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Ted Talk - teacher perspective of the benefit of mindfulness

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Ted Talk - teacher perspective of the benefit of mindfulness

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Mindfulness in Education, Learning from the Inside Out: Amy Burke at TEDxAmsterdamED 2013

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Why Mindfulness Should Be Just As Important As Math in Our Schools

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Jennifer Grace, author of the book, Directing Your Destiny, advocates for teaching meditation and mindfulness in schools.

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4 Ways to Cultivate Mindfulness in the Classroom

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When is the last time you did absolutely nothing for 10 whole minutes? Not texting, talking or even thinking? Mindfulness expert Andy Puddicombe describes the transformative power of doing just that: Refreshing your mind for 10 minutes a day, simply by being mindful and experiencing the present moment. (No need for incense or sitting in uncomfortable positions.)

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The Landscape of Mindfulness and Meditation in Adult Education: A Partial Prescription (and Critique) for Lifelong Learning and Well-Being

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The Landscape of Mindfulness and Meditation in Adult Education: A Partial Prescription (and Critique) for Lifelong Learning and Well-Being

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"Mindfulness Ιn Everyday Life" Jon Kabat Zinn with Oprah Winfrey

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Link to how Barnsley College encourage mindfulness

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Apps and Websites

Bubble Breathing

Breathing is important, we do it each day unconsciously. Focusing on breathing can be slow down our breathing and help us relax. Start off slow and then building up your practice can be a great way of developing your mindfulness skill. A minute of deep, controlled breathing a day can help you manage stress, anxiety and creates a calmer sense of self. Calm have created a Bubble Breathing exercise, why not give it a go?

Gratitude and Self-Care

When winding down and getting ready for bed, think of five things that you have been grateful for during the day.
Keeping aware of your gratitude is a great way at helping to maintain a positive outset. Why not use our Gratitude Journal to help you track your feelings.

Another way you could keep aware of your gratitude is through scrapbooking. Here is a guide to scrapbooking to help you get started.

It is important to keep looking after yourself, why not try our self-care checklist. You can do this weekly to keep track of the care you are giving to yourself. There is also a self-help workbook to work through.

Mindfulness Resources

Why not try a 10 minute mindfulness session, created by Calm.
If you have some time, why not try this 30 minute body scan.
Join us on a virtual mindfulness walk. This was filmed following COVID-19 guidelines at Longshaw Estate, Padley Gorge.
The little book of Mindfulness
Mindful colouring book

Meditation Session

Take some time to reset your body and mind with this 10 minute Headspace session.
Take a look at this 15 minute guided meditation session to help find peace in uncertain times.
Learn more about meditation with the Netflix series: Headspace Guide to Meditation.
Try a new 10 minute guided meditation session, fill your day full of gratitude and relaxation through meditation techniques.
Are you feeling stressed or overwhelmed? Why not try this 10 minute meditation session designed to reduce stress.

Weekly Meditations

Join our weekly meditations and spend time practicing your mindfulness and meditation techniques.
Every Tuesday 12.30pm-13.00pm.
Email: HWBC@barnsley.ac.uk to book a place.
The workshop is currently virtual.

Journaling

Write down your thoughts and feelings to create a journal. It is a good way to help you gain control of your emotions and improve your mental health. As well as journaling, why not try scrapbooking?

The Sanctuary

If you're feeling anxious, stressed, like you need to take time out, visit The Sanctuary in the Health and Wellbeing Centre, Old Mill Lane Campus. The Sanctuary is a safe space with sensory aids such as fidget toys, stress balls and weighted neck wraps to help you relax and recuperate.

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Breathing is important, we do it each day unconsciously. Focusing on breathing can be slow down our breathing and help us relax. Start off slow and then building up your practice can be a great way of developing your mindfulness skill.

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Powerful Video about Mindfulness in Schools

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how beneficial is mindfulness for teachers

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how beneficial is mindfulness for teachers

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Journal article on Promoting mental health and wellbeing in schools

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The methodology outlined in this protocol follows a similar procedure to that of the AWARE trial [ 48] in relation to recruitment strategy and the economic evaluation. Both the INSPIRE trial (which this paper describes) and the AWARE trial are being conducted by the same team as part of a wider programme. The Additional file 1 provides an overview of enrollment, intervention and assessment timelines for INSPIRE.

Design

INSPIRE (INterventions in Schools for Promoting Wellbeing: Research in Education) is a four-arm cluster RCT including three intervention conditions (Mindfulness Practices, Relaxation and SSW) and one wait-list control (Usual Provision).

Interventions are delivered to whole school classes as part of the school curriculum. Assessment is undertaken at baseline (prior to intervention randomisation), and then 3-6 months and 9-12 months after interventions have been delivered. Figure 1 outlines a Consolidated Standards of Reporting Trials (CONSORT) Diagram showing the overall trial design.

Consolidate Standards of Reporting Trials (CONSORT) diagram

Site recruitment

Recruitment of schools began in March 2018 and will close in July 2019. Based on specification from the Department for Education, this study aims to recruit Year-7 and Year-8 pupils (aged 11-13 years) in 64 secondary schools and Year-4 and -5 pupils (aged 8-10 years) in 160 primary schools across England. Within each secondary school, three Year-7 and three Year-8 classes will be required to take part. Primary schools will work with up to four classes (minimum one Year-4 and one Year-5 class).

Schools will be recruited via a range of different networks and mailing lists, including bought data on English schools (school mailings), the Schools in Mind network hosted by the Anna Freud National Centre for Children and Families (AFNCCF), AFNCCF associates and collaborators, the National Institute for Health Research, Public Health England, school commissioners and local authority leads. The project will also be advertised in education publications and on various social media platforms.

Incentives for schools to take part, include:

£1000 remuneration in recognition of administrative commitments

The opportunity to introduce whole-class mental health and wellbeing interventions with support from leading experts in child mental health

The chance to receive free mental health and wellbeing training for selected school staff

An evaluation feedback report for your school

Contributing to the wider evidence base on what works for school-based mental health support and how it can best be delivered

A letter of thanks from the Department for Education acknowledging the school's important role in this project

Participant recruitment

Following recruitment of schools, participants in relevant year groups are recruited in two stages. Schools first select delivery groups in each year who will receive an intervention (if allocated). Following this, schools send letters to parents/carers of pupils in these delivery groups. The letter provides information about the study and explains parents/carers' right to opt their child out of the evaluation. The letter also explains that pupils will only be involved in the study if they assent online before completing the baseline survey. Finally, young people must assent by reading through an online information sheet and ticking boxes agreeing to take part. If they do not assent, they cannot be part of the trial. The first young person joined the trial on the 17 September 2018.

Inclusion/exclusion criteria

Schools are eligible to participate if:

1. 1.
They are a primary school (state-funded/academy/independent) willing to deliver an intervention to one or two Year-4 classes, and one or two Year-5 classes in their school

2. 2.
They are a secondary school (state-funded/academy/independent) willing to deliver an intervention to three Year-7 classes and three Year-8 classes in their school

3. 3.
They are willing to be allocated to Mindfulness Practices, Relaxation, SSW or continue with usual provision

4. 4.
They are willing to allocate 5 min per day for young people to practise these skills for the spring term if allocated to Mindfulness Practices or Relaxation

5. 5.
They are willing to allocate eight 40-min lessons to deliver the programme over the spring term if allocated to SSW

6. 6.
They are able to send staff to a regional training session, if required

Young people are eligible to take part if:

Schools are not eligible to take part if:

1. 1.
They are a non-mainstream specialist school (e.g., pupil referral unit)

2. 2.
They are unable to commit to the study requirements above

3. 3.
They are already taking part in similar trials (e.g., MYRIAD [ 30])

4. 4.
They are outside of England

Young people are not eligible to take part if:

1. 1.
Their parents do not provide consent for them to take part

2. 2.
They do not assent to take part

3. 3.
They are not in specified year groups

While privately funded schools are invited to express interest in the project, they will only form < 2% of the total sample. Single-sex schools are also eligible to take part but will be limited to < 5% of the sample.

Interventions

Across the active arms of the trial, schools are required to select staff to attend and deliver the interventions. There are no criteria for this role and this can include, but is not limited to: teachers, senior school leaders, teaching assistants, or special educational needs coordinators (SENDCos).

