In this qualitative study, we explored Dutch secondary vocational schoolteachers’ prior expectations of a Mindfulness-Based Stress Reduction (MBSR) training. We report on their short- and long-term experiences regarding mental health outcomes and personal or mindfulness/prosocial competencies.
Method
Between September 2016 and June 2020, we interviewed 32 teachers participating in a cluster randomised controlled trial prior to partaking in a MBSR training (T0); 27, immediately after the training (T1); and 16, 9 months after finishing the training (T3). No interviews were held on T2, 3 months after finishing the training. Qualitative data was analysed using directed content analysis.
Results
Analysis of the data at T0 resulted in five themes regarding the participants’ prior expectations related to the MBSR training. Data analysis at T1 and T3 resulted in 10 themes regarding their experiences, four of which were the same as at T0: one mental health outcome (i.e. stress and unpleasant feelings) and three personal competencies (i.e. being in the present, taking distance, and recognising and changing dysfunctional patterns). The fifth "other" theme at T0 was knowledge of mindfulness and of mindfulness skills. Six additional themes emerged related to a new mental health outcome (i.e. inner calmness and pleasant feelings) and five personal competencies (i.e. being aware, concentration, acceptance and non-judgment, communicating, and showing compassion towards yourself and others).
Conclusion
Our results suggest that MBSR can reduce teachers’ stress, increase inner calmness, and foster mindfulness and prosocial competencies.
Preregistration
The trial was registered with the Dutch Trial Register (www.trialregister.nl): NL5581 (July 2016).
Opmerkingen
Beatrice Van der Heijden, Hubert Korzilius, Pascale Peters and Josephine Engels contributed equally to this work.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
To maintain and improve public education, both the quality of teaching and teachers’ personal development need to be addressed (Bragg et al., 2021; Sancar et al., 2021; Van der Steeg & Gerritsen, 2013). Teachers have demanding jobs (e.g. work pressure and social-emotional demands) in combination with few job resources, such as professional autonomy (Douwes & Hooftman, 2019; Skaalvik & Skaalvik, 2020). Consequently, in a Dutch survey study conducted in 2017, stress and burnout complaints were mentioned by more than one in five teachers in the educational sector (Douwes & Hooftman, 2019). Moreover, recent studies revealed that especially women, who are overrepresented in the teaching population, carry the burden of increased childrearing demands during the COVID-19 lockdown (Zamarro & Prados, 2021), thereby putting them at an even more serious risk for burnout (Kupers et al., 2022). Teachers’ well-being is especially troublesome in Dutch secondary vocational schools. This can be attributed to the poor capacity for implementing occupational health interventions. Causes can be attributed to poorly equipped middle managers, a culture of teachers’ learned helplessness, authoritarian leadership, a lack of mutual trust between management and employees, and frequent policy changes by the Ministry of Education (Schelvis et al., 2016; Snoek, 2021). To carry out their tasks adequately, however, vocational teachers need competencies mentioned in the qualification dossier for teachers in Dutch secondary vocational schools (MBO Raad, n.d.), a publication by the Dutch secondary vocational schools’ council. Different personal competencies are emphasiszed such as being aware, taking distance/self-reflection, regulating emotions, and self-responsibility.
Training these competencies is important since neuropsychological studies of mindfulness training suggest that mindfulness can increase attention regulation, working memory, body-awareness, and emotion-regulation (Chiessa et al., 2011; González-Palau & Medrano, 2022; Hölzel et al., 2011; Vago & Silbersweig, 2012: Whitfield et al., 2022). However, a systematic review on Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) did not support the claim of attention improvements. The review found improvements in cognitive flexibility, meta-awareness, and working memory (Lao et al., 2016). Likewise, a systematic review and meta-analysis on mindfulness attention induction by Gill and associates (2020) found a relatively small effect on cognitive functioning. Moreover, a qualitative review on health care workers’ experiences of mindfulness training mentioned improvements in personal well-being, self-compassion, and presence when relating to others (Morgan et al., 2015). In addition, two quantitative systematic reviews on the effects of mindfulness-based interventions for teachers (Emerson et al., 2017; Lomas et al., 2017) reported a decrease in experienced stress and an increase in mindfulness and prosocial competencies (i.e. capabilities that are intended to benefit another person or group, like connecting/communicating, kindness, compassion, helping), such as emotion regulation, compassion, and awareness. Emerson et al. (2017) also found an improvement in teachers’ self-efficacy. A qualitative review on employees’ experiences of mindfulness interventions (Eby et al., 2019) reported stress reduction as a perceived benefit. Another qualitative review on caring professionals, including teachers, nurses, psychotherapists, and social workers (DeMauro et al., 2019), described increases in therapeutic presence, listening, non-judgment, compassion, self-care, emotional awareness, and emotion regulation. In their overall review, Zhang and colleagues (2021) found that mindfulness-based interventions are effective for improving biopsychological conditions, including depression, anxiety, stress, insomnia, addiction, psychosis, pain, hypertension, weight control, cancer-related symptoms, and prosocial behaviours. They posited that this type of interventions can be beneficial in the healthcare settings, in schools, and at the workplace but called for more research to investigate its efficacy when dealing with different problems. In a similar vein, Kriakous and associates (2021), who conducted a systematic review, concluded that MBSR is an effective intervention which can help to improve the psychological functioning (i.e. reducing experiences of anxiety, depression, stress, mindfulness, and self-compassion but not resilience) of healthcare professionals. However, they posited that future research with longer-term follow-up is needed to explore the continuing effects of mindfulness on different psychological constructs.
In sum, the findings from earlier research presented above suggest that MBSR could contribute to teachers’ personal development, reduction of stress, anxiety, and burnout, and handling social-emotional teaching demands regarding relations with students and supportive classroom climates (Bonde et al., 2022; Hidajat et al., 2023; Roeser et al., 2012; Taylor et al., 2021). In addition, findings of a cluster randomised controlled trial on mindfulness-based stress reduction and an organisational health intervention on Dutch teachers’ mental health (Janssen et al., 2022) suggest that enhanced mindfulness enables teachers to mentally disengage from their work during leisure time, which allows them to experience fewer symptoms of psychological strain. However, to date, little is known about the impact of MBSR on the personal experiences of teachers, such as their development of mindfulness and prosocial competencies. Moreover, more in-depth knowledge about the role of prior expectations is needed to explore whether these might have a placebo effect, anticipating that an intervention will result in experiences regardless its content (Bensing & Verheul, 2010). This demands qualitative methods (Boot & Bosma, 2021; Ramanadhan et al., 2021) as this helps to gain a deeper understanding of teachers’ expectations and experiences with MBSR.
