Journal of Consulting and Clinical Psychology
January 1, 2000
John D. Teasdale, Zindel V. Segal, James Williams et al.
2,613 citations
Mindfulness-based cognitive therapy (MBCT), a group intervention, trains recovered recurrently depressed patients to disengage from depressive thinking patterns that can trigger relapse. In a randomized trial with 145 recovered recurrently depressed patients, MBCT plus treatment as usual was compared to treatment as usual alone over 60 weeks. For patients with three or more previous depressive episodes (77% of the sample), MBCT significantly reduced the risk of relapse or recurrence. However, for patients with only two previous episodes, MBCT did not reduce relapse. MBCT offers a promising, cost-effective psychological approach to preventing relapse in recovered recurrently depressed patients.
Journal of Consulting and Clinical Psychology
January 1, 2004
S. Helen Ma, John D. Teasdale
1,401 citations
Mindfulness-based cognitive therapy (MBCT) added to usual care reduced relapse from 78% to 36% in recovered depressed patients with three or more previous episodes, replicating earlier findings. In patients with only two recent episodes, relapse rates were 20% with usual care and 50% with MBCT. MBCT was most effective at preventing relapses not preceded by life events. Relapses in the two-episode group were more often linked to significant life events. The two-episode group reported less childhood adversity and later first depression onset, suggesting distinct populations. MBCT is an effective way to prevent relapse in patients with three or more previous episodes.
Journal of Consulting and Clinical Psychology
January 1, 2002
John D. Teasdale, Richard G. Moore, Hazel Hayhurst et al.
966 citations
Metacognitive awareness—experiencing negative thoughts and feelings as passing mental events rather than as reflections of the self—may protect against depression relapse. In a vulnerable group of residually depressed patients, reduced accessibility of this metacognitive set was linked to greater relapse risk. Cognitive therapy (CT) and mindfulness-based cognitive therapy (MBCT) both reduced relapse by increasing metacognitive awareness, not by altering belief in thought content. CT increased accessibility of metacognitive sets in residually depressed patients, and MBCT did so in recovered depressed patients. These therapies may work by changing how people relate to their thoughts.
Journal of Consulting and Clinical Psychology
January 1, 2009
Gina M. Biegel, Kirk Warren Brown, Shauna L. Shapiro et al.
657 citations
A randomized clinical trial tested the mindfulness-based stress reduction (MBSR) program for adolescents aged 14 to 18 years with various mental health diagnoses in an outpatient psychiatric setting. Compared to those receiving treatment as usual, adolescents who completed MBSR reported fewer symptoms of anxiety, depression, and somatic distress, along with improved self-esteem and sleep quality. The MBSR group also showed a higher rate of diagnostic improvement over five months and greater increases in global functioning, as rated by clinicians unaware of treatment assignment. These results suggest MBSR may be a useful addition to standard outpatient mental health care for adolescents.
Journal of Consulting and Clinical Psychology
December 3, 2013
J. Mark G. Williams, Catherine Crane, Thorsten Barnhofer et al.
418 citations
Mindfulness-based cognitive therapy (MBCT) plus treatment as usual (TAU) did not significantly reduce the risk of relapse to major depressive disorder over 12 months compared with cognitive psychological education (CPE) plus TAU or TAU alone among people with at least three previous episodes. The hazard ratio for MBCT versus CPE was 0.88, and for MBCT versus TAU was 0.69, both with confidence intervals crossing 1.0. However, severity of childhood trauma influenced relapse risk: each one-standard-deviation increase in trauma severity raised the hazard ratio to 1.26. Among participants with above-average childhood trauma, MBCT offered significant protection compared with TAU (hazard ratio 0.43) and a non-significant advantage over CPE. For those with below-average trauma, no differences between treatments appeared.
Journal of Consulting and Clinical Psychology
June 30, 2014
Julieta Galante, Ignacio Galante, Marie‐jet Bekkers et al.
379 citations
A systematic review and meta-analysis of 22 randomized controlled trials found that kindness-based meditation (loving-kindness and compassion meditation) moderately reduces self-reported depression and increases mindfulness, compassion, and self-compassion compared to passive control groups. Positive emotions also increased compared to progressive relaxation. However, results were inconclusive against active controls, and the evidence suffered from low to moderate methodological quality and imprecision due to small studies. Some people may initially find the practice challenging. Overall, kindness-based meditation shows benefits for well-being and social interaction, but larger, well-conducted trials are needed.
Journal of Consulting and Clinical Psychology
June 25, 2018
Maya C. Schumer, Emily K. Lindsay, J. David Creswell
321 citations
Brief mindfulness training programs, ranging from single sessions to interventions lasting up to two weeks, modestly reduce negative affectivity such as depression, anxiety, rumination, and stress. A meta-analysis of 65 randomized controlled trials with 5,489 participants found a small but significant effect compared to control programs. Community samples showed larger benefits than student samples, while clinical and nonclinical samples did not differ. However, after accounting for publication bias, the overall effect was substantially reduced, suggesting unpublished null findings may inflate the apparent benefits. The findings highlight the need for continued rigorous evaluation of these increasingly popular interventions.
Journal of Consulting and Clinical Psychology
January 1, 1976
Daniel J. Goleman, Gary E. Schwartz
279 citations
Meditation may help manage stress by inducing a low-arousal state that inhibits the autonomic activation typical of the stress response. If the temporary effects of meditation become lasting traits, its significance as a daily stress intervention could be major. Experienced meditators practicing transcendental meditation showed a stress reactivity pattern that contrasts with that of chronically anxious individuals, particularly in faster stress recovery and lower state and trait anxiety levels.
Journal of Consulting and Clinical Psychology
March 12, 2012
Peter Bieling, Lance L. Hawley, Richard T. Bloch et al.
239 citations
Mindfulness-based cognitive therapy (MBCT) fosters metacognitive skills—specifically the ability to decenter from thoughts and feelings and to approach them with curiosity—that are not acquired through antidepressant medication alone. In a randomized trial, patients who discontinued antidepressants and received MBCT showed significant increases in decentering and wider experiences, while those who continued medication or switched to placebo did not. These skills predicted lower depression scores at 6-month follow-up. The findings suggest that MBCT's effectiveness for preventing depressive relapse may stem from cultivating a decentered, curious stance toward one's own mental events.
Journal of Consulting and Clinical Psychology
January 1, 2007
Helen F. Coelho, Peter H. Canter, Edzard Ernst
227 citations
Mindfulness-based cognitive therapy (MBCT), a class-based program for preventing relapse of major depression, shows additive benefit to usual care for patients with three or more previous depressive episodes, according to evidence from two randomized clinical trials. However, because control groups did not isolate MBCT-specific effects, the findings cannot be attributed to the therapy itself. A systematic review of four relevant studies identified methodological weaknesses, highlighting the need for further research to determine whether MBCT has specific effects beyond general care.
Journal of Consulting and Clinical Psychology
June 18, 2012
Freda McManus, Christina Surawy, Kate Muse et al.
177 citations
Mindfulness-based cognitive therapy (MBCT) added to usual services reduces health anxiety more than usual services alone, with moderate effect sizes immediately after treatment (Cohen's d = 0.48) and at one-year follow-up (d = 0.48). At one year, 36% of MBCT participants still met criteria for hypochondriasis versus 76% of those receiving usual services alone. Improvements in mindfulness mediated the reduction in health anxiety symptoms. The findings suggest MBCT is a useful addition for patients with health anxiety.
Journal of Consulting and Clinical Psychology
June 1, 2008
J. Mark G. Williams, Ian Russell, Daphne Russell
165 citations
The authors clarify methodological points from a prior review of mindfulness-based cognitive therapy (MBCT). They describe the randomization procedures used in two major MBCT trials, show that participants receiving treatment as usual did not worsen, and argue for experimental designs that isolate the active treatment component. Reanalyses using multilevel modeling to correct for intragroup correlations reinforced original findings: among patients with three or more previous depressive episodes, MBCT significantly reduced the risk of a further episode and significantly decreased mean Beck Depression Inventory scores after treatment.
Journal of Consulting and Clinical Psychology
June 9, 2016
Erin C. Walsh, Tory A. Eisenlohr‐Moul, Ruth A. Baer
72 citations
A 4-week mindfulness-based intervention reduced salivary inflammatory markers IL-6 and TNF-α in college women with elevated depressive symptoms, compared with a contact-control group. Both groups showed similar reductions in self-reported depression. Reductions in IL-6 were sustained at a 3-month follow-up in the mindfulness group. Higher baseline depressive symptoms predicted greater reductions in inflammation among those who received mindfulness training. The findings suggest that mindfulness training may lower inflammatory immune markers commonly linked to depression, possibly protecting against future depressive episodes, though the reductions in inflammation were not explained by changes in depressive symptoms.
