







































   Columbia Social Work Review, Volume V       43

Children and the Mind/Body Connection: Mindfulness-Based 
Practice with Children Who Have Cancer 

Claire Schoen

In recent years, clinicians have increased their use of mindfulness-based 
practice and have extended its use to the treatment of adults who have 
cancer. Although research has demonstrated the physical and psycholog-
ical benefits of these practices with adult cancer patients and with chil-
dren in the general population, there is little research specifically on the 
use of mindfulness-based practices with children who have cancer. This 
article first explores existing research on the use of mindfulness-based 
practices with both adults who have cancer and children in the general 
population. The article then provides examples of cancer organizations 
using mindfulness-based practices in the treatment of children who have 
cancer. Last, the author provides recommendations for group mindful-
ness-based programs designed for children who have cancer in outpa-
tient or community-based settings and discusses the role of social work-
ers in facilitating the research and implementation of such programs. 

 The use of mindfulness-based practice has increased in recent 
years, as has the research on its physical and psychological benefits 
(Burke, 2010). Research points to significant benefits of mindful-
ness-based practices for adults undergoing treatment for or recovering 
from cancer (Baer-Wu, 2010; Speca, Carlson, Goodey, & Angen, 2000). 
Researchers also have begun to investigate the positive psychological 
and social benefits of mindfulness-based practices with children (Burke, 
2010; Greenberg & Harris, 2012; Hooker & Fodor, 2008; Napoli, 2004; 
Thompson & Gauntlett-Gilbert, 2008). Yet, research on the effects of 
mindfulness-based practices with children who have cancer remains 
limited. 
 It is critical that social workers begin to examine the potential 
benefits of incorporating mindfulness-based practices into the treatment 
of children who have cancer. Social workers are poised to be leaders in 
the development, implementation, and evaluation of such holistic pro-
grams because of the profession’s tradition of expanding the medical 
model to incorporate clients’ individual, social, and familial needs. 



44       Columbia Social Work Review, Volume V

Children and the Mind/Body Connection

 This article first defines mindfulness-based practice and then 
explores the existing research on the use of mindfulness-based practices 
with both adults who have cancer and children in the general population. 
Next, the article highlights existing programs that incorporate mindful-
ness-based practices in the treatment of children who have cancer. Final-
ly, the author provides recommendations for group mindfulness programs 
designed for children who have cancer in outpatient or community-based 
settings and discusses the role of social workers in the development and 
implementation of such programs.
 

Mindfulness-Based Practice: A Definition

 Mindfulness can be defined as “the awareness that emerg-
es through paying attention on purpose, in the present moment, and 
nonjudgmentally to the unfolding of experience moment by moment” 
(Kabat-Zinn, 2003, p. 145). Mindfulness-based practice includes both 
“formal” practices such as yoga, body scans, or sitting meditation and 
“informal” practices such as daily mindful tasks or breath awareness 
(Kabat-Zinn, 2003, p. 148). In mindfulness-based practice there is no 
outcome or goal; rather, the focus is on remaining present and observing, 
describing, and acting with awareness (Carmody & Baer, 2008). Mind-
fulness-based practice also maintains a strong emphasis on nonjudgmen-
tal acceptance; all emotions or sensations are observed carefully but not 
evaluated as good or bad, true or false (Baer, 2003).
 Mindfulness-based practice originated in a number of Eastern 
meditation practices, but Buddhism is primarily credited with its devel-
opment (Kabat-Zinn, 2003). Western researchers and clinicians have 
introduced mindfulness-based practices into mental health treatment 
programs and, for the most part, are teaching the skills independently of 
their religious and cultural origins (Baer, 2003). Increasingly evidence 
supports a number of modalities, which have stemmed from mindful-
ness-based practice, including Mindfulness-Based Stress Reduction, 
Mindfulness-Based Cognitive Therapy, Dialectical Behavior Therapy, 
and Acceptance and Commitment Therapy (Baer, 2003; Carmody & 
Baer, 2008). These interventions have become progressively popu-
lar to treat “well” individuals and clients suffering from chronic pain, 
life-threatening illness, and Axis I Disorders. Research suggests these in-
terventions are successful because mindfulness-based practices incorpo-



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Schoen

rate exposure, cognitive restructuring, relaxation, and acceptance, leading 
to symptom reduction and improved well-being (Baer, 2003; Carmody & 
Baer, 2008).

