Skip to main content Accessibility help

What and who? Mindfulness in the mental health setting

  • Tamara A. Russell (a1) and Gerson Siegmund (a2)


A strong and growing evidence base exists for the use of mindfulness-based interventions to prevent relapse in major depression and for the self-management of chronic physical health conditions (e.g. pain), but the evidence in other domains of mental health work is still emerging. Much work is being conducted outside the evidence base and standardised protocols, and by individuals with varied levels of experience and training. The (mis)perception of mindfulness as a ‘simple technique’ belies the complexity and skill needed to deliver a mindfulness training that has real therapeutic and transformative power. We propose a framework to help clinicians think through the suitability of mindfulness for their particular client group with the intention of providing guidance for thoughtful decision-making.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      What and who? Mindfulness in the mental health setting
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      What and who? Mindfulness in the mental health setting
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      What and who? Mindfulness in the mental health setting
      Available formats


This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence to Tamara Russell (


Hide All

Declaration of interest




Hide All
1 Kristeller, JL, Wolever, RQ. Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation. Eat Disord 2010; 19: 4961.
2 Chadwick, P. Mindfulness for psychosis. Br J Psychiatry 2014; 204: 333–4.
3 Russell, T. Body in mind training: mindful movement for severe and enduring mental illness. Br J Wellbeing 2011; 2: 13–6.
4 Cusens, B, Duggan, GB, Thorne, K, Burch, V. Evaluation of the breathworks mindfulness-based pain management programme: effects on well-being and multiple measures of mindfulness. Clin Psychol Psychother 2010; 17: 6378.
5 Khoury, B, Lecomte, T, Fortin, G, Masse, M, Therien, P, Bouchard, V, et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev 2013; 33: 763–71.
6 Grossman, P, Niemann, L, Schmidt, S, Walach, H. Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 2004; 57: 3543.
7 Piet, J, Hougaard, E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clin Psychol Rev 2011; 31: 1032–40.
8 Fjorback, LO, Arendt, M, Ornbøl, E, Fink, P, Walach, H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials. Acta Psychiatr Scand 2011; 124: 102–19.
9 Khoury, B, Sharma, M, Rush, SE, Fournier, C. Mindfulness-based stress reduction for healthy individuals: a meta-analysis. J Psychosom Res 2015; 78: 519–28.
10 Bawa, FLM, Mercer, SW, Atherton, RJ, Clague, F, Keen, A, Scott, NW, et al. Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. Br J Gen Pract 2015; 65: e387400.
11 Godfrey, K, Gallo, L, Afari, N. Mindfulness-based interventions for binge eating: a systematic review and meta-analysis. J Behav Med 2015; 38: 348–62.
12 Huang, H, He, M, Wang, H, Zhou, M. A meta-analysis of the benefits of mindfulness-based stress reduction (MBSR) on psychological function among breast cancer (BC) survivors. Breast Cancer 2016; 23: 568–76.
13 Cavanagh, K, Strauss, C, Forder, L, Jones, F. Can mindfulness and acceptance be learnt by self-help? A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clin Psychol Rev 2014; 34: 118–29.
14 Mindfulness All-Party Parliamentary Group. Mindful Nation UK. Mindfulness Initiative, 2015 (
15 Carlson, L, Carlson, LE. Mindfulness-based interventions for physical conditions? A narrative review evaluating levels of evidence. ISRN Psychiatry 2012; 2012: 651583.
