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TEACHING MINDFULNESS TO MIDDLE SCHOOL STUDENTS AND

HOMELESS YOUTH IN SCHOOL CLASSROOMS

_______________

A Thesis

Presented to the

Faculty of

San Diego State University

_______________

In Partial Fulfillment

of the Requirements for the Degree

Master

of

Social Work

_______________

by

David Paul Viafora

Summer 2011

iii

Copyright 2011

by

David Paul Viafora

All Rights Reserved

iv

DEDICATION

I would like to dedicate this work to Mia, who has continually offered her loving

support and encouragements to me in so many ways, even while facing significant challenges

in her own life. Thank you for teaching me to be more real, creative, and sensitive to the

needs of the youth. I have enjoyed learning from your ability to see the seeds of inner-

wisdom and compassion that are always present in children. Thank you for your support and

faith in my deepest aspirations, as well as all the delicious and nutritious meals you have

cooked for me during my studies they were excellent.

v

The cosmos is filled with precious gems.

I want to offer a handful of them to you this morning.

Each moment you are alive is a gem,

shining through and containing Earth and sky,

water and clouds.

It needs you to breathe gently

for the miracles to be displayed.

Suddenly you hear the birds singing,

the pines chanting,

see the flowers blooming,

the blue sky,

the white clouds,

the smile and the marvelous look

of your beloved.

Cherish this very moment.

Let go of the stream of distress

and embrace life fully in your arms.

~ Thich Nhat Hanh

Call Me by My True Names

Let us put our minds together

and see what life we can make for our children.

~ Sitting Bull, Lakota Sioux, 1877

vi

ABSTRACT OF THE THESIS

Teaching Mindfulness to Middle School Students and Homeless Youth in School Classrooms

by David Paul Viafora

Master of Social Work San Diego State University, 2011

The prevalence and early onset of mental and emotional health problems for children and adolescents suggest an urgent need to explore the potential of preventive intervention programs to strengthen the emotional well-being of youth and insulate them from the harmful effects of stress and other risk factors of daily life. A small but growing base of research shows that mindfulness-based interventions with children and adolescents demonstrate treatment feasibility and acceptability, with encouraging findings in emotional and cognitive well-being, and externalizing behaviors. Mindfulness is the ability to focus one's attention on internal and external experiences as they take place in the present moment, with an attitude of kindness and curiosity. Mindfulness helps individuals to be more accepting and at ease with whatever thoughts, feelings, and bodily sensations arise. When youth are able to simply observe and respond compassionately to their thoughts and impulses without being attached to or pulled by them, they can make choices that are not limited by their habitual emotional reactions. As the research base is still emerging, only a handful of studies have explored mindfulness-based interventions in educational settings; applications of mindfulness have yet to be tested with youth from disadvantaged backgrounds. No studies have empirically evaluated a mindfulness course with middle school students in a classroom setting, or with youth facing homelessness. The purpose of the current study was to evaluate the feasibility, acceptability, and effectiveness of an 8-week mindfulness course in middles school classrooms.

A quasi-experimental design with a non-equivalent comparison group of waitlisted students was used to measure student reported changes over time in the domains of acceptance and mindfulness, psychological inflexibility, and self-compassion. Two treatment groups, composed of students attending a traditional middle school (n=38) and with students attending a specialized school serving homeless youth (n=18) were assessed at pre- and post-test. Participants completed a post-course evaluation questionnaire to illustrate their satisfaction and responses to the mindfulness course and how they may have applied mindfulness skills in their daily lives. The first treatment group improved significantly in the domain of psychological acceptance and mindfulness from baseline to post-intervention and in comparison to the comparison group. Both treatment groups experienced improved changes in psychological inflexibility in relation to the comparison group, though the findings were not significant. Highly positive student evaluations and high course completion rates indicated that the mindfulness course was acceptable to both treatment groups and feasibly implemented in

vii

their school classrooms. Furthermore, the mindfulness skills were applied in various domains of their daily lives, and led to improved sense of well-being, reduced stress, management of difficult emotions, and improved interpersonal dynamics. The study's findings and clinical observations suggest that quality instructor training, teacher support for classroom behavior management, and class size may be important variables that impact the effectiveness of a mindfulness course for students. Future studies may be enticed by the qualitative results to more objectively explore the effects of a mindfulness course upon levels of stress, anger and aggression, overall quality of life in youth, and overall academic performance.

viii

TABLE OF CONTENTS

PAGE

ABSTRACT ............................................................................................................................. vi

LIST OF TABLES ................................................................................................................... xi

LIST OF FIGURES ................................................................................................................ xii

ACKNOWLEDGMENTS ..................................................................................................... xiii

CHAPTER

1 INTRODUCTION .........................................................................................................1 Purpose of Study ......................................................................................................2

Limitations of the Study...........................................................................................3

Organization of the Study ........................................................................................4

2 REVIEW OF THE LITERATURE ...............................................................................6 Adolescence and Mental Health ..............................................................................7

Mental Health Prevention and Early Intervention for Youth.................................10

Universal Prevention Programs .......................................................................12

Selective Preventive Intervention Programs ....................................................13

Indicated Preventive Intervention Programs ....................................................14

Applying Evidence-Based Practice in Review of Preventive Interventions ....................................................................................................16

Mindfulness-Based Interventions ..........................................................................16

What is Mindfulness? ......................................................................................17

Mindfulness: Practicing without Attachment to Outcome ...............................19

Historical Origins of Mindfulness Training .....................................................20

Mindfulness Instructors ...................................................................................21

Mindfulness-Based Stress Reduction (MBSR) ................................................23

Mindfulness-Based Cognitive Therapy (MBCT) ............................................24

How Mindfulness Skills Can Lead to Symptom Reduction and Behavior Change ..............................................................................................24

Exposure ....................................................................................................25

Cognitive Change.......................................................................................25

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Self-Management .......................................................................................26

Acceptance .................................................................................................26

Mindfulness with Adults: Results of Three Meta-Analyses ..................................27

Studies of Mindfulness with Children and Adolescents ........................................33

Mindfulness with Preschool Age Children ......................................................34

Mindfulness Training with Elementary Age Children .....................................36

Mindfulness Training with Middle School Age Youth ...................................39

Mindfulness Training with High School Age Youth .......................................43

Organizations S