Mindfulness in the school curriculum? A nationwide cluster-randomized trial of the effectiveness of implementing a mindfulness-based intervention for 9-16-year-olds students in Danish elementary schools.
Lise Juul, Morten Frydenberg, Emilie Hasager Bonde, Michelle Sand Beck, Katinka Goetzsche, Heidi Berg Nielsen, Lone Overby Fjorback
Social Science & Medicine August 1, 2025 DOI: 10.1016/j.socscimed.2025.118117 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cluster-randomized trial Peer reviewed |
|---|---|
| Sample size | 1,728 |
| Population | Danish elementary school students in grades 4 to 9, including at-risk students |
| Interventions | teacher-training program for integrating a ten-session school-based mindfulness program |
| Duration | 8-month follow-up |
| Topics | Meditation |
| Keywords | Adolescent mesh Mental health mesh Mindfulness mesh Prevention, primary mesh School-based intervention |
| Citations | 12 |
| Key findings | The school-based mindfulness program showed no statistically significant effect on student mental health, and secondary analyses indicated potential harms including increased hyperactivity/inattention among boys and younger students and poorer self-rated health among at-risk students. |
Abstract
This study aimed to investigate the effectiveness of a teacher-training program for integrating a ten-session, school-based mindfulness program into regular classroom instruction in Danish elementary schools. The focus was on the mental health of students in grades 4 to 9. The primary study population comprised at-risk students, with the total students serving as a secondary study population. We also examined whether intervention effects were modified by sex and grade. In a nationwide cluster-randomized trial in 2019-2020 (during COVID-19), schools were randomized 1:1 to either the intervention (54 schools, 97 teachers, 836 students, including 186 at-risk students) or teaching as usual (56 schools, 94 teachers, 892 students, including 165 at-risk students). Thirteen validated self-report measures of mental health were collected at baseline, five, and eight months, with the Strengths and Difficulties Questionnaire Total Difficulties Score as the primary outcome. Intention-to-treat analyses were performed using mixed-effects linear regression models and bootstrapping. Follow-up data were obtained from 25 intervention schools (605 students, including 129 at-risk) and 28 teaching-as-usual schools (745 students, including 143 at-risk). Among at-risk students, Cohen's d for the Total Difficulties score at eight months was 0.05 (95 % CI -0.29 to 0.40), and no statistically significant effect was observed in the total study population. Secondary analyses indicated that the intervention led to increased perceived hyperactivity/inattention-particularly among boys and younger students-and poorer self-rated health among at-risk students. A deeper understanding of the mechanisms in school-based mindfulness-based interventionss and key factors for implementing them with fidelity requires further investigation.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 5
- Unpacking the Black Box: Exploring Differences in Practices, Skills, and Knowledge Taught in School-Based Mindfulness Programs. Prevention Science July 1, 2025
- Mindfulness-based interventions in psychopedagogy for students with Attention Deficit Hyperactivity Disorder (ADHD): a scoping review Frontiers in Psychology August 11, 2026
- Impact of Developmental Stage on Responses to a School-Based Mindfulness Intervention Mindfulness February 26, 2026
- Buddhism and Western Psychology The Palgrave Encyclopedia of Theoretical and Philosophical Psychology 2026
- AI-Supported Mindfulness Interventions Advances in Computational Intelligence and Robotics March 26, 2026
Cites 12
- Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness Frontiers in Human Neuroscience 2012
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Assessing mindfulness in children and adolescents: Development and validation of the Child and Adolescent Mindfulness Measure (CAMM). Psychological Assessment April 11, 2011
- Research Review: The effects of mindfulness‐based interventions on cognition and mental health in children and adolescents – a meta‐analysis of randomized controlled trials Journal of Child Psychology and Psychiatry October 22, 2018
- The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials Perspectives on Psychological Science February 16, 2021
and 7 more in the library