Skip to main content
SpringerLink
Log in

A Pilot Randomized Controlled Trial of a Mindfulness Program for Filipino Children

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

Objectives

This study examines the feasibility and acceptability of a local adaptation of a mindfulness-based cognitive therapy (MBCT) program for Filipino school children, called Kamalayan, that was facilitated by trained public school teachers. It also presents preliminary evidence of program effects on the children’s depressive and anxiety symptoms and difficulties in emotion regulation.

Methods

We utilized a randomized controlled design with an active control condition. Filipino elementary and high school students aged 9 to 16 years old from low-resource schools were randomly assigned to the Kamalayan (n = 87) or the active control Handicrafts condition (n = 99). Changes in outcomes from baseline, immediate post-intervention, and 2-month follow-up were assessed using multilevel modeling.

Results

Participation in the Kamalayan program did not affect depression, anxiety, or emotion regulation. Impulse control difficulties increased for the Handicrafts group across post-intervention and follow-up but remained stable for Kamalayan participants. Depressive symptoms decreased over time for the Handicrafts group but remained stable for the Kamalayan condition. Implementation issues qualify the absence of program effects, such as the impracticability of delivering after-school sessions in the public school context, program content that may be discordant with cognitive-developmental and cultural considerations, and the inadequacy of the personal mindfulness practice of the paraprofessional facilitators.

Conclusions

The findings reaffirm the importance of using active control groups and considering the capacities of facilitators in evaluating the effects of mindfulness-based interventions. Testing mindfulness-based interventions in low-resource, non-Western school settings require deeper contextual adaptation and facilitator preparation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Ames, C. S., Richardson, J., Payne, S., Smith, P., & Leigh, E. (2014). Mindfulness-based cognitive therapy for depression in adolescents. Child and Adolescent Mental Health, 19(1), 74–78.

    Article  PubMed  Google Scholar 

  • Angold, A., Costello, E. J., Messer, S. C., & Pickles, A. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237–249.

    Google Scholar 

  • Atkinson, M. J., & Wade, T. (2015). Mindfulness-based prevention for eating disorders: a school-based cluster randomized controlled study. International Journal of Eating Disorders, 48(7), 1024–1037.

    Article  PubMed  Google Scholar 

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143.

    Google Scholar 

  • Barrera, M., Jr., Castro, F. G., Strycker, L. A., & Toobert, D. J. (2013). Cultural adaptations of behavioral health interventions: a progress report. Journal of Consulting and Clinical Psychology, 81(2), 196–205.

    Article  PubMed  Google Scholar 

  • Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. Journal of Consulting and Clinical Psychology, 77(5), 855.

    Article  PubMed  Google Scholar 

  • Bögels, S., Hoogstad, B., van Dun, L., de Schutter, S., & Restifo, K. (2008). Mindfulness training for adolescents with externalizing disorders and their parents. Behavioural and Cognitive Psychotherapy, 36(02), 193–209.

    Article  Google Scholar 

  • Bourdon, K. H., Goodman, R., Rae, D. S., Simpson, G., & Koretz, D. S. (2005). The strengths and difficulties questionnaire: U.S. normative data and psychometric properties. Journal of the American Academy of Child and Adolescent Psychiatry, 44(6), 557–564.

    Article  PubMed  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

  • Britton, W. B., Lepp, N. E., Niles, H. F., Rocha, T., Fisher, N. E., & Gold, J. S. (2014). A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children. Journal of School Psychology, 52(3), 263–278.

    Article  PubMed  PubMed Central  Google Scholar 

  • Burke, C. A. (2010). Mindfulness-based approaches with children and adolescents: a preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19(2), 133–144.

    Article  Google Scholar 

  • Christopher, M. S., Charoensuk, S., Gilbert, B. D., Neary, T. J., & Pearce, K. L. (2009). Mindfulness in Thailand and the United States: a case of apples versus oranges? Journal of Clinical Psychology, 65(6), 590–612.

