Mindfulness Based Interventions in Secondary Education A Qualitative Systematic Review Intervenciones Basadas en Mindfulness en Educaci N Secundaria

Estudios de Psicologa
Studies in Psychology
ISSN: 0210-9395 (Print) 1579-3699 (Online) Journal homepage: http://www.tandfonline.com/loi/redp20
Mindfulness-based interventions in secondary

education: a qualitative systematic review /
Intervenciones basadas en mindfulness en
educacin secundaria: una revisin sistemtica
cualitativa
lvaro I. Langer, Valentina G. Ulloa, Adolfo J. Cangas, Graciela Rojas &
Mariane Krause
To cite this article: lvaro I. Langer, Valentina G. Ulloa, Adolfo J. Cangas, Graciela Rojas
& Mariane Krause (2015) Mindfulness-based interventions in secondary education: a
qualitative systematic review / Intervenciones basadas en mindfulness en educacin
secundaria: una revisin sistemtica cualitativa, Estudios de Psicologa, 36:3, 533-570, DOI:
10.1080/02109395.2015.1078553
To link to this article: http://dx.doi.org/10.1080/02109395.2015.1078553
Published online: 21 Sep 2015.
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Date: 05 September 2016, At: 03:08
Estudios de Psicologa / Studies in Psychology, 2015

Vol. 36, No. 3, 533570, http://dx.doi.org/10.1080/02109395.2015.1078553
Mindfulness-based interventions in secondary education:

a qualitative systematic review / Intervenciones basadas en
mindfulness en educacin secundaria: una revisin sistemtica
cualitativa
lvaro I. Langera, Valentina G. Ulloab, Adolfo J. Cangasc, Graciela Rojasd,
and Mariane Krausea
a
Pontificia Universidad Catlica de Chile; bUniversidad del Desarrollo; cUniversidad

de Almera; dUniversidad de Chile
(Received 13 January 2014; accepted 16 July 2014)
Abstract: In order to study the effects of mindfulness meditation interventions administered to adolescents within their educational institutions, a qualitative systematic review was conducted. Sixteen studies published in main
databases were analysed. The results show that mindfulness, as a prevention
strategy in educational contexts, resulted in significant changes in the followings variables: (a) psychological (e.g., reduction in depressive symptoms); (b)
psychosocial (e.g., increased social skills); and (c) physiological (e.g.,
improvement of blood pressure). Although the results were conclusive, their
interpretation and generalization should be carefully analysed as there were no
medium- and long-term follow-up evaluations, in addition to the fact that
there has been a minimal assessment of the psychological mechanisms
involved in the change processes.
Keywords: mindfulness; prevention; mental health; schools; adolescent
development
Resumen: Con el objetivo de estudiar los efectos de los programas de
meditacin mindfulness aplicados a adolescentes dentro de sus establecimientos educativos, se llev a cabo una revisin sistemtica cualitativa. Se analizaron 16 estudios publicados en las principales bases de datos. Los resultados
muestran que mindfulness, al ser aplicado como estrategia de prevencin en
contextos educativos, produce cambios significativos en variables: (a)
psicolgicas (e.g., disminucin de sintomatologa depresiva); (b) psicosociales
(e.g., aumento de habilidades sociales); y (c) fisiolgicas (e.g., mejora de la
presin sangunea). No obstante, a pesar que los datos son concluyentes en los
parmetros descritos anteriormente, la ausencia de medidas de seguimiento a
English version: pp. 533550 / Versin en espaol: pp. 551567

References / Referencias: pp. 567570
Translated from Spanish / Traduccin del espaol: Liza DArcy
Authors Address / Correspondencia con los autores: lvaro I. Langer, Instituto Milenio
para la Investigacin en Depresin y Personalidad, Escuela de Psicologa, Pontificia
Universidad Catlica de Chile, Av. Vicua Mackenna 4860, Macul, Santiago, Chile.
E-mail: alvaro.langer@gmail.com
2015 Fundacion Infancia y Aprendizaje
534
. I. Langer et al.
mediano y largo plazo, sumada a una mnima evaluacin de los mecanismos

psicolgicos involucrados en los procesos de cambio, sugiere interpretar y
generalizar los resultados de forma cautelosa.
Palabras clave: mindfulness; prevencin; salud mental; escuelas; desarrollo
adolescente
According to the Pan American Health Organization [PAHO] todays most harmful health habits are acquired during adolescence, and manifest as health problems
in adulthood (PAHO, 2010). Between 11% and 33% of young people in Latin
America and the Caribbean have reported having a mental health problem. This
situation has led many countries in the region to redirect health policies for this
age group, focusing efforts on prevention and raising awareness of mental health
issues (Chilean Ministry of Health [Minsal], 2012).
Adolescents spend the majority of their day in educational establishments
(EE). This means that EE play a predominant role in the management and
development of students psychosocial, emotional, cognitive and behavioural
well-being (Berger, Alcalay, Torretti, & Milicic, 2011).
Within psychological interventions that have generated great interest in
researchers and clinicians alike, and which are currently experiencing exponential
growth in research interest, are approaches based on acceptance and mindfulness,
also called third generation cognitive-behavioural therapies (Hayes, Follette, &
Linehan, 2004).
Mindfulness can be described as a theoretical construct, an activity (such as
meditation) or a psychological process (to be in a state of mindfulness) (Germer,
Siegel, & Fulton, 2005). A basic definition of it is: paying attention in a particular
way: on purpose, in the present moment and nonjudgmentally (Kabat-Zinn,
1994, p. 15). The mechanisms of mindfulness include a synergistic effort between
regulating attention, consciousness in the body, affective regulation (including
reappraisal and exposure, extinction and cognitive defusion) and changes in the
perception of the Self (psychological flexibility).
Mindfulness-based interventions include various methods for teaching mindfulness, some of which are formal meditation practices, others are informal
exercises that highlight the importance of being mindful in everyday life (Baer,
2003). These approaches include the Mindfulness-based Stress Reduction
(MBSR; Kabat-Zinn, 1990) programme and the Mindfulness-Based Cognitive
Therapy (MBCT; Segal, Williams, & Teasdale, 2002). These interventions have
broad empirical support. In fact, recent meta-analyses and systematic reviews
suggest that mindfulness is an effective intervention for the treatment of various
mental health problems such as depression and anxiety (see, for example,
Hofmann, Oh, Sawyer, & Witt, 2010), and can complement treatments for various
mental disorders such as eating disorders, substance abuse, psychosis and bipolar
disorder, among others (Baer, 2006; Langer, Cangas, Salcedo, & Fuentes, 2012;
Ludwig & Kabat-Zinn, 2008).
Non-clinical studies show that mindfulness can assist in stress reduction and
improve the quality of peoples lives (e.g., Nyklek & Kuijpers, 2008), improve
Mindfulness in schools / Mindfulness en las escuelas
535
attention skills (Jha, Krompinger, & Baime, 2007) and help with alexithymia or
social skills issues (De la Fuente, Franco, & Salvador, 2010).
Although the vast majority of studies have been conducted on adults, many
publications suggest that mindfulness-based approaches for children and adolescents, both in populations made up of patients and for healthy populations (Burke,
2009), are feasible and accepted. With regard to clinical studies, the results
showed a significant reduction in drowsiness, worry, stress, aggressive behaviour
and symptoms of attention deficit disorder with hyperactivity, in addition to
improvements in the quality of sleep, subjective happiness, conciousness, and
changes in neurocognitive measures related to awareness (Bgels, Hoogstad, Dun,
Schutter, & Restifo, 2008; Singh et al., 2007; Zylowska et al., 2008).
With regard to non-clinical studies, studies that have applied mindfulness in
schools are of special interest (Garrison Institute, 2005). Because adolescence is a
period of psychopathological vulnerability, interventions for the prevention and
promotion of mental health must, on the one hand, facilitate access to prompt
psychological assistance and, on the other, be appealing to young people. An
analysis of non-traditional psychotherapeutic strategies developed in adolescents
natural context, such as a school setting (Wisner, Jones, & Gwin, 2009), is thus
relevant.
The specific objective of this systematic review is to examine the results,
which have been published in both English and in Spanish, of the effects of
mindfulness meditation programmes administered to adolescents in their educational establishments.
Method
Procedure
A systematic review of the studies that published results of mindfulness-based
interventions administered to adolescents in their educational establishments until
September 2013 was carried out. The review followed recommendations by the
PRISMA statement for reporting systematic reviews (Urrtia & Bonfill, 2010).
The following databases were reviewed: WEB of SCIENCE, PSYCHINFO,
SCOPUS AND PUBMED, DIALNET, SCIELO AND REDALYC, using the
keywords:
Mindfulness*school (schools or education)
Mindfulness*adolescence (adolescence)
Mindfulness*school*adolescence
The search was limited to articles that had been published in journals in English or
Spanish, mindfulness-based interventions that had been carried out in schools and
administered to groups of more than five people, those that had used adolescents
who were 12 years old and older or secondary education students and those that
had an experimental or quasi-experimental design. Studies that had not used a
control group were accepted. Studies that were excluded from the review
536
. I. Langer et al.
Number of citations identified in the

Searches:
1,075
Total number of duplicate citations deleted:

107
Total number of unique citations filtered:

968
Total number of complete text articles

analysed to determine their eligibility:
39
Total number of deleted citations:

929
Number of complete text articles excluded:

23
Total number of studies included in the

qualitative and quantitative synthesis of
the systematic review:
16
Figure 1. Flowchart showing the information with the different stages carried out during
the qualitative systematic review.
included: programmes that complemented mindfulness meditation with other

interventions; adolescents with psychiatric disorders; and interventions administered in special needs schools.
Figure 1 shows a flowchart of the information with the different phases carried
out during the qualitative systematic review.
Results
A total of 16 mindfulness intervention programmes administered to students in
secondary schools were selected; their main characteristics are shown in Table 1.
Excluding three studies that used a selective prevention strategy (Barnes,
Pendergrast, Harshfield, & Treiber, 2008; Beauchemin, Hutchins, & Patterson,
2008; Bei et al., 2013), all the studies that were analysed used students who did
not show psychological or physical disorders.
The description of the articles were organized into three categories, according
to a measured variable: (a) emotional, including depression, anxiety, stress,
positive/negative affect and emotion regulation; (b) psychosocial, including psychological well-being, mindfulness, self-empowerment, self-concept, social skills,
academic performance not including emotional or symptomatic variables; and
(c) physiological, such as cardiovascular measures and sleep.
Sample
Intervention
Duration
Beauchemin N = 34
et al.
(learning
(2008)
difficulties)
Private school
29% girls
Average of
16.61 years
Barnes et al. N = 73
(2004)
Grade 7
Secondary
schools
46.5% girls
Average of
12.3 years
Mindfulness
meditation
(Kabat-Zinn,
1994)
Two sessions
lasting 45 min +
five daily 5- to
10-min sessions
for five weeks
1st MBSR exercise: Daily sessions each

breathing
lasting 10
minutes for three
months at school
and at home +
contact with the
instructor about
the sessions (20
min per week)
Daily 10-minute
Meditation for
Barnes et al. N = 66
sessions at
Mindfulness of
(2008)
Grade 7
school and home
Breathing: main
Two secondary
for three months
exercise for
schools
MBSR
42.4% girls
Average of 15
years
Study
Table 1. Characteristics of the studies included in the systematic review.
34
Uncontrolled
design
- SSRS
- STAI
(Continued )
Day sessions
SBP: p < .05
HR: p < .02
Night sessions:
SBP: p < .01
Sodium expulsion:
p < .03
Sodium content: p < .03
Sodium volume: p < .03
Anxiety as a trait:
p < . 05
Anxiety as a state:
p < . 05
SSRS students: p < . 05
SSRS teachers:
Social skills:
p < . 05; Behavioural
problems:
p < . 05; Academic
achievements: p < . 05
Controlled design. - PA
Randomization for - HR
experimental or - TESU
control group:
health education
20
Effect size * or statistical

significance
Day sessions:
SBP p < . 01
DBS p < . 02
HR p < . 01
Resting time:
SBP p < . 05
Measurements
Randomization for - HR
experimental or - AX
- NSI
control group:
health education
Design
34
Experimental
group

