Clinical Psychology Science and Practice
January 1, 2004
Scott R. Bishop, Mark A. Lau, Shauna L. Shapiro et al.
6,266 citations
Mindfulness has attracted considerable interest as a way to reduce cognitive vulnerability to stress and emotional distress, but it has not been defined operationally. Recent consensus meetings produced a two-component model of mindfulness, specifying each component in terms of specific behaviors, experiential manifestations, and psychological processes. The paper addresses temporal stability and situational specificity, speculates on the conceptual and operational distinctiveness of mindfulness, and discusses implications for instrument development and measurement.
Journal of Clinical Psychology
December 29, 2005
Shauna L. Shapiro, Linda E. Carlson, John A. Astin et al.
3,933 citations
A theoretical model of mindfulness is proposed to explain how it produces positive changes in psychological and physical health. The paper suggests that while mindfulness-based interventions are effective for treating symptoms, the mechanisms behind these effects remain unclear. The model aims to identify potential processes through which mindfulness operates, offering directions for future empirical research on these mechanisms.
Journal of Clinical Psychology
January 1, 2006
Mark A. Lau, Scott R. Bishop, Zindel V. Segal et al.
1,462 citations
A new self-report questionnaire, the Toronto Mindfulness Scale (TMS), measures the state of mindfulness. In two studies, the scale showed good internal consistency and two factors: Curiosity and Decentering. TMS scores increased with more mindfulness meditation experience. In a second study, participants in an 8-week mindfulness-based stress reduction program showed increased TMS scores after treatment, and Decentering scores predicted improvements in clinical outcomes. The TMS is a promising measure with good psychometric properties and predictive validity for treatment outcome.
Psychosomatic Medicine
September 1, 2000
Michael Speca, Linda E. Carlson, Eileen Goodey et al.
1,091 citations
A mindfulness meditation-based stress reduction program reduced mood disturbance and stress symptoms in cancer outpatients. In a randomized trial, 90 patients with various cancer types and stages completed a 7-week program of weekly 1.5-hour meditation groups plus home practice. Compared to a wait-list control group, those in the program showed significantly lower total mood disturbance, including less depression, anxiety, anger, and confusion, and more vigor. They also reported fewer overall stress symptoms, particularly cardiopulmonary and gastrointestinal symptoms, emotional irritability, and cognitive disorganization. Total mood disturbance decreased by 65%, and stress symptoms by 31%.
Psychosomatic Medicine
July 1, 2003
Linda E. Carlson, Michael Speca, Kamala D. Patel et al.
773 citations
An 8-week mindfulness-based stress reduction program for early-stage breast and prostate cancer patients was associated with improved quality of life, reduced stress symptoms, and better sleep quality. Although overall immune cell counts did not change, T cell production of IL-4 increased and IFN-gamma decreased, while NK cell production of IL-10 decreased, suggesting a shift in immune profile away from one linked to depressive symptoms. This is the first study to show changes in cancer-related cytokine production with MBSR participation.
Stress and Health
March 15, 2010
Kathryn A. Birnie, Michael Speca, Linda E. Carlson
599 citations
A community sample participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) programme. After the programme, participants showed significant reductions in stress symptoms and mood disturbance, along with increases in mindfulness, spirituality, and self-compassion. For empathy, perspective taking increased significantly and personal distress decreased significantly, but empathic concern did not change. Changes in self-compassion were linked to changes in mindfulness. Self-compassion and certain aspects of empathy were strongly associated with psychological well-being. The findings suggest MBSR can enhance self-compassion and specific empathy components.
ISRN Psychiatry
November 14, 2012
Linda E. Carlson
183 citations
Mindfulness-based interventions (MBIs), particularly mindfulness-based stress reduction and mindfulness-based cognitive therapy, have been extensively studied for treating symptoms of medical conditions. This review covers the phenomenological experience of coping with chronic illness, theoretical applications of mindfulness, and evaluates evidence across conditions including cancer, pain conditions (chronic pain, low back pain, fibromyalgia, rheumatoid arthritis), cardiovascular disease, diabetes, HIV/AIDS, and irritable bowel syndrome. Most assessed outcomes are psychological and show substantial benefit, though some physical and disease-related parameters are evaluated. The authors argue the field needs more adequately powered randomized controlled trials with active comparison groups and assessment of patient characteristics and program dose.
