The Challenge of Accounting for the Moderator Effect of Risk Exposure on the Effectiveness of Mindfulness-Based Treatments for Youth.

Although many positive psychology interventions like mindfulness-based treatments (MBTs) for youth have been used with a wide array of risk exposed populations (children living in poverty, victims of violence, displaced persons, children with disabilities, etc.), the efficacy of MBTs with regard to the level and domain of risk exposure has been largely overlooked. This oversight contributes to a perception of positive psychology as being decontextualized. The purpose of this meta-analysis is to better understand how a young person's level and domain of risk exposure influences the efficacy of MBTs. Published studies were included if participants were children or adolescents, were RCTs or cluster RCTs, and focused on the effect of an MBT or an MBT component. Specifically, 58 studies were qualitatively analyzed and 42 were quantitatively analyzed. The qualitative analysis evidenced a lack of objectivity in the assessment of risk exposure, with many papers providing very little or no detail on participants' level or domain of risk exposure (whether threats to psychological wellbeing originate with the individual's biology or cognitions, or the social, built or natural environment). Our quantitative analysis showed that MBTs significantly improved main outcomes relative to the control conditions, with a small-to-moderate effect size. Where it was possible to identify the level of risk exposure, we found that MBTs positively moderated treatment response, with better response among those participants with a higher level of risk. We conclude that future Positive Psychology research will need to better account for risk exposure if the discipline is to improve our understanding of which populations benefit most from interventions that promote mindfulness. Supplementary Information: The online version contains supplementary material available at 10.1007/s41042-023-00145-y.