Arts also provide youths a unique method of practicing and embodying mindfulness that does not rely on sitting meditation. The frontal lobe of young peo-ple is generally in the process of developing and their execu-tive functioning skills are limited (Greenberg, 2006). A lack of attention regulation may intensify the difficulty of sitting meditation especially for marginalized youths who are also dealing with challenging life situations. Creative arts-based meditation involving audio tracks and sculpting, actively engage multiple sensory inputs including visual, auditory, and tactile systems. Importantly, by engaging youths in enjoyable and successful activities, they can learn about and practice mindfulness-based practices and concepts.
Research Directions and Implications for Practitioners
Based on reported results and the needs/developmental stages of children and youth, practitioners and researchers should be encouraged to facilitate and study MBIs that focus on arts-based approaches. The study of arts-based MBIs is emergent, which may account in part for their lack of promi-nence in this field and the diversity of approaches being developed and studied. We agree that there is a need for MBIs that are youth-centered in their design and shaped by feedback from youth as opposed to adaptations predeter-mined to be appropriate for use with young people (Diaz et al., 2012). Also, authors writing about arts-based MBIs should more thoroughly describe the synthesis of practice wisdom, research, and feedback used in the design and deliv-ery of their MBI. Generating a sufficient evidence base is
D. Coholic et al.
1 3
vital for the dissemination and study of MBIs. Thus, we encourage researchers and practitioners to draw on existent arts-based MBIs that show promising benefits for children and youth rather than develop new programs.
It may be more complex and challenging to offer crea-tive MBIs as researchers and facilitators require training not just in mindfulness but in arts-based approaches as well. For instance, one could not facilitate the MMA program without having gained advanced belts in various forms of martial arts (Milligan et al., 2015). However, there are ways to address the need for specific facilitator qualifica-tions. As Haydicky et al. (2012) explained, volunteers with martial arts expertise and advanced students of MMA could assist qualified facilitators. We have previously encouraged helping practitioners without specialized degrees in crea-tive therapies to offer arts-based methods as part of their practices because arts-based methods are used as tools for engagement and self-expression, and teaching concepts and practices (Coholic, Lougheed, & Cadell, 2009; Coholic, Lougheed, & LeBreton, 2009). Helping practitioners can access the plethora of resources in arts-based approaches in order to gain confidence in incorporating these practices into their interventions (Carey, 2006; Malchiodi, 2007).
In line with other researchers, we have found that feed-back from youth indicated that the arts-based nature of our MBI was a key component in their engagement and appre-ciation of the program (Coholic & Eys, 2016). Thus, learn-ing and practicing mindfulness, in and of itself, is likely not the only mechanism of change. It is quite possible that the effectiveness of a program might be due to a combination of factors including group work, mindfulness practice, and other factors such as specific cultural practices and/or an arts-based approach to learning mindfulness. As research in this field develops, it might become more evident that some arts-based methods work more effectively for specific issues or youth populations. For instance, we have often struggled with engaging male youth over the age of 15 years in HAP. Perhaps for these young men, learning mindfulness via movement such as karate or outdoor activities would be more appealing and relevant. In general, we need to better understand what methods work for whom, and all of the fac-tors contributing to change as a result of having participated in an MBI.
Limitations
The literature in the area of arts-based MBIs with children and youth includes a wide diversity of programs of varying lengths facilitated with diverse groups of youth. In future reviews, researchers should focus on specific populations and challenges, which could develop our understanding of effective approaches for particular groups of youth. This would also make the review process more manageable and
in-depth. For example, Simpson, Mercer, Simpson, Law-rence, and Wyke (2018) conducted a scoping review that explores MBIs for young offenders. Also, we lacked the time and resources to include a review of dissertations, which may be where some novel approaches are first described and studied. We note that a scoping review is very time consum-ing and additional human resources would have helped us finalize the results in a timely manner. Also, in our review, it was sometimes challenging for us to understand if an MBI could be considered arts-based, especially since many of these MBIs were not described with enough detail. Thus, there is a chance that we eliminated some MBIs because the program was not described in sufficient detail for us to assess how arts-based approaches were used.
Finally, our consultation occurred with a small group of youth. We would have liked to recruit more youth to par-ticipate in multiple group discussions but time constraints and the time of year (it was summer when many youth were unavailable) limited the depth and scope of our process. In the future, we would also like to consult with practitioners/researchers facilitating and studying arts-based MBIs. We would have to conduct this consultation using an on-line video/audio platform given our physical location in a smaller city far from larger urban centres, and the lack of similarly engaged professionals in our community. In conclusion, we note that the attention paid to testing arts-based MBIs has not been robust. Given the known benefits of arts-based methods for children and youth, we believe that more focus should be paid to these practices and how mindfulness-based concepts and skills can be taught using these methods. In this manner, more youth may have the chance to benefit from participating in MBIs.
Acknowledgement We acknowledge the assistance of Mr. Ashley Thomson, Librarian at Laurentian University. The research described in this paper was supported in part by funding from the Social Sciences and Humanities Research Council of Canada.
Compliance with Ethical Standards
Conflict of interest The authors declare that they have no conflict of interest.
Open Access This article is licensed under a Creative Commons Attri-bution 4.0 International License, which permits use, sharing, adapta-tion, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/.
A Scoping Review of Arts-Based Mindfulness Interventions for Children and Youth
1 3
References
Alsubaie, M., Abbott, R., Dunn, B., Dickens, C., Frieda Keil, T., Hen-ley, W., et al. (2017). Mechanisms of action in mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in people with physical and/or psychological conditions: A systematic review. Clinical Psychology Review, 55, 74–91. https ://doi.org/10.1016/j.cpr.2017.04.008.
Archibald, L., & Dewar, J. (2010). Creative arts, culture, and healing: Building an evidence base. Pimatisiwin, 8(3), 1–25.
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a meth-odological framework. International Journal of Social Research Methodology, 8, 19–32. https ://doi.org/10.1080/13645 57032 00011 9616.
Atkinson, M. J., & Wade, T. D. (2015). Mindfulness-based preven-tion for eating disorders: A school-based cluster randomized controlled study: Mindfulness-based eating disorder prevention. International Journal of Eating Disorders, 48, 1024–1037. https ://doi.org/10.1002/eat.22416 .
Bajaj, B., & Pande, N. (2016). Mediating role of resilience in the impact of mindfulness on life satisfaction and affect as indices of subjective well-being. Personality and Individual Differ-ences, 93, 63–67. https ://doi.org/10.1016/j.paid.2015.09.005.
Borquist-Conlon, D., Maynard, B., Esposito Brendel, K., & Farina, A. (2017). Mindfulness-based interventions for youth with anxi-ety: A systematic review and meta-analysis. Research on Social Work Practice, 29(2), 1–11. https ://doi.org/10.1177/10497 31516 68496 1.
Burckhardt, R., Manicavasagar, V., Batterham, P., Hadzi-Pavlovic, D., & Shand, F. (2017). Acceptance and commitment therapy universal prevention program for adolescents: A feasibility study. Child and Adolescent Psychiatry and Mental Health, 11, 27. https ://doi.org/10.1186/s1303 4-017-0164-5.
Carey, L. (Ed.). (2006). Expressive and creative arts methods for trauma survivors. London, UK: Jessica Kingsley Publishers.
Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clinical Psychology Review, 29, 560–572. https ://doi.org/10.1016/j.cpr.2009.06.005.
Chiesa, A., Fazia, T., Bernardinelli, L., & Morandi, G. (2017). Cita-tion patterns and trends of systematic reviews about mindful-ness. Complementary Therapies in Clinical Practice, 28, 26–37. https ://doi.org/10.1016/j.ctcp.2017.04.006.
Coholic, D. (2011). Exploring the feasibility and benefits of arts-based mindfulness-based practices with young people in need: Aiming to improve aspects of self-awareness and resil-ience. Child and Youth Care Forum, 40, 303–317. https ://doi.org/10.1007/s1056 6-010-9139-x.
Coholic, D., & Eys, M. (2016). Benefits of an arts-based mindfulness group intervention for vulnerable children. Child & Adolescent Social Work Journal, 33, 1–13. https ://doi.org/10.1007/s1056 0-015-0431-3.
