Mindfulness in Schools The D-Stress Baltimore Model

Why mindfulness?

“If they can be intentional about their thinking and intentional about their goals now, then by the time they’re adults they can be more successful. This program helps them learn how to govern their feelings and emotions — things that are going to be especially important for them in higher learning institutions and in the workplace.”

—Jan Stevenson wellness coordinator,

Collington Square Middle School

At Elev8 Baltimore, our goal is to ensure that every student is ready to succeed in school and in life. We integrate learning, health and family support services inside public schools, in order to meet students where they are.

Imagine you are a 6th grade student. You are upset with another student who is saying mean things at lunchtime and horse-playing during class. The student makes another jab at you and your heart starts beating faster while feelings of anger and frustration arise. You know in your head that you, shouldn’t raise your fists or your voice in school, but he/she made you really mad. How do you calm down and let things roll off your shoulders, especially when you’ve had an already rough start to your morning? And how do you hold your head up high, when experiences like this cause sadness and anxiety?

This situation is a common occurrence for young people across the country. At Elev8 Baltimore, too many of our middle grade boys were in a state of crisis, dealing with everything from the weight of caring for a sibling to witnessing an act of violence first-hand. Often, when a student experiences trauma, they are referred to a counselor — if available — to address their individual needs. Yet too few of our schools have the counseling resources they need to accommodate every student who could benefit from support. And the social and emotional needs of middle grade boys in particular were interfering with their ability to succeed in school. We realized that something more needed to be done.

In partnership with Dr. Erica Sibinga, of the Department of Pediatrics at Johns Hopkins Bayview, we created the D-Stress Baltimore program to help students deal with stressors in a healthy, positive way without resorting to negative behaviors and conflict. Our goal was to reduce levels of depression and anxiety while helping students reach their academic goals. D-Stress Baltimore teaches students in grades 6-8 how to regulate their responses to difficult feelings and resolve problems in the classroom — a lesson that permeates throughout a student’s life outside of school, in the community and well into adulthood. When the curriculum is applied to classrooms of students with extremely high undercurrents of stress, students’ focus sharpens, and their quality of live improves. The results have been impressive — not only on the individual lives of students in the program, but for school climate as a whole.

Our model is unique in that it blends contemplative practices with scientific research. This allows us to introduce the complex concept of mindfulness in a way that is easy for both adults and students to understand and begin to accept. The technique is imperative towards building a student’s awareness of what’s going on both around them and inside them. It helps young people respond to their emotions in a positive, calm way, rather than in an explosive one, when dealing with friends or teachers, difficult exams and even stressful experiences in their future.

In its early stages, D-Stress Baltimore was designed to address students’ needs at three neighborhood schools: Collington Square Elementary/Middle School, Commodore John Rodgers Elementary/Middle School, and Tench Tilghman Elementary/Middle School. Now, in its third academic year, D-Stress Baltimore has expanded its focus to address the adults in a student’s life too, including parents, teachers and school staff. D-Stress Baltimore adapts the theories and methods of mindfulness-based stress reduction — a 35-year-old mental health approach that helps people reduce their stress and promotes positive coping mechanisms — into a 12-week school-based program for young people. The core elements of the progam are: awareness, attention, acceptance, compassion and kindness. Trained mindfulness instructors teach simple mindfulness techniques during 45-75 minute classes once a week during the school day. Students additionally participate in a health education course to learn about a variety of wellness topics, from the benefits of healthy eating and exercising to wellness and self-care.

We’ve seen the transformative impact of D-Stress Baltimore on school communities and the lives of students. In this guide, we aim to share the lessons we’ve learned through creating and expanding D-Stress Baltimore so that schools and programs across the country can begin to use mindfulness and health education as a teaching and youth development tool. Our hope is that these approaches can help you better serve the full range of needs of youth who have experienced trauma, while creating classrooms where every student can succeed.

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Steps toward success

Focus on prevention. Our model focuses on prevention to complement case-by-case referrals and discipline to address behavioral problems and to ensure successful academic and attendance outcomes. This means that in addition to resolving a conflict after it has taken place, each student learns how to “press pause” and prevent a potential conflict from escalating.

