Abstract
The primary goal of this study was to examine the effects of a synchronous online mindfulness-based psychoeducation program on attentional control and mindfulness levels of Turkish late adolescents and the intervention experiences of the participants. A sample of adolescents (n = 40, Mage 16.7) was randomly assigned to experimental and control groups. There were 10 participants in each four groups. The embedded design with a convergent approach was used. The quantitive data were obtained using the Solomon four group design while the qualitative data were obtained with phenomenological approach. The mindfulness-based intervention consisting of eight sessions and seven workshops was applied online to the experimental groups. The findings revealed that the attentional control and mindfulness levels of the adolescents in the experimental groups were significantly higher compared to the adolescents in the control groups. Regarding the qualitative findings, the adolescents stated that there were improvements in their levels of attentional control, regulating emotions, self-knowledge, self-confidence, optimism, effective communication skills, academic achievement and motivation to study after the program. The findings of the follow-up test showed that improvements in attentional control and mindfulness levels of the adolescents persisted for 8 weeks. The findings showed that the mindfulness-based intervention is a promising tool for late adolescents.
The broad definition of adolescence is the period between childhood and adulthood. The years that accompany the shift from childhood to adulthood are marked by specific changes (Fleming, 2005). The transitional stage between childhood and adulthood, known as adolescence, is marked by modifications to the brain’s structure, emotionality, cognitive function, and social environment (Dahl, 2004). While improvements in reasoning, abstract thought, decision-making, executive functions, and adolescent egocentrism are all part of adolescent cognitive development (Keating, 2004; Piaget, 1969), shifts in identity formation and self-concept are crucial developmental indicators for adolescents (Keating, 2004).
The growth of an individual’s self-concept and self-exploration is an essential aspect of adolescence (Erikson, 1968). Adolescents’ main psychological challenge is to establish a sense of self by looking for an identity and a place in the world (Moreno et al., 2023). When describing the eight developmental stages in the theory of psychosocial development, Erikson (1968) believed that confusion between identity and role is the main source of conflict at this point in life. During this psychosocial crisis of identity versus identity confusion, adolescents attempt to find middle ground between these two extremes. Adolescents need to be able to integrate and combine important previous identifications into a new, fully original form to go through this process (Erikson, 1968). Adolescent identity development includes developing into an independent, self-regulating individual (Kuhn, 2000). The capacity for sustained attention and focus is essential for self-regulation (Rothbart et al., 2006). Attentional control, executive function, and the self-reflection and self-understanding processes associated with identity development are major factors in adolescent behavior (Kuhn, 2000).
Apart from Erikson’s (1968) theory, according to developmental contemporary science (DCS), the goal of which is to apply knowledge from contemplative traditions to create a transdisciplinary approach to understanding the mind-body system (Roeser & Zelazo, 2012), adolescents are more likely to experience modifications to particular brain regions and networks (Carsley et al., 2018; Roeser & Pinela, 2014; Roeser & Zelazo, 2012). The brain changes more quickly in adolescence. New neuronal connections are formed, there is a new process of cell migration, especially in the frontal lobe, and other changes are impacted by external experiences and learning opportunities (Blakemore, 2012). The sensitivity of this period may provide a window of opportunity for the implementation of mindfulness-based intervention (MBI) programs (Bluth et al., 2016; Roeser & Pinela, 2014). The application of mindfulness training may be a promising enrichment strategy that supports adolescents in managing the development of a psychosocial identity, developing specific skills, and capitalizing on the developmental plasticity of the neurological and psychological systems during adolescence (Roeser & Pinela, 2014). By improving self-regulation, self-awareness, sociocognitive abilities, and a sense of agency to navigate both internal and external challenges, mindfulness practices can assist adolescents in overcoming developmental difficulties (Amada & Shane, 2019).
One of the main components of MBIs is teaching participants to direct their attention in a way that helps them stay focused on the experiences of present time while resisting the pull of other internal or external events (Tarrasch, 2018). The ability to pay attention by being aware of and attentive to what is occurring both inside and outside of oneself is a crucial part of practicing mindfulness (Parker & Kupersmidt, 2016). It is believed that practicing mindfulness can improve attention by training the mind to concentrate and maintain attention on one’s thoughts while blocking unwanted or distracting thoughts (Moore & Malinowski, 2009). Research assessing the role of mindfulness in improving attentional abilities in adults has yielded mixed results. Studies have revealed that meditation training or MBIs among adults can enhance sustained attention (Josefsson & Broberg, 2011; MacCoon et al., 2014), selective attention (Becerra et al., 2017; Jensen et al., 2012; Moore & Malinowski, 2009), and executive attention (Ainsworth et al., 2013; Moore et al., 2012; Tang et al., 2007). On the other hand, there are studies indicating no significant differences between meditators and control groups in terms of sustained attention (Polak, 2009; Tang et al., 2007), selective attention (Anderson et al., 2007), or executive attention (Anderson et al., 2007; Polak, 2009; Wenk-Sormaz, 2005).