537
Sample
Intervention
Duration
Experimental
group
Bei et al.
(2013)
10
Modified Bootzin Six sessions, once
N = 10
per week for 90
and Stevens
(poor quality of
min + daily
(2005) treatment
sleep)
practice of
for insomnia
Grade 7
mindfulness
programme:
Private girls
MBCT +
school
cognitive100% girls
behavioural
1315 years
approach for
old
insomnia
120
Learning to breathe Six sessions, twice
Broderick & N = 160
per week for 32 Grade 4,
program:
Grade 3 and 4
Metz
secondary
to 43 min +
introduction to
Private
(2009)
school
practice in class
the topic + group
Catholic
and at home
activities +
secondary
mindfulness
school for
practice
girls
100% girls
Average of
17.4 years
Study
Table 1. (Continued ).
PANAS factors
Negative affect: d = 0.57
Calm, relaxation, selfconcept: d = 0.53
- PANAS
- DERS
- RRS
- SICBC
Controlled design.
Control group:
Grade 3,
secondary school
(Continued )
Actigraphy:
SOL: d = 0.53
SE: d = 0.51
BTavg: d = 0.53
RTavg: d = 0.53
PSQI (global): d = 0.51

significance
- ACTI
- PSQI
- SCAS
Measurements
Uncontrolled
design
Design
538
. I. Langer et al.
Experimental
group
Franco,
Maas
et al.
(2011)
N = 61
Grade 1 from
three public
schools
47.5% girls
Average of
16.75 years
31
Duration
10 sessions, once
Mindfulness
per week for one
programme
and a half hours
Technical
+ 30 min daily
Meditation Flow
practice at home
+ Acceptance
and Commitment
Therapy
metaphors and
exercises +
stories of the Zen
tradition and
Vipassana
meditation +
body-scan
exercises
Intervention
35
Sample
Meditation for the 10 min each day

Brown et al. N = 121
and twice on the
Awareness of
(2011)
(risk of
weekends for
Breathing:
hypertension)
three months.
focus on the
Grade 1,
moment, retain
secondary
attention on
school
breathing and
Two schools
passively
59.5% girls
observe thoughts
Average of 15
years
Study
Measurements
- HR
Randomization
- ACMI
of three
conditions:
mindfulness
group, health
education group
and life skills
group.
With a follow-up
after three
months.
Controlled design. - AP
Randomization for - AFA
the experimental - STAI
and control
group: waiting
list
Design
(Continued )
Self-concept: d = 1.63
Academic performance:
d = 1.57
Anxiety trait: d = 0.64
Anxiety state: d = 0.43
Pre-test to post-test:
ACMI: p = .036
SBP session: p = .018

significance

539
Sample
Franco
(2009)
N = 60
Grade 1 and 2
Baccalaureate
three public
schools
72% girls
Average of
17.3 years
Franco, De N = 84
La Fuente Grade 1 and 2
secondary
et al.
schools
(2011)
72% girls
average of
17.06 years
Study
Duration
10 sessions lasting
Mindfulness
an hour and a
training program:
half once per
guidelines, items
week + 40 min
and
daily practice at
MBSR exercises +
home
Acceptance and
Commitment
Therapy
mindfulness
strategies +
presentation and
discussion of
metaphors and
exercises used in
such therapy +
stories and
accounts about
Zen and
Vipassana
10 sessions lasting
Flow Meditation:
an hour and a
meditation with
half, once per
ACT exercises +
week
accounts of the
Zen tradition and
Vipassana
meditation
Intervention
(Continued )
Post-test between
groups:
Fluidity:
p = .001
Flexibility:
p < .005
Verbal Originality:
p < .005
Intra-group pre-test
monitoring:
Fluidity: p = .001
Flexibility: p = .001
Originality: p = .001
Controlled design. - BV-TPC

Randomization for
the experimental
and control
group: waiting
list
With a follow-up
after three
months
30

significance
AURE factors:
Self-concept and selfesteem: d = 1.71
Capacity for coping and
functioning with and
completion of work:
d = 1.11
Measurements
Controlled design. - AURE

Randomization for
the experimental
and control
group: waiting
list
Design
42
Experimental
group
540
. I. Langer et al.
Sample
N = 522
12 private and
public
schools
29.9% girls
1216 years
old
N = 48
Two public
schools
62.5% girls
average of
15.83 years
Kuyken
et al.
(2013)
Lau & Hue

(2011)
Franco et al. N = 49
(2010)
(South
American
immigrants)
Grade 1 from
Baccalaureate
51% girls
average of
16.45 years
Huppert &
N = 155
Johnson
Two boys
(2010)
schools
100% boys
1415 years
old
Study
Four classes per

week lasting 40
min + eight min
daily workout at
home (with a
specially
designed CD)
Nine lessons, once
per week
Adaptation of
MBSR
Six sessions lasting

Adaptation of
two hours, once
MBSR:
per week + a
stretching
retreat for seven
exercises + daily
hours + 15 min
practice activities
of daily practice
+ bodyscan +
at home
kindness practice
Mindfulness for
Schools
Programme: part
of the normal
curriculum
replacing some
classes
10 sessions lasting
an hour and a
half, once per
week + 30 min
of daily practice
Duration
Mindfulness
techniques:
repetition of
words +
metaphors and
exercises +
bodyscan
Intervention
Controlled design.
No randomization
Control group:
normal classes
Controlled,
universal
intervention with
no
randomization.
With a follow-up
after three
months
Controlled design.
No randomization
256
24
Measurements
(Continued )
FMI dimension:
Mindful presence:
p = .01
SPWB dimension:
Personal growth:
p < .00
DASS & PSS: p = .01
Post-test:
CES-D: p = .004
Follow-up:
WEMWBS: p = .05
PSS: p = .05
CES-D: p = .005
- WEMWBS
- PSS
- CES-D
- MAAS
- FMI
- SPWB
- DASS
- PSS
No differences between
control and
experimental group
Academic Performance:
d = 1.52
Self-concept: d = 1.14

significance
- CAMS-R
- ERS
- WEMWBS
- TIPI
Controlled design. - AP
Randomization for - AFA
the experimental
and control
group: waiting
list
Design
78
24
Experimental
group

541
201
MBSR and MBCT Eight sessions

N = 408
lasting 100 min,
programme for
Grade 14
once per week
adolescents:
Four secondary
experiential
schools
exercises in
Average of
mindfulness +
16.8 years
reflections in
groups +
psychoeducation
+ practice at
home (15 min)
Raes et al.
(2013)
Experimental
group
129
Duration
Learning to Breathe 18 lessons lasting

Programme
1525 minutes,
once a week for
16 weeks
Intervention
N = 216
Two public
secondary
schools
66% girls
Average of 16
years
Sample
Metz et al.
(2013)
Study
- DERS
- PCS
- PS
- ASRES
Measurements
Controlled design. - DASS-21

Randomization for
the experimental
and control
group: waiting
list
With a follow-up
after three
months
Controlled design.
No
randomization.
Control group:
optional choir
class
Design
(Continued )
DERS Dimensions:
Limited access to
regulation strategies:
d = 0.30
Lack of emotional
clarity: d = 0.28
Lack of emotional
awareness: d = 0.34
PCS: d = 0.28
PS: d = 0.40
ASRES: d = 0.62
Post-test: d = 0.32
Follow-up: d = 0.31

significance
542
. I. Langer et al.
Intervention
Mindfulness
N = 49
techniques:
(South
repetition of
American
words +
immigrants)
metaphors and
Public
exercises +
institution
bodyscan
baccalaureate
51% girls
Average of
16.45 years
Sample
30 min of daily
practice
Duration
24
Experimental
group
Measurements
Controlled design. - RSS

Randomization for -TMMS-24
the experimental
and control
group: waiting
list
Design
Self-esteem: d = 1.19
- Dimensions of
emotional
competence:
Clarity: d = 1.08
Repair: d = 1.57

significance
Note: *In controlled studies the effect size has been reported in the post-intervention follow-up as having significant differences between groups. Cohens d: values
greater than 1.5 indicate very high changes, those between 1.5 and 1 high changes, between 1 and 0.5 average, between 0.5 and 0.2 low and under 0.2 very low.
**ACMI, Cook-Medley Hostility Inventory; ACT, Acceptance and Commitment Therapy; ACTI, actigraphy: wrist monitor to measure sleep objective; AFA, Selfconcept Questionnaire form A; AP, Academic Performance: qualifications; ASRES, Affective Self-Regulatory Efficacy Scale; AURE, Self-concept and Selfempowerment Questionnaire; AX, Spielberger Anger Expression Scale; BTavg, average time in bed, BV-TPC, Torrance Verbal battery test for Creative Thinking;
CAMS-R, Cognitive and Affective Mindfulness Scale-Revised; CES-D, Center for Epidemiologic Studies Depression Scale; DASS, Depression Anxiety Stress Scales;
DBP, diastolic blood pressure; DERS, Difficulties in Emotion Regulation Scale; ERS, Ego Resiliency Scale; FMI, Freiburg Mindful Inventory; HR, Heart Rate;
MAAS, Mindful Attention Awareness Scale; MBCT: Mindfulness-based Cognitive Therapy; MBSR, Mindfulness-based Stress Reduction Program; NSI,
Neighborhood Stress Index; PA, Hypertension; PANAS, Positive and Negative Affect Schedule; PCS, Psychosomatic Complaints Scale; PS, Perceived Stress level;
PSQI, Pittsburg Sleep Quality Index, measures subjective sleep; PSS, Perceived Stress Scale; RRS, Ruminative Response Scale; RSS, Rosenberg Self-Esteem Scale;
RTavg, average time to get up; SBP, systolic blood pressure; SCAS, Spence Children Anxiety Scale; SE, sleep efficiency; SICBC, Somatization Index of the Child
Behaviour Checklist; SOL, sleep onset latency; SSRS, Social Skills Rating System; STAI, The State-Trait Anxiety Inventory; SPWB, Scales of Psychological
Wellbeing; TIPI, Ten-Item Personality Inventory; TMMS-24, Trait Metamood Scale-24; TESU, Expulsion rate of urinary sodium; WEMWBS, Warwick Edinburgh
Mental Well-being Scale.
Soriano &
Franco
(2010)
Study

