Mindfulness Interventions for ADHD
Yuanyuan Jiang, PhD, CPsych
Attention Magazine August 2023
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Do mindfulness interventions improve challenges associated with ADHD? Mindfulness involves focusing on the current moment nonjudgmentally. Mindfulness interventions involve enhancing present-moment awareness with the goal of strengthening attention and self-regulation. This research update covers two recent studies that investigated the outcomes of mindfulness-based interventions.
The first study is a review of randomized controlled trials of treatments involving mindfulness for children and adolescents with ADHD. Their findings indicate that such interventions may have significant effects in decreasing ADHD symptoms and improving mindfulness abilities. However, there appeared to be limited effects of these interventions on other psychological difficulties involving mood and oppositionality.
The second study compared the outcomes of children with ADHD involved in intensive behavior treatment with and without a mindfulness component. Results from this study suggest no additional benefit of intensive behavior therapy with a mindfulness component over intensive behavior therapy alone.
Taken together, although there is some support for the positive effects of mindfulness-based interventions, there appears to be little evidence for its unique benefits when compared with intensive behavior therapy.
Mindfulness-based interventions for children and teens with ADHD
This review examined research on mindfulness interventions for youth with ADHD between the ages of five and eighteen. Twelve randomized controlled trials of such interventions were reviewed. Studies were conducted in a number of countries: Romania, Australia, Hong Kong, Italy, Spain, Iran, the Netherlands, and the United States.
There were three types of interventions involving mindfulness used in these studies: meditation training, mindfulness-based psychological treatment, and yoga interventions. Meditation training involved paying sustained attention to a point of focus. Mindfulness-based psychological treatment involved psychological intervention that included mindfulness components, and yoga interventions involved mindful movement through yoga poses. Five of the studies involved mindfulness training not only with youth but also with their parents. In addition to the interventions themselves involving mindfulness, participants were encouraged to undertake homework involving mindfulness programs.
The findings of this review suggest that these interventions were able to reduce ADHD symptoms as well as improve mindfulness. Older children and adolescents appeared to have greater benefits to ADHD symptoms from such interventions, compared to younger children. However, there was less evidence for mindfulness-based interventions in decreasing internalizing symptoms, such as mood difficulties, and externalizing behaviors, such as oppositionality. In addition, the positive effects of these interventions became limited at one to six months after the intervention. This tapering of effects may be due to less home practice of mindfulness exercises, which had been a key component during the interventions.
Overall, this review provides support for the effects of mindfulness-based interventions in reducing ADHD symptoms and improving mindfulness for youth with ADHD. However, only twelve studies were available to be reviewed, and future studies in this area are necessary.
Lee YC, Chen CR, & Lin KC. (2022). Effects of mindfulness-based interventions in children and adolescents with ADHD: A systematic review and meta-analysis of Randomized Controlled Trials. International Journal of Environmental Research and Public Health, 19, 1-15. https://doi.org/10.3390/ijerph192215198
Mindfulness as an adjunct to behavior modification
This study examined mindfulness-based therapy as an added intervention along with intensive behavior treatment. Fifty-eight children with ADHD aged seven to twelve participated in an eight-week summer treatment program, involving nine hours of behavior modification every weekday for eight weeks. This program involved behavior modification that teaches children appropriate behaviors in classroom and recreational settings.
Children were randomly assigned to either intensive behavior intervention or the behavior intervention with a mindfulness component, in which they participated in a twenty-minute mindfulness session three to four times a week for six weeks. This mindfulness session involved mindfulness activities such as mindful movement, mindful breathing, and sensory awareness. The outcomes examined included: (1) observations of children’s behavior in following rules and their verbalizations with staff and peers, (2) tasks that measure components of executive functioning, involving flexible thinking, working memory, and ability to inhibit attention, and (3) parent and child ratings of the child’s mindful awareness.
Findings showed that compared with the intensive behavior intervention from the summer treatment program, treatment with mindfulness was not associated with more positive outcomes in terms of observed behavior of the child, executive functioning tasks, and parent and child ratings of the mindfulness of the child.
All in all, this research suggests that mindfulness interventions may not have unique benefits beyond intensive behavior modification. However, it is necessary for future studies to examine these questions with a larger sample of children.
Ramos MC, Macphee FL, Merrill BM, Altszuler AR, Raiker JS, Gnagy EM, … & Pelham Jr, WE. (2022). Mindfulness as an adjunct to behavior modification for elementary-aged children with ADHD. Research on Child and Adolescent Psychopathology, 50, 1573-1588. https://doi.org/10.1007/s10802-022-00947-9
Yuanyuan Jiang, PhD, CPsych, is an assistant professor in the school of counselling, psychotherapy, and spirituality at Saint Paul University, and an adjunct professor in educational psychology at the University of Alberta. She directs the Attention, Behaviour, and Cognitions (ABC) Lab, which focuses on studying how attention, behavior, and cognitions interact to improve assessments and interventions for children with inattentiveness and/or hyperactivity/impulsivity.
Other Articles in this Edition
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Mindfulness Interventions for ADHD
ADHD in the Classroom: Simple Strategies & Principles
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