The most effective areas that Mindfulness-Based Interventions improve is stress and mindfulness. Internet-based MBIs have a comparable effect on stress reduction to traditional MBSR and MBCT practices. There also appears to be a significant impact of these online MBIs on people’s mindfulness meditation skills. These online mindfulness mediation services have a small impact on depression, anxiety, and well-being. 

Effectiveness of Online Mindfulness Services

Mindfulness-Based Interventions offered online are not as effective in reducing depression and anxiety as face-to-face MBIs. The effectiveness of MBIs in general most likely depends on adhering to the program through continuous practice, which is easier to mandate and regulate with scheduled face-to-face sessions. 

Limitations of Online Mindfulness Services

There are many online services and apps that are available that allow people to practice Mindfulness Interventions such as Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) from one’s own device. The ease of accessibility, lower cost, and convenience of these services are some of the pros of online MBI practices over face-to-face MBIs. 

University of Michigan - Ann Arbor

Georgetown University

Mindfulness-Based Cognitive Therapy (MBCT) is an 8-week psychotherapy program that includes elements of both Cognitive-Behavioral Therapy (CBT) and of Mindfulness-Based Stress Reduction (MBSR) with the goal of enhancing one’s psychological well-being through formal/informal meditation practices. 

Mindfulness-Based Cognitive Therapy

Acceptance and Commitment Therapy (ACT) centers on the utilization of acceptance, values, mindfulness and conventional behavior change methods with the goal of reducing psychological inflexibility. 

Acceptance and Commitment Therapy 

Mindfulness-based stress reduction (MBSR) is an educational therapy program with the goal of teaching individuals both formal and informal/everyday mindfulness techniques to help reduce psychological distress.

Standard MBSR programs are 8-weeks in duration consisting of 26 hours with a 6-hour one day class (total of 32 hours). Participants are also expected to practice 45 minutes per day at home during the program.

Mindfulness-Based Stress Reduction

- Everyday mindfulness
- Formal mindfulness practice
- Mindfulness Apps and Online Services

Forms of Mindfulness Practice

Spijkerman, M. P. J., Pots, W. T. M., & Bohlmeijer, E. T. (2016). Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical Psychology Review, 45, 102–114. https://doi.org/10.1016/j.cpr.2016.03.009

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Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials


MBCT is used in conjunction with mood-regulating medications for patients with bipolar disorder to treat symptoms of depression, anxiety, and mania. This is done to expand courses of treatment and prolong improvement of symptoms, as patients with bipolar disorder can often relapse.

Mindfulness-Based Cognitive Therapy (MBCT) and Bipolar Disorder

Mindfulness based cognitive therapy (MBCT) has been shown to effectively treat depression in patients with diabetes, as well as improve their quality of life and glucose levels. More studies are needed to assess the effectiveness of MBCT on the physical health of patients with diabetes.

Mindfulness-Based Cognitive Therapy and Diabetes

- Patients with Anxiety
- Patients with Depression

Populations that May Benefit Benefit from Mindfulness-Based Cognitive Therapy

Mindfulness Apps and Online Services

Populations positively affected by ACT include: 
- College students
- Parents of Children with Autism Spectrum Disorder
- Individuals with PTSD after Traumatic Brain Injury (TBI)
- Psychotic Patients 
- Depressed patients
- Individuals with chronic pain conditions
- Individuals with both Generalized Anxiety Disorder and Depression
- Physical Therapy Patients

Populations that Benefit from Acceptance and Commitment Therapy (ACT)

The process/way of living through which behaviors and actions are strictly guided by psychological experiences (thoughts, feelings, etc.) rather than ones’ meaningful values or by actions that might be effective. 

Psychological Inflexibility 

Although mindfulness interventions are commonly thought of as a treatment solely for mental and psychological illness, various mindfulness interventions have been used in physical rehabilitation.

