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Cited by 291Mindfulness and Compassion InterventionsPsychotherapy Techniques and ApplicationsDigital Mental Health Interventions

Prospects for a clinical science of mindfulness-based intervention

Open access
Dimidjian, Sona, Segal, Zindel V.·2015·American Psychologist
DOI 10.1037/a0039589PMC PMC5853107
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Abstract

Mindfulness-based interventions (MBIs) are at a pivotal point in their future development. Spurred on by an ever-increasing number of studies and breadth of clinical application, the value of such approaches may appear self-evident. We contend, however, that the public health impact of MBIs can be enhanced significantly by situating this work in a broader framework of clinical psychological science. Utilizing the National Institutes of Health stage model (Onken, Carroll, Shoham, Cuthbert, & Riddle, 2014), we map the evidence base for mindfulness-based cognitive therapy and mindfulness-based stress reduction as exemplars of MBIs. From this perspective, we suggest that important gaps in the current evidence base become apparent and, furthermore, that generating more of the same types of studies without addressing such gaps will limit the relevance and reach of these interventions. We offer a set of 7 recommendations that promote an integrated approach to core research questions, enhanced methodological quality of individual studies, and increased logical links among stages of clinical translation in order to increase the potential of MBIs to impact positively the mental health needs of individuals and communities.

Integrity signals

Registry

Crossref · 10.1037/a0039589

Cites

343 of 343 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 68 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    The MBI field's greatest research activity has been in developing and exploring applications for new populations and target problems.

    “The greatest focus of activity in the MBI field has been dedicated to the development and exploration of applications of MBIs with novel populations and target problems.”
    Quote in the paperSubstantial claim
  • Findingown data

    Most Stage I MBI studies in the mapping extended an MBI to a new problem or population.

    “Most of these studies focus on extending the MBI to a novel problem or population”
    Quote in the paperNot a substantial claim
  • Findingown data

    After screening, 309 articles met inclusion criteria, comprising 118 MBCT and 191 MBSR articles.

    “resulting in a total of 309 articles (MBCT n = 118, MBSR n = 191).”
    Quote in the paperNot a substantial claim
  • Findingcitation

    In nonclinical participants, MBSR showed no significant benefit on subjective well-being compared to the Health Enhancement Program.

    “indicated no significant benefit associated with MBSR on subjective reports of well being”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites MacCoon et al., 2012

      Not checked in the free run.

  • Findingcitation

    MBCT showed specific benefits on some outcomes compared to a relaxation control for tinnitus patients.

    “specific benefits on some outcomes as compared to a relaxation control for patients with tinnitus (Philippot, Nef, Clauw, de Romree, & Segal, 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Philippot, Nef, Clauw, de Romree, & Segal, 2012

      Not checked in the free run.

  • Classified as probably not a substantial claim. 31
  • May combine two claims. 26

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The initial database search returned 3,217 articles.

    “yielding 3,217 articles in the initial search.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only a small number of MBI studies have examined candidate mediators or moderators, and even fewer have formally tested mediation or used methods for personalized treatment selection.

    “our mapping indicates that only a small number of studies have explored candidate mediators or moderators of outcome; and of these, even fewer have tested mediation formally or incorporated recent methods that move the field closer to a personalized medicine framework”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    The mapping at Stage I mainly includes feasibility and pilot testing studies, including nonrandomized open-trial designs.

    “Our mapping at this stage includes mainly feasibility and pilot testing studies including nonrandomized open-trial designs of an MBI”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    MBCT showed no significant benefit compared to an educational control for caregivers of dementia patients, though both active treatments outperformed a respite-only control.

    “MBCT showed no significant benefit as compared to an educational control for caregivers of dementia patients, although both active treatments outperformed a respite only control (Oken et al., 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Oken et al., 2010

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The field has given little scientific attention to operationalizing MBI instructor training requirements and developing scaffolding resources for instructors.

