Potential Pitfalls of Using Mindfulness With Youth

Using Mindfulness with youth is very popular these days, and with good reason. Slowing down to be in the moment has many well-documented benefits. It has grown from a meditation practice for adults, to being widely promoted for children and youth in schools and therapy settings. However, in our enthusiasm for this practice, are we ignoring its potential risks and hazards when it comes to working with youth?

In my consulting work with youth support workers, I’ve taught Dialectical Behaviour Therapy for Adolescents, which is a well-respected program that emphasizes mindfulness as the core skill. I had already added cautions about the use of imaginative and meditative practices with traumatized youth. But a recent debate in the Journal of Child and Adolescent Mental Health alerted me to a broader concern: Our enthusiasm for mindfulness with youth may not be well-founded.

An online search for mindfulness and youth finds many articles, books, and blogs, all extolling its value with few cautions. Even when the subject is high-risk youth, little or no mention is made of potential psychological harm. Yet there are good reasons to be mindful of how we use mindfulness with youth.

Our enthusiasm for mindfulness in youth may not be well-founded.

What are the potential pitfalls of using mindfulness with youth?

It may be ineffective.

• In 2022, a review of studies looking at mindfulness in children and youth found that the results were inconsistent. While there was some benefit for anxiety and stress, there was no evidence that well-being was improved.
• Youth can find it difficult to engage in mindfulness. They have reported finding mindfulness boring, feeling they “had to” do it, thinking it was a waste of time, and preferring to do something else.

It may cause harm.

• MYRIAD is a recent large study of school-based mindfulness training (SBMT). The findings were that mindfulness failed to improve the mental health of children and might have had harmful effects on those who were at risk of mental health problems.
• In a 2017 study, students under age 21 reported a number of dissociative symptoms such as feeling numb, detached, or as if they were floating, and that their heart was beating too fast or self-talk was racing.
• Much of the focus in mindfulness is on meditative practices. But meditation may aggravate trauma by asking someone to pay close attention to their internal experience. This could intensify the thoughts, images, and sensations of their trauma.

The research may not be entirely reliable.

• There may be a bias to report positive research findings, and neglect of reporting of adverse effects.
• Despite evidence of potential adverse effects dating back to the 1970s, it appears these have been largely overlooked.
• Many studies are small and cannot be generalized. For example, an investigation of meditation and exercise for youth with ADHD looks promising, but it only studied 16 white male youth.

Mindfulness was not originally developed as therapy, but as a way to achieve an altered state of mind.

What does this mean for supporting youth in your practice?

Watch out for assuming that any therapy is universally good.

In my previous work as a nurse, I was taught that every medication has adverse effects, and it is important to assess the individual risks and benefits of any treatment.

If we applied this same awareness to our therapeutic practice, we would be intentional about assessing the potential risks vs benefits of mindfulness for individual youth. Keep in mind that mindfulness was not originally developed as therapy, but as a way to achieve an altered state of mind, which could be contraindicated for some individuals.

What works for adults doesn’t necessarily work for children and youth.

Asking children and youth to sit still and meditate doesn’t consider their development stage. Rather, it is important to use age-appropriate methods. These could include any creative activity that requires focus and concentration. For example, arts-based mindfulness or movement therapies may be more suited to young people. Youth should also have the choice of whether to engage in mindfulness.

Be cautious about simplistic understandings of therapeutic practices.

Mindfulness is often put forward in a simplistic way, as exercise for the brain – as if resilience were a muscle to be developed. This “gym model of the mind” can lead to using misguided or inappropriate forms of mindfulness. For example, imagining one’s safe place is one “brain gym” exercise that might be great for some people but harmful if their safe place is in the afterlife.

While meditation is ill advised for traumatized youth, mindfulness is more than meditation.

Don’t throw out the baby with the bathwater.

Despite these cautions, it isn’t necessary to eliminate mindfulness from your practice with youth. While meditation is ill advised for traumatized youth, mindfulness is more than meditation. Going for a walk, breathing, yoga, cooking, and similar activities can all be part of mindfulness practice. I have found that providing colouring pages during workshops helps people to stay grounded and present. Our Mindfulness Counselling Strategies workshop provides a wide variety of skills for mindful awareness.

Mindfulness may indeed be a valuable tool for children and youth. However, this is not entirely clear from the research to date, and it is certainly not a one-size-fits-all. Greater understanding is needed of its application to specific age and developmental groups as well as potential risks for youth mental health concerns.

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