    Article  PubMed  Google Scholar 

  • Crane, R. S., Kuyken, W., Hastings, R. P., Rothwell, N., & Williams, J. M. G. (2010). Training teachers to deliver mindfulness-based interventions: learning from the UK experience. Mindfulness, 1(2), 74–86.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dimidjian, S., & Segal, Z. V. (2015). Prospects for a clinical science of mindfulness-based intervention. American Psychologist, 70(7), 593.

    Article  PubMed  Google Scholar 

  • Felver, J. C., Celis-de Hoyos, C. E., Tezanos, K., & Singh, N. N. (2016). A systematic review of mindfulness-based interventions for youth in school settings. Mindfulness, 7, 34–45.

    Article  Google Scholar 

  • Felver, J. C., & Jennings, P. A. (2016). Applications of mindfulness-based interventions in school settings: an introduction. Mindfulness, 7, 1–4.

    Article  Google Scholar 

  • Fung, J., Kim, J. J., Jin, J., Chen, G., Bear, L., & Lau, A. S. (2018). A randomized trial evaluating school-based mindfulness intervention for ethnic minority youth: exploring mediators and moderators of intervention effects. Journal of Abnormal Child Psychology. https://doi.org/10.1007/s10802-018-0425-7.

    Article  Google Scholar 

  • Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2018). Mindfulness-based interventions for psychiatric disorders: a systematic review and meta-analysis. Clinical Psychology Review, 59, 52–60.

    Article  PubMed  Google Scholar 

  • Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40(11), 1337–1345.

    Article  PubMed  Google Scholar 

  • Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. The British Journal of Psychiatry, 177(6), 534–539.

    Article  PubMed  Google Scholar 

  • Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.

    Article  Google Scholar 

  • Greenberg, M. T., & Harris, A. R. (2012). Nurturing mindfulness in children and youth: current state of research. Child Development Perspectives, 6(2), 161–166.

    Article  Google Scholar 

  • Hoffman, L. (2015). Longitudinal analysis: modeling within-person fluctuation and change. New York: Routledge.

    Book  Google Scholar 

  • Hunsley, J., & Lee, C. M. (2007). Research-informed benchmarks for psychological treatments: efficacy studies, effectiveness studies, and beyond. Professional Psychology: Research and Practice, 38(1), 21.

    Article  Google Scholar 

  • Johnson, C., Burke, C., Brinkman, S., & Wade, T. (2017). A randomized controlled evaluation of a secondary school mindfulness program for early adolescents: do we have the recipe right yet? Behavior Research and Therapy, 99, 37–46.

    Article  Google Scholar 

  • Johnson, C., Burke, C., Brinkman, S., & Wade, T. (2016). Effectiveness of a school-based mindfulness program for transdiagnostic prevention in young adolescents. Behavior Research and Therapy, 81, 1–11.

    Article  Google Scholar 

  • Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.

    Google Scholar 

  • Kirmayer, L. J. (2015). Mindfulness in cultural context. Transcultural Psychiatry, 52(4), 447–469.

    Article  PubMed  Google Scholar 

  • Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., et al. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: an individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565–574.

    Article  PubMed  Google Scholar 

  • Lam, K. (2016). School-based cognitive mindfulness intervention for internalizing problems: pilot study with Hong Kong elementary students. Journal of Child and Family Studies, 25(11), 3293–3308.

    Article  Google Scholar 

  • Lau, N., & Hue, M. (2011). Preliminary outcomes of a mindfulness-based programme for Hong Kong adolescents in schools: well-being, stress, and depressive symptoms. International Journal of Children’s Spirituality, 16(4), 315–330.

    Article  Google Scholar 

  • Lee, J., Semple, R. J., Rosa, D., & Miller, L. (2008). Mindfulness-based cognitive therapy for children: results of a pilot study. Journal of Cognitive Psychotherapy, 22(1), 15–28.

    Article  Google Scholar 

  • Meiklejohn, J., Phillips, C., Freedman, M. L., Griffin, M. L., Biegel, G., Roach, A., et al. (2012). Integrating mindfulness training into K-12 education: fostering the resilience of teachers and students. Mindfulness, 3(4), 291–307.

    Article  Google Scholar 

  • Metz, S. M., Frank, J. L., Reibel, D., Cantrell, T., Sanders, R., & Broderick, P. C. (2013). The effectiveness of the learning to BREATHE program on adolescent emotion regulation. Research in Human Development, 10(3), 252–272.

    Article  Google Scholar 

  • Moriwaki, A., & Kamio, Y. (2014). Normative data and psychometric properties of the strengths and difficulties questionnaire among Japanese school-aged children. Child and Adolescent Psychiatry and Mental Health, 8(1). https://doi.org/10.1186/1753-2000-8-1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nagayama Hall, G. C., Hong, J. J., Zane, N. W., & Meyer, O. L. (2011). Culturally competent treatments for Asian Americans: the relevance of mindfulness and acceptance-based psychotherapies. Clinical Psychology: Science and Practice, 18(3), 215–231.

    Google Scholar 

  • Neumann, A., van Lier, P., Gratz, K., & Koot, H. (2010). Multidimensional assessment of emotion regulation difficulties in adolescents using the difficulties in emotion regulation scale 2010. Assessment, 17, 138–149.

    Article  PubMed  Google Scholar 

  • Raes, F., Griffith, J. W., Van der Gucht, K., & Williams, J. M. G. (2014). School-based prevention and reduction of depression in adolescents: a cluster-randomized controlled trial of a mindfulness group program. Mindfulness, 5(5), 477–486.

    Article  Google Scholar 

  • Riley, J., Corkhill, B., & Morris, C. (2013). The benefits of nitting for personal and social wellbeing in adulthood: findings from an international survey. British Journal of Occupational Therapy, 76(2), 50–57.

  • Sibinga, E. M. S., Perry-Parish, C., Chung, S., Johnson, S. B., Smith, M., & Ellen, J. M. (2013). School-based mindfulness instruction for ubran male youth: a small randomized controlled trial. Preventive Medicine, 57, 799–801.

    Article  PubMed  Google Scholar 

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression. New York: The Guilford Press.

    Google Scholar 

  • Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness-based cognitive therapy for children: promoting mindful attention to enhance social-emotional resiliency in children. Journal of Child and Family Studies, 19(2), 218–229.

    Article  Google Scholar 

  • Snel, E. (2013). Sitting still like a frog: mindfulness exercises for kids (and their parents). Boston, MA: Shambhala Publications, Inc.

  • Spielberger, C. D., & Edwards, C.D. (1973). STAIC preliminary manual for the State-Trait Anxiety Inventory for Children ("How I Feel Questionnaire"). Palo Alto, CA: Consulting Psychologists Press.

  • Thapar, A., & McGuffin, P. (1997). Anxiety and depressive symptoms in childhood: A genetic study of comorbidity. Child Psychology & Psychiatry & Allied Disciplines, 38(6), 651–56.

  • Thompson, M., & Gauntlett-Gilbert, J. (2008). Mindfulness with children and adolescents: effective clinical application. Clinical Child Psychology and Psychiatry, 13(3), 395–407.

    Article  PubMed  Google Scholar 

  • University of the Philippines Population Institute. (2014) #NCRYouthToday: Risk behavior of young people in Metro Manila. Paper presented at the Stakeholders’ Forum on Young People’s Sexuality and Health Situation in the National Capital Region. Manila: Philippines.

  • Villasanta, A.P.V., & Ofreneo, M.A. (2016, September). Diverse voices: Listening to Filipino public school teachers’ journey into mindfulness. Paper presented at the 53rd annual convention of the Psychological Association of the Philippines, Pampanga, Philippines.