    “Operationalizing this requirement and developing scaffolding resources for instructors learning MBI are gaps that exist currently at Stage I.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: MBI instructors are expected to have personal mindfulness meditation practice in addition to professional clinical training.

  • May combine two claims.

    Findingcitation

    MBSR studies often fail to outperform active controls on primary outcomes but show mixed results on secondary outcomes.

    “Studies of MBSR provide similarly complex findings, reporting failure to outperform an active control on primary outcomes but often mixed results on secondary outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Among MBCT-targeted problems, only depression and comorbid health and mental health conditions, and among MBSR studies primarily cancer, show incremental progression from Stage I to later stages.

    “Among problems targeted by MBCT, only work on depression and comorbid health and mental health conditions, and within MBSR studies, primarily work with patients with cancer, show incremental progression from Stage I to subsequent stages.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    The mapping identified studies that integrate basic research methods into later-stage intervention studies, marked with asterisks.

    “Studies identified with asterisks in Stages I–V provide examples of movement to such integration.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The included studies vary in methodological rigor but share a goal of understanding whether an MBI works beyond symptom report and how and for whom.

    “These studies encompass varying degrees of methodological rigor; however, they share the common element of seeking to understand whether an MBI works beyond simply symptom report as well as how and for whom.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In generalized anxiety disorder, MBSR showed no superiority over stress management education on primary anxiety symptom severity but had advantage on secondary anxiety outcomes.

    “A comparison of MBSR and stress management education among patients with generalized anxiety disorder also found no evidence of superiority for MBSR on the primary outcome of anxiety symptom severity, but reported advantage on secondary anxiety outcomes (Hoge et al., 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hoge et al., 2013

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Kuyken et al. (2008) found MBCT comparable to maintenance pharmacotherapy for relapse prevention and cost-effectiveness in primary care, with advantages on residual depressive symptoms, psychiatric comorbidity, and quality of life.

    “Kuyken et al. (2008) examined the effects of MBCT as compared to maintenance pharmacotherapy among patients treated in primary care, with results suggesting comparable relapse prevention and cost effectiveness as well as advantage to MBCT on indices of reducing residual depressive symptoms, psychiatric comorbidity, and quality of life.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kuyken et al. (2008)

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Thompson et al. (2010) compared distance delivery of MBCT via telephone or internet for epilepsy and depressive symptoms (N=40) to WLC, co-facilitated by a layperson with epilepsy and an MPH student.

    “N. J. Thompson et al. (2010) compared “distance delivery” of MBCT via telephone or internet for patients with epilepsy and depressive symptoms (N = 40), as compared to WLC, and the intervention was co-facilitated by a layperson with epilepsy and a master's of public health student.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites N. J. Thompson et al. (2010)

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    A recent meta-analysis reported small to moderate effects and little evidence of specific efficacy for meditation.

    “a recent meta-analysis of the clinical applications of meditation (Goyal et al., 2014), which reported small to moderate effects and little evidence of specific efficacy.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Goyal et al., 2014

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    Only two MBCT trials and one MBSR trial published before 2014 addressed effectiveness, with two focused on economic outcomes.

    “Only two trials of MBCT and one of MBSR were published prior to 2014 that addressed questions of effectiveness, with two focused specifically on economic outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Few studies have tested whether instructors find the interventions they deliver credible, raising the possibility of allegiance effects.

    “few studies have tested the degree to which instructors find the interventions they are delivering to be credible, thus introducing the possibility of allegiance effects”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    van Ravesteijn et al. (2013) found MBCT vs TAU for persistent medically unexplained symptoms had lower hospital costs and higher mental health care costs.

    “van Ravesteijn, Lucassen, Bor, van Weel, and Speckens (2013) examined the cost-effectiveness of MBCT compared with TAU among patients with persistent medically unexplained symptoms, with results indicating lower hospital costs and higher mental health care costs among patients receiving MBCT.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites van Ravesteijn, Lucassen, Bor, van Weel, and Speckens (2013)

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingreasoning

    Lack of attention to Stage V work is a serious gap in developing a clinical science of MBI.

