Why Mindfulness-Based Therapy Can Work For Improving Mental Health

By Morgan Hood|Updated May 31, 2022

What does it mean to be mindful? Mindfulness is a mental state you can achieve by focusing awareness on the present moment noticing your bodily sensations, thoughts, and feelings. For those of us with busy schedules and hectic lives, the idea of trying to remember to notice the present moment may seem out of reach. For others, turning inward may seem scary, as it can bring up hard or painful feelings. When uncomfortable feelings or situations arise, our instinct is often to distract ourselves. But mindfulness allows you to notice and accept your thoughts and feelings without hiding from them or wanting to change them, bringing a sense of peace and increased self-awareness over time.

Acceptance of your thoughts and feelings is an important part of mindfulness. Your focus can easily shift away from the present and into anxiety or rumination if you allow yourself to critique, judge, or try to change the things you're thinking and feeling.

There is no right or wrong way to think, feel, or exist, and mindfulness encourages you to notice how you're existing. This allows you to tune into the present moment, letting worries about the past or future drift away.

Why Does Mindfulness Work For Improving Mental Health?

Though mindfulness has its origins in Buddhist meditation, a secular practice of mindfulness has become mainstream in America since the 1970s. Dr. Jon Kabat-Zinn launched a mindfulness program (Mindfulness-Based Stress Reduction, or MBSR) at the University of Massachusetts Medical School in 1979. Since then, thousands of people have studied mindfulness's physical and psychological benefits. His MBSR techniques are used in schools, hospitals, and other institutions worldwide.

Research on mindfulness has identified several benefits, including:

  • Decreased Rumination. Depression often carries an endless stream of negative thoughts, also called rumination. Mindfulness practices can lead to reduced depressive symptoms, improved outlook, and decreased rumination.
  • Reduced Stress. Evidence suggests that mindfulness can increase positive affect, decrease anxiety, and decrease stress levels. Decreased stress can also benefit the body, like decreased blood pressure and improved sleep.
  • Better Memory. Mindfulness can improve even memory—there are consistent increases in working memory associated with regular meditation and mindfulness.
  • Better Focus. Studies in the previous link show that mindfulness meditation improves cognitive flexibility and attentional functioning.
  • Less Emotional Reactivity. Staying calm in stressful or difficult situations can be extremely challenging. Still, research shows that people who practice mindfulness can more easily disengage from negative emotions than people who don't meditate.
  • Improved Relationships. Relationship satisfaction is based on good communication between partners and each partners' ability to work through relationship problems as a team. Because mindfulness can improve one's ability to communicate and improves the ability to understand as well as handle emotions, mindfulness is also associated with happier relationships.

Mindfulness-Based Online Therapy Interventions

As technology continually advances, more and more services are offered online, including mindfulness-based interventions (MBI). Despite the success many people have had with online therapy, some people may still wonder if therapeutic interventions are as effective online as they are in person. Research shows that online therapies can effectively treat anxiety, depression, and trauma, and there is no difference in patient satisfaction when comparing online therapy to in-person therapy. For both online and in-person therapy, outcomes are better the more time a patient spends in therapy.

While many studies on online therapy, less research has been done specifically on online MBI therapy. However, a recent explorative meta-analysis aimed to discover the efficacy of online MBIs on depression, anxiety, stress, well-being, and mindfulness. It analyzed data from previous studies to compare improvement rates from in-person MBI to online MBI.

According to the study, online MBIs offer several advantages compared to face-to-face therapies. Online therapy is easily accessible, typically without long waiting lists; available to people in rural areas; available for people to utilize in their own space, allowing for more comfort; allow for anonymity, and can be less costly. Additionally, a 2014 study conducted on 500 adults in the United States showed that many prefer individual and online mindfulness therapy interventions over group formats. For nearly half of the participants, the internet was the first choice of therapy format. This suggests that, for many people, online MBIs may be an acceptable or even ideal form of therapy.

Methods For Study

Researchers for this meta-analysis used a wide selection of studies to draw conclusions and enhance understanding of the effects of MBI and online MBI on mental health.

A systematic literature search was conducted in three electronic databases, with each database analyzed for the following search terms: mindful, acceptance, meditation, intervention therapy, treatment, program, online, e-health, internet. Researchers used relatively broad inclusion criteria, including studies that employed MBIs, used internet-based MBIs, administered the intervention to populations 18 years and older, and used controls, whether active or inactive.

From there, a total of seventeen studies were selected for further analysis. Four were conducted in the U.S., four in the Netherlands, and one in the United Kingdom, Austria/Switzerland, Ireland, China, and Canada.

From all the studies, a total population was comprised of 2,360 participants. All participants were adults aged 18 to 58 years. The total sample size ranged from 49 in a pilot study to 551 in a larger trial. Five of the 15 studies were conducted among those with a bodily illness, like chronic pain and cancer recovery patients. Participants had anxiety, depression, or another psychological illness in three studies. In the remaining seven studies, the populations consisted of non-clinical participants like students or employees.

Promising Results

After all, studies were considered, researchers found improvements in depression, anxiety, well-being, mindfulness, and significant improvements in stress. This was not necessarily new information, as over200 studies have demonstrated MBI therapy's ability to improve stress, anxiety, and depression. However, the results were particularly promising for stress reduction, with the improvements of stress from MBI comparable to stress improvements from traditional MBSR and in-person MBI. Additionally, this study revealed that online MBI is also particularly effective at improving mindfulness.

Although research generally indicates that online therapeutic interventions are as effective as face-to-face interventions, the findings of this study may suggest that online MBIs are not equally effective as in-person MBIs when it comes to reducing depression and anxiety. However, there was a lot of variability across the studies in terms of the study population, and researchers suggest that certain subgroups may benefit more from online delivered MBIs than other groups. For example, people with psychological symptoms (like depression) may benefit more from online MBI than those with physical symptoms (like chronic pain). Researchers note that no firm conclusions can be drawn about whether online or in-person MBI is more effective, as more research needs to be done.

All of the data analyzed and discovered about online MBI was relatively new. This is one of the first meta-analyses to analyze the effects of online MBI on mental health. It is agreed that online interventions for mental health will continue to gain popularity as time goes on. The information gathered from this study will aid in future research on the efficacy of online therapeutic interventions.

The Future Of Online Mindfulness-Based Interventions

The primary goal of this explorative meta-analysis was to estimate the overall effect of online MBIs on depression, anxiety, stress, and well-being, and the results demonstrated that online MBIs might be a good alternative to in-person mindfulness therapy, especially for those looking to improve stress levels.

Ultimately, this research indicates that MBIs may be used in various manners and for various purposes. Online MBIs could be an acceptable and useful alternative for those who may benefit from cultivating their mindfulness skills but cannot access traditional in-person forms of MBI therapy. Online MBIs could also be a good option for those on a waitlist for traditional face-to-face MBI.

Additional research is needed to discover if online MBIs are as effective as in-person MBIS, and future research may also benefit from focusing on more narrow and specific criteria. Some examples include a) testing the long-term results of online MBI; b) assessing the efficacy of online MBI in different subgroups (somatic versus psychological illnesses); c) testing the utility of online MBI across various modalities (Acceptance and Commitment Therapy, Mindfulness-based Stress Reduction, Mindfulness-based Cognitive Therapy). It may also be useful to consider the effects of online MBI based on its delivery mode, whether by mobile phone or computer.

Dr. Kabat-Zinn said in an NPR interview, "The more present we are, the more we are our full dimensionality of being, the more we are there for our family, for our friends and our colleagues and for the world itself." When we're able to acknowledge and accept our present condition nonjudgmentally, we can more easily handle the ups and downs of life without becoming overwhelmed by them. If you're looking to improve your ability to handle stress, reach out to the licensed professionals at BetterHelp to get started.


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