Our conceptual model is inspired by the job demands-resources (JD-R) model (Demerouti et al., 2001a, 2001b) as presented in the study protocol (Janssen et al., 2020). It is a descriptive, heuristic model, expressing relations between (groups of) variables, subdivided into personal competencies, work-related perceptions (i.e. job demands and job resources), and outcomes of interventions (i.e. mental health outcomes and work performance). The theoretical perspectives needed to substantiate the relationships between these specific concepts (Bakker & Demerouti, 2017; Bakker et al., 2023; Schaufeli & Taris, 2014) are outlined below.
The Conservation of Resources (COR) Theory (Hobfoll & Shirom, 2000; Westman et al., 2004), a general theory of motivation and stress, is valuable as it helps to reflect on teachers’ motivation for participating in the MBSR training, and on their short- and long-term experiences regarding mental health outcomes and personal or mindfulness/prosocial competencies. The theory’s basic assumption is that people strive to maintain, obtain, and create resources that they value as beneficial for meeting current and future challenges of work and life (Hobfoll, 1989). An important principle of the COR theory is that employees must invest resources, such as time and money, to prevent resource loss and to gain other resources to protect themselves against occupational stress and burnout complaints (Westman et al., 2004). Hobfoll (1989) distinguishes four types of resources: (1) objects, that have physical presence and may be linked to socio-economic status (e.g. shelter and clothing); (2) conditions, such as good health, social relations, and status at work; (3) energy resources (e.g. time, money, and knowledge); and (4) personal resources or competencies (e.g. individual traits and coping skills). These resources are not isolated distinct, but are highly correlated mutually reinforcing resources (Hobfoll, 2011). For teachers particularly, the availability of more conditions at work (e.g. challenging work, autonomy, and social support), energy resources (e.g. time), and personal resources or competencies (e.g. self-efficacy, optimism, and coping skills) will enable them to meet challenges/demands and will, ultimately, result in more work engagement and well-being. This mechanism generates an upwards spiral (gain spiral), characterised by an accumulation of resources (Hobfoll, 1989). In addition to this gain spiral, however, the COR theory also describes a loss spiral: "… those with fewer resources are more vulnerable to resource loss [e.g., diminished mastery or self-efficacy and decreased social support, Authors] and are less capable of resource gain" (Westman et al., 2004, p. 169).
In the context of our research, two reinforcing types of resources (Hobfoll, 1989) are relevant: the condition of good (mental) health and personal competencies. It is interesting to reflect on why teachers, who have busy schedules and experience stress, allocate their scarce time (i.e. an energy resource) to participate in a MBSR training to acquire a better (mental) health and personal competencies (Hobfoll, 1989). This time investment is only reasonable if teachers expect worthwhile effects from the MBSR. Another important item is which post-participation short- and long-term (mental) health effects and personal competencies are actually obtained.
Hölzel et al. (2011), inspired by four theoretical perspectives on the process of mindfulness meditation (Baer, 2003; Baer et al., 2006; Brown et al., 2007; Shapiro et al., 2006), identified four interacting components through which mindfulness works and which stimulate the process of enhanced self-regulation (Carver & Scheier, 2011). The first is attention regulation (Smith & Novak, 2003), which enhances performance and is a prerequisite to stay engaged in meditation: maintaining the focus on a chosen object and returning whenever distracted (Hölzel et al., 2011).
The second is body awareness (Mehling et al., 2009), which increases observation skills: focussing on (subtle) bodily sensations (Hölzel et al., 2011).
The third is emotion regulation (Shapiro et al., 2006), including two different strategies. The first of these, reappraisal or reconstruction, consists of approaching ongoing emotional reactions in a non-judgmental way and with acceptance. This increases positive reappraisal which refers to the reconstruction of stressful events as beneficial and meaningful. The second strategy, exposure, extinction, and reconsolidation, includes meeting unpleasant emotions (e.g. fear, sadness, anger) by turning towards them rather than turning away and discovering that these unpleasant emotions pass. This increases non-reactivity to one’s inner experiences (Hölzel et al., 2011).
The fourth is change in perspective on the self: detachment from identification or decentring (Shapiro et al., 2006), i.e. developing the observer perspective (Kerr et al., 2011). These four interacting components mutually facilitate each other, creating a gain spiral (Garland et al., 2011).
The aim of this qualitative study was to explore the influence of a MBSR training on the development of teachers’ competencies and experiences. To reach this aim, we addressed the following research question: What are the prior expectations, and short- and long-term experiences regarding mental health outcomes and personal competencies of teachers participating in a MBSR training?
To reach this aim, we addressed the following research question: What are the prior expectations, and short- and long-term experiences regarding mental health outcomes and personal competencies of teachers participating in a MBSR training?
Method
Participants
Our qualitative study was part of a cluster randomised controlled trial (CRCT) (Bland, 2004) and examined the short- and long-term effects of a MBSR training on Dutch secondary vocational teachers’ mindfulness, mental health outcomes, and personal competencies (Janssen et al., 2020).
Participating teachers for the MBSR training were recruited from five Dutch secondary vocational schools between June 2016 and March 2019. The MBSR training was implemented between September 2016 and July 2019. Initially, we had difficulties recruiting enough teachers who met the requirements to participate in our study (see the inclusion and exclusion criteria presented in Table 1). We also experienced a large number of dropouts, caused by lack of time, personal circumstances, not fulfilling expectations, and lack of motivation (Janssen et al., 2022). After additional recruitment efforts, 87 teachers met the eligibility criteria and participated in the MBSR training.
Table 1
Eligibility criteria
Inclusion criteria
Exclusion criteria
Teachers in Care, Technology, and Economy courses
Attended mindfulness training in the past 2 years
Employed in a secondary vocational school for at least 2.5 days a week for at least 1 year
Attended stress reduction training (e.g. cognitive therapy or relaxation training) in the past 2 years
For the interviews, we selected participants in the MBSR training by employing purposive sampling (Boeije, 2009), taking account of their baseline characteristics (Table 2). Due to availability constraints of the participants and the interviewer, the participants in the T1 and T3 interviews did not necessarily partake in a T0 interview. As a result, the group of participants was not identical across the three interview samples.
Table 2
Baseline characteristics of the participating teachers
Teacher
Gender
Age1
Educational level2
Course3
Years working4
Interview T0
Interview T1
Inter-view T3
T1
F
47
Acad
Tech
3
X
X
T2
M
38
High
Tech
5
X
X
X
T3
F
57
High
Tech
6
X
T4
F
60
High
Econ
12
X
T5
F
33
Acad
Econ
2
X
T6
M
62
High
Econ
18
X
T7
M
38
Middle
Econ
1
X
T8
F
47
Acad
Econ
14
X
T9
M
60
High
Econ
36
X
X
X
T10
M
59
High
Tech
10
X
X
X
T11
F
57
High
Econ
15
X
X
T12
M
58
Acad
Econ
12
X
X
T13
F
52
Acad
Tech
16
X
T14
M
27
High
Tech
2
X
X
T15
M
65
Acad
Tech
10
X
X
X
T16
F
66
High
Econ
26
X
X
T17
M
60
High
Econ
2
X
X
X
T18
M
50
High
Econ
10
X
X
X
T19
F
52
High
Econ
8
X
X
T20
F
35
High
Tech
9
X
X
T21
F
25
Middle
Econ
4
X
X
X
T22
F
48
High
Tech
1
X
T23
F
58
High
Care
9
X
T24
M
52
High
Tech
2
X
X
T25
F
58
Acad
Care
6
X
T26
F
28
High
Care
2
X
X
X
T27
F
25
High
Tech
3
X
X
X
T28
F
59
High
Care
31
X
X
X
T29
F
58
High
Care
32
X
X
X
T30
F
50
High
Care
2
X
X
T31
M
54
High
Tech
X
T32
M
66
Middle
Econ
2
X
X
T33
F
47
Middle
Care
6
X
X
T34
F
48
High
Econ
3
X
T35
F
56
High
Care
13
X
X
T36
F
57
High
Care
3
X
T37
F
26
High
Care
1
X
T38
F
62
High
Care
17
X
T39
M
49
High
Tech
11
X
T40
F
30
High
Econ
3
X
T41
F
57
High
Care
17
X
Total
F: 27
M: 14
Middle: 4
High: 30
Acad: 7
Care: 12
Econ: 16
Tech: 13
32
27
16
Range
25–66
1–36
Mean
50
10
1Age was calculated at the start of the intervention. The starting date of the interventions differed across schools
2Education level was classified as Low (lower vocational education), Middle (medium vocational education and general secondary education), High (higher professional education), and Acad (academic education)
3Course was classified as care, tech (technology), and econ (economy)
4Years working in this job for this employer
Procedure
To explore prior expectations and short-term (ST) and long-term (LT) experiences, 32 semi-structured interviews were conducted at T0, 27 at T1 (immediately after MBSR training completion), and 16 at T3 (9 months after completion). No interviews were held at T2 (3 months after completion). At T0, telephone interviews were held with the participating teachers about their prior expectations regarding the MBSR training. At T1, the teachers were interviewed face-to-face about their experiences with the training, including its ST effects, and at T3 about their long-term experiences. All interviews were conducted by the first author, an experienced psychologist and interviewer. The participants did not know the interviewer/researcher. In reporting, we followed the COREQ guidelines, being the consolidated criteria for reporting qualitative studies (Tong et al., 2007).
The telephone interviews at T0 lasted 10 min and the face-to-face interviews at T1 and T3 from 25 to 40 min. The interview guides used at T0, T1, and T3 are included in the supplementary information. All interviews were conducted in Dutch, audio-recorded, transcribed verbatim, and anonymised. The illustrative quotes were translated into English by a native English speaker.
The MBSR training consisted of eight 2.5-hr weekly group sessions each with 4–15 participants per group, daily homework involving 45 min of exercise for 6 days a week, and one 7-hr day of silence. The sessions were supervised by qualified mindfulness trainers, who received a script. Each session consisted of meditation exercises (e.g. the breathing space), enquiry, a discussion of homework, psychoeducation, and a specific theme. The specific content of the MBSR group sessions is described in the supplementary material and in an earlier article (Janssen et al., 2020).
Data Analyses
We investigated the prior expectations, and short- and long-term experiences regarding mental health outcomes and personal competencies of teachers participating in a MBSR training. Inspired by the directed content analysis presented by Hsieh and Shannon (2005), we used a deductive coding approach because of the large number of existing conceptualisations in the field of personal resources and working mechanisms behind mindfulness meditation described in the theoretical framework above. To get an overview of the data, the first two authors first read the entire transcripts separately and repeatedly. The authors used a codebook, and new concepts/codes were inductively developed (see the Supplementary Information). For the interview analysis at T0, T1, and T3, codes about mental health and personal competencies were mainly used. Each author identified smaller text units with similar content and labelled them with these codes. The authors discussed the results of the coding and adjusted these until consensus was reached. Related codes/subthemes were then merged into themes, and the codes and (sub)themes were discussed with the other authors. After consensus, the text units of the selected subthemes/themes were compiled, and notable quotations were chosen.
In this article, we report the most important themes and subthemes in the view of the participating teachers. We defined the threshold for reporting (sub)themes as mentioned by ≥ 25% of the participants.
Results
MBSR Training
The analysis of the interview data resulted in 11 themes representing the prior expectations (including motives to participate) and the experiences of teachers participating in the MBSR training (Table 3). The 11 themes included two themes which can be described as mental health outcomes (Items 1–2), eight themes as personal competencies (Items 3–10), and one theme as other, namely knowledge of mindfulness and of mindfulness skills (Item 11). Subthemes were formulated for five of these themes.
Table 3
Themes and subthemes (in italics) frequently mentioned by participating teachers before (T0) and after (T1; T3) the MBSR training
6. Taking distance (decentring, detachment, de-identification; reflection-in-action, reflection-on-action; standstill; not acting on the automatic pilot)
X
X
X
7. Acceptance and non-judgment
X
X
8. Recognising and changing dysfunctional patterns:
• Making conscious choices
• Reducing your targets
• Regulating own emotions
• Standing up for yourself
X
X
X
9. Communicating (listening, asking questions; ability to connect with others) with:
• Students
• Colleagues and others
X
X
10. Showing compassion towards yourself and others
X
X
Other
11. Knowledge of mindfulness and of mindfulness skills
X
For each theme, both the prior expectations (PE = at T0) and the short-term (ST = at T1) and long-term (LT = at T3) experiences are described. In addition, we report the revealed relationships between the themes.
Theme 1: Stress and Unpleasant Feelings
Stress and unpleasant feelings appeared to be an important theme. Three subthemes were distinguished: stress, distress (experiencing unpleasant emotions), and rumination/worrying about the future or the past. Almost all participating teachers reported the presence of stress and unpleasant feelings, including unpleasant emotions (anxiety, panic, annoyance) and ruminating or worrying about the past or future, as prior expectation (PE), and as a reason to participate in the MBSR training. The teachers mentioned different sources of stress and unpleasant feelings, such as work pressure, large classes, complex schedules, failing computer systems, private problems, and lack of stress management skills.
If it’s really busy, you have to be able to say “guys, hello, I’ve already got this and that going on; I’ll let this one go.” The pressure on you is then increased and you say “OK, I’ll do it,” too quickly. Then you can’t sleep at night, and you think “oh dear, how am I going to get all this done, because I don't really have the time.” Get it? So, then you feel pressurised and that makes you a bit uptight, because you've just taken on too much. (T16, PE)
Well, in my job I’m generally “on the go”, with some moments of peace, but mainly I’m doing a lot of running around. I sometimes find it very difficult to find peace when at work, because there’s just so much going on at once. Then I think “oh, I still have to get my email finished” … yes, there’s always a lot going on. I am mainly busy tutoring students ... but every now and then I just need to take a rest and then get going again. I notice that I get very little done, but that I’m always trying to get everything done. Then I’m actually really tired when I get home in the evening. (T29, PE)
Although no short-term experiences of MBSR on reducing stress and unpleasant feelings were found (less than 25% of the participants mentioned these at T1), stress and unpleasant feelings decreased in the long-term.
A new class, for example, that’s always exciting: “will they like me, will they be nice students, will it go well?” At the same time, I think, “these are all things I’m worrying about, making things for myself more difficult, while experience shows that you have always had good experiences with first year students, every class is different, wait, maybe I should deal with this class in the same way, like 'that’ll go well.” Yeah. So, it does help to have a little less stress. (T2, LT)
No, but you know what I mean? I’m more prepared and that gives me a lot of peace. All those little things in one day make me less stressed. (T28, LT)
Theme 2: Inner Calmness and Pleasant Feelings
Four subthemes were identified for the theme Inner calmness and pleasant feelings: enjoying pleasant experiences (small things in life), balance in the body (to feel great physically), peace of mind (not ruminating), and feeling energetic. Although there were no prior expectations related to these positive feelings, the participating teachers indicated that the MBSR training had increased their awareness of pleasant feelings, in both the short- and long-term. They mentioned, for instance, finding rest in nature.
Also learning to enjoy small things and just … It feels like going back to my childhood, that you're like a child looking at an ant, just that. (T39, ST)
Yes, yes, when I go to work by bike or on foot, it doesn't really matter which, I try to find routes where there’s as little traffic as possible. So, I try to cycle along the Rhine so that I can see a bit of water/nature. I enjoy that. Yes, I used to like nature, but I didn't really notice it. I think I’ve learned that now, so that I enjoy it more, that I see it and enjoy it even more. Yes … (T19, LT)
After the training (both short- and long-term), the participants experienced a state of tranquillity, calmness, and peace of mind, resulting in less worrying or brooding on work or private matters (which has a clear relationship with Theme 1, Stress and unpleasant feelings).
Well, it made me feel ... It made me feel very calm. This feeling of being calm meant that I could enjoy both the lesser or the more striking things more. As I said, it made me look around more attentively, so I now enjoy the world more. Things like, I go for a walk more often and I notice things that I didn’t use to. Yes, that's a kind of relaxed feeling. (T40, ST)
I notice that I’m calmer. Where before I could get worked up about something, now I can think, “so what.” (T21, LT)
Theme 3: Being in the Present
At T0 (PE), the participants mentioned that they would like to be more in the here and now, in the moment, enjoying the small things in life, instead of worrying about the future, or thinking about the past.
Just to stay more in the here and now and not be so preoccupied with thoughts about the future or the past, that sort of thing. There's not much you can do about that at the time, anyway. (T27, PE)
I would very much like to be able to better experience the moments in which I live. Yes, I can do that with the sad stuff, but yes, no, that's a bit lame, but I just want to live more in the here and now, not be so afraid of what’s coming next, but just “I’m having fun now” and then be able to dwell on that. Yes, that’s important for me. (T35, PE)
Participants did not report ST-experiences related to this theme. At T3 (LT), teachers mentioned that they had succeeded in being more in the present which, according to them, contributed to their inner calmness (as discussed regarding Theme 2).
I’m more in the present, in the moment, and things around it have become less important. When it comes to tomorrow or yesterday, it’s like “never mind, tomorrow I’ll see. If I’m able to do something about it, I will, but if I can’t do anything now about tomorrow, I won’t.” (T9, LT)
Yes, and of course we discuss it, about “pressure and all that stuff.” But, that makes you much more aware of “OK, how can I manage that, keep it under control.” Then I notice that especially with things like having a quiet breakfast in the morning, but also walking calmly around the school ... Sometimes I really run through the school, but I’m much more aware of it now. (T11, LT)
However, the participants did not always manage to stay in this state of mind in the longer term, being in the present.
I knew it all. I knew it all before that too, how to just ... think positively, then nice things happen, that sort of thing. But, because I've been too busy, I just lost all that. I didn’t have time to think about it or to reflect on it, so I just keep on going, until at a certain moment I’m aware “I’ve lost that old Y (first name).” (T21, LT)
Theme 4: Being Aware
The theme being aware has three subthemes: awareness of the body (physical sensations), awareness of thoughts and emotions, and awareness of behaviour. Less than 25% of the participants, however, mentioned being aware as a prior expectation.
Being Aware of the Body
Most participants reported that they became more aware of physical (body) sensations, in both the ST and LT.
Yes. What I noticed is that I didn't realise I was having palpitations so often, that I was a bit stressed, had inner turmoil. I thought, “good grief, that this is happening so often.” So, I thought “why am I experiencing this, what’s making me so restless?” I then became aware that I had more inner turmoil than I had realised. (T29, ST)
I always cycle to school, it's about twenty minutes. Then I really notice the surroundings ... things like “I feel the wind on my face or through my hair” or “I smell ....” I use my senses more. I see the birds. And I appreciate that more as well. (T28, LT)
Being Aware of Thoughts and Emotions
Participants described that they became aware of their thoughts and emotions, in both the ST and LT.
The moment I’m unhappy about something it’s “can I do something about it and do I want to do something about it, then I have to do something about it and can’t do anything about it, then I have to try not to worry about it because that's just the way it is.” That’s something I’m consciously working on and that really came to me clearly from the mindfulness, like “oh, wait, yes, if I’m consciously working on that, then I can really help myself too.” (T2, LT)
Moreover, the participants’ awareness of the relationship between physical sensations and thoughts and emotions increased. Physical sensations were regarded as a warning that the participant could exceed their limits.
And now I feel it more quickly. Then I think “oh, this doesn't feel good or this is unpleasant, why and what is that; is it the environment, is it the people here - are these the reasons I’m not feeling great?” I’m more aware of that now than before. (T29, LT)
Being Aware of Behaviour
Participants described that they became aware of their dysfunctional behaviour, both in the ST and LT.
I'm also the kind of person who’s very quick to have an opinion and to say something about it, to interfere, as I sometimes call it. I let that go a lot now ... at least, I still have to train myself to do so, but I’m more aware that I should just let things go. (T39, ST)
I think “ok, then I’ll just work a bit longer.” But, at a certain point, of course, it's simply not enough to work longer, to have your vacation cancelled, to have your day off cancelled ... This all creeps in and before you know it, your evenings are taken up with lessons. Then I think “wait a minute, something’s going terribly wrong here, so I have to do something about it.” (T11, LT)
Theme 5: Concentration
Concentration refers to focus, attention regulation, and minimizing distractions. In the ST, many teachers mentioned better attention regulation and more focus.
I can focus much better when I do yoga exercises, so it combines with my physicality. (T38, ST)
Yes, yes. And it’s also about focusing on the little things, right? So indeed, your breathing, enjoying a shower, that sort of thing. That does give you peace, which eventually lasts a bit longer through the day. And that’s also because you can do that at different times of the day. So, I did the deep breathing exercises in the morning before I got up. (T38, ST)
Theme 6: Taking Distance
Taking distance includes practices such as decentring, detachment, and reflection-in-action or reflection-on-action, rather than operating on the automatic pilot. At T0 (PE), teachers mentioned that when they were stressed, they wanted to be able to stop for a moment and reflect on the situation (reflection-in-action) to be able to make considered choices about whether a particular behaviour would be helpful or not. In this way, they tried to avoid their reliance on their automatic pilot, wanting to react in a more conscious way. They also expressed a desire to learn strategies for letting go during difficult situations or when experiencing negative thoughts, in order to achieve greater rest and relaxation.
Uhm ..., well if you then ..., uhm, ... to put it nicely: steer clear of that day’s madness for a while and, as I say, don't get drawn into it so much. For example, in the classroom or so, uhm ... that you sometimes react angrily ..., you could better channel anger or so, ... stay calm, ... or something like that. (T7, PE)
It always takes me a long time before I do things; I really can't do anything about ... That I've thought about what I'll do next time, but then I'm still stuck with the idea that I didn't do it right. I know you can make mistakes, but I can't stand it. So just let it go … yes, let go. Yes. Yes, I think that's it. (T35, PE)
Both ST- and LT-experiences were reported. The increased awareness of physical sensations, thoughts, emotions, and behaviour (see Theme 4) could result in increased reflection-on-action and reflection-in-action. Teachers indicated being enabled to disengage or de-identify from their thoughts and feelings about the school they worked for and their students.
Just to give a helping hand, the moment you grab the door handle to go inside - just to say that, where am I, how am I, am I all right? Yes, if no, rest a moment. And then walk inside. That’s really become an anchor for me. And that way I can feel right - I know where I stand when I go into a lesson or a meeting. (T11, ST)
“Well, that’s enough”; then I make some time for myself and say “well, don’t do that now, think about it for a moment, what did you say about yourself, that you should be milder, that you shouldn't react too quickly ...” Then I take a moment... Sometimes it only lasts a few seconds or so, but I take a moment to say “OK, just calm down.” Then I also notice that my initial excitement subsides. Then I can say what I want to say in a calmer, more friendly way. (T9, LT)
Some teachers mentioned that they developed the habit of briefly pausing between appointments with two students to be able to pay attention to their breathing, and to reflect on their feelings.
I think it’s all about attention, directing my attention. What I do more consciously is, between one pupil or student and the next, always do a little breathing exercise. That’s also linked to organising my papers, a moment of peace before I move on to the next one. I didn't do that as much before. (T13, LT)
The participants mentioned that when they were stressed in the classroom (see Theme 1) about students or private life, they were able to stop for a moment and reflect on the situation to make considered choices about whether particular behaviour would be helpful or not.
Yes, just being aware of your body. Yes ... that’s also an effect. Yes, indeed, when I walk through the corridors from class to class, I don't let myself be led by the thought of, “I’ve got to be on time” for example – which would make my walk through the corridor stressed without my realising it. So, then I just think, “OK, that’s the time, I'm not going to walk any faster by thinking that, so I'd better let go of that thought and just walk to the classroom, nice and calm.” (T27, ST)
Those feelings of stress; as soon as I recognise them or notice that they’re coming up, I already know, “OK, stop, I mustn’t do that anymore.” Then I can immediately put it into perspective, put it aside and do something, for example go for a walk or think about my breathing for a moment, to get rid of that stress. (T19, LT)
Theme 7: Acceptance and Non-judgement
Acceptance, so be it, is the opposite of avoiding or fighting against (mostly unpleasant) feelings. No prior expectations were mentioned by the participants. However, the MBSR training clearly resulted in attitudinal changes that the participants considered helpful in the classroom, in both the short- and long-term. They experienced being less critical about and more accepting of difficult experiences which led to increased tranquillity and calmness (see Theme 2). Some teachers even indicated their vulnerability as a human being, for example referring to disease and mortality.
Yes. Being bothered by the other people’s behaviour; I’ve noticed that this has already decreased. (T33, ST)
Yes, it’s true, but notice it and that’s it. Then I bring myself back to reality and I see what’s happening again. Then I think, well, yes. (T39, ST)
Accepting in any case that this is my team, and that I have make the best of it, I can't change that. So, there’s a bit of acceptance about a few things. Yes, accepting things. I notice that with more things, like, “no, you just have to accept that this is how it is.” It doesn’t mean that you always have to agree, but you have to go along with it and deal with it, give it a place. I think that’s the main thing. (T33, ST)
Or … “OK, you’re just a part of the world then, you’re also transient, so you shouldn’t make such a big deal out of it.” Of course you do, but “that’s the way it is, you have to accept it.” I tried to do it a bit like that … distancing yourself from your own perceived “important” role. Well, I’m going to die one day, just like everybody else. (T19, LT)
Theme 8: Recognising and Changing Dysfunctional Patterns
Recognising and changing dysfunctional patterns implies gaining insights into one’s own automatic, not always helpful, mindsets and behavioural patterns, and being enabled to change them. Based on the interviews, we divided these patterns into four subthemes: making conscious choices (prioritising and limiting efforts), reducing own targets (good is good enough; less perfectionistic), regulating your emotions, and standing up for yourself (implying expressing your own needs and particular interests; caring for yourself).
