Psychological Medicine
December 29, 2016
Rebecca Crane, Judson A. Brewer, Christina Feldman et al.
861 citations
A framework defines essential characteristics of mindfulness-based programs (MBPs) like MBSR and MBCT, distinguishing them from other interventions. MBPs draw from contemplative traditions, science, medicine, psychology, and education; are grounded in a model addressing causes of human distress and pathways to relief; foster present-moment focus, decentering, and an approach orientation; cultivate qualities such as joy, compassion, wisdom, equanimity, and self-regulation; and involve sustained intensive meditation training, experiential inquiry, and exercises. The framework aims to support clarity for systematic research and maintain integrity as MBPs expand into healthcare, education, criminal justice, and workplaces.
Journal of Child Psychology and Psychiatry
October 22, 2018
Darren Dunning, Kirsty Griffiths, Willem Kuyken et al.
596 citations
A meta-analysis of 33 randomized controlled trials involving 3,666 children and adolescents found that mindfulness-based interventions produce small but significant improvements in mindfulness, executive functioning, attention, depression, anxiety/stress, and negative behaviors compared to control conditions. However, when only the 17 trials with active control groups (1,762 participants) were analyzed, significant benefits were limited to mindfulness, depression, and anxiety/stress, with effect sizes (Cohen's d) of 0.42, 0.47, and 0.18 respectively. The authors conclude that mindfulness interventions can improve youth mental health but note that larger definitive trials are needed to confirm these effects and understand how they work.
Behaviour Research and Therapy
May 10, 2017
Christine E. Parsons, Catherine Crane, Liam J. Parsons et al.
553 citations
Participants in Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR) complete about 64% of their assigned home mindfulness practice, which amounts to roughly 30 minutes per day, six days per week over eight weeks. Across 43 studies involving 1,427 participants, this estimate varied widely. In 28 studies with 898 participants, there was a small but significant positive association between the amount of self-reported home practice and better intervention outcomes. The findings suggest that while participants do not fully complete assigned practice, the practice they do complete is linked to benefits.
Mindfulness
September 21, 2011
Rebecca S. Crane, Willem Kuyken, J. Mark G. Williams et al.
232 citations
Interest in Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) has grown rapidly in the UK, prompting health, education, and social work practitioners to develop competencies as mindfulness-based teachers. This has raised fundamental questions about training processes, standards, and competence assessment. The paper examines how competencies are addressed in secular mainstream contexts, presents a framework for how teaching competencies develop in trainees, and reviews current assessment methodologies. The authors argue for continued international dialogue among mindfulness-based trainers and teachers to build a robust professional context for future teachers.
Mindfulness
April 26, 2010
Rebecca S. Crane, Willem Kuyken, Richard P. Hastings et al.
205 citations
Mindfulness-based approaches, supported by several randomized controlled trials, help prevent depressive relapse and recurrence, and are recommended by the UK's National Institute for Health and Clinical Excellence for use in the National Health Service. These approaches also appear helpful for anxiety disorders and chronic physical health problems, with growing interest in applying them to personality disorders, substance abuse, and eating disorders. The authors review the UK context, outline criteria for teacher competence and training steps, and discuss challenges and future directions for ensuring evidence-based mindfulness approaches are available in health care and other settings.
Behavioural and Cognitive Psychotherapy
June 10, 2009
Mark Allen, Andrew Bromley, Willem Kuyken et al.
158 citations
People with recurrent depression who took part in Mindfulness-Based Cognitive Therapy (MBCT) reported that the program helped them gain control over their thoughts and feelings, accept difficult experiences, improve relationships, and also noted the struggle involved in the practice. These four themes—control, acceptance, relationships, and struggle—emerged from interviews with 20 participants one year after treatment. The findings suggest that MBCT works through multiple psychological processes, not just one, and that participants find both benefits and challenges in the therapy.
Mindfulness (N Y)
January 1, 2015
Alison Evans, Rebecca Crane, Lucinda Cooper et al.
28 citations
A framework for supervising teachers of mindfulness-based interventions (MBIs) is presented, developed from the experience of eight supervisors, existing literature, and the authors' own training and supervision work. The framework maps the distinctive features of mindfulness-based supervision (MBS) using concentric circles that represent its essence, form, content, and process. The aim is to support the expansion of MBIs without compromising their integrity and efficacy by increasing the availability of competent supervision.
Psychotherapy research : journal of the Society for Psychotherapy Research
November 1, 2024
Shannon Maloney, Jesus Montero-Marin, Willem Kuyken
17 citations
Mindfulness-Based Cognitive Therapy-'Taking it Further' (MBCT-TiF) improved mental well-being more than ongoing mindfulness practice alone in 164 graduates of mindfulness-based programs. This improvement occurred through increases in mindfulness, self-compassion, and decentering—each independently mediated the effect. For depression, all three mediators also played a role, but only mindfulness and decentering mediated effects on psychological quality of life and anxiety. The findings suggest that MBCT-TiF works by enhancing these three psychological skills, though future research should test them together and alongside other potential mediators like equanimity.
BMJ mental health
August 24, 2024
Shannon Maloney, Merle Kock, Yasmijn Slaghekke et al.
16 citations
A systematic review of 27 randomized controlled trials found that mindfulness skills, decentering, and attitudes such as self-compassion are significant indirect pathways through which mindfulness-based programs improve mental health and well-being. Only four studies examined mechanisms within specific mindfulness practices. The evidence for alternative mechanisms like attention and awareness remains limited, especially regarding well-being outcomes, mental health promotion, and comparisons with active controls. The authors call for high-quality trials with powered multivariate mediation analyses to address these knowledge gaps and guide future interventions.
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.
Mindfulness
January 1, 2023
Shannon Maloney, Christina Surawy, Maryanne Martin et al.
9 citations
Four specific mindfulness practices from Mindfulness-Based Cognitive Therapy (body scan, mindful movement, breath and body, and befriending) produced similar state- and trait-level improvements in self-compassion, mindfulness, decentering, interoceptive awareness, and psychological quality of life among 160 adults from the general population. After a single session, state-level effects were observed across all candidate mechanisms and outcomes except decentering, with effect sizes ranging from 0.27 to 0.86. After two weeks of daily practice, trait-level improvements occurred in psychological quality of life and most mechanisms (effect sizes 0.26 to 0.64). No practice proved superior to any other. Changes in mindfulness, self-compassion, decentering, and body listening were linked to better psychological quality of life and more self-led practice.
Global advances in integrative medicine and health
January 1, 2023
Chelsea J Siwik, Shelley R Adler, Patricia J Moran et al.
7 citations
Mindfulness-based cognitive therapy (MBCT) reduces depression relapse, but about one-third of graduates relapse within a year. Focus groups with MBCT graduates and teachers revealed that the course is highly valued and sometimes life-changing. However, graduates struggle to maintain mindfulness practices and sustain benefits after the course ends, despite using community groups, apps, or retaking the course. One participant described finishing MBCT as feeling like "falling off a cliff." Both graduates and teachers strongly desired additional support, such as a maintenance program, to help sustain long-term benefits and reduce relapse risk.
Mindfulness
January 1, 2025
Marc-Henri Deroche, Willem Kuyken, Teruhisa Uwatoko et al.
5 citations
Mindfulness-Based Cognitive Therapy (MBCT) can help higher education address student distractibility and superficial engagement caused by information overload, guiding the journey from information to knowledge and from knowledge to wisdom. Drawing on Buddhist studies, philosophy of education, anthropology, clinical psychology, and psychiatry, the article argues that mindfulness training should move beyond isolated interventions to become the very thread of learning. It reviews evidence on student mental health, listens to students' existential concerns, and uses T. S. Eliot's questions about information, knowledge, wisdom, and Life to frame an epistemic and developmental model. Ultimately, mindfulness is conceived as forming attention and fostering the joy of learning to achieve both academic excellence and human flourishing.
The British journal of psychiatry : the journal of mental science
April 1, 2025
Jesus Montero-Marin, Verena Hinze, Shannon Maloney et al.
