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Effectiveness of the learning to BREATHE mindfulness curriculum on adolescent psychological outcomes: a systematic review
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Alireza Eivaznezhad Firouzsalari1    , Mohammad Narimani *2 , Sajjad Basharpoor2 , Seyedeh Maryam Mousavi1 |
1- Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
2- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran |
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Abstract: (1479 Views) |
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. |
Article number: 6 |
| Keywords: Adolescent, Learning to BREATHE, Mindfulness, Review |
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Full-Text [PDF 792 kb]
(263 Downloads)
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Type of Study: Review |
Subject:
Special
Received: 2025/11/2 | Accepted: 2025/12/27 | Published: 2025/12/28
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1. Shah Hosseini M, Roshani R, Taghavi Larmaei S, Rostami Janaghard R, Entezari Z. The effectiveness of dialectical behavioral therapy on psychological distress in children and adolescents with self-harm and suicidal thoughts: a systematic review. J Child Ment Health. 2025;12(2):70-85. [Persian]. [Link] [ DOI:10.61882/jcmh.12.2.5] 2. Poormirzaei M, Bagheri M, Askarizadeh G. The effectiveness of mindup curriculum on psychological well-being and personality traits of girl students. J Child Ment Health. 2022;9(2):92-107. [Persian]. [Link] [ DOI:10.52547/jcmh.9.2.8] 3. Nahang AA, Mosavi Najafi F, Mohammadi R. The effect of mindfulness training on emotional self-regulation and psychological resilience of unsupervised children. J Child Ment Health. 2020;7(1):106-117. [Persian]. [Link] [ DOI:10.29252/jcmh.7.1.10] 4. Broderick PC, Metz S. Learning to breathe: a pilot trial of a mindfulness curriculum for adolescents. Adv Sch Ment Health Promot. 2009;2(1):35-46. [Link] [ DOI:10.1080/1754730X.2009.9715696] 5. Saadipour E, Soltanizadeh H, Ebrahim Ghavam S. The effect of mindfulness training on academic procrastination in students with high and low test anxiety. J Child Ment Health. 2020;6(4):266-277. [Persian]. [Link] [ DOI:10.29252/jcmh.6.4.24] 6. Lupini F, Basch M, Cooke F, Vagadori J, Gutierrez-Colina A, Patterson Kelly K, et al. breathe-tid: Using iterative mixed methods to adapt a mindfulness-based intervention for adolescents with type 1 diabetes: design and development. Contemp Clin Trials. 2024;142:107551. [Link] [ DOI:10.1016/j.cct.2024.107551] 7. Broderick PC, Frank JL. Learning to breathe: an intervention to foster mindfulness in adolescence. New Dir Youth Dev. 2014;2014(142):31-44. [Link] [ DOI:10.1002/yd.20095] 8. *Basch M, Lupini F, Ho S, et al. Mindfulness-based group intervention for adolescents with type 1 diabetes: initial findings from a pilot and feasibility randomized controlled trial. J Pediatr Psychol. 2024;49(10):769-779. [Link] [ DOI:10.1093/jpepsy/jsae071] 9. Metz SM, Frank JL, Reibel D, et al. The effectiveness of the learning to breathe program on adolescent emotion regulation. Res Hum Dev. 2013;10(3):252-272. [Link] [ DOI:10.1080/15427609.2013.818488] 10. Bluth K, Roberson PN, Gaylord SA. A pilot study of a mindfulness intervention for adolescents and the potential role of self-compassion in reducing stress. Explore. 2015;11(4):292-295. [Link] [ DOI:10.1016/j.explore.2015.04.005] 11. Eva AL, Thayer NM. Learning to breathe: a pilot study of a mindfulness-based intervention to support marginalized youth. J Evid Based Complementary Altern Med. 2017;22(4):580-591. [Link] [ DOI:10.1177/2156587217696928] 12. *Shomaker LB, Pivarunas B, Annameier SK, et al. One-year follow-up of a randomized controlled trial piloting a mindfulness-based group intervention for adolescent insulin resistance. Front Psychol. 2019;10:1040. [Link] [ DOI:10.3389/fpsyg.2019.01040] 13. Dalager SL, Annameier S, Bruggink SM, et al. Mindfulness-based group intervention for an adolescent girl at risk for type 2 diabetes: a case report. Adv Mind Body Med. 2018;32(4):9. [Link] [ DOI:10.1016/j.ctim.2017.04.003] 14. Malinowski T. The effects of a six-week mindfulness intervention designed for adolescents on emotion regulation and perceived stress in college students. West Chester University Doctoral Projects. 2023;153. [Link] 15. *Gómez-Odriozola J, Calvete E. Effects of a mindfulness-based intervention on adolescents' depression and self-concept: the moderating role of age. J Child Fam Stud. 2021;30:1501-1515. [Link] [ DOI:10.1007/s10826-021-01953-z] 16. *Bluth K, Campo RA, Pruteanu-Malinici S, et al. A school-based mindfulness pilot study for ethnically diverse at-risk adolescents. Mindfulness. 2016;7(1):90-104. [Link] [ DOI:10.1007/s12671-014-0376-1] 17. Twenge JM. Increases in depression, self-harm, and suicide among US adolescents after 2012 and links to technology use: possible mechanisms. Psychiatr Res Clin Pract. 2020;2(1):19-25. [Link] [ DOI:10.1176/appi.prcp.20190015] 18. *Felver JC, Clawson AJ, Morton ML, et al. School-based mindfulness intervention supports adolescent resiliency: a randomized controlled pilot study. Int J Sch Educ Psychol. 2019;7:111-122. [Link] [ DOI:10.1080/21683603.2018.1461722] 19. *Dvořáková K, Kishida M, Li J, et al. Promoting healthy transition to college through mindfulness training with first-year college students: pilot randomized controlled trial. J Am Coll Health. 2017;65(4):259-267. [Link] [ DOI:10.1080/07448481.2017.1278605] 20. *Lau AS, Kim JJ, Nguyen DJ, et al. Effects of preference on outcomes of preventive interventions among ethnically diverse adolescents at-risk of depression. J Clin Child Adolesc Psychol. 2020;49(6):820-836. [Link] [ DOI:10.1080/15374416.2019.1639514] 21. *Fung J, Guo S, Jin J, et al. A pilot randomized trial evaluating a school-based mindfulness intervention for ethnic minority youth. Mindfulness. 2016;7:819-828. [Link] [ DOI:10.1007/s12671-016-0519-7] 22. *Fung J, Kim JJ, Jin J, et al. A randomized trial evaluating school-based mindfulness intervention for ethnic minority youth: exploring mediators and moderators of intervention effects. J Abnorm Child Psychol. 2019;47:1-19. [Link] [ DOI:10.1007/s10802-018-0425-7] 23. *Lam K, Seiden D. Effects of a brief mindfulness curriculum on self-reported executive functioning and emotion regulation in Hong Kong adolescents. Mindfulness. 2020;11(3):627-642. [Link] [ DOI:10.1007/s12671-019-01257-w] 24. *Frank JL, Broderick PC, Oh Y, et al. The effectiveness of a teacher-delivered mindfulness-based curriculum on adolescent social-emotional and executive functioning. Mindfulness. 2021;12(5):1234-1251. [Link] [ DOI:10.1007/s12671-021-01594-9] 25. *Eivaznezhad Firouzsalari A, Narimani M, Basharpoor S. The Effect of learning to breathe curriculum on self-compassion and anxiety symptoms in adolescent girls and boys. IJPN 2025; 13 (4) :72-85. [Persian]. [Link] 26. *Helminen EC, Zhang X, Clawson AJ, Morton ML, Cary EL, Sinegar SE, Janack P, Felver JC. Stress-buffering effects of mindfulness programming for adolescents in schools during periods of high- and low-stress. ECNU Rev Educ. 2022;8(1):209-227. [Link] [ DOI:10.1177/20965311221100563] 27. *Ray LA, Pike JM, Machuca LA, et al. 1192-P: Implementation-effectiveness trial of a mindfulness-based intervention with diabetes education in adolescents with type 1 diabetes. Diabetes. 2024;73. [Link] [ DOI:10.2337/db24-1192-P] 28. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the prisma statement. Ann Intern Med. 2009;151(4):264-269. [Link] [ DOI:10.7326/0003-4819-151-4-200908180-00135] 29. Shuster JJ. Cochrane handbook for systematic reviews for interventions, version 5.1.0. 2011;126-130. [Link] [ DOI:10.1002/jrsm.38] 30. Lisy K, Porritt K. Narrative Synthesis: Considerations and challenges. Int J Evid Based Healthc. 2016;14(4):201. [Link] [ DOI:10.1097/01.XEB.0000511348.97198.8c] |
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Eivaznezhad Firouzsalari A, Narimani M, Basharpoor S, Mousavi S M. Effectiveness of the learning to BREATHE mindfulness curriculum on adolescent psychological outcomes: a systematic review. J Child Ment Health 2025; 12 (4) : 6 URL: http://childmentalhealth.ir/article-1-1551-en.html
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