Systematic review of mindfulness-based cognitive therapy and mindfulness-based stress reduction via group videoconferencing: Feasibility, acceptability, safety, and efficacy.

Delivering mindfulness-based programs like MBCT and MBSR through videoconferencing is feasible and acceptable, with medium positive effects on mental health outcomes compared to inactive controls (effect sizes from 0.44 to 0.71). Compared to in-person delivery, videoconference-based programs showed little difference, with all confidence intervals crossing zero. Safety considerations were largely unreported. The evidence on mindfulness or self-compassion as mechanisms of action was inconclusive. The review included ten studies with physical health and nonclinical samples, not mental health populations. Future research should target mental health populations using noninferiority designs and develop guidelines for remote delivery.

Study at a glance

Abstract

Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR) are effective in reducing distress among people with physical or mental health problems. However, implementation is limited by variable geographic provision, ability to travel, and the need for remote service delivery during the coronavirus disease 2019 (COVID-19) crisis. Integration with Internet-enabled technologies like videoconferencing potentially enhances access. This article reports a systematic review exploring the feasibility, acceptability, safety, and efficacy of delivering MBCT/MBSR by videoconferencing (MBCT/MBSR-VC). No restrictions were made about population or study design. Eleven online databases were searched and 10 studies met inclusion criteria. Narrative synthesis was used because of study heterogeneity. Articles featured physical health and nonclinical samples, but not mental health. Three studies had moderate-strong methodological quality. Results supported the feasibility and acceptability of MBCT/MBSR-VC. Considerations of safety were largely unreported. MBCT/MBSR-VC demonstrated medium positive effects on mental health outcomes compared with inactive controls (ds = 0.44 -0.71), and little difference compared with active controls like in-person delivery (all confidence intervals crossed zero). Evidence regarding mindfulness or self-compassion as potential mechanisms of action was inconclusive. Future implementation research should target mental health populations using noninferiority designs. Adapting MBCT/MBSR to remote delivery will require development of guidelines and training packages to ensure best practice in this medium and adherence to evidence-based MBCT/MBSR models.