Coholic, D., Eys, M., & Lougheed, S. (2012). Investigating the effec-tiveness of an arts-based and mindfulness-based group program for the improvement of resilience in children in need. Journal of Child and Family Studies, 21, 833–844. https ://doi.org/10.1007/s1082 6-011-9544-2.
Coholic, D., Lougheed, S., & Cadell, S. (2009a). Exploring the help-fulness of arts-based methods with children living in foster care. Traumatology, 15, 64–71. https ://doi.org/10.1177/15347 65609 34159 0.
Coholic, D., Lougheed, S., & LeBreton, J. (2009b). The helpful-ness of holistic arts-based group work with children living in foster care. Social Work with Groups, 32, 29–46. https ://doi.org/10.1080/01609 51080 22909 66.
Coholic, D., Schinke, R., Oghene, O., Dano, K., Jago, M., McAl-ister, H., et al. (2019). Arts-based interventions for youth with mental health challenges. Journal of Social Work. https ://doi.org/10.1177/14680 17319 82886 4.
Davis, K., Drey, N., & Gould, D. (2009). What are scoping stud-ies? A review of the nursing literature. International Journal of Nursing Studies, 46, 1386–1400. https ://doi.org/10.1016/j.ijnur stu.2009.02.010.
Diaz, N., Liehr, P., Curnan, L., Brown, J. L. A., & Wall, K. (2012). Playing games: Listening to the voices of children to tailor a mindfulness intervention. Children, Youth and Environments, 22, 273–285. https ://doi.org/10.7721/chily outen vi.22.2.0273.
Fjorback, L., Arendt, M., Ornbol, E., Fink, P., & Walach, H. (2011). Mindfulness-based stress reduction and mindfulness-based cog-nitive therapy: A systematic review of randomized controlled trials. Acta Psychiatrica Scand., 124, 102–119. https ://doi.org/10.1111/j.1600-0447.2011.01704 .x.
Gordon, J. S., Staples, J. K., Blyta, A., Bytyqi, M., & Wilson, A. T. (2008). Treatment of posttraumatic stress disorder in postwar Kos-ovar adolescents using mind-body skills groups: A randomized controlled trial. Journal of Clinical Psychiatry, 69, 1469–1476. https ://doi.org/10.4088/jcp.v69n0 915.
Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Infor-mation and Libraries Journal, 26, 91–108. https ://doi.org/10.1111/j.1471-1842.2009.00848 .x.
Greenberg, M. T. (2006). Promoting resilience in children and youth. Annals of the New York Academy of Sciences, 1094, 139–150. https ://doi.org/10.1196/annal s.1376.01.
Harnett, P. H., & Dawe, S. (2012). Review: The contribution of mind-fulness-based therapies for children and families and proposed conceptual integration. Child and Adolescent Mental Health, 17, 195–208. https ://doi.org/10.1111/j.1475-3588.2011.00643 .x.
Haydicky, J., Wiener, J., Badali, P., Milligan, K., & Ducharme, J. (2012). Evaluation of a mindfulness-based intervention for ado-lescents with learning disabilities and co-occurring ADHD and anxiety. Mindfulness, 3, 151–164. https ://doi.org/10.1007/s1267 1-012-0089-2.
Hayes, S., Strosahl, K., & Wilson, K. (1999). Acceptance and com-mitment therapy: An experiential approach to behavior change. New York: Guilford.
Himelstein, S., Hastings, A., Shapiro, S., & Heery, M. (2012). A qualitative investigation of the experience of a mindulness-based intervention with incarcerated adolescents. Child and Adolescent Mental Health, 17, 231–237. https ://doi.org/10.1111/j.1475-3588.2011.00647 .x.
Horesh, D., & Gordon, I. (2018). Mindfulness-based therapy for traumatized adolescents: An underutilized, understudied inter-vention. Journal of Loss and Trauma, 23, 627–638. https ://doi.org/10.1080/15325 024.2018.14380 47.
