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TABLE 1

Evidence Summary by Topic

Study, year (design)Sample Size, NAge, yStudy GoalInterventionOutcomes
Biofeedback      
 Knox et al, 2011 (clinical trial)5  24 9–17 Examined changes in anxiety and depression Heart rate variability biofeedback based on a session-by-session protocol Biofeedback-assisted relaxation training can be useful in decreasing anxiety and depressive symptoms 
 Palermo et al, 2010 (meta-analysis)6  1247 (25 studies) 9–17 Quantify the effects of psychological therapies for the management of chronic pain in youth Cognitive-behavioral therapy, relaxation therapy, and biofeedback Omnibus cognitive-behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction 
 Monastra et al, 2005 (review)7  N/A 6–19 Effects of EEG biofeedback on ADHD EEG biofeedback EEG biofeedback was determined to be “probably efficacious” for the treatment of ADHD 
 Eccleston et al, 2002 (systematic review)8  808 6–18 Efficacy of psychological therapy of children and adolescents with chronic pain Variety of biofeedback modalities Treatments examined are effective in reducing the severity and frequency of chronic pain 
Clinical hypnosis      
 Rutten et al, 2013 (systematic review)9  108 5–18 Assess efficacy of HT in pediatric patients with FAP and IBS Gut-directed HT Therapeutic effects of HT seem superior to standard medical care in children with FAP or IBS 
 Accardi and Milling, 2009 (systematic review)10  528 3–19 Effectiveness of hypnosis in reducing procedure-related pain Hypnosis Hypnosis was more effective than standard medical care or control at relieving pain in children during medical procedures 
 Vlieger et al, 2007 (RCT)11  53 8–18 Effectiveness of hypnosis for FAP and IBS 6 sessions of 50 min over a 3-mo period of gut-directed HT Gut-directed HT is highly effective in the treatment of children with longstanding FAP or IBS 
 Richardson et al, 2006 (systematic review)12  313 3–18 Effectiveness of hypnosis for procedure-related pain and distress in pediatric patients with cancer Hypnosis Hypnosis has the potential to reduce procedure-related pain and distress in pediatric patients with cancer 
 Butler et al, 2005 (RCT)13  44 4–15 Examine whether hypnotic relaxation could reduce distress for children who undergo VCUG Hypnosis Results indicate significant benefits for the hypnosis group 
 Calipel et al, 2005 (RCT)14  50 2–11 Efficacy of hypnosis on anxiety and perioperative behavioral disorders Hypnosis Hypnosis alleviates preoperative anxiety 
Guided imagery      
 Weigensberg et al, 2014 (RCT)15  35 14–17 Determine the effects of the mind-body modality of IGI in obese Latino adolescents 12 weekly sessions of a lifestyle education plus IGI program The IGI group showed significant reductions in leisure sedentary behavior and increases in moderate physical activity 
 van Tilburg et al, 2009 (pilot study)16  34 6–15 Test a home-based, guided imagery treatment protocol using audio and video recordings 2-mo guided imagery treatment Guided imagery treatment plus medical care was superior to standard medical care only for the treatment of abdominal pain 
 Weydert et al, 2006 (RCT)17  22 5–18 Evaluated the therapeutic effect of guided imagery for children with recurrent abdominal pain 4 weekly sessions of guided imagery with progressive muscle relaxation Significantly greater decrease in the number of days with pain 
Meditation and MBSR      
 Britton et al, 2014 (RCT, pilot)18  101 11.7 (mean) Effects of a nonelective, classroom-based, teacher-implemented, mindfulness meditation intervention on standard clinical measures of mental health and affect 6-wk program with daily mindfulness meditation practice Both control and intervention groups decreased significantly on clinical syndrome subscales and affect but did not differ in the extent of their improvements 
 Sibinga et al, 2014 (RCT)19  43 13–21 Explore the specific effects of MBSR for urban youth 8 weekly 2-h MBSR sessions and a 3-h retreat MBSR did not result in statistically significant differences in self-reported survey outcomes of interest but was associated with qualitative outcomes of increased calm, conflict avoidance, self-awareness, and self-regulation for urban youth 
 Sibinga et al, 2013 (RCT)20  41 11–14 Effects of a school-based MBSR program for young urban males 12-session programs of MBSR Results provide cautious support that MBSR enhances self-regulatory processes for urban male youth, including improved psychological symptoms and enhanced coping 
 Sibinga et al, 201621 (RCT) 300 12 (mean) Ameliorate the negative effects of stress and trauma among low-income, minority, middle-school public school students 12-wk program MBSR students had significantly lower levels of somatization, depression, negative affect, negative coping, rumination, self-hostility, and posttraumatic symptom severity 
 Barnes et al, 2012 (RCT)22  62 15–17 Impact of TM on LVM in African-American youth at increased risk of development of cardiovascular disease 15-min TM sessions twice/day for 4 mo TM decreased LVM index in prehypertensive African-American adolescents 
 Wright et al, 2011 (RCT)19  121 14–15 Impact on ABP in African-American patients at increased risk of development of essential hypertension BAM each weekday, 10-min sessions for 3 mo BAM participants showed significant reductions in self-reported hostility and 24-h systolic ABP 
 Flook et al 2010 (RCT)23  64 7–9 Evaluate school-based program of MAPs 30-min MAPs, twice/week for 8 wk Stronger effect of MAPs on children with executive function difficulties 
 Biegel et al 2009 (RCT)24  102 14–18 Assess the effect of the MBSR program for adolescents with heterogeneous diagnoses in an outpatient psychiatric facility 8 weekly MBSR classes, meeting 2 h/wk MBSR may be a beneficial adjunct to outpatient mental health treatment of adolescents 
 Barnes et al, 2004 (RCT)25  100 15–17 Determine the impact of stress reduction on blood pressure in adolescents by the TM program 15-min TM sessions, twice/day for 4 mo Beneficial impact of the TM program in youth at risk of the development of hypertension 
 Barnes et al, 2003 (RCT)26  45 15–18 Determine the effect of stress reduction via the TM program on school rule infractions in adolescents 15-min TM sessions, twice/day for 4 mo TM program conducted in the school setting has a beneficial effect on absenteeism, rule infractions, and suspension rates 
Yoga      
 Hagins et al, 2013 (RCT)27  30 10–11 Effects of yoga on physiologic response to behavioral stressor tasks 50 min yoga, 3 times/wk for 15 wk No significant differences in physiologic responses to behavioral stressors between groups 
 Telles et al, 2013 (RCT)28  98 8–13 Effects of yoga on physical fitness, cognitive performance, self-esteem 45 min yoga, 5 d/wk for 3 mo Social self-esteem higher in control versus yoga group, whereas general and parental self-esteem improved 
 Khalsa et al, 2012 (RCT)29  121 15–19 Evaluate potential mental health benefits of yoga for adolescents in secondary school 30–40 min yoga, 2–3 times/wk for 11 wk Measures of anger, resilience and fatigue/inertia significantly improved 
 Nidhi et al, 2012 (RCT)30  72 15–18 Efficacy of yoga on glucose metabolism and blood lipid values in adolescent girls with PCOS 60 min yoga, 7 d/wk for 12 wk Fasting insulin, fasting blood glucose, and insulin resistance were significantly improved 
 White, 2012 (RCT)31  155 8–11 Efficacy of yoga to reduce perceived stress, enhance coping abilities, self-esteem, and self-regulation 60 min yoga, 1 d/wk for 8 wk, as well as 10 min yoga homework 6 d/wk Self-esteem and self-regulation increased in both groups, whereas the yoga group reported greater appraisal of stress and greater frequency of coping 
 Mendelson et al, 2010 (RCT)32  97 9.7 and 10.6 (mean) Improve adjustment among chronically stressed and disadvantaged youth 45 min yoga, 4 d/wk for 12 wk Significant improvement in the RSQ Involuntary Engagement Scale and component subscales for rumination, intrusive thoughts, and emotional arousal 
Study, year (design)Sample Size, NAge, yStudy GoalInterventionOutcomes
Biofeedback      
 Knox et al, 2011 (clinical trial)5  24 9–17 Examined changes in anxiety and depression Heart rate variability biofeedback based on a session-by-session protocol Biofeedback-assisted relaxation training can be useful in decreasing anxiety and depressive symptoms 
 Palermo et al, 2010 (meta-analysis)6  1247 (25 studies) 9–17 Quantify the effects of psychological therapies for the management of chronic pain in youth Cognitive-behavioral therapy, relaxation therapy, and biofeedback Omnibus cognitive-behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction 
 Monastra et al, 2005 (review)7  N/A 6–19 Effects of EEG biofeedback on ADHD EEG biofeedback EEG biofeedback was determined to be “probably efficacious” for the treatment of ADHD 
 Eccleston et al, 2002 (systematic review)8  808 6–18 Efficacy of psychological therapy of children and adolescents with chronic pain Variety of biofeedback modalities Treatments examined are effective in reducing the severity and frequency of chronic pain 
Clinical hypnosis      
 Rutten et al, 2013 (systematic review)9  108 5–18 Assess efficacy of HT in pediatric patients with FAP and IBS Gut-directed HT Therapeutic effects of HT seem superior to standard medical care in children with FAP or IBS 
 Accardi and Milling, 2009 (systematic review)10  528 3–19 Effectiveness of hypnosis in reducing procedure-related pain Hypnosis Hypnosis was more effective than standard medical care or control at relieving pain in children during medical procedures 
 Vlieger et al, 2007 (RCT)11  53 8–18 Effectiveness of hypnosis for FAP and IBS 6 sessions of 50 min over a 3-mo period of gut-directed HT Gut-directed HT is highly effective in the treatment of children with longstanding FAP or IBS 
 Richardson et al, 2006 (systematic review)12  313 3–18 Effectiveness of hypnosis for procedure-related pain and distress in pediatric patients with cancer Hypnosis Hypnosis has the potential to reduce procedure-related pain and distress in pediatric patients with cancer 
 Butler et al, 2005 (RCT)13  44 4–15 Examine whether hypnotic relaxation could reduce distress for children who undergo VCUG Hypnosis Results indicate significant benefits for the hypnosis group 
 Calipel et al, 2005 (RCT)14  50 2–11 Efficacy of hypnosis on anxiety and perioperative behavioral disorders Hypnosis Hypnosis alleviates preoperative anxiety 
Guided imagery      
 Weigensberg et al, 2014 (RCT)15  35 14–17 Determine the effects of the mind-body modality of IGI in obese Latino adolescents 12 weekly sessions of a lifestyle education plus IGI program The IGI group showed significant reductions in leisure sedentary behavior and increases in moderate physical activity 
 van Tilburg et al, 2009 (pilot study)16  34 6–15 Test a home-based, guided imagery treatment protocol using audio and video recordings 2-mo guided imagery treatment Guided imagery treatment plus medical care was superior to standard medical care only for the treatment of abdominal pain 
 Weydert et al, 2006 (RCT)17  22 5–18 Evaluated the therapeutic effect of guided imagery for children with recurrent abdominal pain 4 weekly sessions of guided imagery with progressive muscle relaxation Significantly greater decrease in the number of days with pain 
Meditation and MBSR      
 Britton et al, 2014 (RCT, pilot)18  101 11.7 (mean) Effects of a nonelective, classroom-based, teacher-implemented, mindfulness meditation intervention on standard clinical measures of mental health and affect 6-wk program with daily mindfulness meditation practice Both control and intervention groups decreased significantly on clinical syndrome subscales and affect but did not differ in the extent of their improvements 
 Sibinga et al, 2014 (RCT)19  43 13–21 Explore the specific effects of MBSR for urban youth 8 weekly 2-h MBSR sessions and a 3-h retreat MBSR did not result in statistically significant differences in self-reported survey outcomes of interest but was associated with qualitative outcomes of increased calm, conflict avoidance, self-awareness, and self-regulation for urban youth 
 Sibinga et al, 2013 (RCT)20  41 11–14 Effects of a school-based MBSR program for young urban males 12-session programs of MBSR Results provide cautious support that MBSR enhances self-regulatory processes for urban male youth, including improved psychological symptoms and enhanced coping 
 Sibinga et al, 201621 (RCT) 300 12 (mean) Ameliorate the negative effects of stress and trauma among low-income, minority, middle-school public school students 12-wk program MBSR students had significantly lower levels of somatization, depression, negative affect, negative coping, rumination, self-hostility, and posttraumatic symptom severity 
 Barnes et al, 2012 (RCT)22  62 15–17 Impact of TM on LVM in African-American youth at increased risk of development of cardiovascular disease 15-min TM sessions twice/day for 4 mo TM decreased LVM index in prehypertensive African-American adolescents 
 Wright et al, 2011 (RCT)19  121 14–15 Impact on ABP in African-American patients at increased risk of development of essential hypertension BAM each weekday, 10-min sessions for 3 mo BAM participants showed significant reductions in self-reported hostility and 24-h systolic ABP 
 Flook et al 2010 (RCT)23  64 7–9 Evaluate school-based program of MAPs 30-min MAPs, twice/week for 8 wk Stronger effect of MAPs on children with executive function difficulties 
 Biegel et al 2009 (RCT)24  102 14–18 Assess the effect of the MBSR program for adolescents with heterogeneous diagnoses in an outpatient psychiatric facility 8 weekly MBSR classes, meeting 2 h/wk MBSR may be a beneficial adjunct to outpatient mental health treatment of adolescents 
 Barnes et al, 2004 (RCT)25  100 15–17 Determine the impact of stress reduction on blood pressure in adolescents by the TM program 15-min TM sessions, twice/day for 4 mo Beneficial impact of the TM program in youth at risk of the development of hypertension 
 Barnes et al, 2003 (RCT)26  45 15–18 Determine the effect of stress reduction via the TM program on school rule infractions in adolescents 15-min TM sessions, twice/day for 4 mo TM program conducted in the school setting has a beneficial effect on absenteeism, rule infractions, and suspension rates 
Yoga      
 Hagins et al, 2013 (RCT)27  30 10–11 Effects of yoga on physiologic response to behavioral stressor tasks 50 min yoga, 3 times/wk for 15 wk No significant differences in physiologic responses to behavioral stressors between groups 
 Telles et al, 2013 (RCT)28  98 8–13 Effects of yoga on physical fitness, cognitive performance, self-esteem 45 min yoga, 5 d/wk for 3 mo Social self-esteem higher in control versus yoga group, whereas general and parental self-esteem improved 
 Khalsa et al, 2012 (RCT)29  121 15–19 Evaluate potential mental health benefits of yoga for adolescents in secondary school 30–40 min yoga, 2–3 times/wk for 11 wk Measures of anger, resilience and fatigue/inertia significantly improved 
 Nidhi et al, 2012 (RCT)30  72 15–18 Efficacy of yoga on glucose metabolism and blood lipid values in adolescent girls with PCOS 60 min yoga, 7 d/wk for 12 wk Fasting insulin, fasting blood glucose, and insulin resistance were significantly improved 
 White, 2012 (RCT)31  155 8–11 Efficacy of yoga to reduce perceived stress, enhance coping abilities, self-esteem, and self-regulation 60 min yoga, 1 d/wk for 8 wk, as well as 10 min yoga homework 6 d/wk Self-esteem and self-regulation increased in both groups, whereas the yoga group reported greater appraisal of stress and greater frequency of coping 
 Mendelson et al, 2010 (RCT)32  97 9.7 and 10.6 (mean) Improve adjustment among chronically stressed and disadvantaged youth 45 min yoga, 4 d/wk for 12 wk Significant improvement in the RSQ Involuntary Engagement Scale and component subscales for rumination, intrusive thoughts, and emotional arousal 

ABP, ambulatory blood pressure; ADHD, attention-deficit/ hyperactivity disorder; BAM, breathing awareness meditation; HT, hypnotherapy; IGI, Interactive Guided Imagery; LVM, left ventricular mass; MAP, mindful awareness practice; N/A, not available; PCOS, polycystic ovary syndrome; RSQ, Responses to Stress Questionnaire; VCUG, voiding cystourethrography.

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