    “The lack of attention to Stage V work is a serious gap in an effort to develop a clinical science of MBI.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    Stage III has been underemphasized in MBI studies.

    “Stage III has been underemphasized in studies of MBI (and clinical psychological science generally).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Some active controls match frequency and duration of sessions, while others involve shorter sessions.

    “although some active controls carefully match the frequency and duration of sessions (e.g., Philippot et al., 2012), others are structurally different, involving shorter sessions (e.g., Y. W. Kim et al., 2009).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Philippot et al., 2012

      Not checked in the free run.

    • cites Y. W. Kim et al., 2009

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    The last decade saw an exponential increase in the number of MBI studies and the breadth of clinical problems and populations targeted.

    “The last decade has witnessed an exponential rate of increase in the number of studies and the breadth of clinical problems and populations targeted.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In Vøllestad et al. (2011), mindfulness statistically mediated anxiety symptom changes after MBSR, but the analysis did not demonstrate true mediation because temporal precedence was absent.

    “Vøllestad, Sivertsen, and Nielsen (2011) who describe a well-conceived analysis in which mindfulness statistically mediated changes in anxiety symptoms following MBSR, but owing to the absence of temporal precedence for these changes did not demonstrate true mediation.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Vøllestad, Sivertsen, and Nielsen (2011)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    MBSR and MBCT are distinguished from other related interventions by their predominant focus on mindfulness meditation, eight-week structure, daily home practice, and instructor training requirements.

    “MBSR and MBCT are distinguished by the predominant focus on mindfulness meditation practices, the 8-week course structure, active daily home practice of mindfulness meditation and the role and training requirements of the instructor.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Failure to specify clear intervention targets and mediating processes may reduce the public health impact of MBI research.

    “failure to attend to the “basics” may undermine the potential public health impact of research on MBIs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The overall consensus of these meta-analyses is that MBIs work, although many individual studies have methodological quality problems.

    “although most have emphasized problems with the methodological quality of many individual studies, the overall consensus appears to be “yes.” We concur with these interpretations”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Formerly depressed patients showed larger increases in depressogenic thinking styles after a sad mood induction than healthy controls, suggesting that a depression history is linked to greater access to depressive cognition during mild sad mood.

    “formerly depressed patients showed greater increases in depressogenic thinking styles, suggesting that a history of depression was associated with increased access to depressive cognition in the context of mild sad mood (Teasdale, 1988).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Teasdale, 1988

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Although intervention studies suggest MBCT has promise for these patients, basic research supporting a rationale for why is often lacking.

    “Although intervention studies suggest that MBCT has promise for such patients, the basic research necessary to support a rationale for “why” is often lacking”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    MBCT was developed by Segal, Williams, and Teasdale by extending MBSR and integrating it with cognitive-behavioral therapy.

    “Segal, Williams and Teasdale (2012) built upon this early foundation with the development of MBCT, extending and integrating the framework and practices of MBSR with cognitive-behavioral therapy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Segal, Williams and Teasdale (2012)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    MBSR originated with Jon Kabat-Zinn and colleagues in 1979 at the University of Massachusetts Medical Center.

    “MBSR originated in the work of Jon Kabat Zinn and colleagues in 1979 at the University of Massachusetts Medical Center (Kabat-Zinn, 1990).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kabat-Zinn, 1990

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The rapid growth of new potential indications for MBIs risks neglecting the link between Stage 0 and later stages.

    “The rapid proliferation of new potential indications for MBIs risks neglecting the link between Stage 0 and subsequent stages.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The field risks failing to advance if Stage I research is treated as sufficient to proceed to broad dissemination and implementation, or if it stalls by accumulating more Stage I studies.

