Can a little bit of mindfulness do you good? An exploration into the safety and effectiveness of unguided mindfulness based self-help interventions

Traditional in-person mindfulness-based interventions are effective in teaching mindfulness skills and improving mental health outcomes in clinical, non-clinical and working populations. Limited availability of these interventions however inhibits the translation of research into practice and unguided mindfulness-based self-help (MBSH) provides a popular alternative to accessing mindfulness training. However, there is not yet an evidence-based consensus on the safety and effectiveness of these interventions, and rigorously controlled adequately powered trials are lacking. This thesis was intended to address these issues.

Chapter 1 introduces the thesis by considering the burden of mental health problems and work-related stress and the potential for unguided MBSH to address these issues. Chapter 2 presents findings from the first systematic review and meta-analysis of specifically unguided MBSH delivered via both digital and non-digital intervention materials on mindfulness, stress, and other key mental health outcomes in any adult population. Chapter 3 presents findings from the first adequately powered multi-site randomised active-controlled trial of an unguided MBSH intervention on mindfulness, stress, mental health, and work-related outcomes in healthcare staff.

As discussed in Chapter 4, the evidence from this empirical work suggests that unguided MBSH is a safe, acceptable, and effective tool for teaching mindfulness skills that yields small but significant benefits on stress and mental health outcomes relative to control conditions, both broadly and in healthcare workers specifically, and with relatively minimal time investment from users. While these findings provide important assurances about the safety and utility of already widely available MBSH resources, greater clarity is needed in respect of the relative efficacy of these interventions in different contexts and populations and suggestions for advancing the field are provided.