Across two randomized controlled trials, a mindfulness-based intervention (MBI) improved mindfulness, distress tolerance, anxiety, and depression more than control conditions. In Study 1, 374 adults with moderate emotional distress were assigned to MBI or a waitlist; in Study 2, 170 adults with emotional disorders were assigned to MBI or a control group. Changes in distress tolerance explained the intervention's effects on anxiety and depression. Distress tolerance also preceded improvements in depression over time, but not in anxiety. Distress tolerance appears to be a mechanism through which MBIs reduce emotional distress, suggesting that boosting distress tolerance could strengthen these interventions.
Adding facilitator-supported mindfulness-based self-help (MBSH) to usual treatment leads to faster and greater reductions in anxiety and depression for people with emotional disorders. In a randomized trial with 302 patients from four centers, those who received MBSH plus usual care showed significantly more improvement in symptoms, mindfulness, physical symptoms, stress, sleep, and inner peace immediately after the program compared to those receiving usual care alone. Some benefits, including reduced depression and stress and increased mindfulness, appeared as early as three to five weeks and were maintained three months later. The approach is a scalable and effective addition to clinical practice.