Stress and Health
November 28, 2006
Michael J. Mackenzie, Linda E. Carlson, Marleny Munoz et al.
178 citations
Nine cancer patients who completed an 8-week Mindfulness-based Stress Reduction (MBSR) program and continued attending weekly drop-in sessions described five themes from adding meditation to their lives: opening to change, self-control, shared experience, personal growth, and spirituality. These themes were used to develop theory about how MBSR creates change for cancer patients, which may help refine programs to better support patients during diagnosis, treatment, and recovery.
Social Work in Health Care
May 24, 2006
Holly G. Minor, Linda E. Carlson, Michael J. Mackenzie et al.
166 citations
Caregivers of chronically ill children often experience high chronic stress. A Mindfulness-Based Stress Reduction (MBSR) program offered to parents at a large urban children's medical center substantially reduced stress and mood disturbance. Forty-four caregivers, mostly mothers of children with special needs diagnosed an average of 7 years prior, completed the program. Before the intervention, they reported very high stress and mood disturbance. Over the 8-week program, stress symptoms decreased by 32% and total mood disturbance by 56%, both statistically significant. The findings suggest MBSR provides effective relief for this population, though further studies with more rigorous methods are needed.
Cancer Management and Research
June 1, 2015
Linda E. Carlson, Codie R. Rouleau, Sheila N. Garland
152 citations
Mindfulness-based interventions (MBIs) in cancer care reduce psychological distress, sleep disturbance, and fatigue, and promote quality of life and spirituality. Evidence suggests MBIs may also influence immune function, stress hormone regulation, and nervous system activity, but whether these biological changes lead to meaningful health benefits remains unclear. The review highlights three outcome categories—symptom reduction, positive psychological growth, and biological outcomes—and notes that the popularity of MBIs must be balanced against scientific evidence for specific clinical effects.
Psycho-oncology
November 16, 2009
Kathryn A. Birnie, Sheila N. Garland, Linda E. Carlson
152 citations
An 8-week mindfulness-based stress reduction (MBSR) program for 21 couples where one partner had cancer led to significant reductions in mood disturbance and symptoms of stress—including muscle tension, neurological/gastrointestinal, and upper respiratory symptoms—for both patients and their partners. Mindfulness levels significantly increased in both groups. After the program, partners' mood disturbance scores were positively correlated with patients' stress symptoms and negatively correlated with patients' mindfulness levels. The program improved psychological functioning and mindfulness for both members of the couple.
The Journal of Alternative and Complementary Medicine
December 1, 2008
Maria B. Ospina, Kenneth Bond, Mohammad Karkhaneh et al.
140 citations
A systematic review of 400 clinical trials on meditation (published 1956-2005) found that most studies have poor methodological quality, with significant threats to validity across all major quality domains. The five broad categories of meditation practices studied were mantra meditation, mindfulness meditation, yoga, t'ai chi, and qigong. The most common clinical conditions examined were hypertension, miscellaneous cardiovascular diseases, and substance abuse. Although methodological quality has improved over time by 0.014 points per year, future trials must be more rigorous in design, execution, analysis, and reporting.
Integrative Cancer Therapies
April 13, 2012
Sheila N. Garland, Rie Tamagawa, Sarah C. Todd et al.
91 citations
Participation in an 8-week mindfulness-based stress reduction (MBSR) program led to significant increases in mindfulness among 268 individuals with cancer. These increases accompanied a 55% reduction in mood disturbance and a 29% reduction in stress symptoms. Gains in mindfulness accounted for 21% of the mood improvement and 14% of the stress reduction. The two most important mindfulness skills for better psychological functioning were being aware of the present moment and refraining from judging inner experience.
The Journal of Positive Psychology
June 30, 2014
Laura E. Labelle, Linette Lawlor‐Savage, Tavis S. Campbell et al.
78 citations
Cancer patients who participated in Mindfulness-Based Stress Reduction (MBSR) showed increased spirituality, posttraumatic growth, and mindfulness compared to those on a waitlist. The study involved 135 patients in the MBSR group and 76 in the waitlist control group, with assessments before, during, and after the program or waiting period. Changes in all facets of mindfulness were found to mediate the effects of MBSR on spirituality and posttraumatic growth. Developing mindfulness skills through MBSR may help cancer patients find greater meaning, peace, connectedness, and personal growth.
Psychology of Religion and Spirituality
May 1, 2009
Kenneth Bond, Maria B. Ospina, Nicola Hooton et al.
67 citations
A panel of 7 meditation experts reached consensus through a 5-round Delphi study on essential criteria for defining meditation for systematic review. Essential features include a defined technique, logic relaxation, and a self-induced state. Optional features include psychophysical relaxation, a self-focus skill or anchor, altered consciousness, mystical experience, suspension of logical thought, embedding in a religious/spiritual/philosophical context, or mental silence. The results highlight challenges in distinguishing meditative from nonmeditative practices and offer an approach to operationalizing meditation for comparative research.
Annual Review of Psychology
September 14, 2022
Linda E. Carlson
50 citations
People diagnosed with and treated for cancer commonly experience distress, anxiety, depression, fear of recurrence, and caregiver burden, along with fatigue, pain, and sleep disturbance. This review covers psychological reactions across the disease continuum and evaluates interventions such as acceptance-based and mindfulness therapies, mind-body approaches, meaning-based therapies for advanced disease, and psychedelic therapy. It also identifies methodological shortcomings in the evidence base, offers design recommendations, and discusses future directions including pragmatic research designs, digital health interventions, and implementation science.
Consciousness and Cognition
July 1, 2014
Michael J. Mackenzie, Linda E. Carlson, David M Paskevich et al.
38 citations
A single yoga session for female cancer survivors was linked to steady increases in focused attention and positive mood, while changes in heart activity matched the intensity of each yoga sequence. Shifts in attention and mood were predicted by concurrent cardiac activity. Participants reported that awareness of breathing, physical movement, and increased relaxation were possible reasons for yoga's benefits. Yoga may work mainly as a meditative method for regulating attention and affect, distinct from exercise or relaxation alone.
Current Oncology
June 30, 2025
Haley D M Schuman, Chantal Savard, Raèf Mina et al.
9 citations
A systematic review and meta-analysis of 11 placebo-controlled randomized trials and 4 open-label studies found that psychedelic-assisted therapy with psilocybin or ketamine can reduce depression and anxiety in adults with cancer. Meta-analysis of four ketamine trials (354 participants) showed a large, rapid effect on depression and anxiety. Three psilocybin trials (101 participants) also showed a large effect on depression, though with wide variability. Non-randomized studies of MDMA and LSD suggested promise but were less rigorous. The authors conclude that psychedelic-assisted therapy may offer meaningful relief for cancer-related distress, but effects vary by therapeutic model and context, and more oncology-specific trials are needed.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
June 12, 2025
Linda E. Carlson, Jennifer M Jones, Devesh Oberoi et al.
4 citations
A large pragmatic trial compared two mind-body interventions—Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ)—for distressed cancer survivors. Participants could choose their preferred program or be randomly assigned; all were also randomized to immediate intervention or a waitlist. Among 587 participants (average age 60.7, 75% female, mostly breast cancer survivors), both MBCR and TCQ groups improved more than waitlist controls on total mood disturbance, with small to medium effects. Choosing a program or being randomly assigned did not affect outcomes. The largest improvements were in tension, anger, and vigor for MBCR, and anger, depression, and vigor for TCQ.
The oncologist
January 17, 2025
Cristiane Decat Bergerot, Paulo Gustavo Bergerot, Errol J Philip et al.