The prior expectations only refer to the third subtheme regulating your emotions.
Yes, I think you do become more aware of your thoughts or feelings, calmer. I’m always calm, but not at the moment when I explode. I know I shouldn't and yet it happens. (T21, PE)
A recent example: all the tests had been organised. So, I had arranged “he sits in that classroom, he sits there.” I also took over a classroom. Then we took a break, I came back and there was a whole pile of new tests on my desk. Like, “oh …, where am I going to put all these students?” I only had three. Then I can get very panicky. I stayed reasonably cool that time, but that’s an example of what happens regularly, that I really panic, like “oh ..., help and now?” (T33, PE)
Making Conscious Choices
The participants realised that they had a choice when dealing with stressors. They were better able to manage their ST and LT-time by prioritising, realistic planning, and setting limits. They improved their self-regulation, and this resulted in tranquillity and calmness.
Yes, I’ve become more aware that everything can be a kind of choice and that you can also make a good choice, instead of always continuing as an autopilot. (T27, ST)
I've agreed with myself now; to be able to meet all the students, especially to get to know them, if they're at the same institution and on the same internship days; then I'll take them together. Before, I did that separately, so that gives me extra time. I now think differently - “a final interview can’t take longer than three quarters of an hour.” I always took an hour, often more. So, I’m not going to do that either. I’ve already agreed that with myself. (T29, LT)
Reducing Own Targets
Half of the participants reduced their perfectionism in the ST and LT: feeling too responsible for students, working too many hours, having too many tasks, fear of failing, and trying to meet their own very high expectations.
Yes. So, I notice it especially when in private, that I’m a bit more relaxed, that I don’t beat myself up when I make a mistake or when I’m angry. (T40, ST)
Yes, but I needed that too. I suffered a bit from perfectionism. I wanted to manage everything, … I wanted to be ahead of everything. All of which were at the expense of myself. In those days, I could stay at school until six or seven o’clock to make sure my things were finished. And now I think “yes, hello, I’m off home.” (T27, LT)
Regulating Your Emotions
Half of the participants indicated that they were able to reduce their emotion in a conversation with a student or colleague, and that they could change the expression of their emotion in the ST and LT.
I wasn’t happy with myself, a lot of stress. All sorts of things were happening. Of course, this is true for everyone - all sorts of things happen that can make you sad or nervous or angry. Learning to deal with that is mainly what I got from the mindfulness training. Things are more pleasant now. Of course, stress and stuff still happen, but I find it easier to deal with. Yes (T18, ST)
I spend all day in discussions, don’t I? Yes, I do that better now, I think. I could still do better, but I’m also someone who’s quick to show my feelings. Sometimes it’s better to do that less and just stay calm. Suppose a student doesn't do what he or she is supposed to, then I can be very fixed in my way of questioning and about the planning. Then I think “OK, no, let’s do it differently.” Then I sit back in my chair, I feel my back and my seat and my feet on the ground. “Okay, stay calm, it's not going to help anyone if I let my feelings show, the point is to get the student moving, not me.” (T28, LT)
Standing Up for Yourself
Almost half of the participants indicated that they were taking better care of themselves, without feeling guilty or selfish in both the ST and LT. At school, this resulted in saying "No" more often, which made them feel less tired.
I now take time and make space for myself … I take good care of myself. (T12, ST)
Yes, I think I’m more visible than before. Yes, I make my presence more obvious … I think so … yes … I think so. (T29, ST)
I've become very aware that those moments of rest in the day are really important and that for you it’s important to be consciously present about what you're doing… and that you get a lot more done and that when in contact with people, you work much more from your own point of view, like “what do I want, what do I think?” If I didn’t do that, I’d just lose myself and then I’d be busy all day doing all kinds of things. I’d just go on and on and on, and at the end of the day I’d be completely exhausted. (T27, LT)
These participants also reported having gained more insights in their own automatic, not always helpful, patterns, and most of the teachers described behavioural changes that arose from being in the present (Theme 3), awareness (Theme 4), taking distance (de-identifying) (Theme 6), and accepting (Theme 7).
I’m exercising more, doing more sport. (T2, ST)
I am reacting less strongly to situations. (T39, ST)
I think I’m now listening a bit more, that’s what I’m trying to do. I’m trying not to be continually caught between things all the time, but to listen more and be more normal ... that’s what I’m doing now. It's very difficult though. (T33, ST)
And one important thing that I’ve resolved is about eating. I’ve always taken very bad care of myself in terms of eating habits. In fact, I still do, well, not “always.” Now, of my five working days, I do okay on four. At least, I pay attention to it by actually sitting down on the couch in the morning, before starting the day, quietly eating my bowl of muesli or drinking my cup of coffee, quietly looking around. Yes, I never used to do any of that. (T11, LT)
This means that not all participants indicated that they had succeeded in making behavioural changes, but they were at least able to reflect upon this.
So, I don’t allow myself those moments of rest. I don’t give myself the time to keep applying it. (T18, LT)
Theme 9: Communication Skills
Communicating implies listening, asking questions, and enhancing the ability to connect with others. Two subthemes were distinguished: communicating with students, and communicating with colleagues and others. Although no expectations prior to the intervention were mentioned, the participants reported both ST- and LT-experiences.
Communicating with Students
The teachers mentioned that because of the intervention, their communication with students in the ST and LT had become less automatic or impulsive: more patience and attention, more to-the-point, less anger, and describing their own emotions earlier. Some teachers even did mindfulness exercises to calm their students.
Yes, I now involve the pupils a bit more, in the lesson. I’m a bit more creative about preparing stuff and things like that. And, on the other hand, I’ve also learned that when you’re in front of a class, the ambiance and being connected with your students is very important to achieve things, so getting the ambiance right to do things together. (T27, ST)
Yes. Well, I’ve always had a reasonable to very good relationship with my students, so I don’t often have this ... I can sometimes be a bit finicky, but I’ve never really come under pressure or had arguments with students about that. But, even there I do notice it, yes. I think I’ve become a bit more tolerant. I think maybe that’s the right word. I’ve become more tolerant, less quick to say, “you have to do it”, let’s listen first. (T9, LT)
Yes, that I am called in more often by colleagues because a pupil is sad or because they say, “can you take a look, he’s totally upset, can I let him go home safely?” Yes. Yes. I don’t know if it was really like that during the training or if I made it up myself, that’s how it works, but at a certain point we were breathing and I had this image of “I breathe in like this, like that, and then that goes through all those thoughts, then I breathe out like that and that makes the thoughts lighter or something.” I do this exercise with my students, saying “well, look at this.” That’s how it works for me and when I’m with Installation Technology, I use an expansion vessel. Let’s see what fits. (T19, LT)
Communicating with Colleagues and Others
After the training, the teachers indicated that they were also more aware of their communication with colleagues and others in both the ST and LT. They were more open-minded, had closer relationships, showed more self-disclosure, and were more vulnerable.
