Mixed-methods evaluation comparing the impact of two different mindfulness approaches on stress, anxiety and depression in school teachers

BMJ Open. 2019 Jul 4;9(7):e025686. doi: 10.1136/bmjopen-2018-025686.


Objectives: This study compared the impact of two different 8-week mindfulness based courses (.b Foundations and Mindfulness-Based Stress Reduction (MBSR)), delivered to school teachers, on quantitative (stress, anxiety and depression) and qualitative (experience, acceptability and implementation) outcomes.

Design: A mixed-methods design was employed. Matched-paired t-tests were used to examine change from baseline, with imputation conducted to account for those lost to follow-up. Qualitative methods involved 1:1 semistructured interviews (n=10). Thematic analysis was used to explore differences in experience between courses.

Setting: Courses took place in UK primary schools or nearby leisure centres, 1:1 interviews took place via telephone.

Participants: 44/69 teachers from schools in the UK were recruited from their attendance at mindfulness courses (.b and MBSR).

Interventions: Participants attended either an MBSR (experiential style learning, 2 hours per week) or .b Foundations (more classroom focused learning, 1.5 hours per week) 8-week mindfulness course.

Outcome measures: Stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Scale) were evaluated in both groups at baseline (n=44), end of intervention (n=32) and 3-month follow-up (n=19).

Results: Both courses were associated with significant reductions in stress (.b 6.38; 95% CI 1.74 to 11.02; MBSR 9.69; 95% CI 4.9 to 14.5) and anxiety (.b 3.36; 95% CI 1.69 to 5.0; MBSR 4.06; 95% CI 2.6 to 5.5). MBSR was associated with improved depression outcomes (4.3; 95% CI 2.5 to 6.11). No differences were found in terms of experience and acceptability. Four main themes were identified including preconceptions, factors influencing delivery, perceived impact and training desires/practical application.

Conclusion: .b Foundations appears as beneficial as MBSR in anxiety and stress reduction but MBSR may be more appropriate for depression. Consideration over implementation factors may largely improve the acceptability of mindfulness courses for teachers. Further research with larger samples is needed.

Keywords: anxiety; depression; mindfulness; mixed methods; stress; teachers.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / prevention & control*
  • Depression / prevention & control*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Mindfulness / methods*
  • Psychiatric Status Rating Scales
  • Qualitative Research
  • School Teachers / psychology*
  • Stress, Psychological / prevention & control*
  • United Kingdom