Mindfulness online: a preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress
Open accessAbstract
Objectives: Stress has been shown to have a number of negative effects on health over time. Mindfulness interventions have been shown to decrease perceived stress but access to interventions is limited. Therefore, the effectiveness of an online mindfulness course for perceived stress was investigated. Design: A preliminary evaluation of an online mindfulness course. Participants: This sample consisted of 100 self-referrals to the online course. The average age of participants was 48 years and 74% were women. Interventions: The online programme consisted of modules taken from Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy and lasted for approximately 6 weeks. Primary and secondary outcome measures: Participants completed the Perceived Stress Scale (PSS) before the course, after the course and at 1-month follow-up. Completion of formal (eg, body scan, mindful movement) and informal (eg, mindful meal, noticing) mindfulness activities was self-reported each week. Results: Participation in the online mindfulness course significantly reduced perceived stress upon completion and remained stable at follow-up. The pre-post effect size was equivalent to levels found in other class-based mindfulness programmes. Furthermore, people who had higher PSS scores before the course reported engaging in significantly more mindfulness practice, which was in turn associated with greater decreases in PSS. Conclusions: Because perceived stress significantly decreased with such limited exposure to mindfulness, there are implications for the accessibility of mindfulness therapies online. Future research needs to evaluate other health outcomes for which face-to-face mindfulness therapies have been shown to help, such as anxiety and depressive symptoms.
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Mindfulness has previously been associated with stress reduction and improved relaxation, among other benefits.
“Mindfulness has previously been associated with stress reduction and improved relaxation, among other benefits [16,58,59].”
From Web-Based Mindfulness Meditation as an Adjunct to Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Feasibility Evaluation Study (2024) · cites this paper as [58]
The Abstract Results report reduced perceived stress after the online mindfulness course, and the introductory passage describes prior evidence of stress reduction. Our copy does not report improved relaxation, so that part of the cited claim is unsupported. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEmerging evidence supports the feasibility of online self-help mindfulness training in non-clinical populations.
“While emerging evidence supports the feasibility of online self-help mindfulness training in non-clinical populations (Glück and Maercker, 2011; Krusche et al., 2012), there is a severe lack of research to support such interventions for those with clinical levels of depression and anxiety.”
From Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial (2018) · cites this paper as Krusche et al., 2012
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A Mindfulness-Based Intervention: Differential Effects on Affective and Processual Evolution
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Rodriguez, M. A., Eisenlohr-Moul, T. A., Weisman, J., & Rosenthal, M. Z. (2021) · JMIR Formative Research · doi:10.2196/25772 · Cited by 24 · see citing works
Callahan, C. E., Kimber, J. M., Hu, E., Tanner, L., & Kunkle, S. (2023) · JMIR mhealth and uhealth · doi:10.2196/52968 · Cited by 23 · see citing works
“App-based mindfulness interventions of longer duration, such as those from 4 to 12 weeks, have shown improvements in not only mindfulness and perceived stress but also depression, anxiety, and overall well-being [11,20,21].”
BackgroundStjernswärd, S., & Hansson, L. I. (2016) · Health & Social Care in the Community · doi:10.1111/hsc.12360 · Cited by 21 · see citing works
“…et al. 2014) and healthy populations (Gl€uck & Maercker 2011, Krusche et al. 2012), such as reduced levels of stress (Gl€uck & Maercker 2011, Krusche et al. 2012), including caregiver stress and burden (Epstein-Lubow et al. 2006, Bloom et al. 2012, Paller et al. 2015) and reduced symptoms…”
BackgroundResultInfluentialChittaro, L., & Vianello, A. (2016) · Interacting with Computers · doi:10.1093/iwc/iwv044 · Cited by 19 · see citing works
Stjernswärd, S., & Hansson, L. I. (2016) · Informatics for Health and Social Care · doi:10.1080/17538157.2016.1177533 · Cited by 19 · see citing works
“Despite the lack of contact with an instructor and fellow participants (often viewed as important facilitators to change) in mindfulness-based interventions online, the results were comparable to f2f interventions (33).”
BackgroundResultRiley, T. D., Roy, S., Parascando, J. A., Wile, K., LaGamma, C., Dong, H., & Zgierska, A. E. (2022) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2021.0415 · Cited by 18 · see citing works
Lu, F., Xu, Y., Yu, Y., Zhao, R., Peng, L., Liu, B., & Li, M. (2023) · Nurse Education in Practice · doi:10.1016/j.nepr.2023.103640 · Cited by 17 · see citing works
Terapias cognitivo-conductuales de tercera generación (TTG): la atención plena / mindfulness
Moreno-Coutiño, A. B. (2012) · Revista Internacional de Psicología · doi:10.33670/18181023.v12i01.66 · Cited by 17 · see citing works
Kraft, S., Wolf, M., Klein, T., Becker, T. M., Bauer, S., & Puschner, B. (2017) · JMIR mhealth and uhealth · doi:10.2196/mhealth.7095 · Cited by 14 · see citing works
Mindfulness Training & Assessment and Intelligence
Drigas, A. S., & Karyotaki, M. (2018) · International Journal of Recent Contributions from Engineering Science & IT (iJES) · doi:10.3991/ijes.v6i3.9248 · Cited by 14 · see citing works
Web-based training for post-secondary student well-being during the pandemic: a randomized trial
Wang, Y., & Farb, N. A. S. (2022) · Anxiety Stress & Coping · doi:10.1080/10615806.2022.2079637 · Cited by 13 · see citing works
“Additionally, the lack of significant reduction in stress is surprising considering the well-documented positive effects of mindfulness and stress reappraisal training (Huebschmann & Sheets, 2020; Krusche et al., 2012; Mak et al., 2015).”
BackgroundLekkas, D., Price, G. D., McFadden, J. R., & Jacobson, N. C. (2021) · Mindfulness · doi:10.1007/s12671-021-01723-4 · Cited by 13 · see citing works
“Krusche et al. (2012b) reported a significant decrease in subjects’ perceived stress as a result of participation in the intervention; however, given the aim of the work, data analysis relied on basic descriptive statistics and, most notably, did not examine how mindfulness exercise practice…”
BackgroundMethodResultInfluentialParkinson, B., Lawrence, M., McElhinney, E., & Booth, J. (2022) · Journal of Holistic Nursing · doi:10.1177/08980101221135723 · Cited by 13 · see citing works
“A comprehensive summary of Be Mindful has been published (Krusche et al., 2012; Querstret et al., 2017).”
BackgroundPositive Technology for Helping People Cope with Stress
Villani, D., Cipresso, P., Gaggioli, A., & Riva, G. (2016) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-4666-9986-1.ch014 · Cited by 13 · see citing works
Using a 10‐day mindfulness‐based app intervention to reduce burnout in special educators
Russell, A., & Smyth, S. (2023) · Journal of Research in Special Educational Needs · doi:10.1111/1471-3802.12599 · Cited by 11 · see citing works
Integrative perspectives on mindfulness, music and music therapy: A literature review
Hwang, M. H. (2021) · Approaches An Interdisciplinary Journal of Music Therapy · doi:10.56883/aijmt.2023.90 · Cited by 11 · see citing works
“…is adapted to increase students’ ability to concentrate in class and also for people who have experienced a scattered or unsettled mind to stay calm (Baer, 2003, 2015; Carlson et al., 2007; Kang et al., 2009; Krusche et al., 2012; Paul et al., 2007; Vøllestad et al., 2011; Winbush et al., 2007).”
