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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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“traditional psychotherapy alone can show limitations such as moderate effect sizes as well as a lack of generalizability and endpoint improvement, depending on the target population.”
From The Groundswell Community Surf Therapy Intervention for At-Risk Women and Changes in Body Acceptance, Resilience, and Emotional Regulation (2024) · cites this paper as [17]
In the citing paper
“a recent systematic and meta-analytic review evaluated a range of psychological interventions and their effects on mental well-being and found that mindfulness-based interventions demonstrated significant small to moderate improvements in general and mentally and physically ill population samples (van Agteren et al., 2021).”
From Pathways to mental well-being for graduates of mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR): A mediation analysis of an RCT. (2024) · cites this paper as van Agteren et al., 2021
In the citing paper
“MBPs have demonstrated promising effects in addressing mental health across a wider distribution of the population (Galante et al., 2021; Khoury et al., 2013; van Agteren et al., 2021).”
From Pathways to mental well-being for graduates of mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR): A mediation analysis of an RCT. (2024) · cites this paper as van Agteren et al., 2021
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“Hardly any studies have examined the impact of multitheoretical intervention [58].”
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“, randomization or allocation) in full, which is also a common issue in the field (83).”
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“…of the average effect size of other positive psychology interventions (ds from 0.20 to 0.61) reported in meta-analyses (Sin and Lyubomirsky, 2009; Bolier et al., 2013; Weiss et al., 2016; Chakhssi et al., 2018; Hendriks et al., 2018, 2020; Carr et al., 2020; van Agteren et al., 2021).”
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“Implementing psychological interventions through online or remote health can be a potential cost benefit for current referral pathways and treatment models [17]. online MBIs can be used as the adjunctive therapy in patients with cancer to manage cancer-related symptoms [18].”
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“…exercises and awareness of present thoughts and feelings or mind – body exercises designed to develop a sense of calmness and balance; see van Agteren et al., 2021), relaxation (psychomotor techniques which target the central nervous system and a reduction in sympathetic activation), and…”
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Welfare systems and mental health in OECD and EEA countries: a scoping review
Ribanszki, R., Taylor, K. S., Scheutzow, J., Fonseca, J. A. S., & Ponzo, S. (2022) · Humanities and Social Sciences Communications · doi:10.1057/s41599-022-01391-2 · Cited by 20
“However, it is widely recognised that the absence of mental illness is not equal to mental well-being and these two concepts are correlated but separate dimensions of psychological functioning (Keyes, 2005; van Agteren et al., 2021).”
BackgroundLiu, Z., Sang, X., Liu, Y., Yu, C., & Wan, H. (2024) · Primary care diabetes · doi:10.1016/j.pcd.2024.09.006 · Cited by 25
Balci, S., Küchler, A., Ebert, D. D., & Baumeister, H. (2023) · Clinical Psychology in Europe · doi:10.32872/cpe.9341 · Cited by 24
“However, trials with waitlist control groups tend to yield higher effect sizes (van Agteren et al., 2021), thus in order to validate the StudiCareM-E’s efficacy, research should initially test this in a powered trial with more follow-up points, and compare it to treatment as usual, a placebo…”
ResultJayasinghe, A., Wrobel, A. L., Filia, K., Byrne, L. K., Melvin, G. A., Murrihy, S., Moller, C. I., Berk, L., Berk, M., & Cotton, S. (2023) · Psychological Medicine · doi:10.1017/s0033291723001733 · Cited by 19
“In line with prior reviews (e.g. van Agteren et al., 2021), the outlined groupings were selected to capture these aspects of wellbeing.”
ResultBlasco‐Belled, A., Tejada‐Gallardo, C., & Alsinet, C. (2023) · Psychology and Health · doi:10.1080/08870446.2023.2250382 · Cited by 22
“Given the growing interest in PPIs (van Agteren et al., 2021), the current study systematically reviewed and meta-analyzed the effects of these interventions on mental well-being and psychological distress in people with chronic pain.”
Li, H. Z., Zhang, R., Lee, Y., Kraut, R. E., & Mohr, D. C. (2023) · doi:10.31234/osf.io/m3vjt · Cited by 19
Peterson, A. L., Moore, B. A., Evans, W. R., Young-McCaughan, S., Blankenship, A. E., Straud, C. L., McLean, C. S., Miller, T. L., Meyer, E. C., & for the STRONG STAR Consortium (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1299532 · Cited by 19
Maloney, S., Montero-Marin, J., & Kuyken, W. (2024) · Psychotherapy Research · doi:10.1080/10503307.2023.2269299 · Cited by 18
“MBPs have demonstrated promising effects in addressing mental health across a wider distribution of the population (Galante et al.,2021; Khoury et al., 2013; van Agteren et al., 2021).”
BackgroundProverbial positive psychology: can we leverage African ancient wisdom to promote flourishing?
Appiah, R. (2023) · The Journal of Positive Psychology · doi:10.1080/17439760.2023.2282771 · Cited by 19
“Fostering a mutual, positive relationship is a highly prized goal of positive psychology (van Agteren et al., 2021).”
InfluentialBell, C. N., George, R. S., Honan, C. A., Bell, L. J., Jolly, A. T. W., & Matthews, A. J. (2025) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2025.102632 · Cited by 28
Wieners, L., van Zyl, L. E., Radstaak, M., & Schotanus-Dijkstra, M. (2021) · International Journal of Wellbeing · doi:10.5502/ijw.v11i4.1489 · Cited by 19
“These people might already engage more in prosocial behaviour compared to people low in self-esteem (Marshall et al., 2014; Zuffianò et al., 2014) and could perhaps benefit more from other wellbeing interventions (Hendriks, Warren et al., 2019; van Agteren et al., 2021).”
BackgroundA meta-review of psychological resilience during COVID-19
Seaborn, K., Henderson, K., Jacek Gwizdka, A., & Chignell, M. (2022) · npj Mental Health Research · doi:10.1038/s44184-022-00005-8 · Cited by 20
Prydz, M. B., Czajkowski, N. O., Eilertsen, M., Røysamb, E., & Nes, R. B. (2024) · JMIR Mental Health · doi:10.2196/49050 · Cited by 18
McGowan, A. L., Boyd, Z. M., Kang, Y., Bennett, L., Mucha, P. J., Ochsner, K. N., Bassett, D. S., Falk, E. B., & Lydon‐Staley, D. M. (2022) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001159 · Cited by 19
Blasco‐Belled, A., González‐Carrasco, M., & Casas, F. (2023) · Journal of School Psychology · doi:10.1016/j.jsp.2023.101255 · Cited by 21
Buckley, R., Cooper, M., & Zhong, L. (2024) · People and Nature · doi:10.1002/pan3.10723 · Cited by 19
Wang, Y., King, R. B., Fu, L., & Leung, S. O. (2023) · Applied Research in Quality of Life · doi:10.1007/s11482-023-10232-6 · Cited by 18
“Practically, most of the identified factors are malleable, and they could be improved through educational interventions (e.g., Jessor et al., 2003; Lee et al., 2015; van Agteren et al., 2021).”
Effectiveness of 234 interventions to improve life satisfaction: A rapid systematic review
Tiley, K., Crellin, R., Domun, T., Harkness, F., & Blodgett, J. M. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117662 · Cited by 16
Nashiro, K., Yoo, H. J., Min, J., Cho, C., Nasseri, P., Zhang, Y., Lehrer, P. M., Thayer, J. F., & Mather, M. (2022) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-022-01019-7 · Cited by 20
Lewis, K. J., Walton, C. C., Slemp, G. R., & Osborne, M. S. (2022) · Mindfulness · doi:10.1007/s12671-022-01990-9 · Cited by 24
Maloney, S., Montero‐Marín, J., & Kuyken, W. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104478 · Cited by 16
Nawa, N. E., & Yamagishi, N. (2024) · BMC Psychology · doi:10.1186/s40359-024-01606-y · Cited by 28
Jin, R., Liu, C., Chen, J., Cui, M., Xu, B., Yuan, P., & Chen, L. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1426777 · Cited by 14
Management of adolescent scoliosis: a comprehensive review of etiology and rehabilitation
Kuang, H., Chen, L., Huang, M., & Chen, J. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1596400 · Cited by 15
“Studies have shown that psychological interventions can signi fi cantly improve patients ’ mental state, enhance their con fi dence in rehabilitation, and improve treatment compliance (92).”
Wang, H., & Yu, X. (2023) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2023.100721 · Cited by 18
Cooper, K., Kumarendran, S. M., & Barona, M. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102411 · Cited by 19
Courbet, O., Daviot, Q., Kalamarides, V., Habib, M., & Villemonteix, T. (2024) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-024-01220-x · Cited by 28
“In a recent meta-analysis examining the efficacy of different types of psychological interventions supporting psychological well-being in adults, MBIs displayed the largest effect sizes both in non-clinical and clinical popula - tions (van Agteren et al., 2021 ).”
Appiah, R. (2022) · Culture & Psychology · doi:10.1177/1354067x221118916 · Cited by 19
“…of a wide range of PPIs (Bolier et al., 2013; Carr et al., 2020; Chakhssi et al., 2018; Hendriks et al., 2020; Sin & Lyubomirsky, 2009; van Agteren et al., 2021; Weiss et al., 2016) and concluded that PPIs, largely, can promote subjective well-being and reduce negative affect,…”
BackgroundResultInfluentialRodriguez, J. E., Williams, D. R., & Bürkner, P. (2023) · British Journal of Mathematical and Statistical Psychology · doi:10.1111/bmsp.12299 · Cited by 14
García-Álvarez, D., Soler, M. J., Cobo‐Rendón, R., & Hernández-Lalinde, J. (2022) · Sustainability · doi:10.3390/su141811728 · Cited by 21
Metadata
- Authors
- van Agteren, J., Iasiello, M., Lo, L., Bartholomaeus, J., Kopsaftis, Z., Carey, M., & Kyrios, M.
- Affiliations
- Flinders University (AU)
- South Australian Health and Medical Research Institute (AU)
- University of South Australia (AU)
- ORCID
- Venue
- Nature Human Behaviour
- Published
- 2021-04-19
- Volume
- 5
- Issue
- 5
- Pages
- 631-652
- ISSN
- 2397-3374 (ISSN-L)
- OpenAlex
- W3153837393
- Cited by
- 510
- References
- 557
- Citations by year
- 2026: 89 · 2025: 120 · 2024: 124 · 2023: 87 · 2022: 74 · 2021: 16
- FWCI
- 11.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Human Behaviour (publishedVersion)
- PubMed (publishedVersion)
- Funders
- James and Diana Ramsay Foundation
- Topics
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- psychological intervention, psychological well-being, mindfulness-based interventions, positive psychology interventions, acceptance and commitment therapy, cognitive behavioral therapy, reminiscence intervention, intervention intensity, clinical populations, non-clinical population, intervention efficacy
- MeSH terms
- Psychosocial Intervention, Behavior Therapy, Humans, Mental Health, Psychotherapy, Treatment Outcome, Acceptance and Commitment Therapy
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