16 National Institute of Health and Clinical Excellence. Depression in Adults: Recognition and Management (CG90). NICE, 2009.
17 Ma, SH, Teasdale, JD. Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. J Consult Clin Psychol 2004; 72: 3140.
18 Teasdale, JD, Segal, ZV, Williams, JM, Ridgeway, VA, Soulsby, JM, Lau, MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000; 68: 615–23.
19 Godfrin, K, van Heeringen, C. The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: a randomized controlled study. Behav Res Ther 2010; 48: 738–46.
20 Kuyken, W, Hayes, R, Barrett, B, Byng, R, Dalgleish, T, Kessler, D, et al. Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. Lancet 2015; 386: 6373.
21 Williams, JMG, Duggan, DS, Crane, C, Fennell, MJV. Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior. J Clin Psychol 2006; 62: 201–10.
22 Williams, JMG, Alatiq, Y, Crane, C, Barnhofer, T, Fennell, MJV, Duggan, DS, et al. Mindfulness-based cognitive therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning. J Affect Disord 2008; 107: 275–9.
23 Williams, JMG, Crane, C, Barnhofer, T, Brennan, K, Duggan, DS, Fennell, MJV, et al. Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial. J Consult Clin Psychol 2014; 82: 275–86.
24 Bangor University Centre for Mindfulness Research and Practice. Resources. Available at (accessed 27 Jun 2016).
25 Williams, JMG, Kuyken, W. Mindfulness-based cognitive therapy: a promising new approach to preventing depressive relapse. Br J Psychiatry 2012; 200: 359–60.
26 Perich, T, Manicavasagar, V, Mitchell, PB, Ball, JR, Hadzi-Pavlovic, D. A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder. Acta Psychiatr Scand 2013; 127: 333–43.
27 Simon, NM, Otto, MW, Wisniewski, SR, Fossey, M, Sagduyu, K, Frank, E, et al. Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry 2004; 161: 2222–9.
28 Keller, MB. Prevalence and impact of comorbid anxiety and bipolar disorder. J Clin Psychiatry 2006; 67 (suppl. 1): 57.
29 Hofmann, SG, Sawyer, AT, Witt, AA, Oh, D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol 2010; 78: 169–83.
30 Wong, SYS, Mak, WWS, Cheung, EYL, Ling, CYM, Lui, WWS, Tang, WK, et al. A randomized, controlled clinical trial: the effect of mindfulness-based cognitive therapy on generalized anxiety disorder among Chinese community patients: protocol for a randomized trial. BMC Psychiatry 2011; 11: 187.
31 Khoury, B, Lecomte, T, Gaudiano, BA, Paquin, K. Mindfulness interventions for psychosis: a meta-analysis. Schizophr Res 2013; 150: 176–84.
32 Cramer, H, Lauche, R, Haller, H, Langhorst, J, Dobos, G. Mindfulness- and acceptance-based interventions for psychosis: a systematic review and meta-analysis. Glob Adv Health Med 2016; 5: 3043.
33 Russell, TA, Arcuri, SM. A neurophysiological and neuropsychological consideration of mindful movement: clinical and research implications. Front Hum Neurosci 2015; 9: 282.
34 Teasdale, JD. Mindfulness training and problem formulation. Clin Psychol Sci Pract 2003; 10: 157–60.
35 Kuyken, W, Watkins, E, Holden, E, White, K, Taylor, RS, Byford, S, et al. How does mindfulness-based cognitive therapy work? Behav Res Ther 2010; 48: 1105–12.
36 Dobkin, PL, Irving, JA, Amar, S. For whom may participation in a mindfulness-based stress reduction program be contraindicated? Mindfulness 2011; 3: 4450.
37 Crane, RS, Kuyken, W, Williams, JMG, Hastings, RP, Cooper, L, Fennell, MJV. Competence in teaching mindfulness-based courses: concepts, development and assessment. Mindfulness 2012; 3: 7684.
38 Boudette, R. Integrating mindfulness into the therapy hour. Eat Disord 2011; 19: 108–15.