In the literature, although individual studies conducted with children and adolescents have revealed that mindfulness practices contribute positively to youth’s attentional control skills (e.g. Black & Fernando, 2014; Parker et al., 2015; Schonert-Reichl & Lawlor, 2010; Semple et al., 2010; Suárez-García et al., 2020; Tarrasch, 2018), there are studies revealing no significant positive changes (e.g., Kuyken et al., 2022; Ricarte et al., 2015). The benefits of mindfulness and meditation on attention and related cognitive variables have already been the subject of numerous meta-analyses and systematic reviews (e.g., Dunning et al., 2022; Eberth & Sedlmeier, 2012; Felver et al., 2016; Maynard et al., 2017; Sedlmeier et al., 2012; Zenner et al., 2014) in addition to individual studies. The meta-analyses on the effects of mindfulness and meditation on attention and related cognitive variables have shown a range of effect sizes ranging from small to large (see Eberth & Sedlmeier, 2012; Maynard et al., 2017; Sedlmeier et al., 2012; Zenner et al., 2014). There may be several reasons why individual studies and meta-analyses evaluating the effectiveness of mindfulness programs on attention have produced mixed findings and had different effect sizes. A plausible explanation could be that the measurement instruments employed in the studies have inconsistencies (Gülden & Yalçın, 2024). Another explanation may be that many of the current studies on the benefits of mindfulness training in both adults and children have significant methodological flaws (Davidson, 2010; Greenberg & Harris, 2012; Monsillion et al., 2023; Tarrasch, 2018). For example, a review (Felver et al., 2016) revealed that only approximately 30% of the studies conducted to date have used a comparison condition, and approximately 50% have randomized participants to a condition. Researchers recommend that future studies in this field using more rigorous experimental designs with random assignment could strengthen the evidence base for MBIs for adolescents (Felver et al., 2016; Mak et al., 2018; Phan et al., 2022). Furthermore, a variety of populations are subjected to MBIs, including those of varying ages, clinical conditions, cultural backgrounds, and socioeconomic statuses (Porter et al., 2022). In particular, while Black and Fernando (2014) conducted their study with a sample of children in the kindergarten-sixth grade range, Ricarte et al. (2015) conducted the study with a sample aged between 6 and 13 years. Although research is starting to show that MBIs might be more effective at some developmental stages than at others (see Gómez-Odriozola & Calvete, 2021), the available data do not provide strong support for the optimal types of interventions for each group or variables that may be easier to modify in each situation (Porter et al., 2022). Previous research has overlooked the impact of particular developmental periods by concentrating only on the efficacy of interventions (Carsley et al., 2018). It is challenging to provide guidance for future MBI implementation with a particular age group of students or within a specific school environment due to the wide range of student ages included in the studies (McKeering & Hwang, 2019). To overcome this challenge, more research is required to determine what age-appropriate behaviors are, and qualitative research may be highly helpful in this regard (Greenberg & Harris, 2012). In accordance with the window of opportunity explanation provided by DCS theory, the period between the ages of 14 and 18 is seen as an important time for mindfulness to be effective due to increased brain plasticity (Giedd, 2008), and studies have suggested that MBIs might be more effective in late adolescents than in younger adolescents (e.g., Carsley et al., 2018; Gómez-Odriozola & Calvete, 2021). More studies focusing on MBIs targeting late adolescents are necessary to ascertain whether this period has a greater impact on training response.
The interconnected and dynamic elements of human behavior and development are social and cultural factors (Raeff & Benson, 2003). It is important to consider the role of culture in MBIs. A qualitative study by Montero-Marin et al. (2023) suggested that culture could have an impact on MBIs, revealing that students from different ethnic minorities may respond differently to school-based mindfulness training. Nonetheless, the majority of research on MBIs in school settings originates from the United States or Canada (Weare, 2018). For instance, a total of 54 studies were carried out in the United States or Canada for the Klingbeil et al. (2017) meta-analysis, revealing that only four studies were carried out in Asia, while 18 were conducted in Europe or Australia. Similarly, Lam and Seiden (2020) reported that little mindfulness research has been conducted with Asian children. Given that Turkey is situated at a distinctive crossroads between the East and the West, both geographically and culturally (Martin & Alacaci, 2015), and that adolescents in Turkey may need different social-emotional learning opportunities and challenges than adolescents in more Western contexts (Bacanlı, 2012), investigating the effectiveness of MBI for Turkish adolescents can contribute to the literature. There are some studies on MBIs among Turkish adolescents (e.g., Güldal & Satan, 2022), but to our knowledge, there are no studies examining attentional control and mindfulness among Turkish adolescents. Additionally, a review of the literature related to the intervention modality revealed that MBIs in schools are generally delivered in a face-to-face group format (Porter et al., 2022; Weare, 2018). Considering the growing need for effective online interventions and the opportunities they provide, more research on MBIs investigating delivery methods is required (Porter et al., 2022; Wisner, 2017).
Overall, to address all these gaps in the literature, in the present study, we aimed to evaluate the effectiveness of a synchronous online mindfulness-based psychoeducation program for Turkish late adolescents. Because employing a single quantitative or qualitative study may not be enough to understand mindfulness complexities (Huynh et al., 2019), we used an embedded design with a convergent approach to determine the effectiveness of a synchronous online MBI on late adolescents’ attentional control and mindfulness when the pretest sensitization effect was controlled using the Solomon four-group design and to determine the experiences of adolescents in mindfulness-based psychoeducation programs, which can provide additional insight into the quantitative data and to enrich our understanding of the program’s effects among late adolescents. In this study, we prioritized the quantitative strand. We have supported quantitative findings with qualitive findings, and all findings obtained from the study were discussed jointly.
Method
Participants
The study was conducted with adolescents in 11th grade in a public high school in Ankara, the capital city of Türkiye in 2021. The participants’ ages ranged from 16 to 18 years, with a mean age of 16.75 years. They were teenagers from middle-class families who participated in society. Out of the group, only one had parents who were not together. The majority of the participants’ fathers had a high school education, while their mothers had completed only elementary school. On average, they had two or three siblings including themselves. The program and conditions of participation were announced to the students. There were 78 students who volunteered to participate in the program and met the conditions for participation in the program, including having a phone, tablet or computer to participate in the program online, having an internet connection, and having a room where they could be alone at home during session hours. According to the Solomon four-group design, two of the four groups in the study were pretested, and the other two groups were not pretested. The experimental treatment is administered to one of the untested groups and one of the pretested groups; the remainder are not (Crano & Brewer, 2002). In this case, equality cannot be guaranteed in terms of the pretest scores of the groups that are not pretested. Shadish et al. (2002) suggested that in cases where the sample size is small, equality cannot be achieved between groups with simple random assignment, and in this case, simple random assignment should be avoided in cases where the total sample size of the researchers is less than 200. Before being assigned to the experimental groups, participants may be categorized when it is desirable to have more control over the causes of variance. A blocked design is one way in which random assignment might occur (Crano & Brewer, 2002). Based on this information, the groups were equalized using the random blocking method. Because studies have shown that attention is associated with academic achievement (e.g., Diehl et al., 2006) when using random blocking, students’ previous academic year weighted mean scores were used. The volunteers from the low, medium and high blocks were randomly allocated to the experimental and control conditions within each of the four groups, controlling for gender. While MBIs can be conducted in face-to-face groups of 10 to 15 people, Chadi et al. (2020) suggested that smaller groups of 8 to 10 people be preferred for online interventions, as this will provide more opportunities for interaction between participants and the group leader. Furthermore, Brown (2004) suggested that when there are more than ten participants in psychoeducation groups for adolescents, an assistant counselor should be present. Given the available data, ten students were assigned to each group to guarantee and keep track of everyone’s participation in computer screen activities and foster greater group dynamics.
Procedure
In this study, an 8-week mindfulness-based psychoeducation program consisting of 8 sessions and 7 workshops developed by the first researcher was used. The themes of the sessions and workshops held in the same week were the same. Information sharing and learning activities were mostly included within the sessions, while practice-oriented activities were carried out within the workshops. The first session of the same week is referred to as a session; the second session, which is more practice-focused, is referred to as a workshop. The aim of the workshops was to reinforce what the participants had learned during the sessions. The program was conducted online for groups experimental 1 and experimental 2. No intervention was applied to the control groups in the study. The program was implemented by the first author, and the second author supervised the first author and checked the fidelity. Prior to the program, the group leader held a meeting with the parents of the participants to provide detailed information about the program to be implemented, and the parents signed the required consent forms. This study has been approved by the Ethics Committee of Ankara University. The main purpose of the program was to help the participants gain mindfulness skills and to integrate these skills into their daily lives. Before the main program was implemented, the pilot program was conducted, and the necessary changes were made based on the findings. All sessions were implemented online during the 8-week intervention period. The program was implemented with groups of 10 twice per week for 50 minutes online. Before implementing the program, a messaging group consisting of the parents of the participants was created, and throughout the 8 weeks, the parents were informed about the number of sessions to provide the adolescents with an appropriate setting during the sessions. From the start to the end of the program, except for three participants who did not attend one workshop, all the other adolescents participated in all the sessions.
MBIs that had been previously implemented in the literature were taken into consideration when designing the program. The common themes of the current programs included mindfulness of the body, mindfulness of thoughts, mindfulness of emotions, and compassion. Given that non-judgmentalism is one of the components of mindfulness, it was determined to be incorporated into the program. How mindfulness and attention are related has also been highlighted. Consequently, the themes of the mindfulness-based psychoeducation program were determined as follows: mindfulness attention and brain, mindfulness of body, body sensations and concentration skills, mindfulness of thoughts, mindfulness of emotions, describing versus judging, gratitude and compassion and general review of the group process.
It was important to incorporate the short activities in which the individuals would actively participate while planning the activities to be included in the program. The length of the practices was expanded progressively week by week. The program’s longest meditation-based mindfulness exercise has been determined to be 8 to 10 minutes. The practices were sent to the participants as audio recordings rather than as written text. As focusing on breathing is the simplest and most effective way to provide concentration, awareness and relaxation (Napoli et al., 2005), each session of the program started with breathing meditation, and the duration of the meditation practice gradually increased with the subsequent sessions with the aim of increasing the attentional control of the participants. Throughout the program, the importance of practice was emphasized, and the participants were asked to perform the breathing exercise every day. To integrate the practices into the lives of the adolescents, they were encouraged to practice at least one of the informal mindfulness practices from daily life, such as drinking coffee, brushing teeth, and climbing stairs every day during the program. The reminder messages were sent to the participants at regular intervals by the group leader. Within the scope of reflexivity, throughout the program, the first author kept a journal in which she noted her feelings and thoughts and evaluated both the process and herself. She shared this information with the second author, who provided feedback.
Measures
The Personal Information Form
All participants in the study were asked to complete a brief questionnaire assessing demographic variables. The questionnaire included questions about gender, age, number of siblings, mother’s and father’s education levels, mother’s and father’s occupations, and mother’s and father’s marital status. The personal information form was administered to all groups in the study 1 week before the program.
Attentional Control Scale (ACS)
A self-report instrument for assessing individual differences in attentional skills related to voluntary executive functions developed by Derryberry and Reed (2002) was used. The items on the scale are scored on a 4-point scale (1-almost never and 4-always). Higher scores indicate a higher level of attentional control. Akın et al. (2013) examined the validity and reliability of the Turkish version of the scale for university students. The researchers of this study examined the validity and reliability of the Turkish version of the scale in 428 high school students aged 13 to 18 years (Mage = 15.64, SD = 1.16). According to the findings of the confirmatory factor analysis, all items loaded one factor; the goodness-of-fit index values of the model were S-Ba χ;2 = 545.49, SD = 150, S-B χ2/SD = 3.63, RMSEA = .079, CFI = .95, TLI = .94, SRMR = .076. The Cronbach’s alpha internal consistency coefficient of the scale was .87. The range of the corrected item-total correlations was .34 to .61. The overall results showed that the scale could be used as a valid and reliable tool to evaluate high school students’ attentional control characteristics.
Child and Adolescent Mindfulness Measure (CAMM)
Mindfulness was assessed using the Child and Adolescent Mindfulness Measure (CAMM) developed by Greco et al. (2011). The scale was developed to assess present-moment awareness and nonjudgmental, nonavoidant responses to thoughts and feelings. The items in the measure are scored on a 5-point scale (0–never true and 4 always true). A high score obtained from the scale means that the individual’s level of mindfulness is high. A validated Turkish version (Çıkrıkçı, 2016) was used in the study. The Turkish version of the CAMM revealed that it was a valid instrument for measuring mindfulness among children and adolescents, with excellent fit indices of X2 = 67.97, SD = 20, X2/SD = 3.39 RMSEA = .06, CFI = .93, GFI = .97, and TLI = .91. The Cronbach’s alpha internal consistency coefficient of the scale was .73. The range of the item-total correlations was .34 to .61.
