Cited by 524Mindfulness and Compassion InterventionsPsychotherapy Techniques and ApplicationsDigital Mental Health Interventions

The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials

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Goldberg, Simon B., Riordan, Kevin M., Sun, Shufang, Davidson, Richard J.·2022·Perspectives on Psychological Science

Abstract

In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on four or more trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses ( k = 336 RCTs, N = 30,483 participants). MBIs showed superiority to passive controls across most PICOS ( ds = 0.10–0.89). Effects were typically smaller and less often statistically significant compared with active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. Because MBIs show promise across some PICOS, future RCTs and meta-analyses should build on identified strengths and limitations of this literature.

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Crossref · 10.1177/1745691620968771

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113 of 113 references verified0 citation errors · 0 not checkable

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  • Much of the self-transcendence literature relies on self-report instruments that face issues of construct overlap and response bias.

    “Much of the ST literature relies on self-report instruments such as the Self-Transcendence Scale (109) and the Nondual Awareness Dimensional Assessment (38), which—like other contemplative measures—face issues of construct overlap and response bias (110).”

    From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [110]

    The Discussion’s “Potential Sources of Bias” section says that self-report outcomes in mindfulness-based intervention research are vulnerable to social desirability and other biases. It does not establish construct overlap or assess the Self-Transcendence Scale, the Nondual Awareness Dimensional Assessment, or self-transcendence literature generally. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • Mindfulness meditation has shown promise for reducing burnout in clinicians.

    “Mindfulness meditation (MM) is one individual‐level solution that has shown promise for reducing burnout in clinicians, but has not been studied in GCs.”

    From The effects of mindfulness meditation on burnout in clinical genetic counselors: A three-arm randomized controlled trial (2026) · cites this paper as Goldberg et al., 2022

    The Results > Synthesis of Results (page not available) report that mindfulness-based interventions performed better than passive controls for healthcare professionals and trainees. The copy does not identify burnout as an outcome of those comparisons, so it supports promise in that population but not the specific claim about reducing burnout. (LLM, conf=0.82)

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  • Meditation trials with passive controls can overestimate effect sizes by 30%-40% compared to those with active controls.

    “Meditation trials with passive controls can overestimate effect sizes by 30%–40% compared to those with active controls (Goldberg et al., 2022; Goyal et al., 2014).”

    From The effects of mindfulness meditation on burnout in clinical genetic counselors: A three-arm randomized controlled trial (2026) · cites this paper as Goldberg et al., 2022

    The Results (Synthesis of Results, page not available) say effect sizes were generally smaller when mindfulness-based interventions were compared with active rather than passive controls. Our copy does not quantify that difference as 30%–40% or establish that passive controls overestimate effects by that amount. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • A 2022 systematic review found mindfulness superior to active controls for stress in healthcare providers.

    “A 2022 systematic review found mindfulness superior to active controls for stress in healthcare providers (Cascales‐Pérez et al., 2021; Goldberg et al., 2022).”

    From The effects of mindfulness meditation on burnout in clinical genetic counselors: A three-arm randomized controlled trial (2026) · cites this paper as Goldberg et al., 2022

    The Results (Synthesis of Results, Comparison with active controls, Post-treatment; page unavailable) report superiority over active controls both for healthcare professionals/trainees as a population and for stress as an outcome. They do not report a stress-specific finding for healthcare providers. The same section says mindfulness was not superior to specific active controls for stress, so the claimed population–outcome combination is not established by this paper. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • Comparisons to a passive control can both overestimate effect sizes and identify effectiveness erroneously.

    “These findings need to be interpreted with caution, given that they arise from secondary analyses, and because it has been well demonstrated that comparisons to a passive control can both overestimate effect sizes and identify effectiveness erroneously (Davidson & Kaszniak, 2015; Goldberg et al., 2022; Kinser & Robins, 2013).”

    From The effects of mindfulness meditation on burnout in clinical genetic counselors: A three-arm randomized controlled trial (2026) · cites this paper as Goldberg et al., 2022

    The Method (Eligibility Criteria; page unavailable) says that control-group strength changes the magnitude of mindfulness-intervention effects and that passive controls cannot account for nonspecific treatment ingredients. The Results (Synthesis of Results; page unavailable) report smaller, less often significant effects against active controls. This supports caution about inflated effect sizes, but the paper does not establish that passive controls identify effectiveness erroneously. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

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Cites

1 retracted

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Research works printed but not linked: 4

  1. Analayo. (2018). Satipatthana meditation: A practice guide. Cambridge: Windhorse Publications.
  2. Higgins JPT, & Green S (2008). Cochrane Handbook for Systematic Reviews of Interventions. London: John Wiley & Sons.
  3. National Institute for Health and Care Excellence (NICE). (2009). Depression in adults: Recognition and management. Retrieved from: https://www.nice.org.uk/guidance/cg90 31990491
  4. Teleki JW (2010). Mindfulness-based stress reduction: A meta-analysis of psychological outcomes (Unpublished doctoral dissertation). PGSP-Stanford PsyD Consortium, Palo Alto, CA.

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Authors
Goldberg, S. B., Riordan, K. M., Sun, S., & Davidson, R. J.
Affiliations
  • University of Wisconsin–Madison (US)
  • Brown University (US)
Corresponding author
Goldberg, Simon B.
Venue
Perspectives on Psychological Science
Published
2021-02-16
Volume
17
Issue
1
Pages
108-130
ISSN
  • 1745-6916 (ISSN-L)
  • 1745-6924
OpenAlex
W3132572579
Cited by
520
References
111
Citations by year
2026: 117 · 2025: 120 · 2024: 102 · 2023: 101 · 2022: 53 · 2021: 26 · 2020: 1
FWCI
9.36
Type
journal article
Language
en
Open access
Locations
  • Perspectives on Psychological Science (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (R01MH43454, T32MH078788)
  • National Center for Complementary and Integrative Health (K23AT010879, P01AT004952)
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, effect size, passive control, active control, evidence-based treatment, publication bias, risk of bias, adverse effects, statistical power, heterogeneity, moderators
MeSH terms
Humans, Bias, Randomized Controlled Trials as Topic, Mindfulness

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