BackgroundThe uptake and outcomes of an online self-help mindfulness programme during COVID-19
Li, I., Chen, A. Z., Newby, J. M., Kladnitski, N., Haskelberg, H., Millard, M., & Mahoney, A. (2022) · Clinical Psychologist · doi:10.1080/13284207.2022.2045866 · Cited by 10 · see citing works
The Effectiveness of Internet-Based Mindfulness Interventions for Physical and Mental Illnesses
Krolikowski, A. (2013) · International Journal of Cyber Behavior Psychology and Learning · doi:10.4018/ijcbpl.2013100106 · Cited by 10 · see citing works
Unresolved Issues in the Application of Mindfulness-Based Interventions for Substance Use Disorders
Witkiewitz, K. A., & Black, D. S. (2014) · Substance Use & Misuse · doi:10.3109/10826084.2014.852797 · Cited by 9 · see citing works
Lucas‐Thompson, R. G., Rayburn, S. R., Seiter, N. S., Broderick, P. C., Smyth, J. M., Coatsworth, J. D., & Henry, K. L. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.579556 · Cited by 9 · see citing works
Johansson, B., & Bjuhr, H. (2016) · International Journal of Social Science Studies · doi:10.11114/ijsss.v4i3.1389 · Cited by 8 · see citing works
Landry, C. A., McCall, H. C., Beahm, J. D., Titov, N., Dear, B., Carleton, R. N., & Hadjistavropoulos, H. D. (2024) · JMIR Formative Research · doi:10.2196/54132 · Cited by 6 · see citing works
“Mindfulness has previously been associated with stress reduction and improved relaxation, among other benefits [16,58,59].”
BackgroundMudiyanselage, C. A. K. R. A., Ewens, B. A., Smyth, A. M., Dickson, J. M., & Ang, S. G. M. (2024) · Mindfulness · doi:10.1007/s12671-024-02365-y · Cited by 7 · see citing works
“…in face-to-face modes (Kabat-Zinn, 1982; Segal et al., 2002), but are being increasingly delivered online via pre-recorded guidance (Bailey et al., 2018), or via online courses with synchronous mindfulness practice sessions (Bogosian et al., 2021; Cavalera et al., 2019; Krusche et al., 2012).”
Vertola, G., Marcello, A., Bottone, M., Sperandeo, R., Muzii, B., Scandurra, C., & Maldonato, N. M. (2022) · IEEE International Conference on Cognitive Infocommunications · doi:10.1109/coginfocom55841.2022.10081617 · Cited by 7 · see citing works
Interest in online interprofessional elective mind-body skills (MBS) training
Gupta, S. J., Kemper, K. J., & Lynn, J. (2017) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2017.12.009 · Cited by 7 · see citing works
Beurskens, J., Waal, G. H., & Wanten, G. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.12.026 · Cited by 6 · see citing works
Landry, C. A., McCall, H. C., Beahm, J. D., Titov, N., Dear, B., Carleton, R. N., & Hadjistavropoulos, H. D. (2023) · doi:10.2196/preprints.54132 · Cited by 6 · see citing works
Immersive VR as a Promising Technology for Computer-Supported Mindfulness
De Paolis, L. T., Arpaia, P., D’Errico, G., Gatto, C., Moccaldi, N., & Nuccetelli, F. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-87595-4_12 · Cited by 5 · see citing works
Schaller, H., & Karing, C. (2024) · Ecopsychology · doi:10.1089/eco.2024.0004 · Cited by 6 · see citing works
“Some authors assume that the presence of others (e.g., guided group context, other participants) is an important part of learning in the context of mental health issues (e.g., Kabat-Zinn, 1982; Karing, 2023; Krusche et al., 2012).”
Contextual assessment: evaluating a novel self-guided online therapeutic assessment
Levis, M., & Levis, A. J. (2020) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2020.1794010 · Cited by 5 · see citing works
“56%, a rate lower than related online studies (Krusche et al. 2012; Cavanagh et al. 2018).”
BackgroundInfluentialLiu, X., Zhang, Y., Cheng, H., Dong, H., You, Y., Wu, Y., Yang, C., & Jing, L. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1339517 · Cited by 4 · see citing works
“Our research utilized a 4-week training program (26, 27), and there is ongoing debate regarding the optimal frequency of mindfulness training (28).”
MethodAlqahtani, F., & Orji, R. (2025) · Human Behavior and Emerging Technologies · doi:10.1155/hbe2/8111089 · Cited by 14 · see citing works
Mind‐body therapies: an intervention to reduce work‐related stress in veterinary academia
Artemiou, E., Gilbert, G. E., Callanan, A., Marchi, S., & Bergfelt, D. R. (2018) · Veterinary Record · doi:10.1136/vr.104815 · Cited by 4 · see citing works
Programas de ordenador basados en mindfulness . Una revisión de la literatura médica
López-Montoyo, A., Modrego‐Alarcón, M., Morillo, H., García‐Campayo, J., & Quero, S. (2016) · Mindfulness & Compassion · doi:10.1016/j.mincom.2016.09.003 · Cited by 4 · see citing works
García-Medina, I. (. )., & Tur-Viñes, V. (. ). (2017) · Universidad de Alicante eBooks · doi:10.14198/medcom/2017/10_cmd · Cited by 4 · see citing works
Levis, M., & Levis, A. J. (2021) · British Journal of Guidance and Counselling · doi:10.1080/03069885.2021.1970111 · Cited by 3 · see citing works
Self-Help Mindfulness-Based Cognitive Therapy
Jones, F. W., Strauss, C., & Cavanagh, K. (2016) · Springer eBooks · doi:10.1007/978-3-319-29866-5_10 · Cited by 3 · see citing works
“Turning to the fi nal intervention considered in this chapter, the Be Mindful course is another online , self-help variant of MBCT [ 25 ].”
MethodVideo Conferencing for Mindfulness Programs: Benefits, Experiences, and Recommendations
Meissner, T. (2017) · International Journal of Whole Person Care · doi:10.26443/ijwpc.v4i2.126 · Cited by 3 · see citing works
Positive Technology for Helping People Cope with Stress
Villani, D., Cipresso, P., Gaggioli, A., & Riva, G. (2020) · IGI Global eBooks · doi:10.4018/978-1-7998-3432-8.ch038 · Cited by 2 · see citing works
Manning, J. B., BLANDFORD, A. E., & Edbrooke-Childs, J. H. (2024) · Journal of Medical Internet Research · doi:10.2196/50457 · Cited by 2 · see citing works
“Stress management interventions have proliferated, motivated by challenges including therapy costs, accessibility, and unmet needs of employees [7-11] with over 1000 stress apps found in web-based stores [12].”
Loneliness, Mindfulness and Hope: Empowering Rehabilitation Processes
Margalit, M. (2018) · Examines in Physical Medicine & Rehabilitation · doi:10.31031/epmr.2018.01.000517 · Cited by 2 · see citing works
“000517 Volume 1 - Issue - 4 was found when mindfulness instructions were delivered online [17].”
Background
- Authors
- Krusche, A., Cyhlarova, E., King, S., & Williams, J. M. G.
- Affiliations
- University of Oxford (GB)
- Mental Health Foundation (GB)
- Wellmind Media Ltd, Brighton, UK
- Corresponding author
- Krusche, Adele
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2012
- Volume
- 2
- Issue
- 3
- Pages
- e000803
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC3358627
- OpenAlex
- W2135220831
- Cited by
- 121
- References
- 24
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 6 · 2023: 3 · 2022: 8 · 2021: 11 · 2020: 8 · 2019: 5 · 2018: 15 · 2017: 13 · 2016: 18 · 2015: 14 · 2014: 4 · 2013: 8 · 2012: 1
- FWCI
- 10.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMJ Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- mindfulness, perceived stress, mindfulness-based stress reduction, mindfulness-based cognitive therapy, online intervention, feasibility, mindfulness practice, stress reduction
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