The DOI matches its Crossref record; 551 of the 557 references it cites were found in a registry or an index.
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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“Among the various approaches available to promote P-WB, mindfulness-based interventions (MBIs) have demonstrated the greatest efficacy in both clinical and non-clinical populations [79].”
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Williams, D. R., Rodriguez, J. E., & Bürkner, P. (2021) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/9vkqy · Cited by 11
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(2021) · Nature Human Behaviour · doi:10.1038/s41562-021-01131-7 · Cited by 14
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“Past research showed that several wellbeing interventions have been proven effective in ameliorating the mental wellbeing in the general population, which include multi-component positive psychology interventions (PPIs, multi-component) and reminiscence interventions (van Agteren et al., 2021).”
BackgroundSelf-citationSantini, Z. I., Thygesen, L. C., Koyanagi, A., Stewart-Brown, S. L., Meilstrup, C., Nielsen, L., Olsen, K. R., Birkjær, M., McDaid, D., Koushede, V., et al. (2022) · Mental Health & Prevention · doi:10.1016/j.mhp.2022.200247 · Cited by 24
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Prediction Modeling of Mental Well-Being Using Health Behavior Data of College StudentsPreprint
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“For example, a recent meta-analysis [7] showed that mindfulness (e.”
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“Furthermore, personalization and technological advances are likely to optimize the impact of well-being interventions [6].”
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“Universal interventions using principles drawing on CBT, ACT, or positive psychology (e.g., gratitude training, expressive writing) have all been shown to aid in the promotion of well-being (van Agteren et al., 2021) and the development resilience (Joyce et al., 2018).”
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“…skills by, for example, improving awareness and connection to others (Bonde et al., 2022; Dahl et al., 2020), as well as enhancing distal mental health outcomes, such as reduced perceived stress, and improved well-being (De Vibe et al., 2017; Khoury et al., 2015; van Agteren et al., 2021).”
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Olaya, B., Feltz-Cornelis, C. M. V. D., Roijen, L. H., Merecz‐Kot, D., Sinokki, M., Naumanen, P., Shepherd, J., van Krugten, F. C. W., de Mul, M., Staszewska, K., et al. (2022) · Digital Health · doi:10.1177/20552076221131145 · Cited by 13
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“[35], interventions based on mindfulness-based multifactorial positive psychology are effective instead of gratitude interventions alone.”
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“( Seligman, 2011; van Agteren et al., 2021).”
Wilkie, L., Fisher, Z., Geidel, A., Goodall, I., Kamil, S., Wyn-Davies, E., & Kemp, A. H. (2026) · Nature Human Behaviour · doi:10.1038/s41562-025-02369-1 · Cited by 18
“Notably, one meta-analysis highlighted that mindfulness-based interventions ( g = 0.42) and multicomponent positive psychological interventions ( g = 0.28) had the strongest effects 19 .”
InfluentialSigurdardottir, S., Aspelund, T., Guðmundsdóttir, D. G., Fjorback, L. O., Hrafnkelsson, H., Hansdóttir, I., & Juul, L. (2023) · BMC Psychiatry · doi:10.1186/s12888-022-04504-y · Cited by 11
“It could be feasible to integrate cost-effective, evidence-based mental health interventions like Mindfulness-based Cognitive therapy [32] or therapies involving positive psychology interventions to the standard care [31] and tackle mental health via a broader lifestyle approach, focusing on nutrition, exercise, sleep…”
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“Researchers who published a meta-analysis from 2021 found that mindfulness-based interventions were among the most effective interventions in improving mental wellbeing compared to other types of mental health promoting interventions (van Agteren et al., 2021).”
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“…concept either as subjective wellbeing, thus studying personal pleasure, happiness, affect, de Jong and Koti ˇ sov´a and life satisfaction, or as psychological wellbeing: optimal psychological functioning, self-realisation, meaning or purpose, and positive relationships (Van Agteren et al., 2021).”
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“Recent work has also suggested that mindfulness is better than many psychothera-pies for promoting overall well-being (van Agteren et al., 2021), and this may be because it targets two of the most promising strengths for enhancing well-being after violence and other trauma.”
Assessing well-being in clinical research and treatment
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“showed that approaches such as mindfulness were effective in improving mental wellbeing in both clinical and non-clinical populations (36).”
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“…interventions, character strengths interventions, gratitude interventions, and multicomponent PPIs—have focused on furthering subjective wellbeing, psychological well-being, affectivity, and a combination of subjective and psychological well-being (cf. meta-analysis by van Agteren et al., 2021).”
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Psychological wellbeing in teachers. Study in teachers of early childhood and primary education
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“…well-being; happiness was found to be correlated with eudemonic well-being and life satisfaction; Eudemonic well-being was found to be correlated with self-esteem and life satisfaction; and self-esteem was found to correlate with life satisfaction, in line with previous research [17,18,35,67].”
