The lancet. Psychiatry
June 1, 2025
Thorsten Barnhofer, Barnaby D. Dunn, Clara Strauss et al.
9 citations
About half of patients with depression who complete the UK National Health Service Talking Therapies stepped care pathway still have symptoms. A randomized trial tested whether adding mindfulness-based cognitive therapy (MBCT) via videoconference to treatment as usual improves outcomes for these patients. At 34 weeks, the MBCT group had significantly lower depression scores than the treatment-as-usual group (adjusted difference -2.49 points on the PHQ-9). The MBCT group also had slightly lower healthcare costs and higher quality-of-life scores, with a 99% chance of being cost-effective at the £20,000 per QALY threshold. No serious adverse events occurred. MBCT is an effective and scalable further-line treatment for depression that does not remit after psychological therapy.
Psychotherapy and Psychosomatics
June 12, 2026
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
1 citation
For adults with difficult-to-treat depression—those who have not responded to prior treatments, have treatment-resistant depression, or have a chronic course—mindfulness-based cognitive therapy (MBCT) is likely superior to usual care, reducing depressive symptoms by a standardized mean difference of -0.40 at post-treatment and -0.41 at medium-term follow-up. There was a 92% and 85% probability, respectively, that these benefits exceeded a minimal important difference. However, MBCT did not show clear superiority over other active psychosocial interventions, and no robust moderators of outcome were identified across baseline severity, chronicity, or comorbidity.
PLoS One
October 23, 2025
Daniel Cullen, Kate Cavanagh, Clara Strauss
A qualitative study explored how National Health Service staff identify with mindfulness in-groups and engage with mindful practices. The findings suggest that social identification with mindfulness groups influences staff members' engagement with these practices, highlighting the role of group identity in sustaining mindfulness in a workplace setting.
JMIR Research Protocols
May 26, 2025
Elena Nixon, Shireen Patel, Priya Patel et al.
A randomized controlled trial will compare Mindfulness-Based Cognitive Therapy for Life (MBCT-L) with a routinely offered Stress Reduction Psychoeducation (SRP) program for healthcare and other public sector staff in the United Kingdom. The trial aims to determine whether MBCT-L is more effective than SRP in reducing perceived stress and improving mental health and work-related outcomes. A total of 260 participants were recruited into 26 groups across NHS trusts, with outcomes measured at 6, 12, and 20 weeks. The primary outcome is change in perceived stress from baseline to 20 weeks. A qualitative substudy with 30 participants will explore perceived well-being changes and barriers to uptake. Data analysis is underway.
Psychological Medicine
July 13, 2026
Thorsten Barnhofer, Barnaby D. Dunn, Clara Strauss et al.
Mindfulness-based cognitive therapy (MBCT) plus treatment as usual leads to greater symptom improvement than treatment as usual alone in adults with difficult-to-treat depression who have not remitted after high-intensity psychological therapy. The therapy works partly by increasing decentering—the ability to observe thoughts and feelings as temporary mental events—and this mechanism remains effective even when depressive symptoms are severe. Higher baseline depression severity does not limit the acquisition of decentering skills or the overall treatment effect; instead, decentering is more strongly linked to symptom reduction in those with more severe depression. These findings support using MBCT across a broad range of symptom severity.
Scientific Reports
December 13, 2023
Guy W. Fincham, Clara Strauss, Kate Cavanagh
A large randomized trial assigned 400 participants to either coherent breathing at about 5.5 breaths per minute or a matched attention-placebo at 12 breaths per minute, practiced for about 10 minutes daily over 4 weeks. Both groups showed similar improvements in stress, anxiety, depression, and wellbeing from baseline to post-intervention and at a 1-month follow-up, but there was no significant difference between the two breathing techniques. The results indicate that coherent breathing does not provide added benefit over a well-designed placebo breathing exercise for mental health and wellbeing.
Mindfulness
December 1, 2023
Eleanor Miles, Faith Matcham, Clara Strauss et al.
Viewing mindfulness meditation as a health behavior, rather than only a technique, can help people develop and sustain a long-term practice. The Sussex Mindfulness MEDitation (SuMMed) model synthesizes health behavior theories with research on mindfulness to describe the stages people go through as they build a meditation habit and the processes that help them move from one stage to the next. The model highlights the need to support individuals to continue practicing after formal instruction ends and suggests how maintaining a meditation habit can be facilitated, offering a roadmap for future research and practical suggestions tailored to different stages of behavior change.
Scientific Reports
January 9, 2023
Guy William Fincham, Clara Strauss, Jesus Montero-Marin et al.
A meta-analysis of 12 randomized controlled trials with 785 adult participants found that breathwork interventions were associated with lower self-reported stress compared to control conditions, with a small-to-medium effect size. Breathwork also showed similar reductions in anxiety and depressive symptoms. The authors urge caution due to moderate risk of bias in most studies and call for more rigorous research to avoid overhyping the evidence.
PLoS One
June 15, 2016
Clara Strauss, Kate Cavanagh, Annie Oliver et al.
A meta-analysis of 12 randomized controlled trials involving 578 participants found that mindfulness-based interventions (MBIs) reduce symptom severity for people currently experiencing a depressive disorder, but not for those with a current anxiety disorder. MBIs showed a moderate benefit over control conditions on primary symptom severity. The benefit was significant for depressive symptoms but not for anxiety symptoms. Effects were present when compared with inactive controls but not with active controls. Mindfulness-based cognitive therapy (MBCT) showed a significant effect, while mindfulness-based stress reduction (MBSR) did not. The authors suggest MBIs may be considered for people with current depressive disorder.