Journal of Consulting and Clinical Psychology
January 1, 1976
J. Cole Smith
70 citations
Introduced in 1959 by Maharishi Mahesh Yogi, transcendental meditation (TM) involves sitting quietly twice daily for 15 to 20 minutes while passively attending to a special thought called a mantra. The technique has been taught to at least 600,000 persons, partly because Maharishi claimed it is a natural and effective cure for mental illness. In a study comparing TM to a control treatment called periodic somatic inactivity (PSI)—which involved simply sitting with eyes closed—the PSI technique was contrived to match every aspect of TM except the meditative focus. The text does not report findings or outcomes.
Journal of Consulting and Clinical Psychology
February 1, 2022
Michael Moore, Mark A. Lau, Emily A. P. Haigh et al.
33 citations
Decentering—the ability to observe thoughts and feelings as temporary events in the mind—may help reduce relapse in major depression, but it is not unique to mindfulness-based cognitive therapy (MBCT). In a randomized trial, 227 formerly depressed adults received MBCT, relaxation group therapy (RGT), or treatment as usual (TAU). During acute treatment, depression levels increased in RGT and TAU but not in MBCT. Gains in decentering from mid- to posttreatment predicted reduced depression in MBCT and TAU, but not RGT, and were linked to lower relapse rates across all groups over 12 months. These exploratory findings suggest decentering is a potent but nonspecific mechanism.
Journal of Consulting and Clinical Psychology
July 17, 2023
Sona Dimidjian, Robert Gallop, Joseph J. Lévy et al.
14 citations
The Mindful Mood Balance (MMB) program, a digitally delivered version of mindfulness-based cognitive therapy, combined with usual depression care, produced greater improvements in decentering, mindfulness, and rumination than usual care alone among adults with residual depressive symptoms. Changes in these three processes each predicted a lower likelihood of depressive relapse. The findings indicate that the program's benefits operate through the same mechanisms as in-person mindfulness-based cognitive therapy and that these mechanisms can be engaged through digital delivery.
Journal of Consulting and Clinical Psychology
September 1, 2024
Barnaby D. Dunn, Laura Warbrick, Rachel Hayes et al.
10 citations
Mindfulness-based cognitive therapy with support to taper medication (MBCT-TS) increases positive affect more than continuing antidepressant medication alone, and this increase partly explains the reduced risk of relapse or recurrence in people with recurrent depression. In a randomized trial of 424 adults with three or more prior depressive episodes, MBCT-TS led to significantly greater positive affect at posttreatment compared with maintenance antidepressants. Across both treatments, higher positive affect at intake predicted a lower hazard of relapse over two years. Among participants who had not relapsed by posttreatment, a greater rise in positive affect mediated a reduced risk of subsequent relapse. The findings indicate that boosting positive affect is one mechanism through which MBCT-TS protects against relapse when discontinuing antidepressants.
Journal of Consulting and Clinical Psychology
April 1, 2024
Yuval Hadash, Tatyana Veksler, Omer Dar et al.
8 citations
Intensive meditation retreats produce primarily pleasant peak experiences—such as deep peace or sudden insights—rather than unpleasant ones. In a preregistered study, 96 adults attending 6-day Vipassana retreats reported more pleasant peak experiences than 47 matched controls from the same meditation community. Unpleasant peak experiences did not differ significantly between groups. At two-week follow-up, both pleasant and most unpleasant peak experiences were rated as more beneficial than harmful, with a large average effect size (Cohen's d = 1.61). The findings contradict uncontrolled retrospective studies suggesting that intensive meditation training often leads to adverse experiences.
Journal of Consulting and Clinical Psychology
September 28, 2023
Christian A. Webb, Matthew J. Hirshberg, Oscar González et al.