39 Zamir, DR. The Impact of Meditation on the Therapist and Therapy [Master's thesis, Pacific University]. 2009. Available at: (accessed 27 June).
40 Keane, A. The influence of therapist mindfulness practice on psychotherapeutic work: a mixed-methods study. Mindfulness 2014; 5: 689703.
41 Horst, K, Newsom, K, Stith, S. Client and therapist initial experience of using mindfulness in therapy. Psychother Res 2013; 23: 369–80.
42 Grepmair, L, Mitterlehner, F, Loew, T, Bachler, E, Rother, W, Nickel, M. Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study. Psychother Psychosom 2007; 76: 332–8.
43 Grossman, P, Van Dam, NT. Mindfulness, by any other name? Trials and tribulations of Sati in western psychology and science. Contemp Buddhism 2011; 12: 219–39.
44 Teasdale, JD, Chaskalson (Kulananda), M. How does mindfulness transform suffering? II: the transformation of dukkha. Contemp Buddhism 2011; 12: 103–24.
45 Grabovac, AD, Lau, MA, Willett, BR. Mechanisms of mindfulness: a Buddhist psychological model. Mindfulness 2011; 2: 154–66.
46 Shapiro, SL, Carlson, LE, Astin, JA, Freedman, B. Mechanisms of mindfulness. J Clin Psychol 2006; 62: 373–86.
47 Demarzo, MMP, Cebolla, A, Garcia-Campayo, J. The implementation of mindfulness in healthcare systems: a theoretical analysis. Gen Hosp Psychiatry 2015; 37: 166–71.
48 Klatt, MD, Buckworth, J, Malarkey, WB. Effects of low-dose mindfulness-based stress reduction (MBSR-ld) on working adults. Health Educ Behav 2009; 36: 601–14.
49 Creswell, JD, Pacilio, LE, Lindsay, EK, Brown, KW. Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology 2014; 44: 112.
50 Mackenzie, CS, Poulin, PA, Seidman-Carlson, R. A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Appl Nurs Res 2006; 19: 105–9.
51 Manocha, R, Gordon, A, Black, D, Malhi, G, Seidler, R. Using meditation for less stress and better wellbeing. A seminar for GPs. Aust Fam Physician 2009; 38: 454–8.
52 Howells, A, Ivtzan, I, Eiroa-Orosa, FJ. Putting the ‘app’ in happiness: a randomised controlled trial of a smartphone-based mindfulness intervention to enhance wellbeing. J Happiness Stud 2016; 17: 163–85.
53 Plaza, I, Demarzo, MMP, Herrera-Mercadal, P, García-Campayo, J. Mindfulness-based mobile applications: literature review and analysis of current features. JMIR mHealth uHealth 2013; 1: e24.
54 Crane, RS, Kuyken, W. The implementation of mindfulness-based cognitive therapy: learning from the UK health service experience. Mindfulness 2013; 4: 246–54.
55 HCPC. Standards of Conduct, Performance and Ethics. Health and Care Professions Council, 2014: pp. 118.
56 Singh, NN, Lancioni, GE, Winton, ASW, Singh, AN, Adkins, AD, Singh, J. Mindful staff can reduce the use of physical restraints when providing care to individuals with intellectual disabilities. J Appl Res Intellect Disabil 2009; 22: 194202.
57 Singh, NN, Lancioni, GE, Winton, ASW, Wahler, RG, Singh, J, Sage, M. Mindful caregiving increases happiness among individuals with profound multiple disabilities. Res Dev Disabil 2004; 25: 207–18.
58 van der Oord, S, Bögels, SM, Peijnenburg, D. The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. J Child Fam Stud 2012; 21: 139–47.
59 Linehan, M. Skills Training Manual for Treating Borderline Personality Disorder. Guilford Press, 1993.
60 Russell, TA, Tatton-Ramos, T. Body in mind training: mindful movement for the clinical setting. Neuro-Disability Psychother 2014; 2: 108–36.

What and who? Mindfulness in the mental health setting

  • Tamara A. Russell (a1) and Gerson Siegmund (a2)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

What and who? Mindfulness in the mental health setting

  • Tamara A. Russell (a1) and Gerson Siegmund (a2)
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *