Ash’s fit-for-work note sits on her dressing table, next to a hairbrush full of blonde strands and a curling foil blister pack stamped with the word “Temazepam”. The doctor’s cursive script spells out the words “stress and anxiety”, but the image in the mirror tells you more: weight loss, insomnia, hair loss, eczema, fatigue.

This fit note is Ash’s last. Her resignation letter is on her headteacher’s desk. She had already tried going part time; the stress was the same, the pay was lower. She’d already considered looking for another position in a different school; the prospect of job hunting felt overwhelming. She had already taken a break; the symptoms dulled, but they did not disappear, and on her return they, too, returned.

So she was leaving. She didn’t know what else she could do.

Ash’s story isn’t unique. Stress in teaching is worse than in other professions, according to recent findings from the National Foundation for Educational Research: teachers are more likely to be working longer hours, and to be feeling stressed and anxious about their job (bit.ly/nferresearch).

Meanwhile, figures obtained via a freedom of information request in January last year estimated that 3,750 teachers are signed off with stress (bit.ly/longtermstressleave), and a YouGov poll of teachers found that 83 per cent feel “stressed”, with nearly a third (32 per cent) “very stressed” (bit.ly/teacherstressepidemic). What’s more, nearly half of teachers say that their morale has declined in the past year and any discussion about teacher retention quickly turns to stress as a reason the retention rate is so poor, with a third of teachers having left the profession within five years of qualifying (bit.ly/teacher-retention-rate).

Efforts to try and turn these figures around have been plentiful, and stubbornly ineffective. But, increasingly, schools are adopting an approach they hope might just work: mindfulness interventions for teachers.

For the past few years, wellbeing weeks have been scheduled into the calendar, whole-staff Insets on laughing yoga have been drafted in for the first day of term and after-school yoga classes have crept onto the bulletin board. In fact, it’s becoming ever more difficult to find a school that is not offering at least some form of mindfulness to staff.

The message appears to be: if we can’t significantly change the job, maybe we can better support teachers to cope with the job.

But is there any evidence that mindfulness can really do that? If it can, might that create a narrative of victim blaming against teachers like Ash? And is there a chance it could, in fact, make things worse?

A slippery concept

If you doubt the saturation of the teacher mindfulness market, just conduct a few general Google searches: there are mindfulness talks, workshops, courses, classes, gurus, programmes, tools, apps, equipment, food, drink - all marketed at schools desperately trying to support staff mental health. Teachers and their stress are now big business.

Mindfulness has its roots in Buddhism, but what most of these interventions and techniques offer is a more secular version.

“At its most basic level, mindfulness helps train your attention to be more aware of what is actually happening, rather than worrying about what has happened or might happen,” is the description used by the Mindfulness in Schools Project (MiSP).

If that feels vague to you, then you’re not alone: there still seems to be plenty of confusion as to what mindfulness is. It’s not yoga, but it does use the same principles. It’s not therapy, but it can help therapeutic treatment. It’s not just meditation, but it does involve meditative approaches.

It’s something with which academics researching mindfulness have struggled, too. A recent article in The Harvard Gazette highlighted the many studies being conducted into mindfulness but explained the main issue with the research was “defining mindfulness itself”. It added that a further problem is trying to pick through the plethora of different mindfulness techniques (bit.ly/harvard-mindfulness).

It’s a challenge Professor Willem Kuyken, principal investigator at the University of Oxford Mindfulness Research Centre, acknowledges, but one that he says can be overcome.

“Mindfulness is a complex construct, and like any complex construct, you can either talk about it with all of its complexity or you can distil that complexity down to its essence,” he explains. “This doesn’t mean we shouldn’t use the words, just as wisdom and love are complex constructs - it just means that when we talk about mindfulness, wisdom and love, we have to be skilled at distilling them down to their essence.”

Kuyken says he would define mindfulness as “a natural capacity we all have to pay attention to our experience of the world in a particular way, a way that is imbued with care, with curiosity and with patience”.

He has been involved in some of the largest studies of mindfulness for adults in the UK. What is clear is that there is good evidence in several areas that mindfulness can be effective.

“Just as there are different types of physical exercise - for cardiovascular fitness or strength etc - it’s the same for mindfulness practice,” he explains. “There are approaches for stabilising attention, to support us in feeling calmer, or being more compassionate.

“The most research has been in the area of health - pain, depression, addiction - and we can say with great certainty that, with those programmes, mindfulness can help.”

