Meditation, mindfulness, and acceptance methods in psychotherapy: A systematic review

Meditation, mindfulness, and acceptance (MMA) methods are popular in psychotherapy, but their impact when integrated into individual therapy sessions is unclear. A systematic review of 4,671 references found only three studies meeting inclusion criteria. In the one experimental study (162 participants), adding mindfulness meditation did not improve outcomes beyond other active treatments like progressive muscle relaxation or treatment-as-usual (effect sizes ranged from 0.00 to 0.12 for general clinical symptoms). Two small qualitative studies (5 therapist-patient dyads; 9 adults) suggested patients may find MMA methods helpful. The authors call for future research on optimal dosage, timing, patient characteristics, cultural adaptations, and measurement of MMA constructs in individual therapy.

Study at a glance

Abstract

Objective: Meditation, mindfulness, and acceptance (MMA) methods have gained popularity among psychotherapists and the public. The impact of these strategies as implemented in treatment packages (e.g., mindfulness-based interventions) has been studied extensively. However, the impact of integrating MMA strategies into individual psychotherapy has not been established.Methods: To address this gap in the literature, we conducted a systematic review of empirical (quantitative or qualitative) studies investigating the use of MMA methods during individual psychotherapy in adult samples.Results: After reviewing 4671 references, only three studies (one quantitative, two qualitative) met our inclusion criteria. The one experimental study (n = 162) provided no evidence that including mindfulness meditation improved outcomes beyond other active interventions (ds = 0.00–0.12 for effects on general clinical symptoms vs. progressive muscle relaxation and treatment-as-usual, respectively). Two qualitative studies (n = 5 therapist-patient dyads in one study, n = 9 adults in one study) provided preliminary evidence that patients may find MMA methods helpful.Conclusions: We highlight future directions for work in this area, including clarifying optimal dosage and timing, identifying patient characteristics associated with beneficial or adverse effects, investigating cultural adaptations, and clarifying how MMA constructs can be measured within individual psychotherapy. We conclude by highlighting training recommendations and therapeutic practices.