The Semi-structured Individual Interview Form
To explore the participants’ subjective experiences and perceptions about the program, a semi-structured individual interview form was used. The semi-structured individual interviews were conducted online with the participants 1 week after the intervention. The interviews lasted 9 to 28 minutes, with an average of 15 minutes. While developing the semistructured individual interview form used in the study, the opinions of two experts were asked, and the interview form was shaped based on the feedback received. The form consisted of questions to determine participants’ perceptions about the method of implementation of the program, the content of the program, the group leader, and the perceived effects of the program on the participants. In the interview, open-ended questions were included. Some of the questions in the interview were as follows: What was your experience like taking part in the program? The program was implemented online rather than face to face. What are your thoughts on this subject? If you evaluate yourself before and after joining the program, do you think there is a difference between you before and after the program? To avoid being misleading and reflecting researchers’ own opinions, no direct questions were asked regarding attention. At the time of the study, the first author was a PhD student in guidance and psychological counseling under the supervision of the second author, who had come to the field with a background in psychological guidance practices, child/adolescent education and psychology. The current study’s theoretical and practical background was developed during doctoral coursework. Her interests and perspectives as a researcher were influenced by her experiences of counseling and teaching youth.
Data Analyses
Analyses of Quantitative Data
The flowchart proposed by Braver and Braver (1988) was followed while performing analyses for the Solomon four-group designs. The analyses were performed separately for each dependent variable. Testing sensitization to pretesting is the first step in the Solomon four-group research design. Two-way ANOVA was performed on posttest scores. There was no pretest sensitization when the main effect of the pretest and interaction between the pretest and treatment were not statistically significant. According to Braver and Braver (1988), once it is determined that there is no pretest sensitization, the main effect of treatment between the experimental group and the control group should be examined by two-way ANOVA. If the findings demonstrate that the main effect for treatment is statistically significant, it can be stated that the treatment is effective. Before performing two-way ANOVA, the statistical assumptions for two-way ANOVA were examined.
A follow-up test was applied to the participants in the experimental 1 and experimental 2 groups 8 weeks after the end of the program to determine the permanence of the MBI. The Wilcoxon matched pairs signed rank test was performed to determine the difference between the attentional control and mindfulness posttest and follow-up test scores of the participants in the experimental groups. To ensure the equality of the groups in the study, various analyses were performed. To determine whether the groups were equivalent in terms of academic achievement scores, one-way ANOVA was performed. Before the analysis, the statistical assumptions for one-way ANOVA were examined. In addition to equalizing the groups in terms of academic achievement, the Chi-square test was applied to determine whether there was a difference between all four groups in terms of age, gender, number of siblings, mothers’ and fathers’ education levels, mothers’ and fathers’ occupations and parents’ marital status. The Mann–Whitney U test was performed to evaluate whether there was a difference between the ACS and CAMM scores of the pretested groups, experimental group 1 and control group 1.
Analyses of Qualitative Data
Semistructured interviews with 20 participants in the experimental groups to explore the program experiences and the changes that occurred in the participants’ lives after the mindfulness-based psychoeducation program were analyzed via qualitative content analysis. While applying the qualitative content analysis method, the processing steps proposed by Schreier (2012) were followed. The semistructured interviews with the participants were conducted using the Zoom platform by the first researcher, and visual recording was used to collect the data. All interviews were transcribed completely without missing anything.
When creating the coding framework, only a portion of the material is used to avoid cognitive overload and loss of material (Schreier, 2012). For this reason, as well as to illustrate the variety of data sources, randomly selected interviews with two boys and two girls were used to construct the coding frame. A successive summarizing strategy was used to generate the main categories and subcategories in a data-driven way. The passages that appeared superfluous were deleted, and the parts of materials that were important as relevant passages to the research question were paraphrased by the researcher. A general explanation was written by comparing the common aspects of all those with similar content, and then the categories were created. Whether there were similar subcategories and, if any, subcategories were narrowed was examined. The subcategories, which were considered to be more comprehensive than the other subcategories, were conceptualized as the main category. In the pilot coding phase, trial coding was applied to the interviews with two female and two male students. Fourteen days later, coding was performed again with the same material. The coding made by the first researcher at different time points was compared, and the second author cross-checked the codes. It was determined that almost all of the units were assigned to the same categories by the researcher after the first coding and the second coding. In the basic analysis phase, all material was coded. Half of the interviews with the students participating in the program were coded in two rounds with 14-day intervals. After the main coding, the double-coded units were compared. There were no inconsistencies between the codings. As a result of the qualitative content analysis, the frequencies indicating how often the categories were coded were presented. The categories were described one after the other by using continuous text.
Findings
Quantitative Findings of the Study
The Analyses Results to Ensure the Group Equality
One-way ANOVA was conducted to determine the equivalence of the groups in terms of academic achievement scores, and the findings revealed that the variances were homogeneous according to Levene’s test (.947, p > .05). There was no significant difference between any of the groups in the study in terms of the weighted average of academic achievement [F(3–36) = .008, p > .05]. The Chi-square test applied to determine whether there was a difference between all four groups in terms of several demographic variables showed that the participants’ age [X2(3) = 1.39], gender [X2(3) = .000, p > .05], number of siblings [X2(9) = 5.47], mothers’ education level [X2(12) = 10.1], fathers’ education level [X2(9) = 5.07], mothers’ occupation [X2(9) = 9.00], fathers’ occupation [X2(12) = 15.5] and parents’ marital status [X2(3) = 3.96] did not differ between groups (all p > .05).
Changes in the ACS and CAMM Scores After the Program
The pretest and posttest mean scores, standard deviation values, maximum and minimum scores obtained from the ACS and CAMM of the participants in the experimental 1 and control 1 groups and the posttest mean scores, standard deviation values, and maximum and minimum scores obtained from the ACS and CAMM of the participants in the experimental 2 and control 2 groups are shown in Table 1.
Pretest Posttest Mean Scores, Standard Deviation and Minimum-Maximum Values of Experimental and Control Groups Regarding Dependent Variables.