Mindfulness-Based Practices with Adults Who Have Cancer

 Over 75% of cancer patients integrate complementary or alter-
native medicine into their treatment plans (Ang et al., 2005). With new 
studies linking psychological stress to cancer, more patients are including 
mindfulness-based practice to address their stress and anxiety (National 
Cancer Institute, 2012). 
 Through standardized measures and patient self-report, a number 
of studies have found that mindfulness-based practice reduces anxiety 
and stress while increasing a patients’ coping abilities and their quality of 
life during treatment (Baer-Wu, 2010; National Cancer Institute, 2012; 
Thompson & Gauntlett-Gilbert, 2008). Similarly, Speca, Carlson, Good-
ey, & Angen, (2000) found that mindfulness-based practices lower mood 
disturbance and emotional irritability in cancer patients, leading to fewer 
physiological problems, such as cardiopulmonary and gastrointestinal 
symptoms. 
 Other studies point to mindfulness-based practice’s efficacy 
in altering brain function and changing thought patterns and attitudes, 
which can help individuals conceptualize and approach their diagnoses 
in emotionally healthier ways (Davidson et al., 2003; Hooker & Fodor, 
2008). Yoga, a form of mindfulness-based practice, has been found to 
help with recovery from cancer treatments by improving sleep patterns, 
reducing fatigue, improving flexibility, and increasing energy levels 
(Bower, Woolery, Sternlieb, & Garet, 2005; Ivy Child International, 
2012). Research has found that even short-term mindfulness-based pro-
grams can be effective in altering immune function, an important compo-
nent of the health of patients undergoing cancer treatment (Davidson et 
al., 2003). 

Mindfulness-Based Practice with Children

 The majority of research on the use of mindfulness-based prac-
tices, and especially studies with cancer patients, focuses primarily on 
their efficacy with adults. Additional mindfulness studies are limited by 



46       Columbia Social Work Review, Volume V

Children and the Mind/Body Connection

their failure to distinguish between children and adults within their study 
designs and analyses (Greenberg & Harris, 2012). Despite the paucity of 
thorough research, extant research demonstrates that mindfulness-based 
practices are appropriate for and beneficial to younger clients (Burke, 
2010). 
 The bulk of research on mindfulness-based practice with chil-
dren has been conducted in schools, which offer easy access to children 
in the general population. This research suggests that the use of mind-
fulness, meditation, and yoga can lead to increased attention, academic 
performance, self-acceptance, and self-understanding and reductions in 
anxiety and stress (Greenberg & Harris, 2012; Hooker & Fodor, 2008; 
Napoli, 2004).
 Research argues that mindfulness-based practices can be benefi-
cial to children because many children are on “autopilot” throughout the 
day, following the directions given by adults in their lives without really 
experiencing the day fully.  As a result, children are an important popula-
tion in which to develop greater self-awareness (Hooker & Fodor, 2008). 
Some scholars have raised concerns that mindfulness is not developmen-
tally appropriate for children because they are not yet capable of abstract 
thought (Greenberg & Harris, 2012). Yet, other researchers contend that 
children are highly creative, imaginative, and open to new experiences 
and opportunities to explore. In addition, young children have “begin-
ners” minds’ and have yet to develop a sense of self-consciousness, 
allowing them to be open to mindfulness-based practice and be compas-
sionate and non-judgmental with themselves (Greenberg & Harris, 2012; 
Hooker & Fodor, 2008).  
 With further research, mindfulness-based practice with children 
could complement other forms of work with children that address chil-
dren’s emotional and physical well-being in child-friendly ways. Now is 
an opportune time to explore the value of mindfulness-based practices 
with children who have cancer.  

