A Guide to Mindfulness Therapy: Types, Application & Efficacy

Mindfulness Therapy
Table of Contents

Mindfulness therapy is a type of therapy that uses mindfulness techniques, such as meditation, focusing on the present moment, and breathing exercises to increase emotional awareness, identify negative thought patterns, and reduce stress. Mindfulness therapy typically involves weekly meetings with a licensed health professional, as well as daily homework assignments.

In this article, we will discuss the different types of mindfulness therapy, techniques used, and research supporting its efficacy. But first, let’s review the defining characteristics of mindfulness.

What is mindfulness?

Put simply, mindfulness refers to the practice of being fully aware in the present moment. It involves paying purposeful attention to your thoughts, feelings, and bodily sensations without judging or immediately reacting to them.

Mindfulness teaches us to see our thoughts and emotions more objectively, instead of accepting them as fact or reacting to them in ways that are ultimately destructive.

Mindfulness also teaches us to slow down and enjoy life’s little moments instead of acting on “auto-pilot.”

Here are some examples of everyday scenarios and automatic versus mindful responses:

SituationAutomatic responseMindful response
You are starving and in a rush to grab lunch before a meeting. You approach your favorite cafe and see a long, snaking line of people waiting to order.Waiting in line, you grow increasingly irritated, checking your watch frequently and imagining your boss reprimanding you for being late. When it is finally your turn to order, you snap in frustration at the cashier.Waiting in line, you notice your blood pressure starting to rise and your muscles becoming tense. You take several deep breaths, imagining that with each exhale you are letting go of the things you can’t control. When it is your turn to order, you smile at the cashier and have a pleasant interaction.
You come home from work to find a pile of dirty dishes in the sink.You roll up your sleeves to get to work. As you wash, you think about a stressful situation at work and become increasingly agitated. You accidentally chip a dish when you place it in the drying rack with too much force.You use the opportunity to tune into your five senses, enjoying the smell of the dish soap and the feel of the warm water on your skin. You recall playing with bubbles as a kid and smile at this happy memory.

Mindfulness therapy applies mindfulness techniques to the treatment of various physical and mental health concerns, including anxiety, depression, and chronic pain. Mindfulness therapy typically occurs in a group setting and is conducted by a licensed health professional. There are several different types of mindfulness therapy, which we will review in the next section.

Types of mindfulness therapy

Mindfulness therapy is an “umbrella” term that encompasses several interventions. The most common are mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and mindfulness-based cognitive-behavioral therapy (MBCBT). Below, I summarize each:

Mindfulness-based stress reduction (MBSR)

MBSR was developed in the late 1970s to help people reduce stress and improve overall well-being. The program typically involves eight weekly sessions, during which participants learn a variety of mindfulness techniques, such as meditation, body scans, and breathing exercises.

Over the past 40 years, MBSR has evolved to treat a variety of conditions, including anxiety, depression, and insomnia. It has also been helpful in managing stress-related physical conditions such as irritable bowel syndrome, chronic fatigue, and hypertension.

Mindfulness-based cognitive therapy (MBCT)

MBCT combines mindfulness techniques with cognitive therapy. Cognitive therapy is a type of talk therapy that focuses on identifying and changing negative thought patterns.

MBCT was originally developed as a treatment for recurrent depression. It typically occurs in a group setting in weekly sessions of 2-2.5 hours. Participants are also assigned daily homework assignments. The goal of MBCT is to help break the cycle of negative thoughts and feelings associated with depression.

Mindfulness-based cognitive behavioral therapy (MBCBT)

MBCBT integrates mindfulness and cognitive-behavioral therapy, or CBT. CBT is a type of cognitive therapy that focuses on the interplay of thoughts, emotions, and behaviors.

MBCBT uses some of the same techniques as MBCT but incorporates behavioral interventions such as exposure therapy, which guides participants to gradually confront anxiety-provoking situations. The goal of MBCBT is to provide more comprehensive treatment for conditions such as depression, anxiety, and addiction.

Various other therapies, such as dialectical behavioral therapy (DBT) and acceptance and commitment therapy (ACT) incorporate mindfulness practices but are not considered mindfulness therapies because mindfulness is not the primary focus of treatment.

Now that you are familiar with the different types of mindfulness therapy, let’s talk about how these therapies are applied.

