Mindfulness from a Prevention Perspective Adolescents in the midst of exams, college applications, or just everyday life tell Hazelden Betty Ford's Prevention Specialists that the stress of being a teen is taxing at best, debilitating at worst. Even the healthiest students, in the face of stress, may be tempted to seek immediate relief from their stressors through the use of alcohol or other drugs. Mindfulness, as "the practice of being aware of one's mental, emotional, and physical experience in the present moment with an attitude of non-reactivity," can be a tool to support teens' healthy responses to stress, giving them pause from the impulse to numb their anxieties or run from their woes. In this way, mindfulness provides otherwise reactive teens with the ability to remain in control of their behavioral health choices, even when times are tough or stress is high. By understanding what mindfulness is, how it can support student health, and how it can be integrated into a school day, you and your community can nurture student protective factors, reduce student risks, and prevent the student use of alcohol and other drugs. A Background on Mindfulness As society faces mounting pressures and distractions, mindfulness has emerged as a widespread phenomenon; its benefits have been widely touted from lower school classrooms to the boardrooms of multinational corporations. While the roots of mindfulness can be traced to early Buddhist philosophy, the practice was made mainstream in the 1970s by Jon Kabat-Zinn, a Professor of Medicine Emeritus at the University of Massachusetts Medical School. Kabat-Zinn founded the UMass Medical School Center for Mindfulness, along with Mindfulness-Based Stress Reduction therapy (MBSR), all with the intention of making mindfulness a secular practice of evidence-based science. Today, MBSR is used in more than 200 medical centers across the United States. A growing body of research points to the benefits of mindfulness for conditions including post-traumatic stress disorder, adolescent ADHD, and chronic pain management. Over the past several decades, mindfulness approaches increasingly have been applied to substance abuse treatment and intervention programs. Additionally, according to recent research, mindfulness can also play a practical role in preventing use. Mindfulness can be a powerful protective tool, keeping healthy kids who do not use alcohol and other drugs protected from use through: increased attention improved interpersonal relationships developed compassion regulated emotions decreased stress and anxiety When it comes to mindfulness, we may appreciate the concept but not know where to start. In theory, mindfulness simply means paying attention to the "now" – where we are, what's going on around us – without any judgment or reaction. In practice, mindfulness can be a part of almost any activity. If done with one's full attention, for example, mindful eating, mindful walking, and mindful breathing all can hold health benefits for students and adults alike. For teens, mindfulness can be exceptionally useful for improving communication skills and helping them reduce stress in healthy ways. How to Practically Support Communication Skills Through Mindfulness Mindfulness can strengthen vital personal relationships by teaching students to slow down and be thoughtful with their speech and their actions. The development of such interpersonal skills in early childhood and beyond has been found by the United States Department of Health and Human Services to be protective against later substance abuse in adolescence. These skills can also be incredibly useful for teens who may want to healthfully express concerns to a peer or loved one about risky behavior like teen substance use. When talking to friends about concerning behavior, encourage students to use non-confrontational language such as: "I feel worried..." "I couldn't help feeling scared when..." "I felt hurt when...." Taking attention away from a friend's behavior, and putting the focus on the feelings the behavior generated, encourages dialogue and openness versus embarrassment or defensiveness. A mindful approach centered on care and concern is most likely to lead to productive outcome. Active Listening Active listening is another skill that can ultimately help protect students from risky substance use. Active listening is the process of fully concentrating on what another is saying. It sounds very simple, but we can all think of times when we felt like we weren't heard. Either our listener seemed distracted, or maybe he interrupted us with his own opinions or immediately tried to offer "solutions." Compare the times we don't feel listened to with those times when we feel we truly are. In these times, we feel our message is heard and understood, our points reflected back and validated. Like other mindfulness skills, active listening is developed through intention and practice. Students can be encouraged to strengthen their active listening skills through the following mindfulness exercise, recommended for small group settings in the middle and upper school levels: Divide students into pairs. Have one student in each pair volunteer to be the speaker and the other to be the listener. Explain that the student speaker will have three minutes to talk about some aspect of his/her life. Topic ideas can include hobbies, school subjects, weekend plans, etc. Ask students to avoid gossip or any topics they or others might find personally sensitive. Encourage students to talk about their experiences and their feelings, rather than just stating facts. If a student runs out of things to say, it's perfectly fine for him or her to just say, "I don't know what else to say right now," and then to pause in the moment. Instruct the listener to be attentive to the speaker in each pair. Explain to the listeners that after the speakers' three minutes are up, their task will be to try their best to summarize and paraphrase their speakers' messages back to their speakers. To summarize all that they have heard from the speakers, encourage listeners to use language like, "What I heard you say is..." and "Sounds like what you are saying is...". Instruct the listeners to look out for "non-active listening," like analyzing the message, drifting off into other thoughts or planning a response. After the first round is over, instruct students to switch roles as listener and speaker. After both students have had a turn, discuss the experience together as a class. What was it like to be a speaker? What was it like to be an active listener? How to Practically Support Stress Reduction Through Mindfulness Students have told Hazelden Betty Ford's prevention specialists that one of the reasons they may use drugs is to relax from stress. One of the great advantages of teaching students mindfulness practice is to help them understand and manage healthy and substance-free responses to stress. Adults can help students understand that stress is a natural response to perceived challenges in an environment. These challenges may vary from those that we might consider positive, like starting in the championship game, to negative, like getting into a