Jee, S. H., Couderc, J., Swanson, D., Gallegos, A., Hilliard, C., Blum-kin, A., … Heinert, S. (2015). A pilot randomized trial teach-ing mindfulness-based stress reduction to traumatized youth in foster care. Complementary Therapies in Clinical Practice, 21, 201–209. https ://doi.org/10.1016/j.ctcp.2015.06.007
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Delta.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Prac-tice, 10, 144–156. https ://doi.org/10.1093/clips y.bpg01 6.
Kelly, B. L., & Doherty, L. (2017). A historical overview of art and music-based activities in social work with groups: Nondelib-erative practice and engaging young people’s strengths. Social Work with Groups, 40, 187–201. https ://doi.org/10.1080/01609 513.2015.10917 00.
D. Coholic et al.
1 3
Klassen, S. (2017). Free to be: Developing a mindfulness-based eating disorder prevention program for preteens. Journal of Child and Adolescent Counseling, 3, 75–87. https ://doi.org/10.1080/23727 810.2017.12949 18.
Klatt, M., Buckworth, J., & Malarkey, W. (2009). Effects of low-dose mindfulness-based stress reduction (MBSR-ld) on working adults. Health Education & Behavior, 36, 601–614. https ://doi.org/10.1177/10901 98108 31762 7.
Klatt, M., Harpster, K., Browne, E., White, S., & Case-Smith, J. (2013). Feasibility and preliminary outcomes for move-into-learning: An arts-based mindfulness classroom intervention. The Journal of Positive Psychology, 8, 233–241. https ://doi.org/10.1080/17439 760.2013.77901 1.
Lagor, A., Williams, D. J., Lerner, J., & McClure, K. (2013). Lessons learned from a mindfulness-based intervention with chronically ill youth. Clinical Practice in Pediatric Psychology, 1, 146–158. https ://doi.org/10.1037/cpp00 00015 .
Lang, N. (2016). Nondeliberative forms of practice in social work: Artful, actional, analogic. Social Work with Groups, 39, 97–117. https ://doi.org/10.1080/01609 513.2015.10477 01.
Levac, D., Colquhoun, H., & O’Brien, K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5, 1–9. https ://doi.org/10.11186 /1748-5908-5-69.
Livheim, F., Hayes, L., Ghaderi, A., Magnusdottir, T., Hogfeldt, A., Rowse, J., … Tengstrom, A. (2015). The effectiveness of accept-ance and commitment therapy for adolescent mental health: Swedish and Australian pilot outcomes. Journal of Child and Family Studies, 24, 1016–1030. https ://doi.org/10.1007/s1082 6-014-9912-9.
Lougheed, S., & Coholic, D. (2016). Arts-based mindfulness group work with youth aging out of foster care. Social Work with Groups, 41, 165–178. https ://doi.org/10.1080/01609 513.2016.12586 26.
Malchiodi, C. (2007). The art therapy sourcebook (2nd ed.). New York, NY: McGraw-Hill.
Meagher, R., Chessor, D., & Fogliati, V. (2018). Treatment of pathological worry in children with acceptance-based behav-ioral therapy and a multisensory learning aide: A pilot study: Acceptance-based anxiety treatment for children. Australian Psychologist, 53, 134–143. https ://doi.org/10.1111/ap.12288 .
Milligan, K., Badali, P., & Spiroiu, F. (2015). Using integra mindful-ness martial arts to address self-regulation challenges in youth with learning disabilities: A qualitative exploration. Journal of Child and Family Studies, 24, 562–575. https ://doi.org/10.1007/s1082 6-013-9868-1.
Milligan, K., Irwin, A., Wolfe-Miscio, M., Hamilton, L., Mintz, L., Cox, M., …Phillips, M., (2016) Mindfulness enhances use of secondary control strategies in high school students at risk for mental health challenges. Mindfulness, 7, 219–227 https ://doi.org/10.1007/s1267 1-015-0466-8
Perry-Parrish, C., Copeland-Linder, N., Webb, L., Shields, A. H., & Sibinga, E. (2016). Improving self-regulation in adolescents: Current evidence for the role of mindfulness-based cognitive therapy. Adolescent Health, Medicine and Therapeutics, 7, 101–108. https ://doi.org/10.2147/AHMT.S6582 0.
Pham, M., Rajic, A., Greig, J., Sargeant, J., Papadopoulos, A., & McEwen, S. (2014). A scoping review of scoping reviews: Advancing the approach and enhancing the consist-ency. Research Synthesis Methods, 5, 371–385. https ://doi.org/10.1002/jrsm.1123.
Punch, S. (2002). Research with children: The same or different from research with adults? Childhood, 9, 321–341. https ://doi.org/10.1177/09075 68202 00900 3005.
Ruskin, D., Gagnon, M., Kohut, S., Stinson, J., & Walker, K. (2017). A mindfulness program adapted for adolescents with chronic pain:
Feasibility, acceptability, and initial outcomes. The Clinical Jour-nal of Pain, 33, 1019–1029. https ://doi.org/10.1097/AJP.00000 00000 00049 0.
Segal, Z., Williams, J., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.
Simpson, S., Mercer, S., Simpson, R., Lawrence, M., & Wyke, S. (2018). Mindfulness-based interventions for young offend-ers: A scoping review. Mindfulness, 9, 1330–1343. https ://doi.org/10.1007/s1267 1-018-0892-5.
Sinding, C., Warren, R., & Paton, C. (2014). Social work and the arts: Images at the intersection. Qualitative Social Work, 13, 187–202. https ://doi.org/10.1177/14733 25012 46438 4.
Tan, L., & Martin, G. (2013). Taming the adolescent mind: Prelimi-nary report of a mindfulness-based psychological intervention for adolescents with clinical heterogeneous mental health diagnoses. Clinical Child Psychology and Psychiatry, 18, 300–312. https ://doi.org/10.1177/13591 04512 45518 2.
Tan, L., & Martin, G. (2015). Taming the adolescent mind: A ran-domised controlled trial examining clinical efficacy of an adoles-cent mindfulness-based group programme. Child and Adolescent Mental Health, 20, 49–55. https ://doi.org/10.1111/camh.12057 .
Tharaldsen, K. (2012). Mindful coping for adolescents: Beneficial or confusing. Advances in School Mental Health Promotion, 5, 105–124. https ://doi.org/10.1080/17547 30X.2012.69181 4.
Thompson, M., & Gauntlett-Gilbert, J. (2008). Mindfulness with children and adolescents: Effective clinical application. Clini-cal Child Psychology & Psychiatry, 13, 396–408. https ://doi.org/10.1177/13591 04508 09060 3.
Van Vliet, K. J., Foskett, A., Williams, J., Singhal, A., Dolcos, F., & Vohra, S. (2017). Impact of a mindfulness-based stress reduction program from the perspective of adolescents with serious mental health concerns. Child and Adolescent Mental Health, 22, 16–22. https ://doi.org/10.1111/camh.12170 .
Vollestad, J., Birkeland Nielsen, M., & Hostmark Nielsen, G. (2012). Mindfulness- and acceptance-based interventions for anxiety disorders: A systematic review and meta-analysis. British Jour-nal of Clinical Psychology, 51, 239–260. https ://doi.org/10.1111/j.2044-8260.2011.02024 .x.
Wall, R. B. (2005). Tai chi and mindfulness-based stress reduction in a Boston public middle school. Journal of Pediatric Health Care, 19, 230–237. https ://doi.org/10.1016/j.pedhc .2005.02.006.
Waltman, S., Hetrick, H., & Tasker, T. (2012). Designing, implement-ing, and evaluating a group therapy for underserved populations. Residential Treatment for Children & Youth, 29, 305–323. https ://doi.org/10.1080/08865 71x.2012.72537 4.
Yook, Y. S., Kang, S. J., & Park, I. (2017). Effects of physical activ-ity intervention combining a new sport and mindfulness yoga on psychological characteristics in adolescents. International Jour-nal of Sport and Exercise Psychology, 15, 109–117. https ://doi.org/10.1080/16121 97X.2015.10698 78.
Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools: A systematic review and meta-analysis. Frontiers in Psychology. https ://doi.org/10.3389/fpsyg .2014.00603 .
Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.