  • World Health Organization (2011). Health of adolescents in the Philippines. Retrieved from http://www.wpro.who.int/topics/adolescent_health/philippines_fs.pdf

  • World Health Organization and Department of Health (2007). WHO-AIMS Report on Mental Health System in the Philippines. Retrieved from https://www.who.int/mental_health/evidence/philippines_who_aims_report.pdf.

  • World Health Organization (n.d.). Global Health Observatory Data Repository. Retrieved March 16, 2018 from http://www.who.int/gho/mental_health/human_resources/psychiatrists_nurses/en/.

  • Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools-a systematic review and meta-analysis. Frontiers in Psychology, 5, 1–20.

    Article  Google Scholar 

  • Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: a meta-analysis. Mindfulness, 6(2), 290–302.

    Article  Google Scholar 

Download references

Acknowledgments

We thank the Philippine Department of Education officials; school administrators, teachers, and guidance counselors; and children and parents who participated in the study.

Funding

This research was undertaken with the financial support of Grand Challenges Canada and the Government of Canada, through a grant (0597-04) to the Centre for Mindfulness Studies.

Author information

Authors and Affiliations

  1. Ateneo de Manila University, Quezon City, Philippines

    Liane Peña Alampay, Lourdes Joy T. Galvez Tan, Mira Alexis Ofreneo, Gilda Dans Lopez, Karina Galang Fernandez, Angelique Villasanta & Von Guintu

  2. Texas Tech University, Lubbock, TX, USA

    Antover P. Tuliao

  3. Centre for Mindfulness Studies, Toronto, Canada

    Patricia Baranek, Patricia Rockman, Teresita Angangco, M. Lee Freedman & Leysa Cerswell

Authors
  1. Liane Peña Alampay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lourdes Joy T. Galvez Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antover P. Tuliao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patricia Baranek
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mira Alexis Ofreneo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gilda Dans Lopez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Karina Galang Fernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Patricia Rockman
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Angelique Villasanta
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Teresita Angangco
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. M. Lee Freedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Leysa Cerswell
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Von Guintu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LPA: designed and executed the study, conducted data analyses, wrote the paper. LJGT: collaborated with the design, managed the execution and data, wrote, and edited the final paper.

APT: conducted quantitative data analyses and wrote the quantitative section of the results.

PB: collaborated with the design and execution of the study and contributed to the writing of the paper.

MAO: collaborated with the design and execution of the study and contributed to the writing of the paper.

GDL: collaborated in the development of the Kamalayan program and the training of the paraprofessionals and contributed to the writing of the paper.

KGF: collaborated in the development of the Kamalayan program and the training of the paraprofessionals and contributed to the writing of the paper.

PR: collaborated with the design of the study, the design of the MBCT program for children, and the training of the paraprofessionals.

AV: collaborated with the execution of the study, coordinated data coding and management, contributed to the revisions of the paper.

MLF: collaborated with the design of the study, the design of MBCT program for children, and the training of the paraprofessionals.

TA: collaborated with the design of the study and the training of the paraprofessionals.

LC: collaborated with the design of the study and the training of the paraprofessionals.

VG: collaborated with the execution of the study and data analyses.

Corresponding author

Correspondence to Liane Peña Alampay.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was granted clearance by the institutional ethics review committee of the Ateneo de Manila University. All procedures performed were in accordance with the ethical standards of the institution, the Philippine Health Research Ethics Board, and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the parents of all participating children. Informed consent was also obtained from the participants.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(PDF 98 kb)

ESM 2

(PDF 63 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alampay, L.P., Galvez Tan, L.J.T., Tuliao, A.P. et al. A Pilot Randomized Controlled Trial of a Mindfulness Program for Filipino Children. Mindfulness 11, 303–316 (2020). https://doi.org/10.1007/s12671-019-01124-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-019-01124-8

Keywords

Search

Navigation