An examination of dose in mindfulness-based programs and Mindfulness practice through a dose-response meta-regression and randomised controlled experiments

Mindfulness research has grown exponentially in recent years including research with various doses related to mindfulness-based programs (MBPs) and mindfulness practice. This PhD thesis aimed to further understanding of the effectiveness of different doses related to MBPs and practices through a comprehensive review and experimental studies.

A large-scale dose-response meta-regression including 203 randomised controlled trials (both, compared to inactive and active controls) was completed with 15 dose variables related to MBPs and practice. The outcomes were depression, anxiety, stress, and mindfulness at post-program and follow-up. The meta-regression showed significant dose-response relationships between doses related to actual program use, face-to-face contact, and program intensity and the mindfulness outcome. No robust significant dose-response relationships were found for psychological distress outcomes.

Actual amount of mindfulness practice was frequently not consistently and reliably recorded in the studies included in the dose-response review. Additionally, the review did not support causal conclusions. Therefore, a randomised controlled experiment examined the relative effectiveness of longer (20-minute) and shorter (5-minute) mindfulness practices in a general population sample of novice practitioners. Although both doses were found effective at reducing psychological distress and increasing mindfulness compared to control, results showed that shorter practices had a significantly greater positive effect on mindfulness and stress than longer practices.

Additionally, the effectiveness of a single-dose mindfulness practice was assessed. An online-delivered randomised experiment, with a general population sample, examined the effects of a mindfulness induction on state hope and gratitude. This induction had significant positive effects on both outcomes, and state mindfulness statistically mediated the improvements in state hope and gratitude.

Overall, thesis findings have contributed to the field of mindfulness research by showing that higher and lower MBP and mindfulness practice doses are helpful, but that for novices, lower mindfulness practice doses may be more effective, especially in self-help MBPs without an experienced teacher present.