At the heart of the program, D-Stress Baltimore techniques enable students to become more aware of what’s happening in the present moment — in relation to their thoughts, their bodily sensations and their feelings. For example, when a young man finds himself in a situation where anger and tensions are mounting, he can use mindfulness techniques such as taking three deep breaths, to manage his feelings and deescalate the conflict. Or, if students are struggling because

of trauma in their family or community, they can remember the lesson of the worry box — even difficult emotions that seem overwhelming can be noticed, identified, and placed in the worry box, separate from us; we do not have to over-identify with or become the feeling.

These types of techniques help alleviate some of the students’ immediate negative responses. It’s a new way to resolve current conflicts and prevent future ones, all while keeping students engaged in school and ready to learn in the classroom. In our experience, this focus on prevention pays off — for example, at Collington Square Elementary/Middle School, the percentage of students suspended dropped from 18.2 percent in the 2010-2011 school year to 14.1 percent in the 2012-2013 school year.

Focus on middle grades. The middle grade years are a key pivot point for many young people. Some students are on a pathway to graduation, while others are at risk of dropping out. By middle school, a majority of students in Baltimore schools have either witnessed or personally experienced numerous traumatic situations first-hand, and many of them are taking on greater responsibilities at home, like caring for siblings. On top of all of this, students are enduring the physical changes that come along with puberty. Because this age group faces so many challenges, D-Stress Baltimore is designed to address as many of these needs as possible through a coordinated effort that takes into account every aspect of their lives.

After conducting a trial of the mindfulness techniques in a small, private school in Baltimore with middle grade boys of color, researchers saw reductions in anxiety, improvements in how young people dealt with their anger and reductions in levels of the stress hormone cortisol. Learning how to handle stress and mitigate trauma supports a student’s ability to learn and progress on to high school, ready to graduate.

“We’re teaching kids complicated math problems and how to read novels, but we’re here to also teach them the qualities of being conscientious, aware human beings that are willing and able to give back to their society. When I think about that large picture, I think that everyone should have this skillset.”

— Tawanna Kane lead mindfulness instructor

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Some of these techniques allow students to recognize that there are other ways of interacting with confrontation, that they can take three breaths and be engaged in how things unfold in their lives.

— Dr. Erica Sibinga pediatrician, lead researcher & principal

investigator of D-Stress Baltimore

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Take the time to find well-trained, dedicated facilitators.Site-specific wellness coordinators, mindfulness instructors and health educators play an extremely important role in the overall implementation of the mindfulness model. To that end, taking the time to hire and train your staff is an important investment in the success of the program. For the mindfulness instructors, it is essential to have prior training in mindfulness and mindfulness instruction, and know the effects of learning mindfulness techniques. The mindfulness instructors are personally well-versed in mindfulness and meditation practices that are traditionally used for adults to reduce stress. In the D-Stress Baltimore program, mindfulness instructors participate in a required training program to prepare for effective curriculum implementation.

Relationship building is key.D-Stress Baltimore could not be successful without thoughtful and careful partnerships. Elev8 Baltimore leveraged existing relationships with local principals and teachers to support the team from Johns Hopkins to integrate the D-Stress Baltimore program into each school. This provided an entryway for the program, and each organization shared the weight that partnering with a new school can bring.

As you consider implementing a mindfulness program, start by thinking about what principals, teachers or staff you already have relationships with at new schools you’d like to partner with. Then, begin with those staff to build support for the program. When we launched D-Stress Baltimore, making the right connections with the right people — particularly administrative staff and those who make decisions for the school — allowed for a smoother transition. Securing just one strong staff supporter created somewhat of a ripple effect of support for D-Stress Baltimore to other staff throughout the school.

In addition to administrative staff, it is just as important to get to know the teachers who will be in the classrooms with the mindfulness instructors. Teachers can often provide specific examples of difficulties they’re having with classroom management, and that provides the opportunity to uniquely tailor the model to their needs. A simple conversation about teachers’ experiences can help build rapport that can lead to a good working relationship. Regular one-on-one meetings with teachers and administrations can provide the space to sit down and openly discuss frustrations, needs and areas of support.

As a part of their job, the wellness coordinators, mindfulness instructors and health educators take the time to meet with individual teachers and build working relationships with them before classes start for the school year. They listen and use feedback to make any necessary changes within the curriculum to address a classroom’s needs for the upcoming year. They regularly meet with school staff — including social workers, school counselors and school nurses — throughout the year to address the unique needs of each student. This ongoing relationship building helps create a strong partnership with schools, and helps the program adapt to each classroom’s unique needs.