Mindfulness in Physical Rehabilitation 

- Improves processes of change amongst tested subjects
- Reduces psychological symptoms such as social anxiety and depression
- improves mood processes amongst individuals with PTSD after Traumatic Brain Injury
- it does not require formal practice
- Lessen the likelihood of re-hospitilization for Chronic Mental illness
- Lessen Believability of positive schizophrenic symptoms
- Can decrease symptom occurrence
- less time consuming compared to practices like MBSR
- a trans-diagnostic treatment method: it can treat more than one disorder at a time


Benefits of Acceptance and Commitment Therapy 

Acceptance and Commitment Therapy has been applied in the following formats to bring about positive effects: 

- Self-help programs (self-guided and clinician assisted)

- group interventions (teach skills together)

Acceptance and Commitment Therapy: Formats of Application 

-Acceptance

-Cognitive Defusion

-Being Present

-Self as Context

-Values

-Committed Action



Acceptance and Commitment Therapy: 6 core processes (psychological flexibility model) 

- Values 
- Committed Action 
- Defusion 
- Acceptance 
- Self as Context 
- Connecting with the present moment

Six Processes of Acceptance Commitment Therapy

A study examined the effectiveness of an adolescent ACT prevention program. The program aimed to use ACT methods to prevent teens from developing anxiety, depression, and other psychopathologies rather than using it as a means to treat these symptoms, which is how ACT is typically used. The study used an ACT condition and a control condition, with students in the ACT group participating in the ACT program while the control group participated in normal class activities. Both students and teachers were accepting of the program and found it feasible to implement it into the regular class time schedule. Additionally, students in the ACT condition demonstrated a difference in anxiety/depression scores. 

ACT Prevention Program for Adolescents

Studies have indicated that there are several ways in which ACT can be adapted to suit teenagers' biological, psychological, and social development. Some ways that this can be done is by involving teens' parents and peers, using personalized goal setting, incorporating the teen's interests, and explaining more abstract concepts using more cognitive methods. It is also important to note that evidence has suggested that ACT may be more suitable for some teens more than others, with it tending to be more effective with teens who are able to think more abstractly. 

Adapting ACT for Adolescents 

- Medical students
- Patients with eating disorders
- Traumatic Brain Injury (TBI) patients
- Trauma-exposed women
- Post-treatment breast cancer patients 
- LGBTQIA+ Individuals
- Patients with depression and anxiety

Populations that May Benefit from Mindfulness-Based Stress Reduction (MBSR)

- Decreases overall psychological distress
- Can help improve emotional regulation through attentional deployment

Benefits of Mindfulness-Based Stress Reduction (MBSR)

- Short-term mindfulness-based stress reduction
- Therapeutic interventions that use mindfulness-based stress reduction techniques

Variations of Mindfulness-Based Stress Reduction (MBSR)

Mindfulness-based stress reduction interventions can be incorporated into multiple different settings. These include:

- University elective courses
- Physical Therapy 

Mindfulness-Based Stress Reduction (MBSR) Intervention Settings

Mindfulness Based Stress Reduction (MBSR) interventions have multiple physiological effects including the following:
- Morphometric changes in brain regions
- Increased connection between the amygdala and the ventromedial prefrontal cortex (VMPFC) 

Neurological Effects Resulting From Mindfulness-Based Stress Reduction

Somatic:

- Improved Immune Response

- Improvement in Conditions Worsened by Stress

Neurological:

- Improved functioning of the amygdala and dorsal anterior cingulate cortex

- Increased gray matter in the right anterior insula

- Increased left-sided anterior activation

- Increased connection between the amygdala and the ventromedial prefrontal cortex (VMPFC)

Physical Effects Resulting From Mindfulness-Based Stress Reduction

Exercises in MBSR, such as sitting meditation and the body scan, can give African American women (who are often consumed by caring for the needs of others) a restorative and imperative time-out to quiet the mind and restore balance.

MBSR’s Specific Value for Reducing Stress among African American Women

Everyday mindfulness is a form of mindfulness practice that an individual can do without changing their routine in a drastic way. It involves reminding the self throughout the day to be aware of their senses and what is happening in the moment.

Everyday Mindfulness

Retreat practice is a form of mindfulness practice that involves taking a vacation and participating in a retreat solely dedicated to practicing mindfulness. Often, retreats incorporate long periods of formal meditation practice by having participants complete all activities in silence.

Retreat Practice

Formal mindfulness practice is when an individual sets aside a specific amount of time each day to practice mindfulness. 

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