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An Automated Conversational Agent Self-Help Program: Randomized Controlled Trial
Foran, H. M., Kubb, C., Mueller, J., Poff, S., Ung, M., Li, M., Smith, E. M., Akinyemi, A., Kambadur, M., Waller, F., et al. (2024) · Journal of Medical Internet Research · doi:10.2196/53829 · Cited by 12
“This aligns with earlier findings that psychological interventions tend to be more effective for individuals with mental or physical health issues compared with those in community samples [43].”
Tarrats-Pons, E., Mussons-Torras, M., & Jiménez-Pérez, Y. (2025) · Behavioral Sciences · doi:10.3390/bs15050571 · Cited by 19
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The Land That Time Forgot? Planetary Health and the Criminal Justice System
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The Mental Health Status of Esports Athletes
Kegelaers, J. J., Maîresse, O., Ruysevelt, L. V., Trotter, M. G., Watson, M., Pedraza-Ramirez, I., Bonilla, I., Davis, P., Ragnarsson, J., & Heel, M. V. (2025) · Journal of Electronic Gaming and Esports · doi:10.1123/jege.2025-0017 · Cited by 9
Armaou, M., Araviaki, E., Dutta, S., Konstantinidis, S. T., & Blake, H. (2022) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe12100102 · Cited by 14
Measuring mental wellbeing of children via human-robot interaction
Abbasi, N. I., Spitale, M., Jones, P. B., & Güneş, H. (2022) · Interaction Studies Social Behaviour and Communication in Biological and Artificial Systems · doi:10.1075/is.21027.abb · Cited by 8
Shi, Z., Qu, Y., Yan, Y., & Wang, Q. (2023) · Journal of Youth and Adolescence · doi:10.1007/s10964-023-01924-1 · Cited by 8
“…moving from a de fi cit view of adolescence to the perspective of positive development, and providing a comprehensive understanding of how emotion-related parenting practices could help adolescents navigate the developmental period with both challenges and opportunities (van Agteren et al., 2021).”
Tang, Q., Wang, R., Niu, H., Li, Y., Li, Y., Hu, Z., Liu, X., & Tao, Y. (2024) · PsyCh Journal · doi:10.1002/pchj.757 · Cited by 7
“Specifically, mindfulness (van Agteren et al., 2021) and moving to emptiness technique (Tao et al., 2022) are recommended to alleviate pain in the gut and psychological abnormalities.”
BackgroundGuevarra, D. A., Park, Y., Xu, X., Liou, J., Smith, J., Callahan, P., Simon-Thomas, E. R., & Epel, E. S. (2025) · Journal of Medical Internet Research · doi:10.2196/72053 · Cited by 10
“Because various dimensions of emotional well-being are related to health [25], researchers have suggested interventions for promoting it as a strategy to improve health in both the general population and those with medical conditions [26].”
Experience Similarity, Mindful Awareness, and Accurate Interpersonal Understanding
Kang, Y., Cakar, M. E., Shumaker, K., O’Donnell, M. B., & Falk, E. B. (2022) · Mindfulness · doi:10.1007/s12671-022-01859-x · Cited by 11
Uribe, F. A. R., Favacho, M. F. M., Moura, P. M. N., Cortés‐Patiño, D. M., & Pedroso, J. D. S. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1200960 · Cited by 9
Wellbeing-responsive community: a growth target for intentional mental health promotion
Raymond, I. J., Burke, K. J., Agnew, K. J., & Kelly, D. M. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1271954 · Cited by 9
“Meta-analyses consistently show that programme fidelity, or consistency of delivery as per the intended design, remains a strong predictor of intervention outcomes (48, 49).”
BackgroundEnhancing mental wellbeing by changing mindsets? Results from two randomized controlled trials
Schreiber, C., & Schotanus-Dijkstra, M. (2024) · BMC Psychology · doi:10.1186/s40359-023-01470-2 · Cited by 15
Shum, K. Z., Barry, E., Kiefer, S. M., Fefer, S. A., Suldo, S. M., Mahony-Atallah, K. E., Ferron, J. M., Blass, J., DiLeo, L. L., Lothrop, H., et al. (2024) · Contemporary School Psychology · doi:10.1007/s40688-024-00505-8 · Cited by 8
“Moreover, a meta-analysis showed that multi-component positive psychology interventions (PPIs) are more efficacious than single-target PPIs (van Agteren et al., 2021).”
The Profound Implications of the Meaning of Health for Health Care and Health Equity
Fiscella, K. A., & Epstein, R. M. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12660 · Cited by 9
Matko, K., & Sedlmeier, P. (2023) · Mindfulness · doi:10.1007/s12671-023-02248-8 · Cited by 8
“In a recent meta-analysis, meditation-based interventions proved to be among the most effective psychological interventions to improve mental well-being (van Agteren et al., 2021).”
Lengua, L. J., Smith, M. R., Eo, A., Gonzalez, A. F., & Ruberry, E. (2024) · Mindfulness · doi:10.1007/s12671-024-02307-8 · Cited by 7
“Mindfulness practices have been demonstrated to be effective in reducing mental health problems (van Agteren et al., 2021), as well as reducing parenting stress (Burg-dorf et al., 2019) and supporting effective parenting (Parent et al., 2016; Potharst et al., 2022).”