“We’ve been lucky to work with instructors who are extremely dedicated. It requires both personal training and support, and a deep understanding of the concept of mindfulness.”

— Dr. Erica Sibinga pediatrician, lead researcher & principal

investigator of D-Stress Baltimore

“Here at Collington Square School the D-Stress Baltimore program has really done a good job of supporting the students and reinforcing a positive learning environment.”

— Melvin Holmes principal,

Collington Square Middle School4

Be prepared for the realities of working in a school.As you know, public schools in our country face a wide range of challenges, and those located in low-income communities face even more. To successfully bring a program like D-Stress Baltimore to your school or community, think about the realities that you will be facing in your district. It’s important to have the flexibility to adapt to school-specific issues: each school has its individual character and each student has their own particular needs. Having wellness coordinators in each school facilitates this learning process so that the program can adapt specifically to any given school.

Here are a few of the realities we’ve encountered working in Baltimore:

Large class sizes. Today, many teachers and students are dealing with large class sizes. This requires you to think creatively about how to deliver concepts in ways that kids can actively engage and participate. If possible, try to create smaller classes for the purpose of mindfulness instruction. Alternatively, when introducing a new concept, break the students up into smaller, more intimate groups. This allows you to do more with the practice, and opens up the space for experiential learning to happen.

Consistency matters. Entering into any school environment is going to be tough, but it is helpful to launch a program in conjunction with the start of the school year. This way, students see D-Stress Baltimore as a consistent and permanent component of their learning, rather than categorizing it as an unfamiliar, temporary one. Staff turnover is also a big challenge in many schools and has a negative impact on students. Therefore, when possible, try to retain instructors at the same school site for more than one year. This allows young people to trust that the staff of D-Stress Baltimore is available and reliable as a consistent source of support.

Cultural sensitivity and diversity. Now, more than ever, our classrooms are being comprised of students from diverse backgrounds and the need for culturally responsive approaches is a must. Today’s classrooms require teachers to educate students whose cultures, languages, learning styles and other characteristics vary. It’s important to learn about the lived and historical experiences of individual students in order to understand how to reach them effectively.

Students face harsh realities. Young people often have fragmented home lives, and unfortunately the communities in which students of color live can be riddled with chaos, violence, addiction and poverty. The vast majority of students at our schools are low-income, with a large number of students qualifying for free or reduced price lunch. Having to worry about whether or not they will have a warm place to sleep or three meals a day are real issues they are faced with. We offer mindfulness practices to create space to help them breathe and reflect in the midst of the chaos that surrounds them, while offering tools they can use both in and out of the classroom. We tell students that they are ‘the eye of the hurricane,’ and if they can remain still for a moment, they can make decisions and take action to positively address what is damaged or destroyed around them.

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Collect and use data.There are a lot of programs out there that use curriculum that is not evaluated, so the fact that D-Stress Baltimore has been rigorously evaluated makes it unique.

Evaluations prove the D-Stress Baltimore curriculum has a positive impact on participants. A randomized control trial by Johns Hopkins Bayview, for example, found 7th and 8th-grade male program participants — 96 percent of whom were African American — reduced anxiety and negative coping approaches, as well as gradually decreased the primary stress hormone (cortisol), when compared to the active control group of their Baltimore peers (Sibinga, 2013).

The program is subsequently driven by results from its first year of implementation, which show the benefits mindfulness has on students. With 299 students participating in a randomized controlled trial of instruction of mindfulness compared with health education, students in the mindfulness arm had significantly lower levels of psychological symptoms like depression, self-hostility, and post-traumatic stress (depressive and re-experiencing subdomains), as well as improved standardized reading scores (Sibinga, in preparation). We’ve been able to use these data to make the case to

new schools about the importance and effectiveness of D-Stress Baltimore and to secure buy-in from school staff and parents.

Not only do the quantitative data support the importance of the program, but so do the reactions and stories from students, teachers and principals. At the end of each school year, we conduct youth surveys which give us the chance to hear back directly from the students on how D-Stress Baltimore has impacted them. They shared that they learned how to relax, breathe, center themselves, forgive and walk

away from situations that were inflammatory and unnerving.