Each of the interventions was developed by a group of experts, consisting of psychologists, researchers, the Programme Director of Mental Health and Wellbeing Schools and a Headteacher Quality Assurance Panel. Teachers who delivered interventions as part of the pilot [ 24] also provided feedback which was incorporated into interventions delivered in the full trial. Logic models for the interventions are found in the Additional files 2 and 3.

Mindfulness Practices

This Mindfulness intervention was developed for the trial by the AFNCCF Schools Programme (lead developer: Dr. Rina Bajaj). It is based on the concept of mindfulness as defined by Kabat-Zinn: 'paying attention in a particular way: on purpose, in the present moment, and non-judgmentally' [ 32], and draws on a number of existing mindfulness models including the RAIN approach [ 49] and the two-component model of mindfulness [ 50]. The Mindfulness intervention consists of mindful breathing exercises and other activities focussed on self-awareness of sensations, emotions and thoughts. The exercises are divided into three types: (1) those focussing on the mind; (2) those focussing on the body; (3) those focussing on the world.

School staff complete a half-day face-to-face training course delivered by two AFNCCF professionals that focusses on practising mindfulness exercises. A mindfulness manual - either a primary or secondary school-specific version - is provided. Both manuals contain 21 different activities, as well as suggestions for recommended apps and interactive online games. Mindfulness is delivered to school classes in classrooms for around 5 min each school day at a time chosen by the deliverer, from January to April in the first instance, and this is the period in which implementation is monitored. However, schools are encouraged to continue to practice for 1 year.

Relaxation

This Relaxation intervention was also developed for the trial by the AFNCCF Schools Programme (lead developer: Dr. Rina Bajaj). The intervention consists of relaxation exercises focussing on two main themes: (1) deep breathing and (2) progressive muscle relaxation. School staff complete a half-day face-to-face training course focussing on experiential exercises, delivered by AFNCCF professionals. Manuals containing 20 different activities are provided (primary and secondary school versions). These manuals also include recommendations of apps, videos and interactive online games.

Similar to the Mindfulness model, relaxation exercises are delivered in classes for around 5 min each school day, at a time chosen by the deliverer. School staff alternate every week between deep breathing and progressive muscle relaxation activities. Relaxation is delivered to school classes in classrooms from January to April in the first instance, as this is the period in which implementation is monitored. However, schools are encouraged to continue to practise for 1 year.

Strategies for Safety and Wellbeing

SSW was also developed by the AFNCCF schools programme (lead developer: Dr. Rina Bajaj), who consulted with experts in PB interventions. School staff complete a half-day face-to-face training course with the lead developer. The training focusses on covering the psychoeducational content of an 8-week session plan with lessons adapted for primary or secondary school pupils. The eight sessions are as follows:

1. 1.
It is safe to talk about mental health

2. 2.
You are never too young to talk mental health (primary schools)/We all have mental health (secondary schools)

3. 4.
Early warning signs - noticing our bodies

4. 5.
Early warning signs - noticing our feelings and thoughts

5. 6.
Developing our safety networks

6. 8.
Safe ways of managing emotions

Each session lasts for approximately 40 min and is delivered once a week for 8 weeks.

Usual Practice

Schools allocated to the Usual Practice group are not required to deliver a specific mental health intervention during the programme (June 2018 to January 2021), but may already do so as part of their usual whole-school provision around mental health. All participating schools will complete the Usual Provision Survey at the end of the project (second follow-up) so we are able to track changes in mental health and wellbeing provision. At the end of the project, schools in the Usual Practice arm will select from a suite of training available at the AFNCCF and send up to six staff members on their chosen training.

Study measures

The following measures will be completed prior to the intervention and follow-up will take place at 3-6 and 9-12 months post intervention. All questionnaires will be completed online.

Pupils

Primary outcome measures

For Mindfulness Practices and Relaxation, the primary outcome measure is internalising difficulties as measured by the Short Mood and Feelings Questionnaire (SMFQ) [ 51]

For SSW the primary outcome measure is intended help-seeking, as measured by the General Help-Seeking Questionnaire (GHSQ) [ 52]

Secondary outcome measures

The secondary outcome measures across all interventions include:

Mental health first aid [ 53]

Paediatric Quality of Life (Child Health Utility-9D; CHU9D) [ 54]

Positive wellbeing: Huebner Life Satisfaction Scale (LSS) [ 55]

In addition, secondary school pupils will be asked further questions:

Stigma (knowledge): Mental Health Knowledge Schedule (MAKS) [ 56]

Stigma (behaviour): Reported and Intended Behaviour Scale (RIBS) [ 57]

Stigma (attitudes): Attitudes towards mental health [ 58]

Behavioural problems: Me & My Feelings questionnaire [ 59]

Support from school staff: Student Resilience Survey (SRS) School Connection subscale [ 60] ¹

School staff

Similar to pupils, school staff participating in the project (those who are nominated by the school to deliver the intervention) will complete measures around mental health literacy [ 61, 62, 63, 64, 65] prior to the intervention. Follow-up will take place at 3-6 and 9-12 months post intervention and all questionnaires will be completed online.

Measures for economic evaluation

As part of the assessment, pupils will complete:

In addition to this, school staff delivering the interventions and school finance officers will provide the following data informing the calculation of an intervention cost: time spent preparing and delivering the intervention, staff member salary band, staff member full-time equivalent working hours, staff member pension contributions and national insurance contributions as a percent of their annual salary, and any other staff overheads.

Implementation and process monitoring measures

Usual Provision Survey

Before intervention delivery, and again 1 year later, a senior leader in each school will be asked to complete a survey online regarding current whole-school mental health provision.

Implementation surveys and outcome measures

School staff that deliver an intervention will complete one online implementation survey per delivery group at the end of the initial delivery period. Questions will cover six key aspects of implementation, namely fidelity, quality, dosage, participant responsiveness, reach and adaptations. Within this, three aspects relating to the social validity of the intervention (acceptability, feasibility and utility) will also be assessed using a standardised questionnaire [ 68]. The survey will also capture other aspects related to dosage and the time of day that the intervention was delivered.

Qualitative data and observations

Qualitative implementation and process data will be collected at two time points. The first time point will take place at mid- to late-implementation of each of the interventions. Twelve schools will be recruited from the main sample as qualitative case study schools; one school per intervention in each of the four areas of England (north west, north east, south west, south east). This will not include Usual Practice schools. Case study schools will be recruited via expression of interest, to maximise the likelihood of engagement with the qualitative research, and sampled based on variation in their usual provision around mental health, drawing on data from two items in the first Usual Provision Survey:

1. 1.
Please identify, in the last 2 years, the activities and approaches that have been used in your school and indicate who has delivered/provided these activities

2. 2.
How significant are the following potential barriers to providing effective

mental health support within your school?

While the case study schools could be selected on multiple bases, these contextual factors are those of particular interest to the trial, in terms of how they could affect the implementation and take-up of the interventions within the schools.

Face-to-face or telephone interviews will be conducted with two to three members of staff (including a school senior leadership team member and a staff member delivering the intervention) and one to two focus groups will be conducted face-to-face with pupils (with approximately four to five pupils in each focus group) at each school. Pupils will be selected via expression of interest, and up to 10 will be invited to participate due to risk of attrition or pupils declining to take part. Learning from the feasibility study [ 24] indicated that this sample size would yield a large amount of rich qualitative data, while still being manageable in terms of the research team's capacity.

The interviews/focus groups will be semi-structured, enabling the research team to guide the conversation according to their topics of interest, while at the same time allowing participants to raise issues around these topics that are pertinent to them. All interviews/focus groups will be audio-recorded and transcribed verbatim.

The topics that the interviews with staff will cover include:

1. 1.
Experiences of delivering the interventions and receiving training to deliver the interventions

2. 2.
Perceptions of the barriers and facilitators to delivery

3. 3.
Perceptions of impact

4. 4.
Suggestions for improvement of the interventions

5. 5.
Barriers and facilitators to the sustainability of the interventions

The topics that the focus groups with pupils will cover include:

1. 1.
Experiences of taking part in the interventions

2. 2.
Perceptions of impact and helpful aspects of the interventions

3. 3.
Suggestions for improvement of the interventions

A session of the intervention at each school will also be observed by the research team to gather contextual information about what the interventions look like on the ground. Field notes will be taken during the observation on the process of delivery, the layout of the room, and the atmosphere during delivery. Individual pupil or staff responses will not be recorded.

The second time point will take place approximately 9-12 months after Time 1. At Time 2, we will conduct approximately five follow-up visits with five of the schools from Time 1 at which, according to implementation monitoring survey data, the interventions have been particularly well embedded to explore long-term impact and facilitators to (ongoing) implementation from staff and pupil perspectives. This will involve face-to-face or telephone interviews with one to two members of staff and one face-to-face focus group with pupils at each school. We will also explore potential barriers to long-term impact and implementation through a telephone interview with a staff member at approximately three schools at which, again according to implementation monitoring survey data, the interventions have not been particularly well embedded.

Furthermore, as schools that express interest in taking part as a case study are likely to be the more engaged schools, at the second time point we will also conduct a small number of telephone interviews with staff at schools that have engaged less with the trial in general. This will allow us to gather data on the barriers that they may have experienced to engaging with the trial and could include schools that have dropped out of the trial.

Randomisation of schools

To ensure approximate distribution across conditions, randomisation will be carried out by Kings Clinical Trials Unit (KCTU). Due to recruitment rates the trial is split into two cohorts. Randomisation of schools will take place in two batches (first cohort: 22 and 23 October 2018; second cohort planned for 21 and 22 October 2019). In both randomisations minimisation will be used to take into account regional representation (four recruitment hubs); deprivation as indicated by free school-meal (FSM) eligibility (tertiles of sample FSM rates); current mental health provision (Mindfulness, Relaxation, Strategies for Safety and Wellbeing, other structured lessons; none); and urban/rural situation of school. Only the statistician, quantitative data analyst and economist are blind to intervention allocation.

Data management

All quantitative data will be stored on the University of Manchester's secure server. The Data Manager (JS), along with the Research Assistants (EA and RM) will be responsible for cleaning and coding the data. Qualitative data (audio files and transcripts) will be stored on the AFNCCF's secure server. The Qualitative Research Lead (ES), supported by the Trials Manager (DH), Research Officer (AM) and Research Assistants (RM and EA), will be responsible for data storage, and checking transcripts and ensuring their accuracy.

Sample size

The trial will be analysed on class-level, controlling for school- and class-level clustering, due to the delivery of the intervention within classes. The design for the current trial is a between-school trial. To increase the efficiency of the design, we will use a single set of control schools as a comparator for all three interventions. The schools will be randomised to four groups (Usual Practice, Mindfulness Practices, SSW, Relaxation); around two to three of the schools in each arm will be primary schools and one to three will be secondary schools to accommodate the different numbers of classes and class sizes within each school type.

While cluster effects of emotional distress on school level are usually small [ 69, 70], no data on class-level clustering were available. To our knowledge, so far no study has looked into school-level intra-class correlations (ICCs) of help-seeking. We conducted a pilot study with N = 2289 students nested within 113 classes within 17 schools and we found ICCs of .05 for the SMFQ and of .03 for the GHSQ (with upper borders of bootstrapped 95% confidence intervals of .12 for the GHSQ and .13 for the SMFQ). The following sample size calculation is based on an ICC of ρ = .15, which is still conservative given the estimates found in the pilot (for a significance level of p = .05 and statistical power of β  = .80).

Pre-test values of the outcome measures will be used as predictors of within-school variance. Since pre- and post-tests tend to be correlated, a conservative estimate of R ² = .20 was used. Since only a small effect due to the intervention is expected, MDES = .20 was selected as the target effect size. On average, we assume primary schools to have two classes (with N = 25 students each) and secondary schools to have six classes ( N = 20 students each). Finally, since the analysis of the primary outcome only compares each active treatment individually against the control arm, no correction of error rates was performed for these pre-planned directed hypotheses [ 71].

Accommodating the setting of a delivery from four different study areas, we aim to recruit 56 schools per arm (40 primary; 16 secondary with six classes each). Given this number of classes, the MDES without controlling for any additional variables in the full sample is MDES = .129 ( MDES  = .190 in primary and MDES = .177 in secondary schools only). Including pre-tests leads to an MDES = .127 for the full sample (and MDES = .186 in primary and MDES = .173 in secondary schools). The statistical analyses will be undertaken by an independent statistician (JB) at the University of Dundee.

Statistical analysis of the primary outcome

A detailed statistical analysis plan will be written prospectively, but the sample size calculation was based on estimating three mixed models, each comparing an active treatment with the control arm. The mixed model will allow for school-level clustering; control for baseline levels in the primary outcome; and the minimisation variables (see above). An intervention will be evaluated as potentially effective if the point estimate of the coefficient for the dummy variable coding the difference between intervention and control arm indicates a group difference in the hypothesised direction for the outcome and the cluster-bootstrapped 95% confidence interval does not include zero. The primary outcome tested for the Mindfulness Practices and Relaxation arms is the SMFQ; and for SSW the primary outcome is the GHSQ; all three at 3-6 months' follow-up. The analysis will be intent-to-treat. This analysis will be undertaken using R [ 72]. The potential impact of missing data will be evaluated in a sensitivity analysis using fully conditional specification [ 73].

Economic evaluation

Service use and costs

A Service Information Schedule will be designed to facilitate micro-costing of the interventions. Information on services and supports used by the young people in the study will be collected using a specially adapted version of the CSRI [ 66]. From these data, we will investigate whether patterns of service use and associated costs differ, and explore whether any differences are driven by individual characteristics or baseline level of need.

Cost-effectiveness analysis

To assess whether the interventions are cost-effective relative to Usual Practice, cost-effectiveness and cost-utility analyses will be undertaken for change in (a) the primary outcome measure for each intervention and (b) quality-adjusted life years (derived from the CHU9D) [ 54]. We will employ an analytical approach that allows for adjustment for confounders, the likely non-normal distribution of cost data, the joint analysis of cost and outcome measures and the potential effects of clustering. Results will be presented as cost-effectiveness acceptability curves [ 74] plotting the probability that the intervention will be considered cost-effective compared to treatment as usual against different levels of willingness to pay for an improvement in outcome. Sensitivity analyses will be undertaken by varying assumptions used to calculate the intervention cost. Potential sub-group analyses will be identified post hoc.

Process and implementation analysis

Descriptive statistics will be used to document usual school provision and how this changes over the course of the project, as well as to document the implementation of Relaxation, Mindfulness Practices and SSW. Additionally, for examining implementation, we will compare 'intervention as delivered' from our survey data with 'intervention as planned'. Where applicable, the latter can be used to determine the proportion of participating schools that can be deemed to have achieved at least a minimum standard of intervention delivery (e.g., 'on treatment' status). To assess the relationship between implementation variability and outcomes, multi-level modelling will be used, in which we fit the implementation data noted above (or on treatment status derived from said data) as explanatory variables at the school or class level, to assess the extent to which they are predictive of intervention outcomes at the pupil level.

Qualitative interviews and focus group transcripts will be analysed using thematic analysis [ 75], using the NVivo version 12 [ 76] data analysis software package. Up to three members of the research team will initially code or assign relevant extracts of the transcripts to broad overarching categories, derived 'top-down' from the research questions (e.g., suggestions for improvement). The researchers will then break down the data (transcript extracts) coded within these overarching categories into themes and subthemes, derived 'bottom-up' from the data. A fourth member of the research team will then re-code 10-20% of the transcripts using the themes and subthemes derived from the data by the other members of the team. The purpose of the latter step is to help the original researchers to refine and reflect on their themes and subthemes, with the additional researcher suggesting edits or additions where necessary.

Patient and public involvement

Young people provided input into the development and refinements of the interventions, including what techniques and activities should be included, as well as input into the design of the booklets. In relation to research, young people provided input into what questions were included in the final questionnaires for young people and will be involved in disseminating reports and findings.

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Promoting mental health and wellbeing in schools: examining Mindfulness, Relaxation and Strategies for Safety and Wellbeing in English primary and secondary schools: study protocol for a multi-school, cluster randomised controlled trial (INSPIRE) - Trials

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Background There are increasing rates of internalising difficulties, particularly anxiety and depression, being reported in children and young people in England. School-based, universal prevention programmes are thought to be one way of helping tackle such difficulties. This protocol describes a four-arm cluster randomised controlled trial, investigating the effectiveness of three different interventions when compared to usual provision, in English primary and secondary pupils.

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Thoughts On Life And Love | Mental Health Therapy

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Mandy Kloppers is a cognitive behavioural psychotherapist with over two decades of experience offering mental health therapy.

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How mindfulness education can help reduce stress in the classroom.

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This video looks at how mindfulness can help new and trainee teachers