Treating Anxiety With Mindfulness: An Open Trial of Mindfulness Training for Anxious Children

This study is an open clinical trial that examined the feasibility and acceptability of a mindfulness training program for anxious children. We based this pilot initiative on a cognitively oriented model, which suggests that, since impaired attention is a core symptom of anxiety, enhancing self-management of attention should effect reductions in anxiety. Mindfulness practices are essentially attention enhancing techniques that have shown promise as clinical treatments for adult anxiety and depression (Baer, 2003). However, little research explores the potential benefits of mindfulness to treat anxious children. The present study provided preliminary support for our model of treating childhood anxiety with mindfulness. A 6-week trial was conducted with five anxious children aged 7 to 8 years old. The results of this study suggest that mindfulness can be taught to children and holds promise as an intervention for anxiety symptoms. Results suggest that clinical improvements may be related to initial levels of attention. Keywords: attention; anxiety; children; cognitive therapy; group treatment; psychotherapy, meditation; mindfulness; Mindfulness-Based Cognitive Therapy; stress Despite the high prevalence of pediatric anxiety disorders, there is little research on the long-term efficacy of psychosocial interventions for anxious children and less information about the clinical effectiveness of treatments as utilized in real-world settings (U.S. Department of Health and Human Services, 1999). Several controlled trials suggest that cognitivebehavior therapy (CBT) may be an effective treatment for some children with anxiety disorders (Flannery-Schroeder & Kendall, 2000; Kendall, 1994; Kendall et al., 1997). Treatment gains from one study were reported as being maintained, on average, more than 3 years later (Kendall & Southam-Gerow, 1996). Although these studies have shown efficacy, others have reported mixed results (Last, Hansen, & Franco, 1998) and questions of whether treatment gains can be sustained (Hayward et al., 2000). Given the inconsistent findings and the prevalence of anxiety in children, it is important to examine component parts and to develop potentially new components of treatment. It seems premature at this stage to rule out research into alternative psychosocial treatments that might enhance existing treatments. One treatment that has shown promise in reducing stress and anxiety symptoms in adults is mindfulness meditation. Clinical researchers are expressing growing interest in integrating mindfulness techniques into adult treatments for anxiety and depression (e.g., Kabat-Zinn et al., 1992; Linehan, 1987; Segal, Williams, & Teasdale, 2002). As more studies are reported, researchers are refining definitions of mindfulness. Refer to Brown and Ryan (2003) and Kabat-Zinn (2003) for current discussions about the meanings of this word. We use it here to mean, "paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" (Kabat-Zinn, 1994, p. 4). Mindfulness practices emphasize the observation of internal experiences without distortion from affective, cognitive, or physiological reactivity influencing those experiences. In essence, mindfulness is simply the moment-to-moment practice of dearly discriminating thoughts and emotions from external events (Hendricks, 1975). TREATING ANXIETY WITH MINDFULNESS Similar to CBT, practicing mindfulness can teach clients to recognize anxious feelings, clarify repetitive or maladaptive thoughts, minimize avoidant behaviors, and self-monitor one's coping strategies (Roemer & Orsillo, 2002). Mindfulness meditation is also associated with relaxation (Benson, 1975) and stress reduction (Kabat-Zinn, 1990). Unlike CBT, mindfulness training aims to teach a more accepting relationship of one's thoughts, rather than emphasizing the creation of more positive or adaptive thoughts (Roemer & Orsillo, 2002). …