Stories like these aren’t uncommon. The Elev8 Baltimore youth surveys indicate that boys of color in an Elev8 Baltimore school exhibit a high value for school and recognize school as important to their future.

Having these stories and the quantitative data has allowed Elev8 Baltimore to sustain the program, attract resources and partners, and explain its impact to school staff and parents. Therefore, we highly recommend that you think at the onset about how you will collect data for your program and make sure that data and stories are collected and used regularly.

“I’ve seen the impact that it’s had. This work is really, really important — knowing our inner world, our minds and our emotional lives is hugely important

— and I’m glad to see it spread.”

— Kirk Phillips mindfulness instructor

Reduces post-traumatic stress symptoms (PTSS)

The number of students in the upper 25 percentile for PTSS reduced by one-third.

Improves reading

Significantly more students in the mindfulness group scored in the advanced reading range.

Reduces negative coping approaches

The number of students in the upper 25 percentile for negative coping approaches reduced by one-third.

D-Stress Baltimore is working.Statistics show important gains:

Reduces depressive symptoms

Students in the mindfulness group were less likely to have elevated levels of depressive symptoms (25% vs. 37%).

Transformation takes time. As you bring a mindfulness program to your school or organization, stay patient for results. Although you may not see behavior transformations overnight, you will immediately begin to see a shift in students’ overall mindsets, and and the way they respond to conflict. Some students easily gravitate toward the concept of mindfulness and enjoy it right away. For others who are a bit more resistant, the curriculum includes fun, hands-on activities proven to be effective for students to engage in the concepts of mindfulness. Often providing young men with examples of role models who incorporate mindfulness concepts in their own lifestyles is effective in creating student buy-in. By consistently using mindfulness from the beginning to the end of the school year, the concepts will begin to take root in your school’s culture.

The same also goes for school staff who will need time to engage with the approach. Devoting a series of ongoing professional development days toward mindfulness helps create a foundation to build from. We try to demonstrate that bringing mindful practices into a teacher’s everyday life can impact their whole day. Mindfulness begins from the time you park your car to the time you interact with students in a classroom, from how you greet the security guard to how you interact with the school secretary when you sign in. Teachers may not personally adopt all of the techniques, but will begin to understand that the concept applies to more than classroom lessons, as they begin to see the transformative impact mindfulness has in their school.

“While you may not see so much of a shift in behavior right away, you do start seeing the seeds of behavior change planted in the students. It’s about taking small steps.”

— Lindsey Webb program director

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We hope that this guide can be used as a helpful tool when you think about bringing a mindfulness program to your classroom, school and community. These approaches are working to address the needs of students who have experienced trauma. They can transform learning environments to become healthy places where each student can thrive. We know that each school or community will need to adapt the basic approach and lessons to customize the program for its own unique needs. Our vision is that D-Stress Baltimore and mindfulness programs like it become a permanent part of learning in schools throughout Baltimore and beyond, so that all young people are set on a pathway toward academic and life success.

Looking to the future

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“Toward the end of the school year, you really get to hear back from the students on what they’ve learned and what they’ve gotten out of D-Stress Baltimore. They’ve said they learned how to relax, they learned how to breathe, and how to walk away from situations that were unnerving — skills that can make a lasting impact on entire communities.”

— Denise Parker wellness coordinator

About Elev8 Baltimore, a division of Humanim, Inc.

Elev8 Baltimore, a division of Humanim, Inc. partners with schools, families and the community to ensure that students succeed in school and in life. Launched in 2009, we provide after-school and summer programs, school-based health services and resources, and support and outreach for families in East Baltimore. The theory of change for Elev8 Baltimore posits that students will successfully transition to high school when they are provided with the resources and opportunities to help them attend and stay in school, exhibit a positive attitude toward school and achieve academically.

About Johns Hopkins Bayview Medical Center, Department of Pediatrics

Johns Hopkins Bayview Medical Center (JHBMC) is a not-for-profit Maryland corporation that operates a community- based teaching hospital and long-term care facility.

Within the Johns Hopkins School of Medicine Division of General Pediatrics and Adolescent Medicine, the JHBMC Department of Pediatrics’ mission is to improve the health of children, adolescents, and families in the local community and beyond through excellence and leadership in clinical care, scholarship, education, and advocacy.

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For more information about D-Stress Baltimore: Website: www.elev8baltimore.orgTwitter: @elev8bmorePhone: 410.381.7171