Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial
Natalie Kladnitski, Jessica Simons Smith, Adrian R. Allen, Gavin J Andrews, Jill Maree Newby
Internet Interventions June 22, 2018 DOI: 10.1016/j.invent.2018.06.003 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Uncontrolled feasibility and acceptability trial Randomized Pilot study Peer reviewed |
|---|---|
| Sample size | 22 |
| Population | Adults with anxiety disorders and/or major depression |
| Duration | 7-lesson intervention over 14 weeks, with three-month post-treatment follow-up |
| Measures | K-10, GAD-7, PHQ-9, FFMQ, WEMBWS |
| Topics | Anxiety Depression Meditation |
| Citations | 31 |
| Key findings | Integrating formal and informal mindfulness exercises into a transdiagnostic iCBT program was feasible and was accompanied by large reductions in distress, anxiety, and depression and improvements in mindfulness and well-being from baseline to post-treatment, maintained at three-month follow-up. However, adherence was lower than expected, with only 59.1% of participants completing treatment, and the authors state a randomized controlled trial is needed to test efficacy. |
Abstract
Transdiagnostic internet-delivered cognitive behavioural therapies (iCBT) are effective for treating anxiety and depression, but there is room for improvement. In this study we developed a new Mindfulness-Enhanced iCBT intervention by incorporating formal and informal mindfulness exercises within an existing transdiagnostic iCBT program for mixed depression and anxiety. We examined the acceptability, feasibility, and outcomes of this new program in a sample of 22 adults with anxiety disorders and/or major depression. Participants took part in the 7-lesson clinician-guided online intervention over 14 weeks, and completed measures of distress (K-10), anxiety (GAD-7), depression (PHQ-9), mindfulness (FFMQ) and well-being (WEMBWS) at pre-, mid-, post-treatment, and three months post-treatment. Treatment engagement, satisfaction, and side-effects were assessed. We found large, significant reductions in distress (Hedges g = 1.55), anxiety ( g = 1.39), and depression ( g = 1.96), and improvements in trait mindfulness ( g = 0.98) and well-being ( g = 1.26) between baseline and post-treatment, all of which were maintained at follow-up. Treatment satisfaction was high for treatment-completers, with minimal side-effects reported, although adherence was lower than expected (59.1% completed). These findings show that it is feasible to integrate online mindfulness training with iCBT for the treatment of anxiety and depression, but further research is needed to improve adherence. A randomised controlled trial is needed to explore the efficacy of this program.
Comparable studies
Other non-randomized and open-label trials on anxiety, most cited first.
Citations in the library
Cited by 5
- Online mindfulness interventions in the care of people with physical and mental health conditions: a scoping review. BMJ Open July 18, 2025
- Self-Guided Internet-Based Mindfulness-Informed Stress Management for Generalized Anxiety Disorder: Randomized Controlled Trial With Longitudinal Network Analysis. Journal of Medical Internet Research June 5, 2026
- Effect of the Online Mindfulness-Based Stress Reduction on Anxiety and Depression Status of COVID-19 Patients Treated in Fangcang Hospitals: A Randomized Controlled Trial. Psychology Research and Behavior Management 2023
- Mindfulness-based online intervention for mental health during times of COVID-19. Indian Journal of Psychiatry May 1, 2022
- Attachment-based compassion therapy and adapted mindfulness-based stress reduction for the treatment of depressive, anxious and adjustment disorders in mental health settings: a randomised controlled clinical trial protocol. BMJ Open October 8, 2019
Cites 12
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects Psychological Inquiry October 19, 2007
- Mindfulness-based cognitive therapy for depression August 21, 2006
- Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology Science and Practice 2004
and 7 more in the library