4 citations
A mindfulness app intervention for patients with metastatic renal cell carcinoma (mRCC) on immunotherapy is feasible and acceptable. Among 50 patients from Brazil and the United States, 96% completed the week 4 assessment, and 75% reported high adherence to daily 20-30 minute app activities. Significant improvements occurred in emotional symptoms, fatigue, and quality of life from baseline to post-intervention. The smartphone-based approach received positive feedback, suggesting it may offer accessible psychosocial support for this population.
Integrative Cancer Therapies
January 1, 2025
Haley D M Schuman, Sofia Barkova, Raèf Mina et al.
2 citations
People with cancer often experience deep existential distress that standard psychosocial care does not adequately address. In this qualitative study, 15 participants with various cancer types and stages shared their views on psychedelic-assisted therapy (PAT) as a possible way to relieve psychosocial suffering, especially existential and emotional distress. Four main themes emerged: cautious optimism and differing attitudes toward specific psychedelics; the influence of relationships, stigma, and cultural framing; structural barriers like cost, legality, and unequal access; and the cancer context itself, where unmet needs for existential and spiritual support are common, particularly after active treatment or at advanced stages. Participants saw PAT as a potential adjunct to conventional care but raised concerns about safety, access, and stigma, highlighting the need for equitable, patient-informed implementation.
Seminars in radiation oncology
July 1, 2026
Hanna S W Conradi, Jamie N Petersson, Julie M Deleemans et al.
1 citation
Many people with cancer experience persistent psychological and physical challenges such as anxiety, depression, fatigue, pain, sleep problems, fear of recurrence, cognitive issues, and reduced quality of life. Mind-body interventions, which target the connection between mental and physical processes, are increasingly used alongside standard cancer care. This review examines evidence for interventions including mindfulness, yoga, tai chi, qigong, relaxation, hypnosis, music therapy, acupuncture, massage, and aromatherapy, as well as emerging approaches like psychedelic therapy and nature-based interventions. It summarizes target symptoms, treatment timing, and evidence quality, and calls for more rigorous research, understanding of mechanisms, and broader access across diverse populations and all stages of cancer care.
Current oncology (Toronto, Ont.)
December 22, 2025
Linda E. Carlson, Harriet Richardson, Ron Shore et al.
1 citation
The CAnadian Network for Psychedelic-Assisted Cancer Therapy (CAN-PACT), launched in 2025, aims to address demoralization syndrome and psychosocial distress in Canadians with cancer. The network has six objectives: building a national interdisciplinary network, setting research priorities through stakeholder engagement, developing training for clinicians and researchers, pilot-testing intervention procedures, conducting a multi-center randomized controlled trial of psychedelic-assisted therapy (PAT) for advanced cancer, and informing healthcare policy. CAN-PACT seeks to generate Canadian evidence and prepare the oncology system for equitable access to safe, evidence-based PAT in publicly funded cancer centers.
Global advances in integrative medicine and health
January 1, 2026
Haley D M Schuman, Raèf Mina, Sofia Barkova et al.
Healthcare providers in Canada hold cautious to supportive views on psychedelic-assisted therapy, with ketamine pragmatically accepted for its rapid effects but raising concerns about commercialization, psilocybin seen as promising for end-of-life existential distress yet viewed with mixed feelings, and MDMA considered useful for trauma but constrained by neurotoxicity worries and regulatory barriers. An ethical tension emerged between access to medical assistance in dying and restrictions on psychedelic-assisted therapy in end-of-life care, highlighting policy inconsistencies. Providers emphasized the need for substance-specific guidelines, interdisciplinary education, and evidence-informed regulatory reform.
Psycho-oncology
November 1, 2025
Marie-Estelle Gaignard, Dominica Martin, Jelena Stanic et al.
An online mindfulness program for women with breast or gynecological cancer reduced depression with a medium effect size compared to a control group, though other psychological measures like anxiety, spiritual well-being, and post-traumatic growth showed only favorable trends without statistical significance. At three months, most effects diminished. Qualitative interviews revealed four themes: a safe environment, skill acquisition, enhanced well-being, and exposure to cancer memories. The latter prompted beneficial inner work for most but was deeply challenging for four participants. The program fostered self-exploration and self-efficacy, but challenging experiences also emerged.