Mindfulness-Based Practice in Pediatric Cancer Treatment 
and Therapy

 A number of pediatric oncology outpatient programs and 
cancer-related nonprofits in New York City already include mindful-
ness-based practice in their treatment and therapy. Memorial Sloan-Ket-



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Schoen

tering Cancer Center (MSKCC) has an integrative medicine team that of-
fers services to complement traditional medical care. For children, some 
of these offerings have a basis in mindfulness-based practice, including 
mind/body therapies and yoga. MSKCC’s website suggests that these 
practices can help pediatric cancer patients manage their symptoms and 
improve their quality of life by lessening pain, nausea, headaches, and 
insomnia. Mindfulness-based practices can also help children manage 
anxiety, stress, and depression; decrease fears; enhance coping skills; and 
improve relaxation during procedures, treatments, and long hospital stays 
(MSKCC, 2013). 
 Similarly, Montefiore Medical Center has followed other hos-
pitals in the United States by starting a Kids Kicking Cancer program 
where pediatric oncology patients practice breathing techniques, medi-
tation, and martial arts to help cope with pain and anxiety (Kids Kicking 
Cancer, 2013). Gilda’s Club New York City, an affiliate of a nationwide 
cancer support organization, has a children’s program known as Noo-
gieland that incorporates yoga into their workshops for children who 
have been diagnosed with cancer, have a loved one living with cancer, or 
have a loved one who died from cancer (Gilda’s Club, 2013).1

 Other organizations are developing research-based curricula 
built entirely around mindfulness-based practice. In May 2012, Ivy Child 
International launched a mindfulness program designed originally for pe-
diatric cancer patients. The program is a 16-week certificate program that 
meets once a week for one hour at a time. Classes include 20 minutes 
of circle time to learn mindfulness-based practices, 20 minutes of yoga 
postures, and 20 minutes of discussion. Additionally a self-assessment 
feelings chart is collected at every class. Ivy Child International imple-
ments this mindfulness program in early childhood centers and hospitals 
(Ivy Child International, 2012). 
 All of the aforementioned organizations are taking vital first 
steps in integrating mindfulness-based practice into the treatment of 
children who have cancer.  These programs can serve as foundations for 
further research in the development, implementation, and evaluation of 
mindfulness-based programs in pediatric outpatient or community-based 
organizations.
 

1At the time of this publication, the author worked as an independent contractor for 
Gilda’s Club New York City.



48       Columbia Social Work Review, Volume V

Children and the Mind/Body Connection

Recommendations for Further Research and Practice

 Although many existing pediatric cancer treatment programs 
incorporate mindfulness-based practice there exists a growing need for 
curriculum-based group mindfulness programs for children who have 
cancer. Each stage of the development, implementation, and evaluation 
of these programs must be based in methodologically rigorous, evi-
dence-based research and integrate evaluations that can contribute to 
existing research and help guide future studies.
 The curricula for such programs should be developed using re-
search, literature, and other similar programs as guides. Curricula should 
combine a mixture of mindfulness practices to engage children in varied 
and engaging ways, as particular practices might be more efficacious for 
certain children. Each practice should be included purposefully, with all 
exercises examined in advance to ensure they are developmentally appro-
priate for each group of children (Greenberg & Harris, 2012; Hooker & 
Fodor, 2008; Thompson & Gauntlett-Gilbert, 2008). 
 Curricula should begin with basic mindfulness techniques so 
that the children can experience success early on and feel encouraged to 
continue further. For example, beginning with a 1-5 minute meditation 
exercise would be more effective than asking children to sit still for 10 
or 15 minutes (Hooker & Fodor, 2008). Mindfulness practices could 
include yoga, belly breathing, meditation, daily mindfulness tasks, and 
body awareness (Hooker & Fodor, 2008; Napoli, Krech, & Holley, 2005; 
Bower, Woolery, Sternlieb, & Garet, 2005). All practices need to include 
discussion so that children’s questions, concerns, or discomforts can be 
addressed (Hooker & Fodor, 2008). The practice and discussion must 
focus on acceptance, compassion, and acknowledgment of where each 
child is in the process of her or his illness and experience in the mindful-
ness-based practice program. Children should be encouraged to accept 
that they might feel pain or worry during their treatment and that this 
practice is not intended to deny or pathologize these fears, but rather it 
is designed to help them cope with their experiences (Hooker & Fodor, 
2008). 
 The programs should be held in outpatient pediatric treatment 
centers at the hospitals in which the children are receiving treatment or 
in cancer-focused community-based organizations (Thompson & Gaunt-
lett-Gilbert, 2008). Programs should be designed for implementation in 



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Schoen

groups of children of similar ages so that the children can provide mutual 
support when exposed to practices that might be new or uncomfortable 
at first (Thompson & Gauntlett-Gilbert, 2008).  Programs should be run 
by trained facilitators, who can provide instructions for each practice in 
concrete and clear child-friendly language (Greenberg & Harris, 2012; 
Hooker & Fodor, 2008; Thompson & Gauntlett-Gilbert, 2008). 
Throughout implementation and review, programs should integrate rig-
orous evaluation processes, including standardized measures for the chil-
dren to fill out at baseline and at pre-determined intervals (Kabat-Zinn, 
2003).  These measures could include standardized anxiety or coping 
scales, self-report, and teacher or caregiver report. If possible, the eval-
uations might include analyses of changes in physical health throughout 
participation in the program, whether through self or caregiver report or 
through medical records (Greenberg & Harris, 2012). Analyses can also 
disaggregate data by age and gender, enabling program developers to 
further hone curricula to maximize benefits to clients.
 An ambitious program could also evaluate the effects of mindful-
ness-based programming on family members and caregivers or include 
a simultaneous caregiver mindfulness group. Including caregivers 
acknowledges caregiver stress and enables caregivers to reinforce the 
mindfulness-based practices with the children outside of the program and 
provide additional support and comfort (Greenberg & Harris, 2012). 

Social Work Involvement and Implications

 Social workers can play an integral role in the scientific study 
and practice of mindfulness-based practices with children who have can-
cer. The mission of the social work profession is to serve vulnerable pop-
ulations through incorporation of the person-in-environment approach in 
both research and practice (Code of Ethics of the National Association 
of Social Workers, 2013). Social workers are equipped to advocate for 
and coordinate the treatment of the whole person in her or his context, 
which includes not only the treatment of disease, but also attention to 
psychological, social, behavioral, and spiritual factors involved. This 
holistic practice is in line with the mind/body connection, a central tenet 
of mindfulness-based practice. 
 Social workers are often members of multidisciplinary teams, 
either as part of a hospital treatment team of doctors, nurses, and child 



50       Columbia Social Work Review, Volume V

Children and the Mind/Body Connection

life specialists or as part of a community-based organization’s team of 
psychologists, art therapists, and play therapists. Social workers can take 
the lead in using the expertise of their team members to create holistic 
mindfulness-based programs with attention to the diversity of a child’s 
cancer treatment and therapy experience. Social workers can also be 
instrumental in engaging families, who can then help the children apply 
what they have learned and integrate mindfulness techniques in daily 
routines.
 Finally, social workers are charged to be culturally aware and 
conscious of their therapies and interventions (NASW, 2013). With 
mindfulness-based practices especially, clinicians and researchers must 
find ways to incorporate the practices into Western science and treatment 
plans, while honoring the integrity of the cultures and religions in which 
these practices are rooted. Social workers must find a balance between 
respecting the traditions and providing an environment free of cultural, 
religious, or ideological factors where patients can experiment with ways 
to relieve suffering of both the mind and body (Kabat-Zinn, 2003).  

Conclusion

 Promising research, albeit limited in scope, documents the 
efficacy of mindfulness-based practices with children and adults who 
have cancer in reducing anxiety and increasing coping skills. Thus, 
mindfulness practices could be effective in treating children who have 
cancer (Greenberg & Harris, 2012). More research should be conducted 
to investigate the effects of mindfulness practices in children. Current 
studies and programs can serve as guides so newly developed programs 
are designed specifically to meet the unique needs of children who have 
cancer. A mindfulness-based group program for children who have can-
cer has the potential to treat both the physical and emotional side effects 
of cancer and lead to better overall health and quality of life for these 
children, their families, and their caregivers.
 Medical social workers have the opportunity to engage with 
members of multidisciplinary teams to integrate traditional medical 
treatments with innovative therapies. Moving beyond a rigid medical 
model is crucial for building approaches that treat the whole individual. 
Examining the value of mindfulness-based practices with children who 
have cancer allows for further research that may lead to the incorporation 



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Schoen

of these practices with children who have other chronic illnesses. Social 
workers must continue to pioneer creative, researched-based program-
ming in order to best serve clients and their families.

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