Cited by 510Psychological Well-being and Life SatisfactionMindfulness and Compassion InterventionsDigital Mental Health Interventions

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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing

van Agteren, Joep, Iasiello, Matthew, Lo, Laura, Bartholomaeus, Jonathan, Kopsaftis, Zoe, Carey, Marissa, Kyrios, Michael·2021·Nature Human Behaviour

DOI 10.1038/s41562-021-01093-w

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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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Teepe, G. W., Lukic, Y. X., Kleim, B., Jacobson, N. C., Schneider, F., Santhanam, P., Fleisch, E., & Kowatsch, T. (2023) · BMC Psychology · doi:10.1186/s40359-023-01215-1 · Cited by 8
“…daily routine and serves to (1) increase the efficacy of the intervention [55]; (2) target improvements in self-confidence and self-efficacy [56]; (3) contribute to the intervention’s intensity, which is linked to improving efficacy [57]; and (4) provide an additional measurement for engagement.”
Background
Brief computerised self-help interventions, the “Miracle Question,” and the moderating effects of openness-to-experience
Abdulla, A. (2023) · International Journal of Wellbeing · doi:10.5502/ijw.v13i3.2799 · Cited by 4
Mobile Sensing and Engagement Features in Arabic Mental Well-Being Apps: Systematic Search and Analysis
Aldaweesh, S., Kleek, M. G. V., & Shadbolt, N. (2023) · ACM International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp) · doi:10.1145/3594739.3612875 · Cited by 4
Impact of personal resources on well-being of doctoral students in Indian higher academic institutions
Ganesh, P., Krishna, N. S., & Srivastava, K. B. L. (2023) · The Educational and Developmental Psychologist · doi:10.1080/20590776.2023.2277457 · Cited by 10
“This is a yawning gap since it has been shown that subjective interpretations of well-being, including hedonic and eudaimonic factors, are not simply an antithesis of mental illnesses but also actively contribute to the general health of individuals (van Agteren et al., 2021).”
Background
Psychometric Properties of the Persian Version of the Warwick-Edinburgh Mental Wellbeing Scale (Pr-WEMWBS)
Morowatisharifabad, M. A., Iranpour, A., & Rajabalipour, M. (2024) · Health Scope · doi:10.5812/healthscope-145770 · Cited by 4
Network Analysis of within-person temporal associations among physical activity, sleep, and wellbeing in situPreprint
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) · doi:10.31234/osf.io/q4jn3 · Cited by 4
Editorial: Positive Psychology in Everyday Life
Pocinho, M. M. F. D. D., Garcês, S. F., & Popa, D. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.913569 · Cited by 4
“This happens among different cultures, populations, contexts, and fields of knowledge, similar to the results emphasized by current meta-analyses (Koydemir et al., 2021; van Agteren et al., 2021).”
Result
The science and practice of positive psychology: from a bold vision to PERMA+4
Donaldson, S. I., Gaffaney, J., & Cabrera, V. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91497-0.00129-6 · Cited by 5
Development of “LvL UP”, a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disordersPreprint
Castro, Ó. (2022) · doi:10.31219/osf.io/k5cnm · Cited by 4
Do Character Strengths-Based Interventions Change Character Strengths? Two Randomized Controlled Intervention StudiesPreprint
Gander, F., Wagner, L., & Niemiec, R. M. (2023) · doi:10.31234/osf.io/vtnzq · Cited by 4
The Groundswell Community Surf Therapy Intervention for At-Risk Women and Changes in Body Acceptance, Resilience, and Emotional Regulation
Franceschi, L., Small, N., Goldsby, T., Goldsby, M., Padamada, S., Ziegler, M. G., & Mills, P. J. (2024) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130241278970 · Cited by 3
“17,18 Such individuals are particularly vulnerable to mental health challenges 19,20 and trust is a signi ﬁ cant challenge for them.”