fight with a friend. When stress, either positive or negative, outpaces the ability to cope, over time it can lead to serious health problems such as depression, anxiety, and substance use disorders. This is information that every student must know in order to stay as healthy as possible as they grow. Adults can support students by both modeling and teaching very simple stress reduction practices throughout a routine school day, week or year. For instance, students can be taught to simply notice their breath. Awareness of the breath is one of the foundations of mindfulness practice. Attention to breath as a practice can reduce physiological stress and strengthen the resilience traits in students that can protect them against risky alcohol or other drug use. Noticing the breath shifts the body out of the sympathetic "fight or flight" nervous system and into the parasympathetic nervous system where we can find and claim relaxation and restoration. Students can be encouraged to practice their stress reduction skills through the following mindfulness exercise, recommended for small to large group settings in the middle and upper school levels: Find a comfortable position sitting or standing, ideally where you can be uninterrupted. Straighten your back, but don't be rigid. Let your spine find its natural curve. Relax your shoulders. Let your arms hang down by your sides or sit comfortably in your lap. You can close your eyes if you'd like. If closing your eyes is uncomfortable, you can drop your chin a little and lower the gaze naturally. You can let your gaze rest on a point without focusing on it too much. Feel your breath. Bring your attention to the physical sensation of breathing: the air moving through your nose or mouth, the rising and falling of your belly or your chest. Notice when your mind wanders. When you notice your mind wandering, gently return your attention back to noticing your breath. Continue to breathe slowly, simply feeling the sensations of your breath. When you're ready, gently lift your gaze, or if your eyes are closed, open them. Take a moment to notice how you feel. For Younger Students Younger children can also benefit from mindful breathing. In fact, the earlier a child starts a simple mindfulness practice like attention to breath, the more likely she or he will incorporate this life-long protective skill into his or her lifelong stress reduction toolkit. Breathing exercises for younger children should incorporate a sense of imagination and fun. Our youngest students can be encouraged to strengthen their stress reduction skills through the following mindfulness exercise, recommended for small to medium group settings in the lower school levels: Find a comfortable seat. Once you have settled in, you can close your eyes if you'd like. Imagine yourself in a beautiful garden. What do you see? What do you hear? What type of flowers are there in the garden? Now walk toward a daisy in the garden. Take a deep breath through your nose and smell the daisy. Breathe out through the mouth, releasing all your tension. Repeat the exercise with a rose, a daffodil, a sunflower, and/or any other flowers. Open your eyes and notice how you feel. Growing the Health Benefits of Student Mindfulness Mindfulness skills can be taught quickly and easily in a variety of school settings. For instance, one Hazelden Betty Ford's client school in the United Arab Emirates plays the national anthem over the loudspeakers each morning. During this routine part of their days, students are encouraged to use anthem time to quiet their mind and focus on their breath. Many students describe this ritual as one of their favorite parts of the day, because they rarely have a moment to pause and just be. Consider helping students practice mindfulness by including an exercise or two in an assembly, a classroom warm-up or cool down or during advisory sessions. Like any other skill, encourage students to find opportunities to practice mindful breathing, certainly when stress levels are high, but during ordinary moments as well, such as riding to or from school, walking between classes or to the sports field, or upon waking or heading to bed at the end of the day. The more students practice mindfulness intentionally, even if it's as simple as taking a few deep breaths at different periods throughout each day, the more their abilities to pause and respond healthfully will improve. The regular practice of mindfulness can increase the capacity to stop reacting to stress in risky ways, like using alcohol and other drugs. Mindful students are increasingly able to respond to stress through healthy, substance-free activities, like journaling, listening to music or talking to a trusted friend. Just as a consistent exercise routine can transform the body over time, mindfulness can begin to transform the neuroplastic teen brain, gradually helping students healthfully recognize and respond to their own thoughts, feelings and states of being. Students can also benefit from gaining an understanding of their own risks for and protections against substance abuse from a mindfulness practice. When getting started with mindfulness, it is common for the mind to wander in thought: "I'm cold," "Is this really working?" "What's for lunch?" "I wonder what Amy meant when she said..." Adults can encourage students to identify the thoughts they have during their practices, and to label those thoughts, as "worrying," "planning," "fear," "remembering," etc. This practice helps students to examine their habitual thought patterns. In a mindfulness practice, students can take a step back and gain some perspective about their most common thoughts and feelings. With more practice, the ability to notice one's thought patterns becomes easier and more automatic. This increased self-awareness opens the door to possibility and change. For instance, if a student notices that they are a chronic worrier, eventually they can develop the ability to catch themselves worrying, take a deep breath, and come back to the task at hand. Whereas unchecked worrying may lead to built-up stress and become a risk factor for substance use, worry that is noticed and dealt with early on may be managed or alleviated by the student and his or her support network in healthy ways. Encourage students to notice and share their habitual thoughts and feelings with others, especially with trusted adults in the community. Mindful Students and Adults Too While the exercises provided herein were selected with students in mind, adults also can practice any of them to reap the benefits of mindfulness. Indeed, in randomized controlled trials, educators who learned mindfulness reported greater efficacy in their jobs, better classroom organization, and less stress and burnout. Whether for your students or for yourself, mindfulness practice will support your healthy contributions to your school community. Since adults create and hold culture in a school community, the actions of healthy, mindful adults positively impact the health and wellness of all students. We hope that you will employ a spirit and practice of mindfulness, protecting students from the risks of alcohol and other drug use.