Then you can often be a bit friendlier to your colleagues, that’s right, you can. I think things are getting, uh, better. (T9, ST).
Then they tell me, “I think you’ve changed in the past year; you’ve become more open.” That I don’t only laugh and party, but that I’m more open to show my vulnerability. Yes. So that’s good. Mostly I hear that am more open. (T12, LT)
Theme 10: Showing Compassion Towards Yourself and Others
Showing compassion (being kinder) and empathy to others was experienced as an important effect of the training. The participants reported that they felt more compassion and empathy towards themselves and their colleagues in the ST and LT. More specifically, they saw the commonality between their own struggles and those of their colleagues, recognising the shared humanity.
Stupid mistakes I made today; well, I don’t need to get worked up about them the next day. I Just think…that’s what happened, too bad … something like that. (T10, LT)
So, accepting things as they are [yes], that’s one and uhm ... yes things that you can’t change, worry less about those and yes be kinder to yourself, that’s what I got out of it as well. I’m very good at being negative about myself ... [hmm] but in any case, now I’m more conscious of that so I think, “why should I be so negative about myself?” (T2, ST)
Yesterday, I’m always nice to my students. Always. Always. I always find the students the very, very, very nicest. I always have a great relationship with them. It’s only when they’re really annoying, not doing their homework and so on, then I lash out and say, “listen a minute, I’m not going to enjoy this, of course, but you can’t always freeride.” But, that’s necessary too. That’s also part of the learning process. (T16, ST)
Theme 11: Knowledge of Mindfulness and Mindfulness Skills
At the start of the MBSR training, participating teachers aimed to obtain knowledge about the effects of mindfulness, and about mindfulness techniques, to achieve peace-of-mind, and to prevent stress and burnout complaints. In addition, they indicated that they were very eager to learn mindfulness skills.
Yes, and I do hope I’ll learn something, uhm, like a few techniques or ways of calming myself. (T5, PE)
Yes, well, I hope that I’ll get a few extra clues to timely ward off possible stress, burn-out symptoms or things like that. That’s what I’m hoping for. (T24, PE)
Coherence Between the Themes and the Short- and Long-Term Effects
Their prior expectations about ways to reduce the amount of stress and unpleasant feelings, and to increase being in the present, taking distance, recognising and changing dysfunctional patterns, and increasing their knowledge of mindfulness and of mindfulness skills were largely or partly met. The ST- and LT-experiences regarding mental health outcomes and personal competencies are closely linked. Hence, the effects (among others personal competencies) appeared to be sustained in the LT (Fig. 1).
Fig. 1
ST- and LT-experiences regarding mental health outcomes and personal competencies
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Discussion
Our study provides insights into teachers’ prior expectations to participation in a MBSR training and into their ST- and LT-experiences regarding mental health outcomes and personal or mindfulness/prosocial competencies. The teachers who participated in MBSR indicated that the training had affected their mental health. Our analysis revealed that participants experienced a reduction in stress and unpleasant feelings, and that their inner calmness and pleasant feelings had increased. Moreover, they indicated that their development of personal competencies had been stimulated. That is, the teachers reported an increase in being in the present and being aware of physical sensations, thoughts, emotions, and behaviour, which resulted in their being able to take distance (i.e. they took time for reflection during and after their actions). Their acceptance of and non-judgmental attitude in difficult situations which could activate unpleasant feelings were improved. Insights in dysfunctional patterns increased and most experienced behavioural changes: making conscious choices, reducing their targets, better handling of emotions, and standing up for themselves. Communicating with students, colleagues, and others also improved, and compassion towards themselves and others increased. The ST-experiences regarding mental health outcomes and personal or mindfulness/prosocial competencies seemed to be sustained in the LT (Table 3).
Some teachers, however, only used mindfulness as an awareness tool. More specifically, their participation in the MBSR training had enhanced their awareness and insights in their own behavioural patterns, yet they did not succeed in making any changes to their behaviour. Furthermore, a majority reported that their expectations about the reduction of stress and unpleasant feelings, and the increase of being in the present, taking distance, recognising and changing dysfunctional patterns, and knowledge of mindfulness and of mindfulness skills were largely or partly met.
Our data, as presented in Fig. 1 and Table 3, support the evidence of existing constructs, the increase of mindfulness and prosocial competencies as mentioned in Fig. 2, but not so much the evidence of the process of change. However, while the data suggest the sequential ordering of competencies as visualised in Fig. 2, we have not found strong empirical support for this ordering in our study. We argue that our findings might indicate possible interrelationships between themes of personal competencies (Table 3), which could be revealed in a hypothesised process of change model (Fig. 2). The process of change model was indicated by interviewing MBSR participants, during and after the MBSR training, about the competencies they developed and about their interrelations. This is in line with the theoretical perspectives about the process of mindfulness meditation (Baer (2003), Baer et al. (2006), Brown et al. (2007), and Shapiro et al. (2006)), and with the theoretical model by Hölzel et al. (2011), which was inspired by the previous four authors (Baer (2003), Baer et al. (2006), Brown et al. (2007), and Shapiro et al. (2006)). Personal competencies is a deductive concept (Janssen et al., 2020) and the specific competencies were inductively developed (Fig. 1). The first component, attention regulation, in the model by Hölzel et al. (2011) refers to concentration in our process of change model. The second component, body awareness, corresponds with being aware. Emotion regulation, the third component, forms a part of recognising and changing dysfunctional patterns. Lastly, change in perspective on the self corresponds with taking distance.
Fig. 2
Hypothesised process of change model
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The hypothesised process of change model (Fig. 2) adds several other personal competencies: being in the present; acceptance and commitment; communicating; and showing compassion towards yourself and others. The model suggests a circular and iterative process rather than a linear one.
Furthermore, our findings show similarities with previous studies on the MBSR experiences (DeMauro et al., 2019; Kaunhoven & Dorjee, 2021; Morgan et al., 2015; Schanche et al., 2020; Van Dijk et al., 2022; Verweij et al., 2018). Being aware, taking distance, acceptance and non-judgment, regulating your emotions, communicating with others, and showing compassion towards yourself and others were important themes.