543
544
. I. Langer et al.
Effects on emotional variables

The first intervention was conducted by Raes, Griffith, van der Gucht, and
Williams (2013), in Belgium, who administered a programme developed for
adolescents that combines Mindfulness-Based Stress Reduction (MBSR) and
Mindfulness-Based Cognitive Therapy (MBCT) to students aged 1320 years
old. The study concluded that the mindfulness programme contributed to lowering
levels of symptoms of depression in students at the completion of the programme
and six months afterwards, meaning that the effect was statistically and clinically
significant, and that it showed a combination of preventive and corrective effects.
Furthermore, and agreeing with other interventions based on Mindfulness
Curriculum the inclusion of regular mindfulness meditation in educational
establishments the study carried out by Kuyken et al. (2013) confirmed the
above results. They assessed the feasibility and effectiveness of a universal
prevention programme called the Mindfulness in Schools Programme (MiSP)
for students aged 1216 years old. They also evaluated the mental health
stress and symptoms of depression and well-being of students at the end of the
intervention and three months later, during exams, the most stressful period of the
year. The post-intervention evaluation showed a significant reduction in symptoms of depression, but they found no improvement in stress and well-being
levels. However, in a follow-up they found that the MiSP programme significantly
reduced stress levels and improved well-being as well as a continuing reduction in
symptoms of depression in students. Furthermore, they found that these improvements were significantly related to the frequency with which students practised
mindfulness outside of school. Doing a similar intervention, Broderick and Metz
(2009), from the USA, reported the results of a pilot study, a first for the area of
mindfulness, called Learning to Breathe, a programme for adolescents tailored to
the classroom setting, whose purpose was to assist the development of emotional
regulation. The programme was implemented into the health curriculum of a girls
secondary school class during their final year at college. The results showed that
participants reported a significant decrease in negative affect moods and
general stress levels and increased feelings of calm, relaxation and selfacceptance, compared to the control group. However, they found no significant
improvements in their affective regulation, reflection or somatization. However,
when comparing the intra-group results, they found improvements in all the above
variables, except reflection. The qualitative results of the study indicate that
participants were satisfied with the programme because it helped them to let
go of stressful thoughts and emotions which in turn helped them mange their
stress. An improved control of their reactions was also observed.
Recently, Metz et al. (2013) implemented the universal prevention programme
Learning to Breathe in grades two, three and four in public secondary schools in
Pennsylvania, USA, during the first 1525 minutes of an optional choir course.
The adolescents affective regulation, stress and psychosomatic complaints were
assessed. The results showed that when compared with the control group, participants in the programme showed an increase in affective regulation strategies and
in emotional awareness and clarity. Additionally, students reported a greater
545
reduction in somatic symptoms compared to students in the control group,

specifically regarding difficulties with concentration and irritability. Finally, they
reported a decrease in their stress levels and an improvement in their emotional
self-regulation skills. With regard to the acceptability of the programme, the
average satisfaction score was high, and most of the students said that the
intervention showed them how to calm down, relax and breathe; recognize
emotions; control thoughts and feelings; live in the present, concentrate and focus.
Additionally, Beauchemin et al. (2008), a group of researchers from Vermont,
USA, who administered a mindfulness meditation programme to groups of adolescents aged between 13 and 18 years old who had learning difficulties, obtained
positive results from a comparison of students anxiety levels pre-test and posttest. They found significant reductions in their anxiety as both a state and a trait.
Likewise, Spaniards Franco, Maas, Cangas, and Gallego (2011) implemented the
Meditacin Fluir (Meditation Flow) programme a mindfulness training programme in a class of Spanish students, analysing, among other variables, that
same construct. These authors reported that administering the programme resulted
in decreases in anxiety as a state and a trait for the participant students. Lau and
Hue (2011), in Hong Kong, adapted a mindfulness-based programme for schools
whose students were aged 14 to 16 years old and who had learning and educational performance difficulties. Their findings found that the mindfulness programme significantly decreased symptoms of depression in adolescents, but not
perceived stress, contradicting results from the adult population.
Effects on psychosocial variables

Self-concept was the most assessed psychosocial variable. Specifically, in Spain,
Franco, Maas et al. (2011) and Franco, Soriano, and Justo (2010) observed
positive effects on Spanish and South American (living in Spain) adolescents
self-concept, in all its dimensions: academic, emotional, social and family. Both
studies found that the most significant effect of the intervention was on the
students emotional and academic self-concept. To a lesser extent an effect was
also observed on the social dimension of self-concept. A third study evaluating
this variable found a significant change in self-concept and self-esteem from the
result of the Self-empowerment and Self-concept Questionnaire administered to
participants after the mindfulness intervention (Franco, de la Fuente, & Salvador,
2011).
Worth noting is the improvement of students academic self-concept, given the
educational context in which the programmes are administered. In this regard,
Franco, Maas et al. (2011) and Franco et al. (2010) used academic performance
students average grade as a complementary variable. Both studies showed
that the academic performance of the Spanish and South American students
improved significantly more than their corresponding control groups (Franco,
Maas et al., 2011; Franco et al., 2010). The results of another two measures
self-esteem and emotional capacity administered to a group of South American
immigrants were reported by Soriano and Franco (2010). The results confirmed
546
. I. Langer et al.
significant differences between the control and experimental group, specifically,

an increase in self-concept as well as in two of the three dimensions of emotional
capacity: emotional clarity I can identify and understand my emotional states
well; and repair of mood I am able to regulate my negative emotional states
and retain positive states. The ability to manage feelings the third dimension of
emotional capacity changed to a much lesser extent.
The fifth Spanish study was carried out by Franco (2009) and measured the
effect of the Meditation Flow programme on the verbal creativity of secondary
school students. The study confirmed that after the intervention, participants
levels of verbal creativity increased significantly more than the control group.
Higher mean scores on the following variables were observed for the experimental
group after the intervention: fluency participants ability to produce a large
number of ideas; flexibility ability to switch from one approach to another; and
mental originality ability to provide ideas or solutions that are far from obvious
or an established given.
Other variables considered in this study were mindfulness as a skill in itself
and psychological well-being, results for which no improvement were found.
Findings from the aforementioned study by Kuyken et al. (2013) are consistent
with these conclusions. They found no significant improvements in well-being
immediately after the mindfulness programme was administered but there were
improvements three months after. Despite not having found significant results
from the Freiburg Mindfulness Inventory (FMI), Mindful Attention Awareness
Scale (MAAS) and Scale of Psychological Wellbeing (PSW) total scores, Lau and
Hue (2011) found that participants showed higher levels in the FMI dimension,
conscious presence, and in the SPW dimension, personal growth. Moreover,
Huppert and Johnson (2010), who administered a reduced and modified form of
the Mindfulness-based stress reduction (MBSR) programme in the United
Kingdom, in classes for students aged 14 and 15 years old, also failed to find
significant differences between the control and experimental groups for the variables mindfulness, psychological well-being and resilience. However, the main
finding of this study showed that the amount of individual practice done outside
the classroom predicted improvements in mindfulness and psychological wellbeing measures. Furthermore, they found that well-being was significantly related
to personality variables such as agreeableness and emotional stability. The qualitative results from the article showed that the programme was well accepted by
adolescents and more than half the students in the mindfulness group enjoyed
learning about it and believed they would continue practising it. Lau and Hue
(2011) also reported qualitative results showing that the programme would be
feasible for adolescents at school. Students reported having learned new ways to
reduce stress, understand the mind and body, care for others and appreciate nature
and human relations.
With regard to interpersonal relations, Beauchemin et al. (2008), mentioned
above, analysed students reports and found that their social skills had shown a
significant improvement, while teachers reports on these students reported an
improvement in their social skills, academic performance and behavioural issues.
547
Effects on physiological variables

With regards to physiological measures, four studies were analysed that measured
the impact of mindfulness in cardiac variables and sleep.
Three of those studies are part of a larger study being carried out in the USA
that seeks to analyse the effects of different stress reduction programmes in this
case mindfulness on cardiovascular functions, blood pressure and the heart
rate. In the first research study (Barnes, Davis, Murzynowski, & Treiber, 2004),
the meditation group showed significant decreases in systolic blood pressure at
rest and in daytime ambulatory systolic blood pressure systolic and diastolic
blood pressure and heart rate compared to the control group. The decreases
were only clinically significant at a group level and not at an individual level. The
authors also evaluated the expression of anger and stress, but found no significant
decreases in these variables.
Five years later, researchers from that same group (Barnes et al., 2008)
conducted a similar study to evaluate the impact of a meditation programme,
called Breathing Awareness Meditation (BAM, the main exercise for MBSR), on
blood pressure and sodium levels in African American adolescents who had
average to high blood pressure levels. They found significant differences between
the experimental and control groups in systolic blood pressure during the day and
night, and heart rate during school hours, which decreased significantly in the first
group. However, there were no significant differences in diastolic blood pressure.
Regarding expulsion rates of urinary sodium in the evenings, they decreased
significantly after the BAM programme for the intervention group but increased
in the control group, as did urinary sodium content and volume in urine.
Finally, in the same vein, Brown, Gregoski, Tingen, Barnes, and Treiber (2011)
conducted a comparison between the three intervention programmes that included
BAM, mentioned above, the Skills for Life Training (SLT) programme and a Health
Education Intervention (HEI), carried out with a group of African American
students in ninth grade. Brown et al. (2011) evaluated the degree of hostility and
ambulatory blood pressure in the three groups of students and were able to report
significant decreases in the BAM participants levels of hostility and blood pressure
after the intervention. However, this result was not retained for the three-month
follow-up. The results indicated that decreases in hostility were significantly related
to decreases in the hemodynamic measurements for the BAM and HEI group, at
both times. However, HEI and SLT did not show a significant difference between
pre- and post-intervention nor did they show a difference in the post-intervention
follow-up, except for the SLT group which showed significant decreases in hostility
from between the end of the intervention until the follow-up.
These three studies demonstrate the beneficial effects of breathing-based
meditation on cardiovascular function and sodium management in both normotensive and African American adolescents at risk of developing hypertension.
A pilot study (Bei et al., 2013) was carried out in Australia with the aim of
developing a practical sleep method using a mindfulness-based programme. They
used adolescents who were aged between 13 and 15 years old who had selfreported poor sleep patterns in a private girls secondary school. After
548
. I. Langer et al.
intervention, improvements were seen in objective and subjective quality of sleep,