Zhou, Y., Li, C., Wang, W., & Ding, L. (2023) · Communications Medicine · doi:10.1038/s43856-023-00399-2 · Cited by 8
Hanssen, I., ten Klooster, P. M., Kraiss, J. T., Huijbers, M. J., Regeer, E. J., Kupka, R., Bohlmeijer, E. T., & Speckens, A. E. M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.05.110 · Cited by 9
Recurrent negative autobiographical memories and mental health
Kredlow, M. A., Fitzgerald, H. E., Carpenter, J. K., Taghian, N. R., Otto, M. W., Hofmann, S. G., & Phelps, E. A. (2024) · Journal of Mood and Anxiety Disorders · doi:10.1016/j.xjmad.2024.100074 · Cited by 7
“Some studies have investigated treatments to improve resilience following life adversities [73] and other studies have evaluated the improvement of general wellbeing [74].”
Iacono, G., Elsaesser, C. M., & Courts, C. L. D. (2024) · American Journal of Community Psychology · doi:10.1002/ajcp.12760 · Cited by 7
Middleton, G., Matvienko‐Sikar, K., Briley, A. L., Dutch, D. C., Morgillo, S., Anderson, J., Schranz, N. K., Margrie, F., Kirby, R., Golley, R. K., et al. (2025) · Midwifery · doi:10.1016/j.midw.2025.104296 · Cited by 7
Ibrahim, S. B., Klasnja, P., Gross, J. J., & Slovák, P. (2025) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3706598.3713848 · Cited by 10
Appiah, R. (2023) · International Journal of Mental Health Systems · doi:10.1186/s13033-023-00571-0 · Cited by 7
Smith, I. S., Bind, M., Weihs, K. L., Bei, B., & Wiley, J. F. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12679 · Cited by 9
Aid utility theory: A new way of thinking about and tackling aid utilization neglect
Kassirer, S., & Kouchaki, M. (2023) · Research in Organizational Behavior · doi:10.1016/j.riob.2023.100196 · Cited by 6
Hägglund, K., Kenttä, G., Bentzen, M., Thelwell, R. C., & Wagstaff, C. (2024) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2024.2353288 · Cited by 9
“Following this thread, the monitoring of mood state and energy on a daily basis have been used as promising and sensitive indicators of recovery (Pawsey et al., 2021) and holistic well-being (Parker et al., 2021; van Agteren et al., 2021).”
Ruini, C., Vescovelli, F., Cesarano, V. P., Angelis, G. D., Marco, E. D., Marco, E. L. D., Galeazzi, G. M., Pira, G. L., Pingani, L., & Limone, P. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1397870 · Cited by 12
Teachers’ Work-Life Balance and Well-Being Across Opol East District, Division of Misamis Oriental
Duran, E. P., Pontillas, P. V., & Comon, J. D. (2024) · European Modern Studies Journal · doi:10.59573/emsj.8(4).2024.9 · Cited by 7
Dietvorst, E., de Vries, L. P., van Eijl, S., Mesman, E., Legerstee, J. S., Keijsers, L., Hillegers, M. H. J., & Vreeker, A. (2024) · Digital Health · doi:10.1177/20552076241294105 · Cited by 9
Zhang, M., Yang, Y., Zhao, Y., Sui, C., Sui, Y., Jiang, Y., Liu, K., Yang, S., Wang, L., Chen, B., et al. (2024) · Advanced technology in neuroscience . · doi:10.4103/atn.atn-d-24-00018 · Cited by 9
Nature, activity, and social drivers of mental resilience: a test with mid-life women surfers
Buckley, R., & Cooper, M. (2025) · Tourism Recreation Research · doi:10.1080/02508281.2024.2437716 · Cited by 7
“There is extensive research on differences between individuals (van Agteren et al., 2021), with comparisons between: different components of human psychology, such as cognition or emotion (Bratman et al., 2024); individuals in good or poor mental health, and different types of mental ill health…”
Logan, A. C., & Prescott, S. L. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22081170 · Cited by 8
“Meta-analyses reveal that positive psychology interventions (even if we set aside poor evidentiary quality) have small to modest effect sizes [59,60].”
Carbone, S. R. (2024) · Mental Health & Prevention · doi:10.1016/j.mhp.2024.200324 · Cited by 7
Can destigmatizing mental health increase willingness to seek help? Experimental evidence from Nepal
Lacey, L., Mishra, N., Mukherjee, P., Prakash, N., Prakash, N., Quinn, D. M., Sabarwal, S., & Saraswat, D. (2024) · Journal of Policy Analysis and Management · doi:10.1002/pam.22643 · Cited by 7
Cost-utility analysis of the UPRIGHT intervention promoting resilience in adolescents
Mar, J., Larrañaga, I., Ibarrondo, O., González-Pinto, A. M., Hayas, C. L., Fullaondo, A., Izco-Basurko, I., Alonso, J., Zorrilla, E. P., Fernández-Sevillano, J., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04665-4 · Cited by 6
“Although the literature contains numerous examples of school-based interventions aimed to boost adolescents’ resilience and wellbeing [6], they have rarely undergone economic evaluation [7].”
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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