Last but not least, the outcomes of our study reveal remarkable parallels with the personal or mindfulness/prosocial competencies needed by Dutch secondary vocational teachers (MBO Raad, n.d.). Essential personal competencies needed and cultivated by MBSR are being aware, taking distance or self-reflection, regulating your emotions, and self-regulation. As mentioned earlier, these personal or mindfulness/prosocial competencies are highly correlated and mutually reinforcing (Hobfoll, 2011). For teachers in particular, the availability of these kinds of competencies will enable them to accumulate resources (in this case additional competencies; gain spiral) (Hobfoll et al., 2018; Westman et al., 2004), herewith increasing their capacity to meet (new/additional) challenges/demands. This will result in greater well-being and work engagement.
In our articles on the protocol (Janssen et al., 2020) and the quantitative results of the cluster randomised controlled trial (Janssen et al., 2022), we mentioned the teachers’ exceptionally low score for stress at baseline, given that one in five employees in the educational sector reported stress or burnout complaints in 2017 (Douwes & Hooftman, 2019). It seems that the target group for our intervention — teachers with the highest stress scores — did not participate in our study. We also faced difficulties in recruiting enough participants and experienced a large number of drop-outs, caused by a lack of time, personal circumstances, not fulfilling expectations, and lack of motivation (Janssen et al., 2022). COR theory (Hobfoll & Shirom, 2000; Westman et al., 2004) offers a plausible explanation; it states that those individuals who lack primary resources (e.g. awareness, taking distance, and social ties), and those who lack secondary resources (e.g. time, suffering from high job and/or private demands), are less capable of resource gain and more vulnerable to resource loss (Hobfoll et al., 2018; Westman et al., 2004). Ironically, those who were most in need of obtaining resources were unable to participate. They were caught in a loss spiral (Hobfoll et al., 2018) and were unable to invest enough to gain more resources. Individuals with average stress, less job, and/or private demands, and more time would be more likely to participate in the MBSR training and would obtain relative easily more resources, ending up in an upwards (gain) spiral (Hobfoll et al., 2018). This phenomenon is called the Matthew effect (or accumulated advantage) where the rich get richer and the poor get poorer (Merton, 1988). Those teachers who begin with an advantage (good health, time, knowledge, coping skills) in comparison to their counterparts accumulate more advantage over time, and those teachers who begin at a disadvantage become more disadvantaged over time (Dannefer, 1987; Merton, 1988; O’Rand, 1996).
The participating teachers were able to take advantage of the gain spiral: they could invest enough resources (time; energy; good health/less stress; coping skills) to gain more resources (personal competencies). More careful selection could stimulate participation of teachers who lack resources, using criteria such as the extent of stress/burnout complaints, willingness, presenteeism and absenteeism rate, and genuine understanding of teachers’ needs by the management team (Janssen et al., 2022). Insights in the teachers’ needs gives management the opportunity to provide participating teachers with sufficient and appropriate resources (for example, participating in the training during working hours, energy, social support, gain basic coping skills) to break the loss spiral and generate a gain spiral, characterised by an accumulation of resources (acquire personal competencies during the training).
A positive approach, for instance by emphasizing work pleasure instead of stress, was a great stimulation when recruiting teachers for the study (Bolier et al., 2013; Carr et al., 2021; Schueller, 2010). However, the organisational health intervention sometimes distracted from the person-centred MBSR training. Teachers participated for their own sake instead of in response to the organisation’s problems.
Throughout the MBSR training, teachers were encouraged to practice mindfulness exercises. However, this practice decreased after the training.
Strengths, Limitations, and Future Directions
The longitudinal design of our study, interviewing participating teachers at three time points (T0, T1, and T3), is a strength. This enabled us to determine the sustainability of the findings and possible developments over time, complementing our quantitative study (Janssen et al., 2022). Other strengths were the number of interviews and the focus on positive outcomes.
However, we note several limitations as well. First, the teachers were self-selected, and thus motivated to participate in the MBSR training. Second, some invited teachers did not accept participation or declined to be interviewed at three time points. Therefore, we are not certain whether all experiences, that are of interest given the focus of our study, are included (Klingbeil & Renshaw, 2018). Another consequence of our approach is that we could not detect indications for the effect of prior expectations on subsequent experiences of participants.
Our qualitative study focused on self-reported data from participating teachers. In future studies, observer, supervisor, or students’ observations of actual teachers’ behaviour could also be used to increase data reliability and validity.
Although many of the participating teachers in our study seemed to have benefitted from MBSR training, our sample was based on self-selection. Future research should focus on questions such as whether mindfulness should be offered to all teachers, and what are the best circumstances to offer the training (Maratos et al., 2019).
Furthermore, it would be interesting to interview the same participating teachers at multiple time points during the MBSR training so that the development of personal or mindfulness/prosocial competencies could be detected, and to enable studying the impact of prior expectations on experiences about mental health and personal competencies. For verification of our hypothesised process of change model (Fig. 2), interviews focusing on the interrelationships between mindfulness and prosocial competencies among teachers are required, ideally supplemented with written evaluations of participants.
The experiences of the participating teachers strongly suggest that MBSR, in addition to the attention paid to substantial and educational skills in the formal curriculum, reduces stress, increases inner calmness, and cultivates important personal or mindfulness/prosocial competencies among teachers to help them cope with their very demanding jobs. Therefore, MBSR training can be recommended to teachers working at this and other types of educational institute.
Acknowledgements
The authors would like to thank the participating schools and teachers for their contribution.
Declarations
Ethics Approval and Consent to Participate
The Ethics Committee on Practice-Based Research at HAN University of Applied Sciences (ECPR) and the Medical Ethics Committee (METC) at Radboud University Medical Centre, both located in Nijmegen, the Netherlands, approved the research proposal (Registration no. ACPO 07.12/15; File number CMO: 2019–5266). Both committees stated that the research complied with the requirements of ethical conduct of research as set out in the Netherlands Code of Conduct for Research Integrity and that it fulfilled the criteria of the Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects. The study was carried out in the Netherlands in full compliance with the applicable rules concerning the review of research ethics committees. Participation was voluntary and participants could withdraw at any moment with no consequences. Participants signed informed consent forms before participating in this study.
The trial is registered with the Dutch Trial Register (www.trialregister.nl): NL5581 (September 2016). The first schools were randomly assigned in September 2016.
Consent for Publication
Not applicable.
Competing Interests
All authors declare that they have no competing interests.
Use of Artificial Intelligence
Artificial intelligence was not used.
Disclaimer
The NWO has/had no role in the design, data collection, analysis, or interpretation of the data; the writing of the manuscript; or the decision to submit the study protocol for publication.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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