Note. ACS = attentional control scale; CAMM = child and adolescent mindfulness measure.
Two-way ANOVA of the ACS posttest scores revealed no significant main effect for pretest [F(1–36) = .042, p > .05, partial η2 = .001] and no significant interaction between pretest and treatment [F(1–36) = .523, p > .05, partial η2 = .014], indicating that there was no pretest sensitization in the ACS posttest scores of the participants. The results indicated a significant main effect for treatment [F(1–36) = 30,307, p < .01, partial η2 = .457], indicating that there was a significant difference between the ACS posttest scores of the participants in the experimental groups and the ACS posttest scores of the participants in the control groups. The ACS posttest scores of the participants in the experimental groups were greater than the ACS posttest scores of the participants in the control groups (see Table 1). To determine the permanence of the intervention, a follow-up test, the Wilcoxon matched pairs signed rank test, was applied to the experimental 1 and experimental 2 groups 8 weeks after the program ended. The findings revealed that there was no significant difference between the ACS posttest scores and the follow-up test scores of the participants in experimental 1 (z = .153; p > 0.05) or between the ACS posttest scores and the follow-up test scores of the participants in experimental 2 (z = 1.54; p > .05).
Two-way ANOVA of the CAMM posttest scores revealed no significant main effect for pretest [F(1–36) = .034, p > .05, partial η2 = .001] and no significant interaction between pretest and treatment [F(1–36) = .001, p > .05, partial η2 = .000], indicating that there was no pretest sensitization in the CAMM posttest scores of the participants. The results revealed a significant main effect for treatment [F(1–36) = 19,615, p < .01, partial η2 = .353], indicating that there was a significant difference between the CAMM posttest scores of the participants in the experimental groups and the CAMM posttest scores of the participants in the control groups. The CAMM posttest scores of the participants in the experimental groups were greater than the CAMM posttest scores of the participants in the control groups (see Table 1). To determine the permanence of the intervention, a follow-up test, the Wilcoxon matched pairs signed rank test, was applied to the experimental 1 and experimental 2 groups 8 weeks after the program ended. The findings revealed that there was no significant difference between CAMM posttest scores and the follow-up test scores of the participants in the experimental 1 (z = 1.68; p > .05) and ACS posttest scores and the follow-up test scores of the participants in the experimental 2 (z = .494; p > .05) groups.
The Findings of Qualitative Content Analysis
In this part of the research, the participants’ experiences with the mindfulness-based psychoeducation program and the changes that occurred in the participants’ lives after the program were included. The results of analyzing participants’ experiences with the program and the changes that occurred in the participants’ lives after the program are shown in Table 2. Some representative quotations were included to illustrate these categories.
Categories About the Participants’ Experiences with the Program and the Changes That Occurred in the Participants’ Lives.
The Participants’ Views on the Method of Implementation of the Program
The participants were asked about their opinions on the method of implementation of the program. The results of the analysis are given in Table 2. The participants’ views on the implementation of the program online were examined in two categories: the advantages and the disadvantages of online implementation of the program. The most common theme to emerge from the participants’ views on the advantages was the ease of self-disclosure. The adolescents expressed that online implementation helped them open themselves more easily.
[I12/F]: I think we expressed ourselves better. If we were side by side, we might be worried about how s/he would look at me and read my feelings on my face, but we could talk online without looking at the screen. We could also talk by looking around. We were less afraid. We were able to share our feelings more easily.
To focus easily was the other most common theme obtained from participants’ views on the advantages of the program’s implementation online. Some adolescents expressed that focusing was easier than a face-to-face intervention.
[I9/F]: If we had done it face-to-face, for example, if we had done it at school, maybe doors would have been opened or more noise would have come from outside. I think it was easier to focus in this way because everyone was in their own rooms.
Some of the students said that the implementation of the program provided them with flexibility in terms of time and place, presenting them with the freedom to participate in the program wherever they wanted and allowing them to save time. The most common theme to emerge from the participants’ views on the disadvantages of the programs’ implementation online was the lack of physical intimacy. Most students expressing it as a disadvantage said that online implementation did not negatively affect the process.
[I19/F]: I think that online implementation did not affect it negatively. In other words, it would be better if we were able to see each other closely, but being online did not change much in my opinion. As a result, we all had our cameras on or were able to see and talk to each other. I do not think there was any harm.
Most of the participants expressed that they were glad that the intervention was implemented online. Regarding the disadvantages of online implementation, few students reported that they had internet connection problems and had difficulty opening their cameras during the intervention. Students with internet connection problems sometimes expressed that their voices were not heard.
The Participants’ Views on the Practices in the Program
The participants were asked about their views on the practices in the program. The results of the analysis are given in Table 2. The participants’ views on the practices were examined in three subcategories: the participants’ views on the content, the difficulty in implementing the practices and the difficulty in implementing the practices in daily life. All participants reported that the practices in the program were useful for them, allowing them to learn many new things.
[I12/F]: Normally, if I had read these practices somewhere, “Will these work?” I would say and laugh. However, as I did the activities, my expectation began to grow. It was normally small a, but it was changing from small a to capital A. It turned into an enormous letter A. I think it had strange effects. You do not expect a small ant to carry big things, but they carry. It was like that.
Most of the students in the program expressed that the practices were relaxing and entertaining. One of the participants who stated that the practices in the program were relaxing expressed his thoughts as follows: [I14/M] “It was as if my mind was emptying. It was relaxing. It was as if I was leaving the world and creating a space for myself.” Another participant expressed her thoughts as follows: [I17/F] “I felt like I was lighter. I truly felt like those bad thoughts were gone with those birds. In addition, I truly liked that.” The participants thought that practices were entertaining and expressed their views: [I18/F] “I did all the practices with great pleasure, I mean, I enjoyed each of them individually.” [I16/M] “I think the practices were very entertaining. We did not know how they went anyway. They were going very fast.” Regarding the practices, all of the students who participated in the program stated that they had difficulty focusing while doing the practices in the early sessions of the program but that difficulty decreased over time. Some of the students who participated in the program stated that sometimes they felt uncomfortable while doing the practices and that they were reluctant to do practices.