Background
Internalising symptoms and wellbeing: Meta-analysis of the potential protective role of psychological strengths and interpersonal resources
Sgherza, T. R., Becerra, R., & Naragon‐Gainey, K. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119809 · Cited by 4
The Solution-focused Intervention for Mental health (SIM): description and feasibility testing of a positive psychology intervention in Swedish adolescents
Söderqvist, F., Uvhagen, L., Gustafsson, J., & Franklin, C. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100493 · Cited by 3
The effectiveness and economic evidence of organizational and management interventions to promote mental wellbeing and resilience in elderly care workers and informal caregivers – a systematic review
Vartiainen, A., Lungu, D. A., Rissanen, E., Pirrotta, L., Scopis, L., Schroeder, T., Sogstad, M., Odberg, K. R., Hole, A., Delgado-Saborit, J. M., et al. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13372-7 · Cited by 7
“…used structured therapeutic methods (such as ACT, CBT), and focusing on mindfulness, relaxation and coping skills, can have positive effects in improving mental health outcomes, such as burnout, stress, depression, emotional exhaustion, and general wellbeing among health care workers [24, 64, 65].”
Investigating mental wellbeing self-care in higher education using BERTopic modeling
Ali, M., van Berkel, N., Tag, B., Paananen, V., Oppenlaender, J., Yatani, K., & Hosio, S. J. (2025) · Discover Mental Health · doi:10.1007/s44192-025-00323-1 · Cited by 7
“There exists a plethora of free methods that have been scientifically proven to affect mental wellbeing, including mindfulness and reminis-cence-based approaches [106].”
Effects of a brief online self-compassion training on perfectionism, self-criticism, and social anxiety: A randomized controlled trial
Borgdorf, K. S. A., Aguilar‐Raab, C., & Holt, D. V. (2025) · Internet Interventions · doi:10.1016/j.invent.2025.100870 · Cited by 4
“Yet, mental health research has shifted only recently from problem-oriented, curative approaches to mental health preservation and promotion (van Agteren et al., 2021).”
Influential
Neuroscientific Framework of Cognitive–Behavioral Interventions for Mental Health Across Diverse Cultural Populations: A Systematic Review of Effectiveness, Delivery Methods, and Engagement
Gkintoni, E., & Nikolaou, G. (2025) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe16010002 · Cited by 5
Understanding Challenges and Design Opportunities for Digital Mental Well-Being in Saudi Arabia
Aldaweesh, S. (2024) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3613905.3638189 · Cited by 3
“Accumulating evidence [32, 66] demonstrated promising results for promoting individual mental health and well-being via mobile apps employing psychological interventions such as mindfulness and meditation, positive psychology interventions (PPIs), cognitive behaviour therapy (CBT), self-tracking,…”
Psychological Changes Following MBSR and CCT Interventions in a Brief and Intensive Retreat Format: A Sequential Randomized Crossover Study
Zangri, R. M., Roca, P., Blanco, I., Kulis, M., Díez, G. G., Martín-Subero, J. I., & Vázquez, C. (2024) · Mindfulness · doi:10.1007/s12671-024-02410-w · Cited by 3
“Research on both mindfulness and compassion-based interventions has shown promising results not only for reducing distress but also for enhancing mental health and well-being in healthy adults (Galante et al., 2021; McClin-tock et al., 2019; Spijkerman et al., 2016; van Agteren et al., 2021).”
“The very process made me happier!” Is pleasure research an affective intervention?
Kozlowski, D., Provost, S., & Kern, M. L. (2024) · The Journal of Positive Psychology · doi:10.1080/17439760.2024.2394441 · Cited by 3
“Indeed, PPIs may be the most efficacious interventions for boosting mental well-being in both non-clinical and clinical samples (van Agteren et al., 2021).”
A Bibliometric Analysis of Positive Mental Health Research and Development in the Social Science Citation Index
Omega, P. D., Parung, J., Yuwanto, L., & Ho, Y. (2024) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2024.056501 · Cited by 3
“Although it has been known that well-being is crucial for health, attempts to conceptualize well-being as a study outcome have only recently been undertaken [12].”
