Mindfulness is the practice of purposefully bringing one’s attention to the present moment without judgment. It involves paying attention to thoughts, feelings, and sensations in a curious and open way, allowing them to come and go without getting caught up in them. The goal is increased awareness and acceptance of the present.
Key Points
Rationale
Mindfulness interventionsaim to teach non-judgmental acceptance and observation of moment-to-moment experiences, including difficult emotions, sensations, and beliefs.
Reviews indicate mindfulness holds promise for symptom improvement, supporting continued research on change mechanisms and the feasibility of large-scale implementation.
Method
This review paper identified ten publishedmeta-analysesexamining mindfulness interventions for psychosis, spanning from 2013 to early 2023.
To systematically search for these meta-analyses evaluating mindfulness for psychosis, the key terms “mindfulness,” “psychosis,” and “meta-analysis” were used.
Databases searched were not reported. The meta-analyses included 3 to 26 studies investigating group- and individual-based mindfulness protocols tailored for psychosis, often integrated withcognitive-behavioral therapy (CBT).
Primary outcomes summarized were overall psychotic symptom severity and negative symptoms. No formal risk of bias assessment was undertaken for the included reviews.
Sample
While details of individual study samples were not reported here, the collected study samples across meta-analyses included clinical adult populations with confirmed psychotic disorder diagnoses such asschizophreniaor schizoaffective disorder.
No information was provided regarding the demographic composition of samples across studies.
Statistical Analysis
Key statistical results extracted from the identified meta-analyses were effect sizes gauging the magnitude of pre-post changes or differences between mindfulness groups versus control conditions on psychotic symptom severity.
Effect sizesreported predominantly included Hedges g, a variation of the more well-known Cohen’s d, corrected for smallsample biases.
Larger g values indicate larger effects, with benchmarks of 0.2 = small, 0.5 = medium, 0.8 = large effects.
Results
Reported meta-analytic effect sizes for symptomatic improvements ranged substantially from 0.46 to 0.86 across reviews.
Two meta-analyses found large effect sizes of 0.67 to 0.86, while other reviews converged on more modest small-medium effects of 0.46 to 0.57.
Though not completely consistent, results overall indicate promise and preliminary support for mindfulness to lessen the severity of persistent psychosis symptoms.
Insight
This review offers an insightful, updated overview of the cumulative evidence regarding mindfulness as a supplementary treatment specifically for psychotic conditions.
By collating findings only from meta-analyses, results distill the key effects found across the exponentially growing body of research in this area.
The paper also helpfully discusses critical future research directions focused on mechanisms of therapeutic change, safety, the feasibility of dissemination into routine care, and real-world clinical effectiveness.
Strengths
Limitations
Implications
The reported small-large effect sizes indicate the potential for clinically meaningful reductions in persistent symptoms when mindfulness approaches are applied in research contexts among people with enduring psychotic disorders.
Support for feasibility and effectiveness in community practice remains preliminary, but findings signify promise for wider implementation under pragmatic conditions if tailored appropriately to overcome barriers.
Conclusions
In conjunction with prior treatments, mindfulness training allows individuals with psychosis to relate to their symptoms in more accepting yet detached ways, reducing associated distress and dysfunction.
Current research provides initial evidence for mindfulness as likely safe and useful for lessening psychosis severity.
Open questions remain regarding what specific mechanisms explain benefits, how protocols could be optimized, and whether favorable outcomes endure over extended periods or translate successfully into large-scale practice across broader clinical settings.
Carefully designed implementation research focusing on these issues should be a priority next steps for the field.
References
Primary reference
Ellett, L. (2023). Mindfulness for psychosis: Current evidence, unanswered questions and future directions.Psychology and Psychotherapy: Theory, Research and Practice.https://doi.org/10.1111/papt.12480
Other references
Chadwick, P. (2014). Mindfulness for psychosis. The British Journal of Psychiatry, 204(5), 333-334.https://doi.org/10.1192/bjp.bp.113.136044
Chien, W. T., & Thompson, D. R. (2014). Effects of a mindfulness-based psychoeducation programme for Chinese patients with schizophrenia: 2-year follow-up.The British Journal of Psychiatry, 205(1), 52–59.https://doi.org/10.1192/bjp.bp.113.134635
Learning check
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