[I16/M]: Sometimes I felt very comfortable, sometimes I felt uncomfortable, but even when I felt uncomfortable, I stopped and collected myself for a while and felt comfortable again. We were walking around in our body. For example, things that I did not feel at that time, some pain appeared. It was a little uncomfortable when I felt them. However, later, when I learned to accept them, there was no problem.
Regarding the use of mindfulness exercises in daily life, all of the participants reported that they implemented the practices they had learned in the program in daily life and would implement them in the future. One of the students who participated in the program expressed her view with the following sentences: [I2/F]: The program is over, I did them for the first few days, then I did not do them, but when I realized that I did not do them later, I started doing them again right away. Thankfully, being aware of our own features, I am doing them. I am breathing. I do body scans at night before going to bed. Or sometimes all of a sudden, I ask myself how I am feeling. I think what I am doing right is now like a little snowball. It will grow gradually, and it will help me a lot in the future. I think it will help me a lot in my formation. You know, when a flower is growing, we always add water, just like that. It is like I am greening right now.
The Participants’ Views on the Group Leader of the Program
The participants were asked for their opinions about the group leader. The results of the analysis are given in Table 2. The participants’ views on group leaders were evaluated in two categories: leadership characteristics and personal characteristics. Most students who participated in the program reported that the group leader had knowledge in her field. Another positive aspect highlighted by the students was the expertise of the leader in leading the group. One of the participants reported his view as follows: [I14/M] “You led well. You observed that everyone was able to focus, not focus, follow the activities or not. You were able to notice how everyone felt, what they were thinking. You did a good job.” Regarding the group leader, participants stated that the leader provided the active participation of the members to the process. With respect to this, one of the participants stated that [I13/M] “I think it was perfect. Everyone participated fully. Even those who did not come to our math class came here. I think it was perfect.” In addition to the leadership characteristics of the group leader, regarding the personal characteristics of the group leader, the participants stated that the group leader was interested and tolerant, gave positive energy to the participants and had a soft voice tone.
The Participants’ Views on the Effects of the Program on the Participants
In semi-structured interviews, participants were asked about differences in their lives after the intervention. The results of the analysis of the participants’ views on the effects of the mindfulness-based pscho-education program are given in Table 2. These views were evaluated in two categories: improvements in daily life and improvements in academic life.
The Improvements in Daily Lives of the Participants
All of the students who participated in the MBI reported that their awareness increased after they had attended the program. One of the participants expressed his views on this effect as follows: [I15/M]: I have started to look at things differently. It was not like this before. I had been just doing it. However, now, while drinking coffee, drinking tea, washing my hands, even brushing teeth, I stop and think how it is. Even my perspective on people has changed. I approach things more carefully. I approach with more awareness.
Regarding the improvements in participants’ daily lives, all of the students stated that they were better at regulating their emotions after the intervention. While expressing their thoughts, young people emphasized that they were better at managing their emotions and learned that emotions were temporary. [I17/F]: “I can control myself after the program, and I think they can too. I can think logically when things happen. I do not give immediate responses. I was normally a very angry person. I am not so angry anymore” are sentences of a participant thinking that the program had contributed to regulating her emotions.
Another improvement highlighted by the students was that they got to know themselves better and became more aware of their strengths after the intervention. One of the participants who reported that the program enhanced her self-knowledge/self-esteem expressed her views as follows: [I9/F] “I had not noticed things in myself before in any way. Frankly, I realized the beautiful things around me and myself thanks to these,” while another participant used the following statements: [I17/F] “I have realized how strong I am and that I can achieve anything I want whenever I want.” Some students who participated in the program stated that their judgments changed after the program and that they were less judgmental toward themselves and their surroundings. An increase in optimism was another improvement perceived by the adolescents after the intervention. One of the participants noted that she was more optimistic after the program with the following sentences: [I9/F] “I used to think more negatively; I think more positively now. Because of this negativity, I used to get angry from time to time and cry, but I do not have such nervous breakdowns anymore. I do not cry. There is no old A.” Regarding the changes that occurred in participants’ daily lives after the intervention, some participants reported that they could communicate more effectively. One of the participants expressed her thoughts as follows: [I1/F] “Normally, I am a bit of an aggressive person at home. Only against my brothers. I have begun to be understanding even with them. I have calmed down. I think I understand their feelings better. I communicate better.”
The Improvements in Academic Lives of the Participants
All of the students who had participated in the mindfulness-based psychoeducation program reported that their attentional control skills improved after the program. Two of the participants, who stated that their ability to focus attention and to shift attention had improved after the program, expressed their thoughts as follows: [I9/F]: Before I started the program, I was distracted by the sound of the door, even the tiniest sound, and I could not focus on the lesson for a long time. Now, as soon as I start the lesson, I am not affected in any way by an outside sound. Home folks come in and out of the room; for example, I’m not interested at all, I go on studying. [I5/F]: When I was studying, when a notification came to my phone, my mind went there, and when I looked at the phone again, I could not return to that lesson. However, this is not the case now. For example, we gently brought our attention there, as in the activities we did, and now I am able to do it. I definitely have noticed this change.
Another improvement highlighted by the students was that they listened, read and studied with more awareness after the program. One of the participants expressed his thoughts as follows: [I15/M]: For example, while I was reading long paragraph questions, I forgot the beginning as I got closer to the end. However, now, I feel like I have completely read it and can do it. This has helped me a lot. For example, even while I was listening to the class, there were too many things around me that could distract me, and I was trying to make my desk empty, but now, for example, it is not the case anymore. Now I can listen to that class with awareness.
The motivation to study and academic achievement were the improvements perceived by the students. Two of the participants expressed their thoughts as follows: [I2/F]: I could not solve the questions before because I live in a large family, and later I said to myself, “Who will solve them now?” I was saying that I cannot solve them in this noisy environment, I was saying to myself “I will solve it tomorrow morning.” However, I could not solve it the next morning either. I feel like I have more responsibility now. For some reason or other, I always wanted to do something after the sessions were over. I can say that it has increased my sense of responsibility. [I16/M]: I solved the questions automatically. There were certain types of questions that I solved quickly, and the answers often were wrong because I was so sure that the answers I had given were correct. Now, I have learned to approach questions differently. I look at them from a different perspective. No matter how similar the questions may seem to each other, I have noticed that they are different from each other. The number of correct answers in tests has increased.