Differential explanations of psychological well-being according to clinical personality patterns
Ciofu, V., Marian, A.-L., Apostol, M.-M., & Chiriac, L.-E. (2024) · Current Psychology · doi:10.1007/s12144-024-06897-3 · Cited by 5
“Recent reviews (Galante et al., 2021; Van Agteren et al., 2021 ) have demonstrated some small to moderate effects of mindfulness-based approaches in enhancing well-being across various populations, including individuals experiencing mental or physical health issues, as well as the general…”
“Stop, pause and take a break”: a mixed methods study of the longer-term outcomes of digital emotional wellbeing training for perinatal women
Davis, J. A., Ohan, J. L., Bear, N., Gibson, L. Y., Silva, D. T., Prescott, S. L., & Finlay‐jones, A. L. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-07002-z · Cited by 3
Impact of basic psychological needs fulfillment on teachers’ well-being in Online Communities: Designing for well-being
Aadmi-Laamech, K. E., Santos, P., & Hernández‐Leo, D. (2025) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2025.100706 · Cited by 3
What Works for Aboriginal and Torres Strait Islander Men? A Systematic Review of the Literature
Menges, J. R., Caltabiano, M. L., & CLOUGH, A. R. (2023) · Journal of the Australian Indigenous HealthInfoNet · doi:10.14221/aihjournal.v4n2.5 · Cited by 3
Subgroup specific relations between the goal-striving reasons framework and subjective well-being
Ehrlich, C., & Milston, S. (2023) · Current Psychology · doi:10.1007/s12144-023-04700-3 · Cited by 3
“…for research in Positive Psychology to increase our understanding about which Positive Psychology Intervention (PPI) works best, for whom, and under which circumstances (Fordyce, 1983; Kubzansky et al., 2023; Layous & Lyubomirsky, 2014; Lyubomirsky et al., 2005a, 2005b; van Agteren et al., 2021).”
Pain and associated functional impairment in the Danish general population: the role of mental well-being
Santini, Z. I., Ekholm, O., Koyanagi, A., Stewart-Brown, S. L., Nielsen, L., Meilstrup, C., Koushede, V., & Thygesen, L. C. (2023) · Journal of Public Mental Health · doi:10.1108/jpmh-07-2023-0065 · Cited by 3
A Literature Review of Health and Mental Well-being Indicators and Its Assessment in Sub-Saharan Africa (2014-2022)
Oladele, J. I., Guse, T., & Owolabi, H. O. (2024) · Journal of Research and Health · doi:10.32598/jrh.14.2.2333.1 · Cited by 3
Community‐based health programme for nurses and midwives: A mixed methods evaluation
Jarden, R. J., Jarden, A., Bujalka, H., Weiland, T., Brockenshire, N., Taylor, G., & Gerdtz, M. (2024) · Journal of Advanced Nursing · doi:10.1111/jan.16336 · Cited by 4
“…(Hendriks et al., 2020 ), physical health and well-being interventions (Fadel et al., 2023 ; Shiri et al., 2023 ), psychological interventions (van Agteren et al., 2021 ), positive psychology interventions (Donaldson et al., 2019 ), positive psychological interventions for subjective and…”
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Llorens, L. S., Peñalver, J., & Salanova, M. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104561 · Cited by 4
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Kaubisch, S., Kloek, M., Primbs, R., Iglhaut, L., Piechaczek, C., Keim, P., Feldmann, L., Schulte‐Körne, G., & Greimel, E. (2025) · Internet Interventions · doi:10.1016/j.invent.2025.100872 · Cited by 3
“…systematic review and meta-analysis of psychological interventions to improve mental wellbeing in healthy, mentally, and physically ill populations, van Agteren et al. (2021) found that specifically multi-component PPIs (next to mindfulness-based or cognitive and behavioural therapy-based…”
Will Happiness-Trainings Make Us Happier? An Updated Research Synthesis Using an Online Findings-Archive
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Epigenetic, psychological, and EEG changes after a 1-week retreat based on mindfulness and compassion for stress reduction: Study protocol of a cross-over randomized controlled trialPreprint
Díez, G. G., Martin-Subero, I., Zangri, R. M., Kulis, M., Andreu, C. I., Blanco, I., Roca, P., Cuesta, P., García, C., Garzón, J., et al. (2023) · medRxiv · doi:10.1101/2023.03.03.23286782 · Cited by 3
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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: van Agteren, Joep
Iasiello, Matthew
Lo, Laura
Bartholomaeus, Jonathan
Kopsaftis, Zoe
Kyrios, Michael
Venue: Nature Human Behaviour
Publisher: Springer Science and Business Media LLC
Published: 2021-04-19
Volume: 5
Issue: 5
Pages: 631-652
ISSN: 2397-3374 (ISSN-L)
DOI: 10.1038/s41562-021-01093-w
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: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
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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