Background and Purpose: Adolescence is recognized as one of the most challenging periods of life, and the need to implement effective interventions in this group is very necessary.. The Learning to BREATHE (L2B) curriculum is a new and promising school-based intervention for adolescents, yet a comprehensive systematic review of randomized controlled trials (RCTs) on its efficacy has not so far been conducted. Thus, this study aimed to systematically review RCTs concerning the effectiveness of the L2B on psychological outcomes in adolescents aged 12 to 19, including depression, anxiety, stress, emotion, compassion, resilience, cognitive functions, social support, and life satisfaction.
Method: This systematic review was conducted using keywords such as "Learning to BREATHE," "mindfulness," "adolescen*," "randomized controlled trial," "depression," "anxiety," "stress," "emotion," "compassion," "resilience," "cognitive functions," "social support," and "life satisfaction" across the following databases: PubMed, PsycInfo, Google Scholar, ProQuest, and Scopus (from January 2009 to July 2025). Initially, 490 studies were retrieved based on inclusion criteria. After applying exclusion criteria and assessing quality according to the PRISMA guidelines, 14 studies remained for full analysis. Due to heterogeneity among the studies, data were synthesized and described using a narrative synthesis approach.
Results: The systematic review of 14 RCTs involving 1,314 adolescents indicated that the L2B demonstrates favorable effectiveness in several domains. The curriculum was significantly effective (p < 0.05) in reducing symptoms of depression and anxiety (with effect sizes ranging from g = -0.34 to g = -1.26), and showed substantial efficacy in mitigating perceived stress (g = -0.80). Conversely, results for variables such as self-compassion, resilience, executive functions, and social support were inconsistent across studies. Notably, despite the nature of the intervention, no significant effects were reported for mindfulness, acceptance, or academic performance (including grades and school attendance) (p > 0.05).
Conclusion: The findings of this review suggest that the L2B can be effective in improving key components of adolescent mental health, such as depression, anxiety, and stress. However, further research is required to explore its impact on variables like mindfulness, which serves as the theoretical foundation of the intervention. |