Discussion
The quantitative findings showed that there was a significant increase in the attentional control and mindfulness levels of the participants in the experimental groups compared to the participants in the control groups after the intervention, revealing a large effect size. The findings revealed that there was no pretest sensitization in the ACS or CAMM scores of the adolescents. In other words, the improvement in the participants’ ACS and CAMM scores in the experimental groups was the result of the intervention. In addition, the findings revealed that the increase in the attentional control and mindfulness levels of the students who participated in the program persisted for 8 weeks. The qualitative findings obtained from semi-structured interviews with adolescents also support the quantitative findings. During the interviews, all of the adolescents reported that their attentional control improved. Moreover, the participants stated that they had difficulty doing the practices in the first weeks of the program, and their attention waned; however, in the following weeks of the intervention, although the duration of the practices gradually increased throughout the program, their difficulty performing the practices decreased. This can be interpreted as indicating that their attentional control levels improved. Studies with children and adolescents have shown that participants’ attentional control improves after MBIs (Black & Fernando, 2014; Li et al., 2021; Suárez-García et al., 2020; Zenner et al., 2014). On the other hand, there are studies revealing no significant positive effect on attentional control among adolescents (e.g., Kuyken et al., 2022). A possible explanation for this inconsistency in the results is the different responses to mindfulness training based on developmental stage (Roeser & Pinela, 2014; Roeser & Zelazo, 2012). With the strengthening of meta-cognitive and abstract thinking skills (Piaget, 1969), adolescents may benefit more from mindfulness interventions than younger children (Zoogman et al., 2015). These findings are consistent with the DCS theory, which suggests that adolescence is a time when certain brain networks and regions are more likely to change, which may make a person more receptive to mindfulness training. The factors that influence adolescents shape their development, and mindfulness training may be especially helpful during this time of transition (Carsley et al., 2018).
In addition, all of the adolescents interviewed stated that the program positively affected their academic life. Some participants stated that after the intervention, they studied, read or listened with more awareness and performed better academically. School performance and school functioning may improve as awareness and attention levels increase (Wisner, 2017). Studies have shown that MBIs improve students’ academic performance (e.g., Güldal & Satan, 2022; Mrazek et al., 2013).
In the qualitative strand, all of the adolescents interviewed reported that they had better control over their emotions after the MBI. Attentional control theory (Eysenck et al., 2007) suggests that anxiety negatively affects attentional control and causes more anxiety. Mindfulness moderates the relationship between stress and attention (Li et al., 2021). Changes in the focus of attention result in changes with regard to brain content. Individuals can change their meaning and gain insight into the transient nature of experiences by carefully interacting with them and understanding that they are temporary. In this way, negative situations are seen as temporary rather than deeply disturbing defeats (Dreyfus, 2013). Petranker and Eastwood (2021) suggested that mindfulness is associated with sustained attention owing to enhanced emotion regulation and that improving emotional control is an efficient strategy for improving sustained attention performance. Training attention can also serve as a way to improve emotion regulation (Wadlinger & Isaacowitz, 2011). Previous studies support the positive relationship between emotion regulation, well-being and mindfulness (Devcich et al., 2017; Edwards et al., 2014; Felver et al., 2016; Kang et al., 2018; Portele & Jansen, 2023; Schonert-Reichl et al., 2015; Wisner, 2014; Zhang & Zhang, 2023). However, there are findings revealing that there are no significant pre-post effects on outcomes related to mental health and well-being in early adolescence at ages 11 to 14 (Carsley et al., 2018). Studies that did not have a significant effect were conducted with younger adolescents (e.g., van de Weijer-Bergsma et al., 2012; 8–12 years of age). These results also align with the functions of developmental neuroscience. One factor influencing these differences between younger and older adolescents could be their neurocognitive maturity (Johnson et al., 2017). Late adolescents may prove to be a more advantaged research population in this regard than younger children. It offers a useful framework for selecting interventions that work for a particular population.
The quantitative results showed that the mindfulness levels of the participants in the experimental groups were greater than those of the participants in the control groups after the intervention. Previous studies investigating the effectiveness of MBIs have shown that participants’ mindfulness levels increase after interventions (e.g., Felver et al., 2016; Schonert-Reichl et al., 2015). A review of the various definitions of mindfulness reveals that each of the definitions includes some fundamental themes. One of these fundamental themes is awareness (see Bishop et al., 2004). The qualitative findings of the study also support quantitative findings indicating an increase in the mindfulness levels of participants in the experimental groups. All of the adolescents interviewed reported being more aware of their daily routine activities after the intervention. Mindfulness activities offer the practical application of being more aware of actions and behaviors (Stauffer, 2007). Mindfulness emphasizes staying in the moment and being nonjudgmental toward what individuals experience. Instead of struggling with what they cannot change and measuring their values against the standards of others, they learn to accept their thoughts, feelings and situations (Kabat-Zinn, 1990). Being nonjudgmental is a fundamental component of mindfulness. A review of the various definitions of mindfulness revealed that one of the most common defining themes of mindfulness is being nonjudgmental (Curtis, 2019). In the present study, most of the adolescents interviewed reported being less judgmental toward themselves and others after the intervention. Considering that nonjudgment is one of the components of mindfulness, this finding can be interpreted as an increase in participants’ levels of mindfulness.
