Prevention Science

, Volume 18, Issue 2, pp 164–173 | Cite as

Contemplative Intervention Reduces Physical Interventions for Children in Residential Psychiatric Treatment

  • Joshua C. Felver
  • Richard Jones
  • Matthew A. Killam
  • Christopher Kryger
  • Kristen Race
  • Laura Lee McIntyre


This research explored the effectiveness of a manualized contemplative intervention among children receiving intensive residential psychiatric care. Ten children with severe psychiatric disabilities received 12 sessions (30–45 min) of “Mindful Life: Schools” (MLS) over the course of a month. Facility-reported data on the use of physical intervention (i.e., seclusions and restraints) were analyzed. Acceptability questionnaires and broad-band behavioral questionnaire data were also collected from children and their primary clinicians. Robust logistic regression analyses were conducted on person-period data for the 10 children to explore the timing of incidents resulting in the use of physical intervention. Incidents within each person-period were regressed on indicators of days of contemplative practice and days without contemplative practice. Results indicated that during the 24-h period following MLS class, relative to a comparison 24-h period, children had significantly reduced odds of receiving a physical intervention (OR = 0.3; 95 % CI 0.2, 0.5; p < 0.001). Behavioral questionnaires did not indicate significant contemplative intervention effects (ps >0.05), and MLS was found to be generally acceptable in this population and setting. These data indicate that contemplative practices acutely reduced the utilization of physical interventions. Clinicians seeking to implement preventative strategies to reduce the necessity of physical intervention in response to dangerous behavior should consider contemplative practices. Those wishing to empirically evaluate the effectiveness of contemplative practices should consider evaluating objective measures, such as utilization of physical intervention strategies, as oppose to subjective reports.


Mindfulness Children Residential treatment Yoga Seclusion and restraint 


Compliance with Ethical Standards


This work was supported by the University of Oregon’s Hope Baney Fund Award granted to the first and sixth authors.

Conflict of Interest

The 5th author is the creator of the “Mindful Life: Schools” curricula and is the founder and director of the “Mindful Life” organization. The authors declare that they have no other conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional (i.e., University of Oregon) research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent/assent was obtained from all individual participants included in the study.


