Mindfulness-Based Interventions (MBI) are therapeutic approaches that incorporatemindfulness techniques, such as meditation, breathing exercises, and body awareness, to help individuals manage mental health issues.
MBI aims to help individuals with social anxietydevelop a different relationship with their anxious thoughts and feelings, potentially leading to reduced anxiety symptoms and improved social functioning. This approach offers an alternative or complementary treatment to traditional cognitive-behavioral therapies.
Key Points
Rationale
Social anxiety disorder (SAD) is a debilitating condition that significantly impacts the quality of life of adolescents, limiting their educational attainment, social relationships, and future professional goals (Woodward & Fergusson, 2001).
Cognitive Behavioral Therapy (CBT) has long been considered the gold standard for treating SAD, showing large effect sizes compared to waitlist and psychological placebo control conditions (Mayo-Wilson et al., 2014).
However, CBT has limitations, including the need for specialized training, significant time commitment, and lower-than-expected efficacy in some cases (Hofmann & Smits, 2008).
Mindfulness-Based Interventions (MBI) have emerged as a promising alternative or complementary treatment for SAD.
Studies have shown that MBI can be effective in reducing SAD symptoms over long-term follow-up periods (Liu et al., 2021). However, there is limited research directly comparing the effectiveness of MBI andCBT for treating social anxietyin adolescents.
The study sought to provide evidence-based insights to inform clinical practice and guide future research in this important area of mental health treatment.
Method
The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. It was registered under PROSPERO with Trial Registration number CRD42022369367.
Databases searched included PubMed, Science Direct, Taylor and Francis Online, Web of Science, Wiley Online Library, Medline, World Health Organization, American Journal of Occupational Therapy, and American Psychological Association.
Gray literature was also searched, including Google Scholar and reference lists of relevant papers.
Search strategy and terms:
The search strategy utilized a combination of free concepts and MeSH terms, divided into four thematic categories:
Inclusion and exclusion criteria:
Inclusion criteria:
Exclusion criteria:
Statistical measures
The meta-analysis was conducted using Review Manager 5.4. The standardized mean difference (SMD) and 95% confidence intervals were calculated for group comparisons.
Heterogeneity was assessed using visual heterogeneity, I² statistic, and chi-square test. The quality of evidence was evaluated using the GRADE approach.
Results
Initial studies identified: 9543 Studies included in the final analysis: 3
Characteristics of included studies:
Meta-analysis results:
Individual study results:
Heterogeneity:
Risk of bias:
Insight
The key finding of this meta-analysis is that there is no significant difference between the effectiveness of Mindfulness-Based Interventions (MBI) and Cognitive Behavioral Therapy (CBT) in treating social anxiety among adolescents.
This result is particularly informative because it challenges the notion that CBT is the only effective treatment for social anxiety and suggests that MBI could be a viable alternative or complementary approach.
While earlier studies have shown the effectiveness of both MBI and CBT individually, this research provides a more comprehensive understanding of their comparative efficacy.
The study highlights the potential of MBI as a second or third-line treatment for adolescents with social anxiety disorder, particularly for those who have a strong preference for mind-body interventions or who show insufficient response to first-line treatments like CBT.
This insight is valuable for clinicians and therapists in tailoring treatment approaches to individual patient needs and preferences.
Further research could focus on:
Strengths
The study had many methodological strengths including:
Limitations
This study also had many methodological limitations, including:
These limitations imply that while the findings provide valuable insights, they should be interpreted cautiously. The results may not be fully generalizable to all adolescent populations or clinical settings.
The lack of long-term follow-up data also limits our understanding of the sustained effects of these interventions.
Implications
The results of this study have significant implications for clinical psychology practice and the treatment of social anxiety in adolescents:
Variables that influence the results include the specific MBI and CBT protocols used, the duration and intensity of treatments, the cultural context of the studies, and the characteristics of the patient populations (e.g., age, severity of social anxiety, comorbid conditions).
References
Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials.Journal of clinical psychiatry,69(4), 621.
Liu, X., Yi, P., Ma, L., Liu, W., Deng, W., Yang, X., Liang, M., Luo, J., Li, N., & Li, X. (2021). Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis.Psychiatry research,300, 113935.https://doi.org/10.1016/j.psychres.2021.113935
Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis.The Lancet Psychiatry,1(5), 368-376.https://doi.org/10.1016/S2215-0366(14)70329-3
Woodward, L. J., & Fergusson, D. M. (2001). Life course outcomes of young people with anxiety disorders in adolescence.Journal of the American Academy of Child & Adolescent Psychiatry,40(9), 1086-1093.https://doi.org/10.1097/00004583-200109000-00018
Keep Learning
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.