with the sleep onset latency variable showing the greatest improvement.
Analysing data from an actigraphy a wrist monitor that measures physical
activity and is used to assess waking patterns the authors demonstrated that
there were moderate decreases in students sleep onset latency and an increase in
their sleep efficiency, in addition to small improvements in the overall sleep time.
On average, students fell asleep 30 minutes earlier and woke up 40 minutes earlier
in the morning. Subjective sleep quality improved moderately, with high reductions in sleep onset latency and increased sleep quality, and decreases in subjective sleep dysfunction. The authors found no significant decreases in anxiety
levels, however they did find significant improvements in the separation anxiety
and panic/agoraphobia subscale items on the Spences Childrens Anxiety Scales
(SCAS).
Discussion
Preventing adolescents mental health issues and promoting psychological wellbeing in their natural settings (such as educational establishments), as well as
improving access to intervention, are considered priorities by international health
agencies (e.g., PAHO, 2010). Mindfulness-based interventions have shown promising results in this direction (Garrison Institute, 2005).
In this regard, all the interventions analysed that measured the feasibility of
applying mindfulness in schools, by using qualitative and quantitative measures,
concluded that meditation is well-received by adolescents and showed low
abandonment rates (Moseley & Gradisar, 2009) and a variety of subjective
changes related to a decrease in disturbing emotional states and an increase in
appreciation for human relationships and perceptions of personal empowerment
(Lau & Hue, 2011).
Broderick and Metz (2009) and Raes et al. (2013) suggested that universal
interventions can have more impact on the mental health of adolescents than
programmes focused on adolescents at risk of having mental issues or developing
a mental disorder as it reaches a larger population and has the stated objectives of
early detection, prevention of problems and promoting health and psychological
well-being; it is not only for treatment or recovery.
In this scenario, the results of the review gathered from the studies analysed
suggest that mindfulness is an intervention that has sufficient empirical support to
be used as a preventive strategy for a variety of mental disorders, specifically
because of its capacity to reduce symptoms of depression and anxiety and
improve peoples self-concept, among other reasons. This expands the repertoire
of strategies that have so far proved effective in preventing diseases (both
universal as well as selective or specific) that can start in childhood or adolescence
such as depression (see Martnez et al., 2010). However, many of the studies had
methodological limitations that restrict, in part, the robustness of their results.
Among them the most significant is not having used a control group (e.g.,
Beauchemin et al., 2008) and not randomly assigning participants to the control
549
group. (e.g., Huppert & Johnson, 2010). In addition, in most of the studies the
control group did not have an active component assigned to it to compare the
results with other types of interventions in order to learn more about the mechanisms of change of this kind of meditation (e.g., Soriano & Franco, 2010).
With regard to participants, in most studies small and homogeneous groups
were used (same-sex or same type of educational establishment: e.g., Bei et al.,
2013; Barnes et al., 2004, respectively). Another methodological limitation was
that the programme components that were related to the results were not studied,
which hindered using these studies to develop an understanding of the mindfulness mechanisms. Also, only three papers presented follow-up evaluations.
There are no investigations into whether the results are maintained over time,
one or two years after the intervention was carried out.
With regard to the instruments used in some of the studies, they were not
adapted to an adolescent population, they were instruments that had been developed and validated using adults, and in addition to that, most of the research
studies did not complement self-reported statements with physiological measures.
Some recommendations for future research in the area would be to improve the
limitations of those studies by: using large and heterogeneous groups of participants (in sex, social class, ethnicity) to determine whether the efficiency of the
treatment is definitely extended throughout the group; the randomization of
educational establishments and of the distribution of the experimental and control
groups; the use of a placebo that has the same duration with control groups
(psycho-education or some method of relaxation) to compare the effectiveness
of different interventions.
Expanding and improving the application of the tools is also recommended by
using: approaches that have been adapted to and validated in adolescents; measurements and processing of the results; objective variables such as academic
achievement and performance in attention tests, not just self-reports; reports from
peers, observers, teachers and/or family; stronger psychometric methods such as
clinical interviews (Raes et al., 2013); and using more complex qualitative
analysis. In addition, physiological measures in the individuals natural context
increases the ecological validity of the studies.
Franco, Maas et al. (2011) also propose isolating the differential effects of
meditation more clearly, that is, comparing not only variables, but also the
dimensions of a single variable, and exploring the effects of the meditation
programmes different components, separating those that are responsible for
changes from those that are not.
With regard to interventions, Lau and Hue (2011) argue that the programmes
carried out with adolescents in schools should be made up of between 10 and 12
sessions which last less than an hour each, with participants encouraged to practise at
home or having the option to attend reinforcement sessions. These programmes
should be incorporated into the educational establishments curriculum, that is, they
should not be treated as an extracurricular activity, and they should be given by the
teachers who already work at that school (to avoid possible familiarity problems)
teachers would have to be trained and a manual would be prepared for them. This
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. I. Langer et al.
would require research being conducted into the skills teachers need to administer
the programme in classes (Broderick & Metz, 2009) and adapting meditation
programmes to an educational context, with clear objectives for these populations
and for the courses to be developed (Franco, de la Fuente et al., 2011). In this regard,
the study by Bei et al. (2013) seems to shed light on the fact that a multicomponent
therapeutic approach does not appear to be recommendable, as results do not clearly
show what the most effective component is; they recommend using different
programmes for different processes, even if they are related, for example sleep and
anxiety.
Finally, with regard to this systematic review, incorporating studies into a
heterogeneity of methodologies and scientific rigour can be a limitation in itself
to consider when extrapolating results.
In summary and considering the results as a whole, mindfulness is a viable
intervention model that has sufficient empirical evidence to support its effective
implementation in schools, either as extra-curricular activity or within the school
curriculum. Its implementation can produce significant changes in various variables
(e.g., psychological, psychosocial and physiological), thus being highly recommended for the prevention and raising awareness of mental health issues. Future
research should attempt to respond to those limitations observed in the studies
analysed in this review and thus enrich the intervention model. A special appeal for
studies in Latin America and the Caribbean must be made in order to respond to local
realities, contributing to a broad line of research that is currently being development.
551
Intervenciones basadas en mindfulness en educacin secundaria:

una revisin sistemtica cualitativa
Hoy en da la mayora de los hbitos perjudiciales para la salud, tal como
establece la Organizacin Panamericana de Salud (OPS), se adquieren durante
la adolescencia y la juventud, y se manifiestan como problemas de salud durante
la edad adulta (OPS, 2010). En Latinoamrica y el Caribe, entre un 11 y un 33%
de los jvenes refieren tener algn problema de salud mental. Esta situacin ha
conducido a muchos pases de la regin a redirigir polticas de salud para este
grupo etario, enfocando sus esfuerzos en la prevencin y promocin de la salud
(Ministerio de Salud de Chile [Minsal], 2012).
Actualmente, en los establecimientos educacionales (EE) es el lugar donde los
adolescentes y jvenes pasan la mayor parte del da. Esta situacin otorga a los EE
un rol predominante en el manejo y desarrollo de aspectos psicosociales, emocionales, cognitivos y conductuales de los alumnos (Berger, Alcalay, Torretti, &
Milicic, 2011).
Dentro de las intervenciones psicolgicas que han generado un gran inters en
investigadores y clnicos, y con un crecimiento exponencial de investigaciones en
el rea, se encuentran las aproximaciones basadas en la aceptacin y mindfulness,
o tambin denominadas terapias cognitivo-conductuales de tercera generacin
(Hayes, Follette, & Linehan, 2004).
Mindfulness puede ser descrito como un constructo terico (mindfulness o
conciencia plena), una prctica (como la meditacin) o un proceso psicolgico
(ser o estar en mindfulness) (Germer, Siegel, & Fulton, 2005), siendo una
definicin bsica de ste: prestar atencin de un modo particular, con un
propsito, en el momento presente y sin establecer juicios de valor (KabatZinn, 1994, p. 15). Entre los mecanismos de accin de mindfulness, se destaca
un trabajo sinrgico entre la regulacin de la atencin, la conciencia en el cuerpo,
la regulacin emocional (incluyendo la reevaluacin y exposicin, la extincin y
el distanciamiento cognitivo) y los cambios en las perspectivas del Self (flexibilidad psicolgica).
Las intervenciones basadas en mindfulness incluyen varios mtodos para
ensear la consciencia mindfulness; algunos de estos son prcticas formales de
meditacin, otros son ejercicios informales que enfatizan el mindfulness en la vida
cotidiana (Baer, 2003). Entre estas aproximaciones se encuentra el programa de
Reduccin del Estrs Basado en Mindfulness (MBSR; Kabat-Zinn, 1990) y la
Terapia Cognitiva Basada en Mindfulness (MBCT; Segal, Williams, & Teasdale,
2002). Estas intervenciones cuentan con un amplio respaldo emprico. De hecho,
recientes meta-anlisis y revisiones sistemticas sugieren que mindfulness es una
552
. I. Langer et al.
intervencin efectiva para el tratamiento de diversos problemas de salud mental,

como depresin y ansiedad (ver, por ejemplo, Hofmann, Sawyer, & Witt, 2010), y
mejoras en los tratamientos de diversos trastornos mentales tales como: alimentarios, por abuso de sustancias, psicosis y trastorno bipolar, entre otros (Baer,
2006; Langer, Cangas, Salcedo, & Fuentes, 2012; Ludwig & Kabat-Zinn, 2008).
En mbitos no clnicos los estudios demuestran que mindfulness logra disminuir el estrs y aumentar la calidad de vida de las personas (e.g., Nyklek &
Kuijpers, 2008), mejorando la capacidad de atencin (Jha, Krompinger, & Baime,
2007), y disminuyendo las puntuaciones en alexitimia o dificultades en las
habilidades sociales (de la Fuente, Franco, & Salvador, 2010).
Aunque la gran mayora de estudios se ha desarrollado en poblacin adulta, un
nmero no menor de publicaciones sugieren la viabilidad y aceptabilidad de los
enfoques basados en mindfulness en nios y adolescentes, tanto en pacientes
como en poblacin sana (Burke, 2009). En cuanto a las muestras clnicas, los
resultados indican, por un lado, reducciones significativas en la somnolencia,
preocupacin, estrs, comportamientos agresivos y en sntomas del trastorno por
dficit atencional con hiperactividad, y por otro, mejoras en la calidad del sueo,
en la felicidad subjetiva, conciencia mindfulness, adems de cambios en medidas
neurocognitivas relacionadas a la atencin (Bgels, Hoogstad, Dun, De Shutter, &
Restifo, 2008; Singh et al., 2007; Zylowska et al., 2008).
Con respecto a muestras no clnicas, son de especial preponderancia los
estudios donde se ha aplicado mindfulness en las escuelas (Garrison Institute,
2005). Debido a que la adolescencia es un perodo de vulnerabilidad
psicopatolgica, se requieren intervenciones de prevencin y promocin de la
salud mental, que, por un lado, faciliten el acceso a una atencin psicolgica
oportuna y, por otro, sean atractivas para los jvenes. Es por tanto, relevante
analizar estrategias psicoteraputicas no tradicionales que se desarrollen en el
contexto natural de los adolescentes, como el escolar (Wisner, Jones, & Gwin,
2009).
Especficamente, el objetivo de esta revisin sistemtica, es examinar los
efectos producidos por los programas de meditacin mindfulness aplicados a
adolescentes dentro de sus establecimientos educativos, y publicados tanto en
ingls como en lengua castellana.
Mtodo
Procedimiento
Se realiz una revisin sistemtica de los estudios que expusieran los resultados
de intervenciones en adolescentes basadas en mindfulness realizadas dentro de los
establecimientos educacionales, hasta Septiembre de 2013, considerando las recomendaciones de la declaracin PRISMA para realizar estudios de revisin
sistemticos (Urrtia & Bonfill, 2010).
Las siguientes bases de datos fueron revisadas: WEB of SCIENCE,
PSYCHINFO, SCOPUS Y PUBMED, DIALNET, SCIELO Y REDALYC,
usando las palabras clave:
553
Mindfulness *school (colegios o educacin)

Mindfulness*adolescence (adolescencia)
Mindfulness*school*adolescence
La bsqueda se limit a artculos que estuvieran publicados en revistas en ingls
o espaol, de intervenciones basadas en mindfulness, que fueran realizadas dentro
de los colegios, con muestras mayores a cinco personas, de adolescentes desde los
12 aos en adelante o de enseanza secundaria, con un diseo experimental o
cuasiexperimental. Se aceptaron estudios sin grupo control. Se excluyeron de la
muestra los estudios que incluyeran: programas que complementaran la meditacin
mindfulness con otro tipo de intervencin; adolescentes con patologas psiquitricas,
e intervenciones realizadas en colegios con necesidades especiales.
La Figura 1 muestra un diagrama de flujo de la informacin con las diferentes
fases realizadas en la revisin sistemtica cualitativa.
Resultados
Se seleccion un total de 16 programas de intervencin mindfulness aplicados a
alumnos de enseanza secundaria dentro de las escuelas, cuyas caractersticas
principales se exponen en la Tabla 1.
Nmero de citas identificadas en las
Bsquedas:
1,075
Nmero total de citas duplicadas eliminadas:

107
Nmero total de citas nicas cribadas:

968
Nmero total de artculos a texto completo

analizados para decidir su elegibilidad:
39
Nmero total de citas eliminadas:

929
Nmero de artculos a texto completo

excluidos:
23
Nmero total de estudios incluidos en la

sntesis cualitativa y cuantitativa de la
revisin sistemtica:
16
Figura 1. Diagrama de flujo de la informacin en las diferentes fases realizadas en la

revisin sistemtica cualitativa.
N = 34
(dificultades de
aprendizaje)
Colegio privado
29% mujeres
16.61 aos
promedio
Beauchemin
et al.
(2008)
Barnes et al.
(2008)
N = 73
7 grado
Escuelas
secundarias
46.5% mujeres
12.3 aos
promedio
N = 66
1 grado
Dos escuelas
secundarias
42.4% mujeres
15 aos promedio
Muestra
Barnes et al.
(2004)
Estudio
Meditacin
Mindfulness
(Kabat-ZInn,
1994)
Meditacin para la
Conciencia de la
Respiracin:
ejercicio principal
del MBSR
Ejercicio 1 del
MBSR:
respiracin
Intervencin
Dos sesiones de 45 min

+ cinco
intervenciones diarias
por cinco semanas de
cinco a 10 min
Sesiones diarias de 10
minutos por tres
meses en el colegio y
en la casa + contacto
con el instructor
sobre las sesiones (20
min por semana)
Sesiones diarias de 10
minutos en el colegio
y casa por tres meses
Duracin
34
20
34
Grupo
experimental
Tabla 1. Caractersticas de los estudios incluidos en la revisin sistemtica.
Diseo no controlado
Diseo controlado.
Aleatorizacin a grupo
experimental o grupo
control: educacin en
salud
Diseo controlado.
experimental o grupo
control: educacin en
salud
Diseo
- SSRS
- STAI
- PA
- HR
- TESU
- PA
- HR
- AX
- NSI
Medidas
(Contina )
Ambulatoria de da
SBP: p < .05
HR: p < .02
Ambulatoria de noche:
SBP: p < .01
Expulsin Sodio: p < .03
Contenido de Sodio: p < .03
Volumen de Sodio: p < .03
Ansiedad como rasgo: p < .05
Ansiedad como estado: p < .05
SSRS estudiantes: p < .05
SSRS profesores:
Habilidades sociales: p < .05;
Problemas de
comportamiento: p < .05;
Logros acadmicos: p < .05
Ambulatoria de da:
SBP p < .01
DBS p < .02
HR p < .01
Reposo:
SBP p < .05
Tamao de efecto* o
Significacin estadstica
554
. I. Langer et al.
Brown et al.
(2011)
Broderick &
Metz
(2009)
Bei et al.
(2013)
Estudio
Intervencin
Duracin
Grupo
experimental
Diseo
N = 10
Programa de
Seis sesiones, una vez
10
Diseo no controlado
(calidad del sueo
tratamiento para
por semana de 90
pobre)
insomnio
min + prcticas
1 grado
modificado de
diarias de
Colegio privado de
Bootzin y Stevens
mindfulness
mujeres
(2005): MBCT +
100% mujeres
enfoque
1315 aos
cognitivoconductual para el
insomnio
N = 160
Programa
Seis sesiones, dos veces
120
Diseo controlado.
3 y 4 grado
Aprendiendo a
por semana de entre 4 grado de Grupo control: 3 grado
Escuela secundaria
respirar:
32 y 43 min +
secundaria
de secundaria
catlica privada
introduccin del
prctica en clases y
de mujeres
tema +
en casa
100% mujeres
actividades de
17.4 aos
grupo + prctica
promedio
de mindfulness
Meditacin para la
10 min cada da de la
35
Diseo controlado.
N = 121
Conciencia en la
semana y dos veces
Aleatorizacin a tres
(riesgo de
Respiracin:
los fines de semana
condiciones: grupo
hipertensin)
focalizacin en el
por tres meses.
mindfulness, grupo
1 grado
momento,
educacin en salud, y
enseanza
sostener la
grupo de habilidades
secundaria
atencin en la
para la vida.
Dos colegios
59.5% mujeres
respiracin y
Con seguimiento a los
15 aos promedio
observar
tres meses.
pasivamente los
pensamientos
Muestra
Tabla 1. (Continuacin).
Pretest a Postest:
ACMI: p = .036
SBP ambulatoria: p = .018
- PA
- HR
- ACMI
(Contina )
Factores del PANAS:

Afecto Negativo: d = 0.57
Calma, relajo, autoceptacin:
d = 0.53
Actigrafa:
SOL: d = 0.53
SE: d = 0.51
BTavg: d = 0.53
RTavg: d = 0.53
PSQI (global): d = 0.51
Tamao de efecto* o
- PANAS
- DERS
- RRS
- SICBC
- ACTI
- PSQI
- SCAS
Medidas

555
N = 61
1 grado de
Tres escuelas
pblicas
47.5% mujeres
16.75 aos
promedio
Muestra
Franco, de la N = 84
Fuente
1 y 2 grado
et al.
Escuelas
(2011)
secundarias
72% mujeres
17.06 aos
promedio
Franco,
Maas,
et al.
(2011)
Estudio
Duracin
Programa de
10 sesiones, una vez por
Mindfulness:
semana de 1hr 30
Tcnica
min + 30 min
Meditacin Fluir
prctica diaria en
+ metforas y
casa
ejercicios de la
Terapia de
Aceptacin y
Compromiso +
cuentos de la
Tradicin Zen y
la meditacin
Vipassana +
ejercicios de
body-scan
Programa de
10 sesiones de 1hr 30
entrenamiento en
min una vez por
mindfulness:
semana + 40 min
pautas, elementos
prctica diaria en
y ejercicios del
casa
MBSR + estrategias
mindfulness de la
Terapia de
Aceptacin y
Compromiso +
exposicin y
debate de
metforas y
ejercicios
utilizados en
dicha terapia +
historias y relatos
Zen y Vipassana
Intervencin
42
31
Grupo
experimental
Medidas
Diseo controlado.
- AURE
experimental y grupo
control: lista de espera
Diseo controlado.
- RA
- AFA
- STAI
Diseo
(Contina )
Factores de AURE:
- Autoconcepto y Autoestima:
d = 1.71
Capacidad de afrontamiento,
operatividad y realizacin en
el quehacer: d = 1.11
Autoconcepto: d = 1.63
Rendimiento acadmico:
d = 1.57
Ansiedad rasgo: d = 0.64
Ansiedad estado: d = 0.43
Tamao de efecto* o
556
. I. Langer et al.
N = 60
1 y 2 grado
bachillerato
Tres centros
pblicos
72% mujeres
17.3 aos
promedio
N = 49
(inmigrantes
sudamericanos)
1 grado de
bachillerato
51% mujeres
16.45 aos
promedio
N = 155
Dos colegios de
hombres
100% hombres
1415 aos
Franco
(2009)
Kuyken et al. N = 522

(2013)
12 colegios
privados y
pblicos
29.9% mujeres
1216 aos
Huppert &
Johnson
(2010)
Franco et al.
(2010)
Muestra
Estudio
Duracin
Programa
Mindfulness para
Colegios: parte
del currculum
normal
reemplazando
algunas clases
Adaptacin del
MBSR
Tcnica de
Mindfulness:
repeticin de
palabra+
metforas y
ejercicios +
bodyscan
Cuatro clases semanales
de 40 min + ocho
min de entrenamiento
diario en casa (con
CD especialmente
diseado)
Nueve lecciones, una
vez por semana
10 de 1hr y 30 min una

vez por semana + 30
min de prctica diaria
Meditacin Fluir:
10 de 1hr y 30 min una
meditacin con
vez por semana
ejercicios de la
ACT + relatos de
la tradicin Zen y
meditacin
Vipassana
Intervencin
256
78
24
30
Grupo
experimental
Intervencin universal
controlada sin
aleatorizacin.
tres meses
- WEMWBS
- PSS
- CES-D
(Contina )
Posttest:
CES-D: p = .004
Seguimiento:
WEMWBS: p = .05
PSS: p = .05
CES-D: p = .005
Sin diferencias entre grupo

control y experimental
- CAMS-R
- ERS
- WEMWBS
- TIPI
Diseo controlado.
- RA
- AFA
Diseo controlado.
Sin aleatorizacin Grupo
control: clases
normales
Tamao de efecto* o
Postest entregrupos:
Fluidez: p = .001
Flexibilidad: p < .005
Originalidad Verbal: p < .005
Pretest- Seguimiento intragrupo:
Fluidez: p = .001
Flexibilidad: p = .001
Originalidad: p = .001
Rendimiento Acadmico:
d = 1.52
Autoconcepto: d = 1.14
Medidas
Diseo controlado.
- BV-TPC
tres meses
Diseo

