Mindfulness-Based Interventions for Well-Being and Mental Health in Children and Adolescents
I. Ivlev, M. Pappas, Tamara P. Cheney, Yun Yu, S. Selph, Tracy L. Dana, N. Carney, L. Coyne, Leigh Hedrick, Anna Wilson, Erica L. Hart, Rochelle Fu
May 20, 2026 DOI: 10.23970/ahrqepc_sr_mindfulness (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized |
|---|---|
| Population | Children and adolescents with and without anxiety, depression, and chronic health conditions |
| Interventions | Mindfulness-based interventions (MBIs) Acceptance and Commitment Therapy (ACT) |
| Duration | Outcomes measured at ≥4 weeks; follow-up periods varied across trials |
| Topics | Meditation |
| Key findings | In general populations, MBIs showed small, comparator-dependent, mostly short-term benefits primarily versus inactive controls, with effects versus active controls generally similar. Among youth with diagnosed anxiety or depression, MBIs modestly reduced depression (SMD -0.42) but not anxiety, while ACT showed small improvements in depression and quality of life versus inactive controls. Evidence for children with chronic physical conditions was insufficient. |
Abstract
Objective. To evaluate the effectiveness of mindfulness-based interventions (MBIs) and Acceptance and Commitment Therapy (ACT) for mental health and well-being of children and adolescents with and without anxiety, depression, and chronic health conditions. Data sources. Ovid MEDLINE, PsycINFO, Cochrane Library, and ERIC (2009-April 21, 2025); reference lists of relevant reviews. Review methods. Following the Agency for Healthcare Research and Quality (AHRQ) methods, we included randomized controlled trials (RCTs) of MBIs in outpatient/community settings with outcomes ≥4 weeks. MBIs were defined as repeated practice focused on nonjudgmental self-regulation of attention, delivered by a person trained in mindfulness. Cochrane ROB2 was used; strength of evidence (SOE) was graded per AHRQ guidance. Results. We included 104 RCTs: 82 (N=20,858) in a general population of children, 12 (N=1,197) in those with anxiety/depression, and 11 (N=617) with chronic physical conditions. Most RCTs had moderate to high risk of bias with imprecise estimates. In a general population ages 3-8 years, MBIs produced small improvements in behavioral problems (k=8; N=1,188; SMD -0.15; 95% CI, -0.25 to -0.04; low SOE) and general/social functioning (k=12; N=1,483; SMD 0.18; 95% CI, -0.01 to 0.37; low SOE) versus inactive controls; executive functioning was similar to control. In ages 9-14 years, executive functioning improved modestly at postintervention (k=13; N=1,516; SMD 0.19; 95% CI, 0.05 to 0.37; moderate SOE) and anxiety were slightly lower versus inactive controls (k=18; N=3,823; SMD -0.20; 95% CI, 0.50 to 0.09; low SOE), while depression were similar to controls (k=12; N=5,122; SMD 0.01; 95% CI, -0.08 to 0.06; moderate SOE). In ages 15-18 years, anxiety (k=5; N=501; SMD -0.22; 95% CI, -0.51 to -0.04; low SOE) and depression (k=7; N=905; SMD -0.26; 95% CI, -0.45 to -0.10; low SOE) were slightly lower versus inactive controls, but effects versus active controls were similar and not sustained at followup. ACT in general-population adolescents showed slightly lower anxiety (k=3; N=161; low SOE) but similar depression (k=5; N=417; low SOE). Among youth with diagnosed anxiety or depression, MBIs reduced depression at postintervention (k=6; N=526; SMD -0.42; 95% CI, -0.79 to -0.12; moderate SOE) but showed similar effects for anxiety (k=4; N=312; low SOE). ACT reduced depression (k=2; N=176; low SOE) and improved quality of life (k=2; N=172; low SOE) versus inactive controls; effects versus CBT were uncertain. Effects in children and adolescents with chronic physical conditions were insufficient across outcomes. Reporting of negative effects was limited; one large school-based RCT found no increase in suicidal ideation or self-harm versus active control at ≥6 months (moderate SOE). Conclusions. In general populations, MBIs show small, comparator-dependent, and mostly short-term benefits that are primarily observed versus inactive controls; effects versus active controls were generally similar. In children and adolescents with diagnosed anxiety or depression, MBIs modestly reduce depression at postintervention, while anxiety outcomes were similar to controls; ACT shows small improvements in depression and quality of life versus inactive controls, but the results are uncertain compared to CBT. Effects in those with chronic physical conditions remain insufficient.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |