Implementing twelve-weeks of loving-kindness meditation and mindfulness of breathing for adolescents with nonsuicidal self-injury and their parents: a mixed method pilot study.

A twelve-week program combining loving-kindness meditation and mindfulness of breathing appears feasible for adolescents who engage in nonsuicidal self-injury (NSSI) and their parents. Among 28 adolescents, NSSI behavior decreased significantly at the end of the program and at a three-month follow-up, and depressive symptoms decreased significantly at three months. Parents reported improved emotion regulation and parenting attitudes, and both adolescents and parents perceived better parent-child relationships. Satisfaction with the intervention was high (4.27 out of 5), and adolescent dropout was modest (14.2%), though parent dropout was 33%. Qualitative feedback indicated positive attitudes but challenges in sustaining practice. A larger randomized controlled trial is needed to confirm effectiveness.

Study at a glance

Abstract

Psychosocial interventions for adolescents with nonsuicidal self-injury (NSSI) still needs investigation. This study aims to explore the feasibility and preliminary efficacy of twelve weeks of loving-kindness meditation (mettā) and mindfulness of breathing (ānāpānasati) for adolescents with NSSI and their parents. This was a prospective, quasi-experimental, mixed-method pilot study with no control group. Twenty-eight adolescents and their parents participated in the twelve weeks of loving-kindness meditation and mindfulness of breathing practice. Self-report questionnaires on NSSI behaviors, depressive symptoms, attachment to parents, and parenting behaviors were administered at baseline, mid-intervention, postintervention, and 3-month follow-up only from the adolescents. Semi-structured interviews about the feasibility of the intervention were conducted with 25 parent-adolescents' dyads at post-intervention. A modest dropout of n = 4 (14.2%) was found for adolescents. Nine parents dropouts, with the dropout rate being 33%. The overall satisfaction score of adolescents for the intervention is 4.27 out of 5. Quantitative analysis revealed that there is a significant decrease in adolescents NSSI behavior at postintervention and 3-month follow-up and a significant decrease in adolescents' depressive symptoms at three months follow-up.Qualitative analysis shows that adolescents general has positive attitude toward the intervention, and believe the individual mindfulness practices peaceful but challenging. The experiences in group activity and interactions were rich, but participants failed in persisting the intervention because of multiple obstacles. Attempts to practice mindfulness influenced adolescents' self-injury behavior and also bring positive change in adolescents' emotion. Parents reported increase in emotion regulation and positive change in parenting attitude and behavior. Both adolescents and parents perceived parent-child relationship improvements. Twelve weeks of loving-kindness meditation and mindfulness of breathing seems feasible among adolescents with NSSI and their parents. An adequately powered Randomized Controlled Trial (RCT) is needed to examine this intervention's effectiveness for NSSI behavior, emotional symptoms, and family interaction. The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2200056515) at 7th February 2022.