A Pilot Randomized Controlled Trial of a Mindfulness Program for Filipino Children

Objectives: This study examines the feasibility and acceptability of a local adaptation of a mindfulness-based cognitive therapy (MBCT) program for Filipino school children, called Kamalayan, that was facilitated by trained public school teachers. It also presents preliminary evidence of program effects on the children’s depressive and anxiety symptoms and difficulties in emotion regulation. Methods: We utilized a randomized controlled design with an active control condition. Filipino elementary and high school students aged 9 to 16 years old from low-resource schools were randomly assigned to the Kamalayan (n = 87) or the active control Handicrafts condition (n = 99). Changes in outcomes from baseline, immediate post-intervention, and 2-month follow-up were assessed using multilevel modeling. Results: Participation in the Kamalayan program did not affect depression, anxiety, or emotion regulation. Impulse control difficulties increased for the Handicrafts group across post-intervention and follow-up but remained stable for Kamalayan participants. Depressive symptoms decreased over time for the Handicrafts group but remained stable for the Kamalayan condition. Implementation issues qualify the absence of program effects, such as the impracticability of delivering after-school sessions in the public school context, program content that may be discordant with cognitive-developmental and cultural considerations, and the inadequacy of the personal mindfulness practice of the paraprofessional facilitators. Conclusions: The findings reaffirm the importance of using active control groups and considering the capacities of facilitators in evaluating the effects of mindfulness-based interventions. Testing mindfulness-based interventions in low-resource, non-Western school settings require deeper contextual adaptation and facilitator preparation.