  1. Achenbach, T. M. (2009). The Achenbach System of Empirically Based Assessment (ASEBA): Development, findings, theory, and applications. Burlington: University of Vermont Research Center for Children, Youth, & Families.Google Scholar
  2. Agresti, A. (2002). Categorical data analysis (2nd ed.). Hoboken: Wiley.CrossRefGoogle Scholar
  3. Baker, A. J., & Purcell, J. F. (2005). New York State residential treatment center admissions: Differences in histories of maltreatment, behavioral problems, and mental health problems. Residential Treatment for Children & Youth, 22, 39–53.CrossRefGoogle Scholar
  4. Barnes, V. A., Bauza, L. B., & Treiber, F. A. (2003). Impact of stress reduction on negative school behavior in adolescents. Health and Quality of Life Outcomes, 1, 1–10.CrossRefGoogle Scholar
  5. Birdee, G. S., Yeh, G. Y., Wayne, P. M., Phillips, R. S., Davis, R. B., & Gardiner, P. (2009). Clinical applications of yoga for the pediatric population: A systematic review. Academic Pediatrics, 9, 212–220.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.Google Scholar
  7. Black, D. S., Milam, J., & Sussman, S. (2009). Sitting-meditation interventions among youth: A review of treatment efficacy. Pediatrics, 124, 532–541.CrossRefGoogle Scholar
  8. Borrelli, B. (2011). The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials. Journal of Public Health Dentistry, 71, 52–63.CrossRefGoogle Scholar
  9. Burke, C. A. (2010). Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19, 133–144.CrossRefGoogle Scholar
  10. Chiesa, A., Serretti, A., & Jakobsen, J. C. (2013). Mindfulness: Top-down or bottom-up emotion regulation strategy? Clinical Psychology Review, 33, 82–96.CrossRefPubMedGoogle Scholar
  11. dosReis, S., McCulloch, J. R., Colantuoni, E., Barnett, S. R., Pruitt, D., Zachik, A., & Riddle, M. A. (2010). Early identification of seclusion and restraint patterns during adolescents’ course of residential treatment. Residential Treatment for Children & Youth, 27, 160–174.CrossRefGoogle Scholar
  12. Elliott, S. N., & Treuting, M. V. B. (1991). The behavior intervention rating scale: Development and validation of a pretreatment acceptability and effectiveness measure. Journal of School Psychology, 29, 43–51.CrossRefGoogle Scholar
  13. Felver, J. C., Frank, J. L., & McEachern, A. D. (2014). Effectiveness, acceptability, and feasibility of the Soles of the Feet mindfulness-based intervention with elementary school students. Mindfulness, 5, 589–597.CrossRefGoogle Scholar
  14. Felver, J. C., Celis-de Hoyos, C. E., Tezanos, K., & Singh, N. N. (2016a). A systematic review of mindfulness-based interventions for youth in school settings. Mindfulness, 7, 34–45.CrossRefGoogle Scholar
  15. Felver, J. C., Tipsord, J. M., Morris, M. J., Racer, K. H., & Dishion, T. J. (2016). The effects of mindfulness-based intervention on children’s attention regulation. Journal of Attention Disorders. (in press)Google Scholar
  16. Greenberg, M. T., & Harris, A. R. (2012). Nurturing mindfulness in children and youth: Current state of research. Child Development Perspectives, 6, 161–166.CrossRefGoogle Scholar
  17. Hayes, A. M., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Science and Practice, 11, 255–262.Google Scholar
  18. Huckshorn, K. A. (2005). Six core strategies for reducing seclusion and restraint use. Alexandria: National Association of State Mental Health Program Directors, National Technical Assistance Center.Google Scholar
  19. Huefner, J. C., & Vollmer, D. G. (2014). Characteristics and treatment needs of preadolescent versus adolescent children in an intensive residential treatment program. Residential Treatment for Children & Youth, 31, 301–315.CrossRefGoogle Scholar
  20. IBM Corp. (2015). IBM SPSS Statistics for Windows, Version 23.0. Armonk: IBM Corp.Google Scholar
  21. Kennedy, C. H. (2005). Single-case designs for educational research. Boston: Pearson Education.Google Scholar
  22. Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., & Hofmann, S. G. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review, 33, 763–771.CrossRefPubMedGoogle Scholar
  23. LeBel, J., Stromberg, N., Duckworth, K., Kerzner, J., Goldstein, R., Weeks, M., & Sudders, M. (2004). Child and adolescent inpatient restraint reduction: A state initiative to promote strength-based care. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 37–45.CrossRefGoogle Scholar
  24. LeBel, J., Huckshorn, K. A., & Caldwell, B. (2010). Restraint use in residential programs: Why are best practices ignored? Child Welfare, 89, 169.PubMedGoogle Scholar
  25. Race, K. (2016). Mindful Life: Schools [Program description]. Retrieved from
  26. Serwacki, M., & Cook-Cottone, C. (2012). Yoga in the schools: A systematic review of the literature. International Journal of Yoga Therapy, 22, 101–110.Google Scholar
  27. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373–386.CrossRefPubMedGoogle Scholar
  28. Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York: Oxford University Press.CrossRefGoogle Scholar
  29. Singh, N. N., Lancioni, G. E., Joy, S. D. S., Winton, A. S., Sabaawi, M., Wahler, R. G., & Singh, J. (2007). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15, 56–63.CrossRefGoogle Scholar
  30. Spinazzola, J., Rhodes, A. M., Emerson, D., Earle, E., & Monroe, K. (2011). Application of yoga in residential treatment of traumatized youth. Journal of the American Psychiatric Nurses Association, 6, 431–444.CrossRefGoogle Scholar
  31. Stata Corp. (2015). Stata statistical software: Release 14. College Station: StataCorp LP.Google Scholar
  32. Stewart, D., Van der Merwe, M., Bowers, L., Simpson, A., & Jones, J. (2010). A review of interventions to reduce mechanical restraint and seclusion among adult psychiatric inpatients. Issues in Mental Health Nursing, 31, 413–424.CrossRefPubMedGoogle Scholar
  33. Tang, Y. Y., Hölzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 16, 213–225.CrossRefPubMedGoogle Scholar
  34. Witt, J. C., & Elliott, S. N. (1985). Acceptability of classroom intervention strategies. In T. R. Kratochwill (Ed.), Advances in school psychology (Vol. 4, pp. 251–288). Mahwah: Erlbaum.Google Scholar
  35. Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: A meta-analysis. Mindfulness, 6, 290–302.CrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2016

Authors and Affiliations

  • Joshua C. Felver
    • 1
  • Richard Jones
    • 2
  • Matthew A. Killam
    • 2
  • Christopher Kryger
    • 3
  • Kristen Race
    • 4
  • Laura Lee McIntyre
    • 5
  1. 1.Syracuse UniversitySyracuseUSA
  2. 2.Alpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Youth Villages OregonLake OswegoUSA
  4. 4.Mindful LifeCarbondaleUSA
  5. 5.University of OregonEugeneUSA

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