6 citations
Mechanisms explaining why meditation training works may differ across patient subgroups. Prior research often collapsed heterogeneous groups, obscuring these differences. Using data from 662 participants, researchers developed a Personalized Advantage Index (PAI) to identify individuals likely to benefit more from a meditation app. A moderated mediation analysis showed that mindfulness acquisition mediated better outcomes only for those with higher PAI scores. This suggests that subgroup-specific mediators should be considered to clarify how psychosocial interventions work and to match individuals to the most beneficial treatment.
Journal of Consulting and Clinical Psychology
April 1, 2025
Judy Garber, Denise A Chavira, Emma K Adam et al.
5 citations
An online, coached mindfulness intervention reduced stressor-reactive negative affect—negative emotions triggered by daily stressors—in adolescents aged 12 to 17 with high trait negative affectivity. The randomized controlled trial included 111 youth who were assigned to either the mindfulness program or no intervention. Stressor-reactive negative affect decreased significantly (Cohen's d = .40), and this reduction correlated with improvements in internalizing symptoms. However, the intervention did not affect stressor-independent negative affect or overall momentary negative affect, suggesting its benefits are specific to emotional reactions to stressors.
Journal of Consulting and Clinical Psychology
August 1, 2024
Simon B. Goldberg, Daniel M. Bolt, Cortland J. Dahl et al.
5 citations
Meditation app users who reported increased positive feelings and decreased negative feelings during practice showed greater reductions in psychological distress, both immediately after the program and three months later. In a randomized trial with 243 distressed public school employees, most of whom had clinically elevated depression or anxiety, negative affect during meditation declined over time while positive affect remained stable. Changes in positive affect predicted later distress more strongly than changes in negative affect. The findings challenge the common mindfulness emphasis on nonjudgmental awareness regardless of emotional tone, suggesting that the affective quality of meditation experience matters for outcomes and could guide personalized intervention.
Journal of Consulting and Clinical Psychology
June 1, 2025
Andreas Voldstad, Ananda Zeas-Sigüenza, Anton Skolzkov et al.
2 citations
Mindfulness interventions that train nonjudgmental attention to present-moment experience have a consistent but small effect on romantic relationship satisfaction. A meta-analysis of 28 randomized controlled trials with 6,097 participants found a significant medium effect initially, but this was driven by extreme outliers. After removing those outliers, the effect was small and consistent. Effects were moderated by intervention length, baseline satisfaction, and risk of bias. The certainty of the evidence is very low due to inconsistency, imprecision, risk of bias, and suspicion of publication bias. The findings point to the need for better program theory and rigorous methodology.
Journal of Consulting and Clinical Psychology
December 1, 2024
Reagan L. Miller, Lauren B Shomaker, Mark A. Prince et al.
2 citations
A mindfulness-based intervention combined with community mentoring, compared to mentoring alone, reduced the negative effects of daily life stressors on momentary mindfulness and emotion regulation among adolescents exposed to chronic stressors. In a randomized trial with 81 adolescents (average age 13.75 years; 56% boys; 24% Hispanic/Latino, 57% White), those receiving the mindfulness intervention showed small but significant improvements in mindful attention, mindful nonjudgment, and emotion regulation difficulties at postintervention. The findings suggest mindfulness training may buffer adolescents from the harmful impacts of stress in daily life.
Journal of Consulting and Clinical Psychology
February 7, 2020
J. Henrich, Bergljot Gjelsvik, C. Surawy et al.
A 6-week mindfulness-based cognitive therapy adapted for irritable bowel syndrome (MBCT-IBS) reduced IBS symptoms and improved quality of life in female patients compared with a waitlist control. The therapy appeared to work by reducing maladaptive illness cognitions such as visceral anxiety sensitivity and pain catastrophizing, and by shifting self-referential processing toward less bias toward illness and greater nonjudgmental awareness.
Journal of Consulting and Clinical Psychology
February 1, 2019
Z. Segal, A. Anderson, T. Gulamani et al.
Preventing relapse of major depression may depend on developing the ability to decenter from negative thoughts, not just on managing residual symptoms. In a 24-month follow-up of remitted depressed patients who completed either cognitive therapy or mindfulness-based cognitive therapy, growth in decentering and distress tolerance occurred after treatment ended, while residual symptoms did not change. Greater practice of therapy-acquired regulatory skills after treatment boosted decentering, which in turn predicted a reduced risk of relapse or recurrence over two years. Decentering slope was a significant predictor of prophylaxis, with a hazard ratio of 0.232.