Acceptance and commitment therapy and mindfulness-based interventions in low-income and middle-income countries: A systematic review and multilevel meta-analysis
Juan Camilo Vargas-Nieto, Vanesa Castro-Sanabria, Mateo Bernal, Angela María Henao Gallego, Sara Robayo, Manuela Lozano
Zenodo (CERN European Organization for Nuclear Research) October 24, 2026 preprint DOI: 10.5281/zenodo.23618476 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review protocol |
|---|---|
| Interventions | Mindfulness-Based Interventions (MBIs) Acceptance and Commitment Therapy (ACT) |
| Topics | Meditation |
| Key findings | Proposes that a comprehensive systematic review and meta-analysis is needed to synthesize evidence on Mindfulness-Based Interventions and Acceptance and Commitment Therapy for anxiety, depression, and PTSD in low- and middle-income countries, arguing these transdiagnostic approaches suit task-shifting to non-specialist providers and could inform scaling up mental health care. |
Abstract
Populations in Low- and Middle-Income Countries (LMICs) bear a disproportionate burden of mental health conditions, including anxiety, depression, and post-traumatic stress disorder (PTSD), often exacerbated by conflict, poverty, and limited healthcare infrastructure. The gap between the need for and the availability of mental health services is particularly wide in these settings. Third-wave psychotherapies, such as Mindfulness-Based Interventions (MBIs) and Acceptance and Commitment Therapy (ACT), are transdiagnostic approaches that have demonstrated efficacy in high-income countries for a range of mental health issues. These interventions, which focus on processes like acceptance, mindfulness, and values-based action, are well-suited for task-shifting to non-specialist providers, a key strategy for scaling up mental health care in LMICs. While individual studies and some regional reviews exist, a comprehensive systematic review and meta-analysis is needed to synthesize the global evidence on the efficacy of these specific interventions for anxiety, depression, and PTSD in LMIC contexts. This review will provide a robust estimate of their effectiveness, identify gaps in the literature, and inform clinical practice and policy for scaling up evidence-based mental health care where it is most needed.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |