, Volume 3, Issue 1, pp 60–75 | Cite as

Transforming the Perceptual Situation: a Meta-ethnography of qualitative Work Reporting Patients’ Experiences of Mindfulness-Based Approaches

  • Alice MalpassEmail author
  • Havi Carel
  • Matthew Ridd
  • Alison Shaw
  • David Kessler
  • Debbie Sharp
  • Mark Bowden
  • Julia Wallond


The UK National Institute for Clinical Excellence recommends Mindfulness-based Cognitive Therapy (MBCT) for the prevention of relapse in chronic depression. Since Jon Kabat-Zinn first developed Mindfulness-based Stress Reduction (MBSR) in the 1980s, most research has focused on questions of efficacy, i.e. does mindfulness work? More recently, interest has emerged in how mindfulness-based interventions, such as MBSR and MBCT, are experienced by participants. To evaluate how participants experience the 8-week MBSR/MBCT process, we carried out a meta-ethnography of published qualitative papers since 2001, whose focus is the patient experience of MBCT and MBSR. A systematic search of six databases was carried out. Relevant papers were critically appraised using a modified version of the Critical Appraisal Skills programme tool. Fourteen papers, each representing a unique study, were included in the meta-ethnography. The synthesis describes patients’ experience of the mindfulness process. Linking patient experiences to existing theories of mindfulness and chronic illness, the synthesis conceptualises the way participants develop a new understanding of their illness over time, and the role mindfulness approaches have in helping them manage their difficulties better.


MBCT MBSR Meta-ethnography Therapeutic process Chronic illness Patient experience 



This research was supported by a National Institute for Health Research (NIHR) Fellowship awarded to Dr Alice Malpass.


  1. *Allen, M., Bromley, A., Kuyken, W., & Sonnenberg, S. J. (2009). Participants’ experiences of mindfulness-based cognitive therapy: “It changed me in just about every way possible”, Behavioural and Cognitive Psychotherapy, 37, 413430.PubMedCrossRefGoogle Scholar
  2. *Chadwick, P., Newell, T., & Skinner, C. (2008). Mindfulness groups in palliative care: a pilot qualitative study. Spirituality and Health International, 9, 135144.CrossRefGoogle Scholar
  3. *Dobkin, P. L. (2008). Mindfulness-based stress reduction: What processes are at work? Complementary Therapies in Clinical Practice, 14, 816.PubMedCrossRefGoogle Scholar
  4. *Finucane, A., & Mercer, S. W. (2006). An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. British Medical Psychiatry, 6(14), 114.Google Scholar
  5. *Fitzpatrick, L., Simpson, J., & Smith, A. (2010). A qualitative study of mindfulness-based cognitive therapy (MBCT) in Parkinson’s disease. Psychology and Psychotherapy: Theory, Research and Practice, 83(2), 179192.CrossRefGoogle Scholar
  6. *Griffiths, K., Camic, P. M., & Hutton, J. M. (2009). Participant experiences of a mindfulness-based cognitive therapy group for cardiac rehabilitation. Journal of Health Psychology, 14(5), 675681.PubMedCrossRefGoogle Scholar
  7. *Kerr, C. E, Josyula, K., & Littenberg, R. (2010). Developing an observing attitude: a analysis of meditation diaries in an MBSR clinical Trial. Clinical psychology and psychotherapy, 18(1), 8093.CrossRefGoogle Scholar
  8. *Mackenzie, M. J., Carlson, L. E., Munoz, M., & Speca, M. (2007). A qualitative study of self-perceived effects of mindfulness-based stress reduction (MBSR) in a psychosocial oncology setting. Stress and Health 23, 5969.CrossRefGoogle Scholar
  9. *Mason, O., & Hargreaves, I. (2001). A qualitative study of mindfulness-based cognitive therapy for Depression. British Journal of Medical Psychology, 74, 197212.CrossRefGoogle Scholar
  10. *Morone, N. E., Lynch, C. S., Greco, C. M., Tindle, H. A.,& Weiner, D. K. (2008). “I felt like a new person”. The effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries. The Journal of Pain, 9(9), 841848.PubMedCrossRefGoogle Scholar
  11. *Moss, D., Waugh, M., & Barnes, R. (2008). A tool for life? Mindfulness as self-help or safe uncertainty. International Journal of Qualitative Studies on Health and Well-being, 3(3), 111.CrossRefGoogle Scholar
  12. *Sibinga, E. M. S., Stewart, M., Magyari, T., Welsh, C. K., Hutton, N., & Ellen, J. M. (2008). Mindfulness-based stress reduction for HIV-infected youth: A pilot study. Explore, 4(1), 3637.PubMedCrossRefGoogle Scholar
  13. *Smith, A., Grahman, L., & Senthinathan, S. (2007). Mindfulness-based cognitive therapy for recurring depression in older people: a qualitative study. Aging and Mental Health, 11(3), 346357.PubMedCrossRefGoogle Scholar
  14. *York, M. (2007). A qualitative study into the experience of individuals involved in a mindfulness group within an acute inpatient mental health unit. Journal of psychiatric and mental health nursing, 14, 603608.PubMedCrossRefGoogle Scholar
  15. Baer, R. A. (2009). Self-focused attention and mechanisms of change in mindfulness-based treatment. Cognitive Behaviour Therapy, 38, 15–20.CrossRefGoogle Scholar
  16. Booth, A. (2003). Formulating research questions. In A. Booth & A. Brice (Eds.), Evidence based practice: a handbook for information professionals (pp. 123–148). London: Facet.Google Scholar
  17. Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health & Illness, 4(2), 167–182.CrossRefGoogle Scholar
  18. Carel, H. (2009). “I am well, apart from the fact that I have cancer”: explaining well-being within Illness’. In L. Bortolloti (Ed.), Philosophy and Happiness (pp. 82–89). Basingstoke: Palgrave.Google Scholar
  19. Coffey, K. A., Hartman, M., & Fredrickson, B. L. (2010). Deconstructing mindfulness and constructing mental health: understanding mindfulness and its mechanisms of action. Mindfulness, 1, 235–253.CrossRefGoogle Scholar
  20. Crane, R. (2008). Mindfulness-based cognitive therapy. London: Routledge.Google Scholar
  21. Deikman, A. J. (1996). I = Awareness. Journal of Consciousness Studies, 3(4), 350–356(7)Google Scholar
  22. Dixon-Woods, M., Sutton, A., Shaw, R., Miller, T., Smith, J., Young, B., et al. (2007). Appraising qualitative research for inclusion in systematic reviews: a quantitative and qualitative comparison of three methods. Journal of Health Services Research and Policy, 12(1), 42–47Google Scholar
  23. Faircloth, C. A., Boylstein, C., Rittman, M., Young, M. E., & Gubrium, J. (2004). Sudden illness and biographical flow in narratives of stroke recovery. Sociology of Health and Illness, 26(2), 242–261.PubMedCrossRefGoogle Scholar
  24. Kabat-Zinn, J. (2001). Full Catastrophe Living. London: Piatkus Books.Google Scholar
  25. Malpass, A., Shaw, A., Sharp, D., Walter, F., Feder, G., Ridd, M., et al. (2009). “Medication career” or “Moral career”? The two sides of managing antidepressants: A metaethnography of patients' experience of antidepressants. Social Science & Medicine, 68(1), 154–168.Google Scholar
  26. Mason, B. (1993). Towards positions of safe uncertainty. Human Systems, 4, 189–200.Google Scholar
  27. Mikulas, W. L. (2011). Mindfulness: significant common confusions. Mindfulness, 2, 1–7.CrossRefGoogle Scholar
  28. Noblit, G. W., & Hare, R. D. (1988). Meta-ethnography: synthesising qualitative studies. London: Sage.Google Scholar
  29. Sandelowski, M., Docherty, S., & Emden, C. (1997). Qualitative metasynthesis: issues and techniques. Research in Nursing and Health, 20, 365–371.PubMedCrossRefGoogle Scholar
  30. Sangarakshita. (1998). Know your mind. Birmingham: Windhorse.Google Scholar
  31. Sangharakshita. (2000). Ritual and devotion in Buddhism. Birmingham: Windhorse.Google Scholar
  32. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression. New York: Guildford Press.Google Scholar
  33. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.PubMedCrossRefGoogle Scholar
  34. Teasdale, J. (1999). Meta-cognition, mindfulness and the modification of mood disorders. Clinical Psychology & Psychotherapy, 6, 146–155.CrossRefGoogle Scholar
  35. Thorne, S., Jensen, L., Kearney, M. H., Noblit, G., & Sandelowski, M. (2004). Qualitative Metasynthesis: Reflections on Methodological Orientation and Ideological Agenda. Qualitative Health Research, 10(1), 1342–1386.Google Scholar
  36. Wallace, B. A., & Shapiro, S. L. (2006). Mental balance and well-being. Building bridges between Buddhism and Western Psychology. American Psychologist, 61(7), 690–701.PubMedCrossRefGoogle Scholar
  37. Williams, J. M. G. (2010). Mindfulness and psychological process. Emotion, 10(1), 1–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Alice Malpass
    • 1
    Email author
  • Havi Carel
    • 2
  • Matthew Ridd
    • 1
  • Alison Shaw
    • 1
  • David Kessler
    • 1
  • Debbie Sharp
    • 1
  • Mark Bowden
    • 3
  • Julia Wallond
    • 4
  1. 1.School of Social and Community MedicineUniversity of BristolBristolUK
  2. 2.Department of History, Philosophy and PoliticsUWE BristolBristolUK
  3. 3.MindbasePlymouthUK
  4. 4.Bristol Insight Meditation GroupBristolUK

Personalised recommendations