Mindfulness-based cognitive therapy (MBCT) is a mix of cognitive behavioural therapy (CBT) and mindfulness techniques and has been used to support people with depression. Kuyken explains that 10 randomised controlled trials have demonstrated MBCT is successful - and cost effective - at preventing relapses of depression, and reducing long-term antidepressant use.

Other research has suggested benefits for everything from irritable bowel syndrome to anxiety and stress.

“What we can say definitively is that for adults, including teachers who are at high risk of depression, learning mindfulness can help them stay well in the long term,” says Kuyken. “I think there is also good evidence that mindfulness training can help people to feel less stressed and less anxious.”

He admits, however, that other interventions can produce similar effects. And Dr Gaelle Desbordes, instructor in radiology at Harvard Medical School and assistant in neuroscience at Massachusetts General Hospital, who has conducted extensive research into mindfulness, says the positive results must be put in the context of these other interventions.

“According to a growing body of scientific studies, mindfulness seems to have demonstrable benefits for conditions such as anxiety, depression, chronic pain and addictions,” she explains. “But the effect size is moderate. In other words, mindfulness does not seem to work better than other existing treatments, such as prescription drugs and psychotherapy. There is no evidence to date that mindfulness outperforms these other approaches.”

Despite this caveat, there is encouraging evidence that mindfulness can work for anxiety, stress and depression. But are there enough teachers in an anxious or stressful state to warrant whole-school mindfulness programmes for staff? The short answer is an emphatic “yes”. But the long answer?

‘Skill needs practice’

Tamsin Ford, professor of child and adolescent psychiatry at the University of Exeter, says teachers have higher levels of distress on average than the general population and are more likely to have clinical levels of anxiety and depression.

“We did a secondary analysis of data from a study looking at teacher training and its effect on burnout,” she explains. “We were struck by the high levels of stress in the feedback from the teachers. We compared the data from the teachers with data from a clinical sample of people with depression, and with professionals who took part in a population-based survey - and all had used the same questionnaire that we had used to measure stress. What we found was that teachers were in significantly worse mental health than the professionals in the population, but not as high as those in the clinical study.

“We collected data over nearly three school years, and nearly 10 per cent scored in the range that suggests moderate or severe depression at all four time points in those three years. It is a small sample, but it backs up a lot of the complaints about the retention crisis in teaching, and that teaching is very stressful.”

Not only this, but Ford feels that the very nature of the teaching profession means that it will feel stressful for those who are part of it.

“I think teachers are highly selected as professionals to be obsessional, a bit perfectionistic,” she explains. “Most of them go into teaching because they really care and they want to make a difference, and then if you’re in a situation that is stressful and frustrating, and maybe it’s difficult to make a difference, particularly with the challenging issues facing our current education system, that can be really triggering.”

The surveys cited at the start of this article are good evidence of this - plus speak to any teacher and they will tell you a similar story of anxiety and stress as being “part of the job”.

So, clearly, teaching has a problem and it looks like mindfulness may offer a useful solution. Should yoga mats be a permanent fixture of the school hall, then, ready for whenever staff need them? Not quite.

There is a lot in the literature about what kind of interventions are effective for teachers, and what schools offer tends not to match what the evidence says works.

For example, only running mindfulness as part of compulsory CPD, Inset, in occasional after-school workshops or on team days is definitely something to avoid.

Firstly, this is because forcing someone to take part in a mindfulness programme will almost certainly mean it will not work.

“I don’t think mindfulness should be offered under duress,” says Kuyken. “Mindfulness is one way to support teachers’ mental health and wellbeing, but there are many other things that could help: taking part in triathlons, sleep hygiene, going hiking. There are many ways a teacher can look after themselves, and mindfulness is just one of those, and it is not appropriate to offer it in a conscript way.”

Ford agrees: “Putting on compulsory one-off mindfulness sessions in schools won’t hurt if teachers want to go, but if they don’t, it will just put them off. Compulsive psychotherapy doesn’t work.”

The irregularity of the sessions - even if they are once a half term, or even monthly - are also a problem: mindfulness needs to be practised frequently in order for it to be effective, with many devotees advocating daily practice.

“Like physical exercise, the more you do, then the more benefit you potentially get, and if you stop practising then you can get something of a reversal,” Kuyken warns. “Different practices have slightly different functions, and you do need to put in the ‘time in the gym’.”

A third issue is that, often, the person delivering the mindfulness class won’t be an expert, but a teacher who has done a few classes in their own time. One of the chief concerns of MiSP is that sessions can be run in a very ad hoc way by people not necessarily trained to do so.

“What you don’t want is to have someone who has done a one-day workshop and then thinks they can teach it,” explains Claire Kelly, director of curricula and training at MiSP. “It isn’t relaxation exercises, and it isn’t therapy. It certainly isn’t just ‘emptying your mind while staring at a candle’, and there is a lot of confusion out there about what it is and what it isn’t.”

So what should a programme look like? “The best practice for schools would be an eight-week course because the evidence base for eight-week courses is the strongest,” says Kuyken. “The reason for this is that it is a new skill that you’re forming, and that skill needs practice. When it’s taught in a weekly format, the teachers can go away and practise and see what works and what doesn’t work, and they can feed back to the mindfulness teacher and then have some guidance. It’s a bit like training for a 5k [run] - you need regular practice and feedback.”

Ford sets out a similar ideal: “Effective mindfulness interventions would last eight weeks, and be delivered in groups of 15 or so people, facilitated by a teacher who is trained and accredited in delivering mindfulness training, and has their own mindful practice. It is a manualised psychological intervention, so there is a curriculum that you cover. It would last about an hour and a half to two hours, with a break in the middle.

“In the group, you would have a combination of grouped and paired discussions, and then practised meditations, with feedback afterwards about how it felt, and then exercises to do in between.”

Health warning

How many schools are delivering mindfulness to staff in this way? Unfortunately, sustained interventions delivered by well-qualified professionals usually cost a lot of money, so it is likely only an extremely small number of schools will have an offer matching that recommended by the research.

But something is better than nothing - it can’t do any harm, right? Well, wrong, actually.

“Mindfulness is not easy, and it is really difficult to understand,” says Ford. “It is a psychological approach, and anything that has the power to make people feel better also has the power to make people feel worse. It isn’t good enough to have someone delivering it who is just one page further in the book; it needs to be delivered by an expert who knows what they’re doing.”

The potential negative impact of mindfulness is a real concern, according to Dr Florian Ruths, clinical lead for mindfulness-based therapy for the NHS. He warns that “if not done in a skilful way, vulnerable people (such as people who have experienced trauma, or who have a history of schizophrenia) can actually experience psychotic episodes after beginning mindfulness instruction”.

Ruths feels a health warning, just as with any exercise, is prudent. “We all know that getting on a bike and cycling can be dangerous, so we wear a helmet. If our knee starts to hurt, we tape it - it doesn’t mean we necessarily stop running.”

Desbordes says this health warning is too often silenced in the excitement - and possible overexcitement - about the positive benefits. “While there is growing scientific evidence supporting the benefits of mindfulness training, its positive effects have been exaggerated and its possible negative effects have been understudied,” she says.

There is a further concern for schools to consider, too, according to James Coyne, emeritus professor of psychology in psychiatry at the University of Pennsylvania’s Perelman School of Medicine: they run the risk of offending teachers on religious grounds.

“Mindfulness is a secularised version of a Buddhist practice, and I think if we called it ‘meditation’ then in the United States, for example, there would be problems with the church, because it is an Eastern religion. Some of the promoters of mindfulness want it both ways - they get pictures of themselves with the Dalai Lama, and then deny that it is Buddhism.”

And there is one final problem: in offering such interventions, do schools run the risk of being accused of trying to “hide” the problems causing the stress, or even shifting blame for stress onto the teachers themselves? “If you haven’t done the mindfulness, then the stress is your fault…”

Giant sticking plaster?

Ford says schools should certainly not see mindfulness as a giant sticking plaster for stress and that it should only be used in conjunction with interventions on workload and other stressors.

“I think schools need to think about how teachers can have realistic workloads, and ensure that children with special needs are provided for,” she says. “There is a lot else schools can do to look after their staff, and helping staff look after themselves is just a little bit of that.”

The academics stress that the list of issues above should not be an argument against mindfulness for teachers in schools. Run well, by trained individuals, in accordance with the research, it could clearly be a huge help to those who want to engage with it.

But the potential cost and negative impacts - not least the problem that the stressor potentially remains unaddressed - needs careful consideration.

So, ultimately, is mindfulness for teachers something schools would do best to avoid, leaving it to individuals to pursue if they wish?

“I don’t think there is ever a magic bullet,” says Kuyken. “If a lot of staff are feeling stressed and anxious in a school, then there needs to be a whole range of things that need to be done. Mindfulness might be part of that, but you need to look at workload, work-life balance, the demands being put on teachers and the culture of the school.

“Mindfulness can help, but it should be one part of many things that you can do.”

Grainne Hallahan is senior content writer at Tes and a former teacher. She tweets @heymrshallahan

This article originally appeared in the 3 May 2019 issue under the headline “Mindfulness to the rescue?”

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