Application of mindfulness therapy: techniques, setting, and duration

Mindfulness therapy techniques

The specific techniques used in mindfulness therapy vary based on the therapy provider and patients’ individual needs. However, MBSR, MBCT, and MBCBT are all likely to incorporate:

  • Mindfulness meditation— a practice that involves focusing your attention on the present moment, often by attending to the breath, with the goal of cultivating non-judgmental awareness of thoughts, emotions, and physical sensations.
  • Body scan— a technique that guides you to focus on different parts of your body, usually starting at your feet and working your way up to the top of your head, to increase awareness and promote relaxation.
  • Mindful movement— applying the principles of mindfulness to activities such as yoga, tai chi, or walking, with the goal of developing focus and calm.
  • Breathing exercises—a mindfulness technique that expands the focus on the breath by prescribing structured patterns of breathing– for example, “box breathing,” in which you inhale, hold, exhale, and hold the breath for 4 seconds each.
  • Daily mindfulness— bringing the principles of mindfulness to everyday activities like eating, showering, and driving so that you are fully taking part in these activities instead of letting your mind wander on “auto-pilot.
  • Urge surfing— a mindfulness technique that involves observing and accepting your urges without acting on them, i.e. “surfing” the wave of discomfort until it naturally passes.
  • Journaling— while not a mindfulness technique, journaling can complement mindfulness therapy by recording observations made during mindfulness practice and encouraging additional self-reflection.

Setting and duration

Mindfulness therapy typically occurs in a group setting over the course of 8 weeks. However, research indicates that mindfulness therapy is also effective when conducted via 1:1 sessions and over shorter time frames.

For example, a 2016 study randomly assigned patients with chronic medical conditions and depressive symptoms to 2 groups. Half received group MBCT and the other half received individual MBCT. The study found that MBCT reduced depression and improved well-being regardless of whether it was conducted in group or 1:1 sessions [1].

Other studies have examined the efficacy of brief MBCT lasting less than the traditional 8 weeks. A 2021 study of patients with generalized anxiety found that those who completed a 5-week MBCT program had significantly fewer symptoms of anxiety and depression after completing the program [2].

Taken together, these studies show that mindfulness therapy could help to reduce symptoms and improve well-being, regardless of setting and duration. A licensed mindfulness therapy provider can help you decide which techniques, setting, and duration might work best for you.

In the next section, we will discuss the efficacy of mindfulness therapy in more detail, as well as the conditions it is most commonly used to treat.

Efficacy of mindfulness therapy

Mindfulness-based therapies have been helpful for a variety of mental and physical health issues in both clinical populations (e.g., patients at a physician’s office or clinic) and non-clinical populations (the general public).

For example, a recent review of research concluded that mindfulness therapy was more effective than control conditions— including health education, relaxation training, and psychotherapy— at reducing anxiety, depression, stress, chronic pain, and emotional dysregulation among clinical and non-clinical populations [3].

Most of the current research has focused on MBSR and MBCT, and there is the most evidence supporting the use of these therapies to treat anxiety, depression, chronic pain, and insomnia. Below, I summarize the research corroborating the efficacy of mindfulness therapy:

Anxiety

While stress and anxiety are two different things, both produce a similar physiological response. Since MBSR was created to reduce stress, it’s not surprising that mindfulness therapy can effectively treat anxiety, as well.

A 2020 study of adults with anxiety disorders found that 8 weeks of MBSR was just as effective as medication at reducing symptoms, with fewer side effects [4]. Similarly, a recent review of randomized controlled trials concluded MBSR outperformed CBT as a treatment for anxiety in adolescents [5].

Depression

In a 2000 study of patients with chronic depression, patients who received MBCT were less likely to experience a recurrence of depressive symptoms. Patients were randomly assigned to receive MBCT or treatment, as usual. Only 40 percent of those receiving MBCT experienced a relapse of depression, versus 60 percent of patients who received treatment as usual [6].

Preliminary research indicates that MBCT might be effective as a treatment for severe, sudden-onset, and treatment-resistant depression, but more research is needed in these areas.

Chronic pain

MBSR was first studied as a treatment for chronic pain in the mid-1980s. Patients completing a 10-week MBSR program reported less pain, anxiety, and depression compared to patients receiving traditional treatments for pain [7].

More recently, a group of 115 healthy people were randomly assigned to MBSR or a health enhancement program. All participants were then exposed to a painful heat stimulus while undergoing neuroimaging. Those who completed the MBSR program showed decreased activity in the areas of the brain associated with pain response [8].

Together, these findings suggest MBSR can alleviate pain in both clinical and non-clinical populations and that it works in part by modifying the body’s neurological response to pain.

Insomnia

A new mindfulness therapy called MBTI (mindfulness-based therapy for insomnia) shows promise for patients with insomnia who don’t respond to traditional treatment. A recent study found that insomnia patients who completed 8 weekly, 1-hour sessions of MBTI reported significant improvements in sleep duration and quality. However, these gains diminished at follow-up, showing that additional interventions may be needed to maintain MBTI treatment gains [9].

At this point, you may wonder how simply paying attention to your breath and “living in the moment” can effectively address so many issues! While no one knows the precise mechanisms by which mindfulness therapy improves health and well-being, there are several evidence-based theories, which we will discuss in our next and final section.

How does mindfulness therapy work?

Although mindfulness practices have existed for thousands of years, scientists are only beginning to understand how and why mindfulness is so beneficial.

One theory is that mindfulness affects stress pathways in the brain, particularly in the areas responsible for emotion regulation. This theory is supported by studies that use functional MRI (fMRI) scans to measure brain activity. Patients who practice mindfulness meditation show decreased activity in areas of the brain responsible for emotional arousal [10].

There is also evidence that mindfulness reduces inflammation in the body. In a 2018 study at Harvard University, people who meditated for 8 weeks showed changes in the expression of over 170 genes that regulate inflammation, metabolism, and sleep [11]. This could explain why mindfulness therapy is effective in treating conditions like chronic pain, which is often associated with inflammation.

The bottom line

Mindfulness therapy is a type of therapy that combines mindfulness practice with other techniques to reduce stress and improve overall well-being. There are several types of mindfulness therapy, including mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and mindfulness-based cognitive-behavioral therapy (MBCBT). While these therapies traditionally occur in a group setting over the course of 8 weeks, there is evidence that mindfulness therapy is also effective when conducted in individual sessions and/or over shorter time frames.

Which mindfulness therapy is right for you depends on individual preference and the issues you are hoping to address. MBSR may be more effective for chronic pain and anxiety, while MBCT may be more helpful in reducing the relapse of depressive symptoms. In addition, there is a new therapy called mindfulness-based therapy for insomnia (MBTI) that shows promise as a treatment for sleep disturbances.

Sources

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[2] Burgess EE, Selchen S, Diplock BD, Rector NA. A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression. Int J Cogn Ther. 2021;14(2):380-398. doi: 10.1007/s41811-021-00105-x. Epub 2021 Apr 20. PMID: 33897938; PMCID: PMC8057287.

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[5] Xiang Zhou, Jieyu Guo, Guangli Lu, Chaoran Chen, Zhenxing Xie, Jiangmin Liu, Chuning Zhang, Effects of mindfulness-based stress reduction on anxiety symptoms in young people: A systematic review and meta-analysis, Psychiatry Research, Volume 289, 2020, 113002, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2020.113002.

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[8] Wielgosz J, Kral TRA, Perlman DM, Mumford JA, Wager TD, Lutz A, Davidson RJ. Neural Signatures of Pain Modulation in Short-Term and Long-Term Mindfulness Training: A Randomized Active-Control Trial. Am J Psychiatry. 2022 Oct;179(10):758-767. doi: 10.1176/appi.ajp.21020145. Epub 2022 Jul 28. Erratum in: Am J Psychiatry. 2022 Oct;179(10):767. PMID: 35899379; PMCID: PMC9529779.

[9] Kalmbach DA, Cheng P, Ong JC, Reffi AN, Fresco DM, Fellman-Couture C, Ruprich MK, Sultan Z, Sagong C and Drake CL (2023) Mindfulness-based therapy for insomnia alleviates insomnia, depression, and cognitive arousal in treatment-resistant insomnia: A single-arm telemedicine trial. Front. Sleep 2:1072752. doi: 10.3389/frsle.2023.1072752

[10] Powell, A. (2018, April 9). Harvard researchers study how mindfulness may change the brain in depressed patients. Harvard Gazette. https://news.harvard.edu/gazette/story/2018/04/harvard-researchers-study-how-mindfulness-may-change-the-brain-in-depressed-patients

[11] Knox, R. (2018, April 6). Harvard Study: Clearing Your Mind Affects Your Genes And Can Lower Your Blood Pressure. Www.wbur.org. https://www.wbur.org/news/2018/04/06/harvard-study-relax-genes

Lindsay Schwartz
Lindsay Schwartz
I am a psychotherapist turned mental health writer. My hope is to draw upon my professional experience to provide readers with practical, accessible advice for improving their mental health. When I am not writing or reading about psychology, I’m usually walking my dog or enjoying a mindful moment in nature!