    “This excitement, however, must be tempered, given the risk that the field will fail to advance if Stage I research is seen as a sufficient “green light” to proceed to broad dissemination and implementation of MBI, or if the field “stalls out” by simply amassing more studies at Stage I.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    There are indications that some stages and links between stages warrant greater attention.

    “there are indications that some stages and the links between stages warrant greater attention.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    The NIH stage model does not specify a direct pathway from Stage I to Stages IV or V.

    “the NIH stage model underscores the value of the full cycle of research stages, and notably does not specify a direct pathway from Stage I to Stages IV or V.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Extending MBSR, MBCT, and other MBIs to new populations and conditions may require modifications and tailoring to address salient pathogenic mechanisms.

    “extensions of MBSR, MBCT, and other MBIs to new populations and conditions may require modifications and tailoring to address their salient pathogenic mechanisms”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    A large number of promising uncontrolled studies cannot substitute for later-stage studies, and researchers, practitioners, and the public should not mistake many Stage I studies for evidence of efficacy or effectiveness.

    “The sheer quantity of promising uncontrolled studies cannot substitute for later stage studies; researchers, practitioners, and the public must be cautious not to conflate a lot of studies at Stage I with indications of efficacy or effectiveness.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Lack of clear attention to boundary conditions and scientific plausibility is often cited as a hallmark of pseudoscience.

    “Absence of clear attention to both “boundary conditions” and “scientific plausibility” is often cited as hallmarks of pseudoscience (Lilienfeld, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lilienfeld, 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Such failed findings help inform boundary conditions and strengthen the pathway between Stage I and Stage 0.

    “Such findings help to inform the “boundary conditions” necessary for scientific progress and strengthen the pathway between Stage I and Stage 0”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Many basic research studies have examined correlates of mindfulness meditation and offer methods or proxy markers for integration into applied trials.

    “Many basic research studies have investigated correlates of mindfulness meditation (see Lutz et al., 2015) and provide methods or proxy markers to consider for integration in applied trials.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lutz et al., 2015

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The authors view randomized controlled trials as having specific methodological value for future MBI research and therefore mapped all nonrandomized designs at Stage I.

    “we view the methodological rigor of randomized controlled trials as of specific value for the future of research on MBI; thus, we map all nonrandomized designs at Stage I.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationcitation

    Craigie et al.'s findings raise valuable questions for Stage 0 about potential maintaining factors in generalized anxiety disorder.

    “They highlight valuable questions that can be “sent back” to Stage 0 about potential maintaining factors in generalized anxiety disorder.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Randomized designs with intervention controls allow valid causal inference about whether an MBI has an effect but not about what specifically drives that effect.

    “Such designs permit valid inference about whether the MBI produces an effect on the measured outcome but not about what, specifically, is driving the effect.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: MBIs are multimodal interventions.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    Underemphasizing basic-research links and precise specification of for whom and how treatment works risks making MBI study appear less scientific and more pseudoscientific.

    “Underemphasizing links to basic research and precise specification of for whom and how a treatment works risks situating the study of MBI less as science and more as pseudoscience”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In Arch and Ayers (2013), anxiety-disorder patients were randomized to MBSR or CBT, and treatment response depended partly on baseline depressive symptom severity comorbidity and anxiety sensitivity.

    “Arch and Ayers (2013) provide another instructive example, in which patients with anxiety disorders were randomized to MBSR or cognitive behavioral therapy, with results indicating the response to intervention depended in part on baseline depressive symptom severity comorbidity and anxiety sensitivity.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Arch and Ayers (2013)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    The NIH stage model is proposed as overlapping and mutually informing points along a continuum rather than fixed linear steps.

    “The NIH stage model is proposed not as a fixed and linear set of steps to take in chronological order, but rather as a set of overlapping and mutually informing points along a continuum of research.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Weisz, Ng, and Bearman (2014) describe implementation cliff as voltage drop when interventions move through clinical science process.

    “Weisz, Ng, and Bearman (2014) refer to the “implementation cliff” to describe the “voltage drop” that often occurs as interventions move through the clinical science process.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Weisz, Ng, and Bearman (2014)

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Relative lack of attention to studying broadly implementable instructor training may make MBI vulnerable to implementation cliff and limbo.

    “the relative lack of attention to studying methods of training instructors that can be broadly implemented may make MBI approaches vulnerable to both the implementation cliff and limbo.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: MBI instructors are expected to have personal mindfulness meditation practice in addition to professional clinical training.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The classification of those two studies as Stage III is arguable due to their pilot nature and hybrid use of community and research clinicians.

    “This classification is arguable given the pilot nature of the work and the hybrid use of community and research clinicians”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Recent discussions focus on disruptive innovation to increase reach and access of MBI.

    “Recent discussions have focused, in particular, on the model of “disruptive innovation” in which new technologies may be integrated in the service of increasing reach and access of MBI.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Kazdin & Blase, 2011

      Not checked in the free run.

    • cites Rotheram-Borus, Swendeman, & Chorpita, 2012

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Weisz (2014) describes implementation limbo where resource constraints lower training provider bar.

    “Weisz (2014) also describe the problem of “implementation limbo” in which resource constraints set the “bar” for training providers at ever lower levels”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Weisz (2014)

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Evans and Clarke (2011) describe orphan innovations as effort dedicated to design and initial testing but little care to spreading intervention to contexts of need.

    “Evans and Clarke (2011) describe the problem of “orphan innovations,” in which effort is dedicated to the design and initial testing of an intervention but little care is allocated to the task of spreading the intervention to contexts of need.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Evans and Clarke (2011)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Recommendations in psychotherapy include novel delivery formats such as self-management, brief adaptations, technology-driven delivery, and integration into healthcare packages.

    “Recommendations within general psychotherapy domains have included the examination of novel delivery formats such as self-management and self-help formats, brief or more parsimonious adaptations, technology and media driven delivery formats, and integration within broader healthcare packages (Kazdin & Blase, 2011; Rotheram-Borus, Swendeman, & Chorpita, 2012).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Kazdin & Blase, 2011

      Not checked in the free run.

    • cites Rotheram-Borus, Swendeman, & Chorpita, 2012

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Situating MBI work in clinical psychological science highlights important lessons and gaps in the current evidence base.

    “Doing so highlights important lessons and gaps in our current evidence base.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The public health impact of MBI work is likely enhanced by situating it in a broader clinical psychological science framework.

    “We contend that the public health impact of this work is likely to be enhanced by situating work on MBI in a broader framework of clinical psychological science.”
    Quote in the paperNot a substantial claim
52 of 52

  • The paper relies on this without support.

    MBI instructors are expected to have personal mindfulness meditation practice in addition to professional clinical training.

    “which require a personal practice in mindfulness meditation in addition to professional training in the clinical approach”

  • The paper relies on this without support.

    MBIs are multimodal interventions.

    “MBIs are multimodal interventions.”

  • The paper relies on this without support.

    MBSR and MBCT protocols typically include written and audio guide support for daily home practice.

    “MBSR and MBCT protocols typically include written and audio guide support for daily home practice”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A relatively low-cost mobile application can be widely disseminated and may increase treatment access and utilization, especially among underserved populations.

    “Accessibility is an important area of future study: a relatively low-cost mobile application can be widely disseminated and may increase treatment access and utilization especially among underserved populations (44–46).”

    From Targeting Anxiety to Improve Sleep Disturbance: A Randomized Clinical Trial of App-Based Mindfulness Training. (2022) · cites this paper as [45]

    Recommendation 7 (page unavailable) says new technologies may increase the reach and access of mindfulness-based interventions and that technology-driven formats may aid dissemination. It does not specifically address a low-cost mobile application, increased treatment utilization, or benefits especially for underserved populations. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Psychological theory and research now guides the development of many MBPs.

    “Psychological theory and research now guides the development of many MBPs (Dimidjian & Segal, 2015).”

    From What defines mindfulness-based programs? The warp and the weft (2017) · cites this paper as Dimidjian & Segal, 2015

    In “Indications of Promise” (page not provided), the paper says the field is beginning to anchor interventions in basic research and gives a recent example. But Recommendation 1 says newer applications have less frequently identified their intended targets and often lack the basic research needed to explain why they should work. The paper therefore supports an emerging trend, not the claim that psychological theory and research already guide the development of many MBPs. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Manualized group settings incorporate many components contributing to their observed clinical benefits.

    “These settings incorporate many components contributing to their observed clinical benefits [46–49].”

    From Emotion Regulation as a Mechanism of Mindfulness in Individual Cognitive-Behavioral Therapy for Depression and Anxiety Disorders (2024) · cites this paper as [46]

    Recommendation 4 describes mindfulness-based interventions as multimodal and identifies group support, clinician time, and home practice as components that could affect outcomes (page not available in our copy). It also says the evidence does not establish which components drive the observed benefits, so the claim overstates their contribution as settled. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • A significant gap persists in understanding the effects of mindfulness interventions on therapeutic outcomes when embedded in individual CBT sessions.

    “a significant gap persists in understanding the effects of mindfulness interventions on therapeutic outcomes when embedded in individual CBT sessions [46, 49, 51].”

    From Emotion Regulation as a Mechanism of Mindfulness in Individual Cognitive-Behavioral Therapy for Depression and Anxiety Disorders (2024) · cites this paper as [46]

    Recommendation 4 says existing studies often cannot determine which components of mindfulness-based interventions drive outcomes, supporting a general research gap. The “Bird’s Eye View” section describes MBCT as integrating mindfulness with CBT, but the paper does not establish this gap specifically for mindfulness embedded in individual CBT sessions. Page numbers are unavailable in our copy. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • MBIs aim to understand the root causes of human distress and alleviate it through mindfulness training.

    “MBIs aim to understand the root causes of human distress and alleviate it through mindfulness training (Dimidjian & Segal, 2015).”

    From Mapping mindfulness in psychotherapy: a scoping review on conceptualization, applications, and research directions (2026) · cites this paper as Dimidjian & Segal, 2015

    The Clinical Application of Mindfulness section (page unavailable) describes mindfulness meditation as a core component of MBIs, taught to help prevent depression or reduce stress. Recommendation 1 describes research identifying a specific process involved in depressive relapse and a rationale for addressing it with meditation. The paper does not characterize MBIs as aiming to understand the root causes of human distress generally. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Related

Authors
Dimidjian, S., & Segal, Z. V.
Affiliations
  • University of Colorado Boulder (US)
  • University of Toronto (CA)
ORCID
Venue
American Psychologist
Publisher
American Psychological Association (APA)
Published
2015-10
Volume
70
Issue
7
Pages
593-620
ISSN
  • 0003-066X (ISSN-L)
  • 1935-990X
DOI
10.1037/a0039589
PMC
PMC5853107
OpenAlex
W2398456569
Cited by
291
References
342
Citations by year
2026: 12 · 2025: 16 · 2024: 29 · 2023: 29 · 2022: 25 · 2021: 34 · 2020: 36 · 2019: 34 · 2018: 35 · 2017: 27 · 2016: 12 · 2015: 2
FWCI
31.41
Type
journal article
Language
en
Open access
Locations
  • American Psychologist (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R34MH083866, K23MH077287, R34MH087723)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
mindfulness-based interventions, mindfulness-based cognitive therapy, mindfulness-based stress reduction, clinical translation, evidence base, research gaps, methodological quality, public health impact, mental health
MeSH terms
Humans, Mental Health, Stress, Psychological, Cognitive Behavioral Therapy, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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