557
N = 48
Dos escuelas
pblicas
62.5% mujeres
15.83 aos
promedio
N = 216
Dos escuelas
pblicas
secundarias
66% mujeres
16 aos promedio
N = 408
1 a 4 grado
Cuatro escuelas
secundarias
16.8 aos
promedio
Metz et al.
(2013)
Raes et al.
(2013)
Muestra
Lau & Hue

(2011)
Estudio
Duracin
Ocho de 100 min, una

Programa para
vez por semana
adolescentes de
MBSR y MBCT:
ejercicios
experienciales en
mindfulness +
reflexiones en
grupos +
psicoeducacin +
prctica en casa
(15 min)
Adaptacin del
Seis sesiones de dos hrs,
MBSR: ejercicios
una vez por semana +
de estiramiento +
un retiro por siete hrs
prctica de
+ 15 min de prcticas
actividades
diarias en casa
cotidianas +
bodyscan +
prctica de
bondad
Programa
18 lecciones de 15 a 25
Aprendiendo a
minutos, una vez por
Respirar
semana durante 16
semanas
Intervencin
201
129
24
Grupo
experimental
- DERS
- PCS
- PS
- ASRES
- MAAS
- FMI
- SPWB
- DASS
- PSS
Medidas
Diseo controlado.
- DASS-21
tres meses
Diseo controlado. Sin

aleatorizacin. Grupo
control: clase de coro
electiva
Diseo controlado.
Sin aleatorizacin
Diseo
(Contina )
Dimensiones del DERS:

Acceso limitado a estrategias de
regulacin: d = 0.30
Falta de claridad emocional:
d = 0.28
Falta de conciencia emocional:
d = 0.34
PCS: d = 0.28
PS: d = 0.40
ASRES: d = 0.62
Postest: d = 0.32
Seguimiento: d = 0.31
Dimensin de FMI:
Presencia mindful: p = .01
Dimensin de SPWB:
Crecimiento personal: p < .00
DASS & PSS: p = .01
Tamao de efecto* o
558
. I. Langer et al.
N = 49
(inmigrantes
sudamericanos)
Bachillerato de
enseanza
pblica
51% mujeres
16.45 aos
promedio
Muestra
Tcnica de
Mindfulness:
repeticin de
palabra+
metforas y
ejercicios +
bodyscan
Intervencin
30 min de prctica diaria
Duracin
24
Grupo
experimental
Medidas
Diseo controlado.
- EAR
-TMMS-24
Diseo
Autoestima: d = 1.19
Dimensiones de competencia
emocional:
Claridad: d = 1.08
Reparacin: d = 1.57
Tamao de efecto* o
Note: *En estudios controlados, se reporta tamao de efecto en mediciones con diferencias significativas entre grupos en la postintervencin; d de Cohen: valores
superiores a 1.5 indican cambios muy altos, entre 1.5 y 1 altos, entre 1 y 0.5 medios, entre 0.5 y 0.2 bajos, y menores de 0.2 muy bajos.
**ACMI, Cook-Medley Hostility Inventory; ACT, Terapia de Aceptacin y Compromiso; ACTI, actigrafa: monitor de mueca para medir sueo objetivo; AFA,
Cuestionario de Autoconcepto forma A; ASRES, Affective Self-Regulatory Efficacy Scale; AURE, Cuestionario de Autoconcepto y Autorrealizacin; AX, Spielberger
Anger Expression Scale; BTavg, promedio de tiempo en la cama; BV-TPC, Batera Verbal del test de Pensamiento Creativo de Torrance; CAMS-R, Cognitive and
Affective Mindfulness Scale- Revised; CES-D, Center for Epidemiologic Studies Depression Scale; DASS, Depression Anxiety Stress Scales; DBP, presin arterial
distlica; DERS, Difficulties in Emotion Regulation Scale; EAR, Escala de Autoestima de Rosenberg; ERS, Ego Resiliency Scale; FMI, Freiburg Mindful Inventory;
HR, Ritmo Cardico; MAAS, Mindful Attention Awareness Scale; MBCT: Terapia Cognitiva basada en Mindfulness; MBSR, Programa de Reduccin de Estrs basado
en Mindfulness; NSI, Neighborhood Stress Index; PA, Presin Arterial; PANAS, Positive and Negative Affect Schedule; PCS, Psychosomatic Complaints Scale; PS,
Perceived Stres level; PSQI, Pittsburg Sleep Quality Index, mide sueo subjetivo; PSS, Perceived Stress Scale; RA, Rendimiento acadmico: calificaciones; RRS,
Ruminative Response Scale; RTavg, promedio de tiempo para levantarse; SBP, presin arterial sistlica; SCAS, Spence Children Anxiety Scale; SE, eficiencia del sueo;
SICBC, Somatization Index of the Child Behaviour Checklist; SOL, latencia de comienzo del sueo; SSRS, Social Skills Rating System; STAI, The State-Trait Anxiety
Inventory; SPWB, Scales of Psychological Wellbeing; TIPI, Ten-Item Personality Inventory; TMMS-24, Trait Metamood Scale-24; TESU, Tasa de expulsin de sodio
urinario; WEMWBS, Warwick Edinburgh Mental Well-being Scale.
Soriano &
Franco
(2010)
Estudio

559
560
. I. Langer et al.
Con excepcin de tres estudios que utilizan una estrategia de prevencin

selectiva (Barnes, Pendergrast, Harshfield, & Treiber, 2008; Beauchemin,
Hutchins, & Patterson, 2008; Bei et al., 2013), todos los trabajos analizados
utilizan muestras sin sintomatologa, ya sea psicolgica como fsica.
La descripcin de los artculos fue organizada en tres reas temticas, segn el
tipo de variable medida: (a) emocionales, entre ellas depresin, ansiedad, estrs,
afecto positivo/negativo y regulacin de emociones; (b) psicosociales como el
bienestar psicolgico, mindfulness, autorrealizacin, autoconcepto, habilidades
sociales, desempeo acadmico no incluye variables emocionales o
sintomatolgicas; y (c) fisiolgicas como medidas cardiovasculares y del sueo.
Efectos en variables emocionales

El primer tipo de intervencin fue llevada a cabo por Raes et al. (2013), en
Blgica, quienes aplicaron, a alumnos de 13 a 20 aos, un programa desarrollado
para adolescentes, que combina la Terapia de Reduccin de Estrs basada en
Mindfulness (MBSR) y la Terapia Cognitiva basada en Mindfulness (MBCT). El
estudio concluy que el programa de mindfulness fue capaz de generar niveles
menores de sintomatologa depresiva en los alumnos una vez finalizada la
intervencin y seis meses despus de sta, siendo el efecto, estadstica y
clnicamente significativo, y reflejando una combinacin de efecto curativo y
preventivo.
Por otro lado, dentro de la lnea de intervenciones del Currculum Mindfulness
inclusin de prcticas de meditacin mindfulness en cursos regulares de los
establecimientos educacionales el estudio de Kuyken et al. (2013) confirma los
resultados anteriores. Ellos evaluaron la factibilidad y eficacia de una intervencin
de prevencin universal llamada Programa Mindfulness para los Colegios (MiSP),
dirigida a estudiantes de 12 a 16 aos. Tambin evaluaron la salud mental estrs
y sntomas depresivos y bienestar de los estudiantes una vez finalizada la
intervencin y tres meses despus, en el perodo de exmenes ms estresante del
ao. En la postintervencin encontraron una reduccin significativa de los sntomas
depresivos, sin embargo, no observaron mejoras en el estrs y bienestar. En el
seguimiento encontraron que el programa MiSP redujo significativamente los
niveles de estrs, mejor el bienestar y mantuvo la reduccin de los sntomas
depresivos de los alumnos. Adems, encontraron que estas mejoras se relacionaban
significativamente con el grado en que los alumnos practicaron mindfulness fuera
del colegio. En la misma lnea de intervencin, Broderick y Metz (2009), en EEUU,
reportaron los resultados de un estudio piloto, pionero en el rea, llamado
Aprendiendo a Respirar, un currculum mindfulness para adolescentes, creado
para el setting de la sala de clases con el objetivo de apoyar el desarrollo de la
regulacin emocional. Intervinieron a alumnas de ltimo nivel de enseanza secundaria de un colegio de mujeres, como parte de su currculum en salud. Los
resultados demostraron que las participantes reportaron una disminucin significativa del afecto negativo estados de nimo aversivos y estrs general e
incrementos en los sentimientos de calma, relajacin y auto-aceptacin, en
561
comparacin con el grupo control. Sin embargo, no encontraron mejoras significativas en la regulacin de emociones, ni en rumiacin, ni en somatizacin. No
obstante, al comparar las medidas intra-grupo, hallaron mejoras en todas las variables recin mencionadas, excepto en rumiacin. Los resultados cualitativos del
estudio indican que las participantes estuvieron satisfechas con el programa, porque
les ayud a dejar ir pensamientos y emociones estresantes para manejar el estrs.
Adems se apreci un empoderamiento sobre sus reacciones.
Recientemente, Metz et al. (2013) implementaron el programa universal de
prevencin Aprendiendo a Respirar en alumnos de II a IV grado de enseanza
secundaria de escuelas pblicas de Pennsylvania, EEUU, durante los primeros 15
a 25 minutos de un curso electivo de coro. Se evalu la regulacin emocional, el
estrs y las quejas psicosomticas de los adolescentes. Los resultados indicaron
que los participantes del programa, al ser comparados con el grupo control,
presentaron un aumento en las estrategias de regulacin de emociones y en la
claridad y conciencia emocional. Adicionalmente, los estudiantes intervenidos
reportaron una mayor reduccin en los sntomas somticos en comparacin a
sus contrapartes; especficamente en la dificultad de concentrarse y en la irritabilidad. Por ltimo, estos mostraron un detrimento en la cantidad de estrs autorreportada y un aumento en la escala de eficacia en la autorregulacin afectiva.
Con respecto a la aceptabilidad del programa, el puntaje medio de satisfaccin
respecto a ste, fue alto, y la mayora de los alumnos respondi que la
intervencin les ense a calmarse, relajarse y respirar, adems de a reconocer
emociones y formas de controlar pensamientos y sentimientos, a vivir en el
presente, y a concentrarse y focalizarse.
Adicionalmente, Beauchemin, Hutchins, y Patterson (2008), un grupo de
investigadores de Vermont, EEUU, que intervino mediante un programa de
meditacin mindfulness a adolescentes de entre 13 y 18 aos con dificultades de
aprendizaje, obtuvo resultados positivos en cuanto a los niveles de ansiedad,
encontrando disminuciones importantes desde el pretest al postest en la ansiedad
como estado y como rasgo. Asimismo, los espaoles Franco, Maas, Cangas, y
Gallego (2011), aplicaron el programa Meditacin Fluir un programa de
entrenamiento en mindfulness a alumnos espaoles, analizando entre otros, el
mismo constructo. Estos autores reportaron que la intervencin provoc, en los
adolescentes intervenidos, reducciones en ambas dimensiones, ansiedad estado y
rasgo. Por otra parte, Lau y Hue (2011), en Hong Kong, realizaron una adaptacin
de un programa basado en mindfulness en escuelas con alumnos de 14 a 16 aos
con bajas habilidades y desempeo en el aprendizaje. Entre sus resultados, se
demostr que el programa mindfulness disminuy significativamente los sntomas
depresivos en los adolescentes, no as el estrs percibido, contradiciendo los
resultados obtenidos en la poblacin adulta.
Efectos en variables psicosociales

El autoconcepto fue el constructo ms evaluado dentro de las variables psicosociales. Especficamente, en Espaa, tanto Franco, Maas et al. (2011) como
562
. I. Langer et al.
Franco, Soriano, y Justo (2010) observaron efectos positivos en adolescentes

espaoles y sudamericanos residiendo en Espaa en cuanto al autoconcepto
total, incluyendo todas sus dimensiones: acadmica, emocional, social y familiar.
Ambos estudios encontraron el mayor efecto de la intervencin en el autoconcepto emocional y el acadmico, mientras que el efecto de menor magnitud, fue
observado en la dimensin social del autoconcepto. Un tercer estudio que evalu
esta variable, encontr un cambio de alta intensidad en el factor autoconcepto y
autoestima del Cuestionario de Autorrealizacin y Autoconcepto, despus de la
intervencin mindfulness (Franco, de la Fuente, & Salvador, 2011).
Llama la atencin la mejora del autoconcepto acadmico dado el contexto
educativo en que se dan las intervenciones. Al respecto, tanto Franco, Maas et al.
(2011) como Franco et al. (2010) utilizaron el desempeo acadmico, mediante el
promedio de notas, como una variable complementaria a la evaluacin. Ambos
estudios demostraron que el rendimiento acadmico, tanto del grupo de estudiantes espaoles como el de sudamericanos, mejor significativamente ms que
los respectivos grupos control (Franco, Maas et al., 2011, Franco et al., 2010).
Los resultados de otras dos mediciones autoestima y capacidad emocional
realizadas en un grupo de inmigrantes sudamericanos fueron reportados por
Soriano y Franco (2010). Los resultados confirmaron diferencias significativas
entre el grupo control y experimental, especficamente, se apreci un aumento de
la autoestima, y en dos de las tres dimensiones de la capacidad emocional:
claridad emocional identifico y comprendo bien mis estados emocionales
y reparacin de los estados de nimo soy capaz de regular los estados
emocionales negativos y mantener los positivos. La capacidad de atender a los
sentimientos tercera dimensin de la capacidad emocional cambi en un
nivel bajo.
El quinto estudio espaol fue realizado por Franco (2009) quien midi el
efecto del programa Meditacin Fluir, en la creatividad verbal de alumnos de
educacin secundaria. El estudio confirm que los sujetos, despus de la
intervencin, incrementaron significativamente ms los niveles de creatividad
verbal, que el grupo control. Una vez finalizada la intervencin, observaron, en
el grupo experimental, puntuaciones medias ms altas en las siguientes variables:
fluidez capacidad del sujeto para producir un gran nmero de ideas; flexibilidad aptitud para cambiar de un planteamiento a otro; y originalidad mental
aptitud para aportar ideas o soluciones que estn lejos de los obvio, o comn
establecido.
Otras variables examinadas en este apartado son mindfulness como una
habilidad en s misma y bienestar psicolgico, en las cuales no se hallaron
mejoras despus de la intervencin. Consistente con esto, es posible mencionar
los hallazgos del estudio ya mencionado de Kuyken et al. (2013) quienes no
encontraron mejoras significativas en el bienestar inmediatamente despus de su
intervencin, pero s despus de tres meses de sta. Por otra parte, Lau y Hue
(2011), a pesar de no haber encontrado hallazgos significativos en los puntajes
totales de las escalas Freiburg Mindfulness Inventory (FMI), Mindful Attention
Awareness Scale (MAAS), Scale of Psychological Wellbeing (PSW), hallaron que
563
los participantes de la intervencin mostraron mayores niveles en la dimensin del

FMI, presencia consciente, y en la dimensin del SPW, crecimiento personal. Por
otra parte, Huppert y Johnson (2010), quienes implementaron una forma reducida
y modificada del programa de Reduccin de Estrs basado en Mindfulness
(MBSR) en el Reino Unido, en alumnos de 14 y 15 aos, tampoco lograron
extraer diferencias significativas entre los grupos control y experimental en las
variables mindfulness, bienestar psicolgico y resiliencia. No obstante, el principal
hallazgo de este estudio indic que el grado de prctica individual llevada a cabo
fuera de la sala de clases, predijo mejoras en medidas de mindfulness y bienestar
psicolgico. Adems, encontraron que el bienestar se relacionaba significativamente con variables de personalidad como afabilidad y estabilidad emocional. Por
otra parte, los resultados cualitativos del artculo indicaron que el programa fue
bien aceptado por los adolescentes y que ms de la mitad de los estudiantes en el
grupo mindfulness disfrutaron aprender sobre mindfulness y pensaron que iban a
continuar con prcticas de mindfulness. Lau y Hue (2011) tambin reportaron
resultados cualitativos que revelaron que el programa sera viable para adolescentes en colegios. Los estudiantes quienes indicaron haber aprendido nuevas
formas de reducir estrs, entender la mente y cuerpo, cuidar de otros, y apreciar la
naturaleza y relaciones humanas.
En relacin a las relaciones interpersonales, Beauchemin et al. (2008), mencionados anteriormente, encontraron que las habilidades sociales, medidas desde
los reportes de estudiantes, mostraron mejoras significativas despus de la
intervencin, mientras que los reportes de profesores revelaron mejoras en las
habilidades sociales, el desempeo acadmico y los problemas de comportamiento
de estos alumnos.
Efectos en variables fisiolgicas

Con respecto a las medidas fisiolgicas, se encontraron cuatro estudios que
midieron el impacto del mindfulness en variables cardiacas y en el sueo.
Tres de ellos se enmarcan en una serie de estudios desarrollados en EEUU que
buscan analizar los efectos de diferentes programas de reduccin de estrs en
este caso mindfulness en funciones cardiovasculares, presin arterial y el ritmo
cardaco. En la primera investigacin (Barnes, Davis, Murzynowski, & Treiber,
2004), el grupo de meditacin exhibi disminuciones significativas en la presin
arterial sistlica en reposo, as como en medidas ambulatorias diurnas presin
arterial sistlica y diastlica, y ritmo cardiaco en comparacin con en el grupo
control. Las disminuciones fueron slo clnicamente significativas a nivel grupal y
no a nivel individual. Los autores evaluaron tambin la expresin de ira y el
estrs, pero no encontraron mermas significativas para estas medidas.
Cinco aos despus, miembros del mismo grupo de investigadores (Barnes,
Harshfield, Pendergrast, & Treiber, 2008) llevaron a cabo un estudio similar, para
evaluar el impacto de un programa de meditacin, denominado Conciencia en la
Respiracin (BAM, ejercicio principal del MBSR), en la presin arterial y los
niveles de sodio en adolescentes afroamericanos con niveles normales-altos de
564
. I. Langer et al.
presin sangunea. Observaron diferencias significativas entre el grupo experimental y control en relacin a la presin arterial sistlica durante el da y la noche,
y el ritmo cardiaco en horas de colegio, los cuales disminuyeron significativamente en el primer grupo. Sin embargo, no hubo diferencias importantes en
cuanto a la presin arterial diastlica. Con respecto a las tasas de expulsin de
sodio urinario en las noches, stas decrecieron significativamente despus del
BAM en el grupo intervenido, pero aumentaron en el grupo control, as como
tambin lo hizo el contenido del sodio urinario y el volumen de ste en la orina.
Por ltimo, dentro de la misma lnea, Brown, Gregoski, Tingen Barnes, y
Treiber (2011) realizaron una comparacin entre tres tipos de intervenciones, entre
ellas la BAM, mencionada anteriormente, un Entrenamiento en Habilidades para
la Vida (LS) y una Intervencin de Educacin en Salud (HE), llevadas a cabo en
un grupo de estudiantes afroamericanos de 9 grado. Brown et al. (2011) evaluaron el grado de hostilidad y la presin arterial ambulatoria en los tres grupos de
alumnos, obteniendo que los participantes de la BAM disminuyeron significativamente sus niveles de hostilidad y la presin arterial una vez finalizada la
intervencin. Sin embargo, este resultado no se mantuvo a los tres meses de
seguimiento. Los resultados indicaron que las disminuciones en la hostilidad se
relacionaron significativamente con disminuciones en las medidas hemodinmicas
en el grupo BAM y HE, en ambos momentos. No obstante, la HE y LS no
lograron provocar cambios significativos ni entre la pre y postintervencin, ni de
la postintervencin al seguimiento, a excepcin del grupo LS que present
disminuciones significativas en la hostilidad desde el trmino de la intervencin
al seguimiento.
Los tres estudios recin expuestos logran demostrar los efectos beneficiosos de
la meditacin basada en la respiracin en el funcionamiento cardiovascular y el
manejo de sodio, tanto en adolescentes normotensivos y como en afroamericanos
con riesgo de desarrollar hipertensin.
Por otro lado, en Australia se llev a cabo un estudio piloto (Bei et al.,
2013) que busc desarrollar un mtodo prctico a travs de un programa
basado en mindfulness para mejorar el sueo. Para ello intervinieron a adolescentes de entre 13 y 15 aos que autoreportaron tener una calidad del sueo
pobre, en un colegio privado de mujeres. Despus de la intervencin, se
observaron mejoras en la calidad del sueo objetivo y subjetivo, siendo la
latencia del comienzo del sueo la variable que present mayores mejoras. A
travs de la actigrafa un monitor de mueca que mide actividad fsica y que
es usado para evaluar los patrones de despertar se concluy que hubo
disminuciones moderadas en la latencia del comienzo del sueo y aumento
de la eficiencia del sueo en las alumnas, adems de mejoras pequeas en el
tiempo total de sueo. En promedio, las alumnas se durmieron 30 minutos
antes y despertaron 40 minutos antes en las maanas, despus de la
intervencin. La calidad de sueo subjetiva mejor moderadamente, con altas
disminuciones en la latencia del comienzo del sueo y aumento de la calidad
del sueo, y bajas en la disfuncin subjetiva del sueo. Los autores no
observaron disminuciones importantes en los niveles de ansiedad, sin embargo,
565
encontraron mejoras significativas en la subescala de ansiedad de separacin y