4 citations
Mindfulness skills mediate the effect of mindfulness-based cognitive therapy (MBCT) on depressive symptoms over 24 months, and this mediation is stronger for people with more severe depression. Among 424 adults with recurrent depression, those with higher severity showed an expected 10-point reduction on the Beck Depression Inventory-II, compared to a 3.5-point reduction for those with lower severity. The findings suggest MBCT with antidepressant tapering support works through a unique mechanism—mindfulness skills—that differs from maintenance medication alone, supporting personalized treatment for recurrent depression.
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.
Global advances in integrative medicine and health
January 1, 2024
Frederick M Hecht, Rebecca S Crane, Patricia Moran et al.
2 citations
Teaching quality in mindfulness-based stress reduction (MBSR) courses, measured by the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC), shows fair to good inter-rater reliability depending on the number of raters. Using a single rater, reliability was fair (intraclass correlation coefficients 0.33–0.56 across six domains); with three raters, reliability was good (0.6–0.8). Among 152 MBSR students, anxiety, depression, fatigue, sleep, and social role function improved from before the course to two and four months later (improvements of 2.3 to 6.3 points). Higher MBI:TAC ratings predicted greater anxiety reduction: each one-unit increase in composite teaching rating was associated with a 0.31-point greater decrease in anxiety score. No significant relationships were found for other health domains.
medRxiv
February 7, 2025
Jakub Vohryzek, Anne Maj van der Velden, Willem Kuyken et al.
1 citation
preprint
Mindfulness-based cognitive therapy (MBCT) alters brain network dynamics during depressive rumination in people with recurrent depression. In a randomized trial, 27 patients received MBCT plus treatment as usual, while 21 received treatment as usual alone. Using fMRI, researchers analyzed brain substates during an induced rumination state before and after treatment. MBCT changed the probability of a specific 'Salience-somatomotor' brain substate occurring during rumination, compared to the control group. These dynamic network changes were linked to reduced depressive symptoms after treatment and at three months follow-up, suggesting a candidate brain mechanism for how mindfulness training improves clinical outcomes.
medRxiv
June 23, 2026
Paulina Clara Dagnino, Anne Maj van der Velden, Henricus G. Ruhé et al.
In people with major depressive disorder, mindfulness-based cognitive therapy (MBCT) plus treatment as usual, compared to treatment as usual alone, increased the hierarchical organization of brain activity during rumination but not at rest. Greater hierarchy—meaning more directional information flow and less recurrent looping—was linked to improvements in clinical and behavioral outcomes. This shift away from self-reinforcing negative mental loops toward more differentiated cognitive and bodily cycles may help explain how MBCT interrupts ruminative thought patterns. Hierarchical brain dynamics could serve as a treatment-sensitive marker and potential mechanism of therapeutic change in MBCT for depression.
Biological Psychiatry Global Open Science
May 14, 2026
Anne Maj van der Velden, Jakub Vohryzek, Paulina Clara Dagnino et al.
Mindfulness-based cognitive therapy (MBCT) alters brain network dynamics during depressive rumination in people with recurrent depression. In a randomized controlled trial with 48 participants, those who received MBCT plus treatment as usual showed changes in the occurrence frequency of a 'salience-somatomotor' brain state during rumination compared to those receiving treatment as usual alone. These neural changes were linked to reduced rumination after treatment and fewer depressive symptoms three months later. The findings suggest that MBCT may work by modifying how the brain's somatosensory and salience networks interact during rumination, offering clues about the brain mechanisms underlying treatment response.
JCPP advances
October 7, 2025
Carolina Guzman Holst, Simona Skripkauskaite, Jack L. Andrews et al.
Most adolescents (69%-80%) followed stable low-problem trajectories for depression risk, social-emotional-behavioural functioning, wellbeing, and anxiety over a one-year school-based mindfulness intervention trial. However, 11%-23% experienced stable high-problem trajectories, 2%-16% showed increasing problems, and 1%-5% showed decreasing problems. Receiving the mindfulness intervention did not affect which trajectory adolescents followed. Individual factors like executive functioning difficulties and baseline mental health risk, along with school climate, predicted trajectory membership, but these effects did not differ between intervention and control groups. The findings indicate that universal interventions may not address the diverse needs of all students.