ORIGINAL PAPER Cognitive-Based Compassion Training: A Promising Prevention Strategy for At-Risk Adolescents Sheethal D. Reddy • Lobsang Tenzin Negi • Brooke Dodson-Lavelle • Brendan Ozawa-de Silva • Thaddeus W. W. Pace • Steve P. Cole • Charles L. Raison • Linda W. Craighead Ó Springer Science+Business Media, LLC 2012 Abstract Compared to the general population, youth in foster care experience multiple psychosocial difficulties due to exceptionally high rates of maltreatment. Many youth in care receive psychological and/or psychotropic treatment but not all require or are willing to accept that level of intervention. For many, a ‘‘mental health’’ approach feels pathologizing. Nevertheless, these youth have suffered maltreatment and interventions to improve their ability to cope with past trauma and their often uncertain present are clearly needed. Cognitively-Based Compassion Training (CBCT) provides an alternative perspective on suffering and can be framed as a wellness intervention that is appropriate for all humans. The present study examined whether a 6-week CBCT intervention would improve psychosocial functioning among adoles- cents in foster care. Seventy adolescents were randomized to CBCT (twice weekly) or a wait-list condition. Youth were assessed at baseline and after 6 weeks. Groups did not differ on measures of psychosocial functioning following training; however practice frequency was associated with increased hopefulness and a trend for a decrease in gen- eralized anxiety. Qualitative results indicated that partici- pants found CBCT useful for dealing with daily life stressors. Adolescents in care were willing to engage in CBCT. The majority reported CBCT was very helpful and almost all reported they would recommend CBCT to a friend. Participants reported specific instances of using CBCT strategies to regulate emotion, manage stress, or to respond more compassionately towards others. Standard- ized self-report measures were not sensitive to qualitative reports of improved functioning, suggesting the need for measures more sensitive to the positive changes noted or longer training periods to demonstrate effects. Practical issues surrounding implementation of such programs in high-risk youth populations are identified. Recommenda- tions are provided for further development. Keywords Foster care Á Meditation Á Maltreatment Á Anxiety Á Adolescents Introduction Although sitting meditation practices have been shown to be effective in helping adults cope with a variety of psy- chological and physiological problems (Chiesa and Serretti 2009; Zeidan et al. (2010), empirical studies of meditation practices in children are few and far between. Nevertheless, a recent meta-analysis (Black et al. 2009) identified 16 quantitative studies conducted since 1982 and concluded that sitting meditation has positive effects on physiological and psychosocial concerns in children as young as 6 years of age. Types of meditation used in these studies included S. D. Reddy Health4Life Program, Children’s Healthcare of Atlanta, Atlanta, GA, USA L. T. Negi Á B. Dodson-Lavelle Á B. Ozawa-de Silva Department of Religion, Emory University, Atlanta, GA, USA T. W. W. Pace School of Medicine, Emory University, Atlanta, GA, USA S. P. Cole Á L. W. Craighead Department of Psychology, Emory University, Atlanta, GA, USA C. L. Raison (&) Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ 85724, USA e-mail: craison@emory.edu 123 J Child Fam Stud DOI 10.1007/s10826-012-9571-7