de pnico/agorafobia de la Escala de Ansiedad Infantil de Spence (SCAS).
Discusin
Prevenir los problemas de salud mental y promover el bienestar psicolgico de los
jvenes y adolescentes en sus contextos naturales (como son los establecimientos
educativos), mejorando as el acceso a la intervencin, son lneas de accin
sugeridas como prioritarias por los organismos de salud internacionales (e.g.,
OPS, 2010). Las intervenciones basadas en mindfulness han demostrado resultados promisorios en esta direccin (Garrison Institute, 2005).
En este sentido, todas las intervenciones que midieron la factibilidad de aplicar
mindfulness en las escuelas, mediante medidas cualitativas y cuantitativas, concluyen que este tipo de meditacin es bien recibida por los adolescentes, demostrando bajas tasas de desercin (Moseley & Gradisar, 2009) y diversos cambios
subjetivos relacionados con la reduccin de estados emocionales perturbadores, el
aprecio por las relaciones humanas y la percepcin de empoderamiento personal
(Lau & Hue, 2011).
Por su lado, Broderick y Metz (2009) y Raes et al. (2013) sugieren que la
intervencin universal puede tener ms impacto en la salud mental de los adolescentes que programas focalizados en adolescentes en riesgo de tener problemas
mentales o con desarrollo de un trastorno mental, ya que alcanza a una mayor
cantidad de poblacin y con objetivos de deteccin temprana, prevencin de
problemas y promocin de la salud y bienestar psicolgico, no solamente tratamiento o recuperacin.
En este escenario, los resultados obtenidos en la revisin de los trabajos
analizados, permiten sugerir que mindfulness es una intervencin con suficiente
respaldo emprico como estrategia de prevencin en diversos trastornos mentales,
especficamente mediante la disminucin de sntomas depresivos, o ansiosos, o la
mejora del autoconcepto, entre otros. Esto ampla, el repertorio de estrategias que
hasta el momento han mostrado su eficacia en la prevencin (tanto universal como
selectiva o especfica) de patologas que se pueden iniciar en la infancia o
adolescencia como la depresin (ver Martnez et al., 2010). Sin embargo, muchos
de los estudios presentaron una serie de limitaciones metodolgicas que restringen, en parte, la robustez de sus resultados.
Entre ellos la ms importante es la ausencia de grupo control (e.g.,
Beauchemin, Hutchin, & Patterson (2008) y la no aleatorizacin en la
asignacin de las muestras a grupo control. (e.g., Huppert & Johnson, 2010). El
grupo control, en la mayor parte de los estudios, adems, no recibi un componente activo que permitiera comparar los resultados del mindfulness con otro tipo
de intervencin, para saber ms sobre los mecanismos de cambio de este tipo de
meditacin (e.g., Soriano & Franco, 2010).
En relacin a los participantes, en la mayora de los estudios se utilizaron
muestras pequeas y homogneas (mismo sexo o mismo tipo de establecimiento
escolar) (e.g., Bei et al., 2013 y Barnes et al., 2004, respectivamente). Otra
566
. I. Langer et al.
limitacin metodolgica es que no fueron estudiados los componentes de los

programas que fueron relacionados con los resultados, lo que impide conocer
los mecanismos de accin del mindfulness a travs de estos estudios. Por otro
lado, solo tres trabajos presentaron medidas de seguimiento, sin embargo, no hay
antecedentes, sobre si los resultados se mantienen en el tiempo despus de uno o
dos aos una vez finalizada la intervencin.
En relacin a los instrumentos utilizados, en algunos de los estudios no
estaban adaptados para la poblacin adolescente, sino que eran instrumentos
desarrollados y validados en adultos, adems, la mayora de las investigaciones
no complementaron las medidas de autoreporte con medidas fisiolgicas.
Algunas recomendaciones para futuras investigaciones en el rea, apuntan a
mejorar las limitaciones de estudios previos mediante: la utilizacin de muestras
ms grandes y heterogneas (en sexo, clase social, etnicidad) para determinar si
definitivamente la eficacia del tratamiento interacta con caractersticas de la
muestra; aleatorizacin de los establecimientos escolares y de la distribucin de
las muestras a grupo experimental y control; el uso de grupo de control con
intervencin placebo de igual duracin (psicoeducacin o algn mtodo de
relajacin) para comparar la eficacia de distintas tcnicas.
Tambin es recomendable ampliar y mejorar la aplicacin de instrumentos
mediante el uso de: medidas adaptadas y validadas en adolescentes; mediciones
de resultado y tambin de proceso; medidas objetivas como el rendimiento
acadmico o desempeo en tests de atencin, y no solamente de autorreporte;
reportes de compaeros, observadores, profesores y/o familiares; mtodos
psicomtricos ms fuertes como la entrevista clnica (Raes et al., 2013) o uso de
anlisis cualitativos ms complejos. Adems, medidas fisiolgicas en el ambiente
natural de los individuos aumentan la validez ecolgica de los estudios.
Franco, Maas et al., (2011) proponen tambin, aislar los efectos diferenciales
de la meditacin ms claramente, es decir, no solo entre variables, sino tambin
entre las dimensiones de una misma variable, y examinar los efectos de los
distintos componentes del programa de meditacin, separando las que son responsables del cambio, de las que no lo son.
Con respecto a las intervenciones, Lau y Hue (2011) plantean que los programas llevados a cabo con adolescentes en colegios, debieran durar entre 10 y 12
sesiones de menos de una hora cada uno, con mayor cantidad de prctica en casa
o sesiones de refuerzo, que debieran incorporarse al currculum regular del
establecimiento educacional, es decir, no como actividad extracurricular, y que
debieran ser ofrecidos por los mismos profesores (para evitar posibles problemas
de rapport), lo que implicara entrenar a los docentes y realizar un manual para
ellos. Para ello sera necesario tambin investigar las habilidades que necesitaran
los profesores para aplicar el programa dentro de las clases (Broderick & Metz,
2009) y adaptar los programas de meditacin al ambiente educacional, con metas
precisas para estas poblaciones o para la temtica que se desea trabajar (Franco, de
la Fuente et al., 2011). Al respecto, el estudio de Bei et al. (2013) nos da luces de
que un enfoque teraputico multicomponente no es recomendable, ya que no se
revela adecuadamente en los resultados cul es el componente ms efectivo, por lo
567
que recomiendan apuntar con programas distintos a procesos distintos, aunque

stos estn relacionados, en su caso, el sueo y la ansiedad.
Por ltimo, en cuanto a esta propia revisin sistemtica, el hecho de incorporar
estudios con una heterogeneidad de metodologas y de rigurosidad cientfica,
puede constituirse en una limitacin a tener en cuenta a la hora de extrapolar
los resultados.
En sntesis, considerando los resultados en su conjunto, mindfulness es un
modelo de intervencin, viable y con suficiente evidencia emprica para avalar la
efectividad de su aplicacin en las escuelas, ya sea como actividad extraprogramtica o dentro del currculo escolar. Su implementacin puede producir
cambios significativos en diversas variables (e.g., psicolgicas, psicosociales y
fisiolgicas), situndola como una estrategia altamente recomendable para la
prevencin y promocin de la salud mental. Futuras investigaciones deben intentar responder a las limitaciones que hasta el momento se observan en los estudios
analizados en esta revisin y de esta forma enriquecer el modelo de intervencin.
Un llamado especial constituye realizar estudios en Latinoamrica y el Caribe que
respondan a las realidades locales, aportando a una lnea de investigacin en
amplio desarrollo.
Acknowledgements / Agradecimientos
This work was funded by the Chilean National Fund for Scientific and Technological
Development, CONICYT/PAI, Apoyo al Retorno de Investigadores desde el Extranjero,
Project N 82130055 and supported by the Fund for Innovation and Competitiveness
(FIC) of the Chilean Ministry of Economy, Development and Tourism, through the
Millennium Scientific Initiative, Grant N IS130005. / Este estudio cont con el financiamiento del Fondo Nacional de Chile de Desarrollo Cientfico y Tecnolgico,
CONICYT/PAI, Apoyo al Retorno de Investigadores desde el Extranjero, Proyecto N
82130055 y apoyado por el Fondo para la Innovacin y la Competitividad (FIC) del
Ministerio chileno de Economa, Fomento y Turismo, a travs de la Iniciativa Cientfica
Milenio, Grant N IS130005.
Disclosure statement
No potential conflict of interest was reported by the authors. / Los autores no han referido
ningn potencial conflicto de inters en relacin con este artculo.
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Mindfulness Based Interventions in Secondary Education A Qualitative Systematic Review Intervenciones Basadas en Mindfulness en Educaci N Secundaria

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Date: 05 September 2016, At: 03:08

Estudios de Psicologa / Studies in Psychology, 2015

Mindfulness-based interventions in secondary education:

Pontificia Universidad Catlica de Chile; bUniversidad del Desarrollo; cUniversidad

English version: pp. 533550 / Versin en espaol: pp. 551567

mediano y largo plazo, sumada a una mnima evaluacin de los mecanismos

Mindfulness in schools / Mindfulness en las escuelas

Number of citations identified in the

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Total number of complete text articles

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Total number of studies included in the

included: programmes that complemented mindfulness meditation with other

1st MBSR exercise: Daily sessions each

Table 1. Characteristics of the studies included in the systematic review.

Effect size * or statistical

Mindfulness in schools / Mindfulness en las escuelas

Effect size * or statistical

Meditation for the 10 min each day

Effect size * or statistical

Mindfulness in schools / Mindfulness en las escuelas

Controlled design. - BV-TPC

Effect size * or statistical

Controlled design. - AURE

Lau & Hue

Four classes per

Six sessions lasting

Effect size * or statistical

Mindfulness in schools / Mindfulness en las escuelas

MBSR and MBCT Eight sessions

Learning to Breathe 18 lessons lasting

Controlled design. - DASS-21

Effect size * or statistical

Controlled design. - RSS

Effect size * or statistical

Mindfulness in schools / Mindfulness en las escuelas

Effects on emotional variables

Mindfulness in schools / Mindfulness en las escuelas

reduction in somatic symptoms compared to students in the control group,

Effects on psychosocial variables

significant differences between the control and experimental group, specifically,

Mindfulness in schools / Mindfulness en las escuelas

Effects on physiological variables

intervention, improvements were seen in objective and subjective quality of sleep,

Mindfulness in schools / Mindfulness en las escuelas

Mindfulness in schools / Mindfulness en las escuelas

Intervenciones basadas en mindfulness en educacin secundaria:

intervencin efectiva para el tratamiento de diversos problemas de salud mental,

Mindfulness in schools / Mindfulness en las escuelas

Mindfulness *school (colegios o educacin)

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