In addition to these findings, some of the students participating in the program reported that as a result of the program, their self-awareness and self-confidence increased. A review of the literature revealed that the findings of previous studies support these results. The self-awareness of the youth who participated in school-based mindfulness programs increased (e.g., Wisner, 2014). Being aware of moment-to-moment experiences instills curiosity, openness, and receptivity in individuals, enabling them to be more kind to themselves (Siegel et al., 2016). In this regard, the nonjudgmental elements emphasized in mindfulness practices can also play an important role. Being nonjudgmental may lead to self-acceptance and self-compassion, which in turn increases personal self-confidence. Self-compassion is important for developing self-confidence (Neff & McGhee, 2010). The nonevaluative and nonjudgmental aspects of mindfulness are believed to support self-acceptance in terms of one’s self-concept (Gómez-Odriozola & Calvete, 2021). Developing an attitude of kindness and compassion toward oneself seems to be an essential component of a healthy adolescent’s identity development (Roeser & Pinela, 2014). Additionally, given that egocentrism is a typical and natural aspect of adolescence and frequently leads to self-awareness and self-criticism (Bluth & Blanton, 2015), mindfulness practices can help adolescents overcome the negative effects of egocentrism by helping them ground and broaden their perspectives (Amada & Shane, 2019). This can lead to more critical and realistic self-perception (Schonert-Reichl & Lawlor, 2010). Consequently, within the framework of psychosocial development theory (Erikson, 1968), which states that the main task of individuals during adolescence is to form a sense of self and identity, it is critical to assist adolescents’ cognitive and emotional growth (Wisner, 2017), which can be accomplished through mindfulness-based practices.
Overall, when the quantitative and qualitative findings obtained from the study are evaluated together, it has been determined that the online MBI is effective in improving the attentional control and mindfulness of late adolescents. It is thought that taking into account the developmental characteristics of adolescents is important in the effectiveness of the program. During the semi-structured interviews, the participants stated that the practices were useful, enjoyable and relaxing. These results suggest that the activities in the program are appropriate for late adolescents. Furthermore, the active participation of the adolescents from the beginning to the end of the program can be interpreted as indicating that the participants enjoyed the process. The qualitative findings demonstrated that most participants were satisfied with the online implementation of the program. According to a study by Chadi et al. (2020), adolescents state that participating in mindfulness-based programs online at home makes it easier for them to express themselves because they are surrounded by familiar objects, and it is pleasant and better to participate from home. The results of a meta-analysis investigating the effects of online MBIs on the mental health of university students show that online MBIs are effective in improving mindfulness in university students (Gong et al., 2023).
The adolescents who participated in the program reported that the group leader was tolerant and energetic and had effective leadership skills. The leadership and personal characteristics of the group leader may also have played a role in the effectiveness of the program. Creating and managing psychoeducational groups requires expertise and knowledge (Brown, 2004). The personal characteristics of the group leader are among the most important factors for the group to achieve its goals (Corey et al., 2014). Warmth, caring for others, sincerity, respect and tolerance are among the main personality traits of an effective group leader (Brown, 2004). Overall, the results of this research may provide insight into the quality of those who deliver successful interventions, as there are notable variations in the interventions delivered across studies, which could affect their efficacy (Emerson et al., 2020).
Limitations and Future Research
This study has both strengths and limitations. A strength of this study is the use of mixed methods to explore the effects of the MBI on adolescents. While the quantitative method provides data that allows statistical analysis, the qualitative method offers a complex picture of the situation (Creswell & Plano Clark, 2011). Additionally, in experimental studies, when pretested, participants can be alerted that the experimenter is attempting to shift their opinions, which increases their resistance to change (Crano & Brewer, 2002). Testing the effect of pretest sensitization on the participants’ ACS and CAMM scores is another strength of the study.
Conducting a follow-up test to determine the permanence of the intervention is another strength of this study. However, the follow-up test was conducted only once, 8 weeks after the intervention. To determine how long the effect of the program lasts, follow-up tests can be repeated at intervals such as 6 months and 1 year, and the findings regarding the permanence of the program can be evaluated. Further important insights could be provided by follow-up testing. Another limitation of the study is the use of self-reported Likert-type scales to assess participants’ attentional control and mindfulness. A more helpful component in future work would be to include teacher assessments of student attention. Moreover, in the study, the messages reminding the participants to practice their homework were sent at regular intervals. However, this study did not track students’ participation in homework practice. Whether the degree to which students’ homework adherence affected the intervention results was not investigated. The effect of the participants’ degree of adherence to homework can be examined in future studies. This study suggested that late adolescence is the ideal time for mindfulness practices; however, additional research, including comparison studies with standardized programs and measures across age groups, is required to confirm this finding.
Conclusion
This study contributes to the literature examining the effectiveness of interventions on adolescents’ development. It focuses on adolescence, which is a period during which the brain is more prone to change. In addition to the mindfulness-based program improving the attentional control and mindfulness levels of late adolescents, some of the participants in the program stated that it also contributed to their emotional regulation, self-awareness, self-confidence, optimism, effective communication skills, study motivation and academic success. The results of this study imply that late adolescence may be a developmental stage during which students can react to and benefit from mindfulness training both immediately and 8 weeks later. The implementation of the program can be included in policies designed to increase students’ academic success because attentional control is at the center of learning and is of critical importance for academic success. It is anticipated that the intervention can also be used in the fields of vocational guidance and career counseling. Increasing adolescents’ awareness of their likes and dislikes will help them make better decisions about their careers. Taking into account the comprehensive advantages of mindfulness training, along with the fact that training not only helps students individually but also facilitates teachers in creating a conducive learning environment by addressing student behavioral changes in the classroom, it is believed that incorporating mindfulness training into school curricula will have a major positive impact on education and teaching process. An MBI integrated into school curricula is thought to significantly benefit late adolescents given the overall benefits of the intervention.
Footnotes
Authors Note
This study is based on the first author’s PhD dissertation at the Ankara University, Graduate School of Educational Sciences under the supervision of the second author.
Author Contribution
ÇG: The design and implementation of the research, the analysis of the results and the writing of the manuscript. İY: Supervision, revision, proofreading.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Ethics Approval
This study has been approved by the Ethics Committee of Ankara University (36/2).
Informed Consent
Informed consent was obtained from all participants and their legal guardians prior to study participation.
Data Availability
The data are available from the corresponding author upon reasonable request.
