, Volume 10, Issue 5, pp 786–798 | Cite as

A Critical Methodological Review of Mixed Methods Designs Used in Mindfulness Research

  • Tuyen HuynhEmail author
  • Holly Hatton-Bowers
  • Michelle Howell Smith


There is growing recognition of the importance and value of integrating quantitative and qualitative research in the same study to provide a better understanding of a research question, to capture the complexity of an experience, and for generating more questions of interest for future studies. As the interest in adopting a mixed methods approach in mindfulness research continues to grow, details can be lacking in terms of how a study was conducted and the procedures used to analyze and interpret the data. In an attempt to understand the pattern of how mixed methods research was used in mindfulness research, we conducted a critical methodological review using content analysis. Specifically, mixed methods articles related to mindfulness research were evaluated in terms of how the articles included key components of mixed methods research designs. From our sample (N = 35), none of the articles included all of the recommended components (explicitly state the mixed methods design, the mixed methods research question(s), the rationale for mixed methods, the priority of the strands, and cite mixed methods literature) in a published mixed methods research study. Findings reveal the growing acceptance of mixed methods studies in mindfulness research and the need for more rigor when using mixed methods designs. Researchers are encouraged to clearly outline the reasons for their design and their research questions. This article provides recommendations and can serve as a reference for mindfulness research using mixed methods designs.


Mindfulness Mixed methods Content analysis Critical methodological review 


Author Contributions

TH: Designed and executed the study, collected the data collection and analyses, and wrote the paper.

HHB: Collaborated with the design, assisted in the data collection and analyses, and wrote the paper.

MHS: Contributed to the overall study design and development, assisted with data collection and analysis, collaborated in writing the method section, and provided feedback and editing throughout the paper.


No funding to declare. This paper is based on worked submitted as the first author’s mixed methods course assignment.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


Articles analyzed in the content analysis are indicated with an asterisk (*).

  1. *Berk, L., Hotterbeekx, R., van Os, J., & van Boxtel, M. (2017). Mindfulness-based stress reduction in middle-aged and older adults with memory complaints: a mixed-methods study. Aging & Mental Health, 1–8.Google Scholar
  2. *Bernay, R., Graham, E., Devcich, D. A., Rix, G., & Rubie-Davies, C. M. (2016). Pause, breathe, smile: a mixed-methods study of student well-being following participation in an eight-week, locally developed mindfulness program in three New Zealand schools. Advances in School Mental Health Promotion, 9, 90–106.Google Scholar
  3. Birnie, K., Speca, M., & Carlson, L. E. (2010). Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR). Stress and Health, 26, 359–371.CrossRefGoogle Scholar
  4. *Birtwell, K., Dubrow-Marshall, L., Dubrow-Marshall, R., Duerden, T., & Dunn, A. (2017). A mixed methods evaluation of a mindfulness-based stress reduction course for people with Parkinson’s disease. Complementary Therapies in Clinical Practice, 29, 220–228.Google Scholar
  5. Bishop, S. R., Lau, M. A., Shapiro, S. L., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., & Devins, G. (2004). Mindfulness: a proposed operational definition. Clinical Psychology, 11, 230–241.Google Scholar
  6. *Bisseling, E. M., Schellekens, M. P., Jansen, E. T., van Laarhoven, H. W., Prins, J. B., & Speckens, A. E. (2017). Mindfulness-based stress reduction for breast cancer patients: a mixed method study on what patients experience as a suitable stage to participate. Supportive Care in Cancer, 25, 3067–3074.Google Scholar
  7. *Bluth, K., Gaylord, S. A., Campo, R. A., Mullarkey, M. C., & Hobbs, L. (2016). Making friends with yourself: a mixed methods pilot study of a mindful self-compassion program for adolescents. Mindfulness, 7, 479–492.Google Scholar
  8. *Bowen, S., Somohano, V. C., Rutkie, R. E., Manuel, J. A., & Rehder, K. L. (2017). Mindfulness-based relapse prevention for methadone maintenance: a feasibility trial. The Journal of Alternative and Complementary Medicine, 23, 541–544.Google Scholar
  9. Bränström, R., Kvillemo, P., & Moskowitz, J. T. (2012). A randomized study of the effects of mindfulness training on psychological well-being and symptoms of stress in patients treated for cancer at 6-month follow-up. International Journal of Behavioral Medicine, 19, 535–542.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Bryman, A. (2006). Integrating quantitative and qualitative research: How is it done? Qualitative Research, 6, 97–113.CrossRefGoogle Scholar
  11. Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23–33.CrossRefPubMedGoogle Scholar
  12. Creswell, J. W., Fetters, M. D., Plano Clark, V. L., & Morales, A. (2009). Mixed methods intervention trials. In S. Andrew & E. J. Halcomb (Eds.), Mixed methods research for nursing and the health sciences (pp. 161–180). Ames, IA: Wiley-Blackwell.Google Scholar
  13. Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
  14. Creswell, J. W., Plano Clark, V. L., Gutmann, M. L., & Hanson, W. E. (2003). Advanced mixed methods research designs. In A. Tashakkori & C. Teddlie (Eds.), Handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage.Google Scholar
  15. *Crowder, R., & Sears, A. (2017). Building resilience in social workers: an exploratory study on the impacts of a mindfulness-based intervention. Australian Social Work, 70, 17–29.CrossRefGoogle Scholar
  16. *Day, M. A., Thorn, B. E., & Rubin, N. J. (2014). Mindfulness-based cognitive therapy for the treatment of headache pain: a mixed-methods analysis comparing treatment responders and treatment non-responders. Complementary Therapies in Medicine, 22, 278–285.Google Scholar
  17. *Eyles, C., Leydon, G. M., Hoffman, C. J., Copson, E. R., Prescott, P., Chorozoglou, M., & Lewith, G. (2014). Mindfulness for the self-management of fatigue, anxiety, and depression in women with metastatic breast cancer a mixed methods feasibility study. Integrative Cancer Therapies, 14, 42–56.Google Scholar
  18. *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. BMC Psychiatry, 6, 1–14.CrossRefGoogle Scholar
  19. Gambrel, L. E., Butler, V. I., & John, L. (2013). Mixed methods research in marriage and family therapy: a content analysis. Journal of Marital and Family Therapy, 39, 163–181.CrossRefGoogle Scholar
  20. *Gambrel, L. E., & Piercy, F. P. (2015). Mindfulness-based relationship education for couples expecting their first child—Part 1: a randomized mixed-methods program evaluation. Journal of Marital and Family Therapy, 41, 5–24.Google Scholar
  21. *George, M. C., Wongmek, A., Kaku, M., Nmashie, A., & Robinson-Papp, J. (2017). A mixed-methods pilot study of mindfulness-based stress reduction for HIV-associated chronic pain. Behavioral Medicine, 43, 108–119.Google Scholar
  22. Greene, J. C., Caracelli, V. J., & Graham, W. F. (1989). Toward a conceptual framework for mixed-method evaluation designs. Educational Evaluation and Policy Analysis, 11, 255–274.CrossRefGoogle Scholar
  23. Guetterman, T. C., & Fetters, M. D. (2018). Two methodological approaches to the integration of mixed methods and case study designs: a systematic review. American Behavioral Scientist, 62, 900–918.CrossRefGoogle Scholar
  24. Hanson, W. E., Creswell, J. W., Plano Clark, V. L., Petska, K. S., & Creswell, J. D. (2005). Mixed methods research designs in counseling psychology. Journal of Counseling Psychology, 52, 224–235.CrossRefGoogle Scholar
  25. Iani, L., Lauriola, M., Cafaro, V., & Didonna, F. (2017). Dimensions of mindfulness and their relations with psychological well-being and neuroticism. Mindfulness, 8, 664–676.CrossRefPubMedGoogle Scholar
  26. *Janssen, L., de Vries, A. M., Hepark, S., & Speckens, A. E. (2017). The feasibility, effectiveness, and process of change of mindfulness-based cognitive therapy for adults with ADHD: a mixed-method pilot study. Journal of Attention Disorders, 1–17.Google Scholar
  27. Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33, 14–26.Google Scholar
  28. Kabat-Zinn, J. (1990). Full catastrophe living: the program of the stress reduction clinic at the University of Massachusetts Medical Center. New York: Delta.Google Scholar
  29. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10, 144–156.Google Scholar
  30. *Keane, A. (2014). The influence of therapist mindfulness practice on psychotherapeutic work: a mixed-methods study. Mindfulness, 5, 689–703.Google Scholar
  31. *Keller, J., Ruthruff, E., Keller, P., Hoy, R., Gaspelin, N., & Bertolini, K. (2017). “Your brain becomes a rainbow”: perceptions and traits of 4th-graders in a school-based mindfulness intervention. Journal of Research in Childhood Education, 31, 508–529.Google Scholar
  32. Kelm, D. J., Ridgeway, J. L., Gas, B. L., Mohan, M., Cook, D. A., Nelson, D. R., & Benzo, R. P. (2018). Mindfulness meditation and interprofessional cardiopulmonary resuscitation: a mixed-methods pilot study. Teaching and Learning in Medicine, 1–11.Google Scholar
  33. *Keyworth, C., Knopp, J., Roughley, K., Dickens, C., Bold, S., & Coventry, P. (2014). A mixed-methods pilot study of the acceptability and effectiveness of a brief meditation and mindfulness intervention for people with diabetes and coronary heart disease. Behavioral Medicine, 40, 53–64.Google Scholar
  34. *Kidd, L. I., Graor, C. H., & Murrock, C. J. (2013). A mindful eating group intervention for obese women: a mixed methods feasibility study. Archives of Psychiatric Nursing, 27, 211–218.Google Scholar
  35. *Lomas, T., Edginton, T., Cartwright, T., & Ridge, D. (2015). Cultivating equanimity through mindfulness meditation: a mixed methods enquiry into the development of decentring capabilities in men. International Journal of Wellbeing, 5, 88–106.Google Scholar
  36. *Luberto, C. M., Wasson, R. S., Kraemer, K. M., Sears, R. W., Hueber, C., & Cotton, S. (2017). Feasibility, acceptability, and preliminary effectiveness of a 4-week mindfulness-based cognitive therapy protocol for hospital employees. Mindfulness, 8, 1522–1153.Google Scholar
  37. 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, 59–69.CrossRefGoogle Scholar
  38. *McIntyre, T. L., Elkonin, D., de Kooker, M., & Magidson, J. F. (2017). The application of mindfulness for individuals living with HIV in South Africa: a hybrid effectiveness-implementation pilot study. Mindfulness, 9, 1–13.Google Scholar
  39. Morse, J. M. (1991). Approaches to qualitative-quantitative methodological triangulation. Nursing Research, 40, 120–123.CrossRefPubMedGoogle Scholar
  40. *Müller-Engelmann, M., Wünsch, S., Volk, M., & Steil, R. (2017). Mindfulness-based stress reduction (MBSR) as a standalone intervention for posttraumatic stress disorder after mixed traumatic events: a mixed-methods feasibility study. Frontiers in Psychology, 8, 1–11.Google Scholar
  41. Nyklíček, I., & Kuijpers, K. F. (2008). Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: is increased mindfulness indeed the mechanism? Annals of Behavioral Medicine, 35, 331–340.CrossRefPubMedPubMedCentralGoogle Scholar
  42. O'Cathain, A., Murphy, E., & Nicholl, J. (2008). The quality of mixed methods studies in health services research. Journal of Health Services Research & Policy, 13, 92–98.CrossRefGoogle Scholar
  43. *Orellana-Rios, C. L., Radbruch, L., Kern, M., Regel, Y. U., Anton, A., Sinclair, S., & Schmidt, S. (2018). Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: mixed-method evaluation of an “on the job” program. BMC Palliative Care, 17, 1–15.Google Scholar
  44. Plano Clark, V., Huddleston-Casas, C. A., Churchill, S. L., Green, D. O. N., & Garrett, A. L. (2008). Mixed methods approaches in family science research. Journal of Family Issues, 29, 1543–1566.CrossRefGoogle Scholar
  45. Plano Clark, V. L., & Ivankova, N. V. (2016). Mixed methods research: a guide to the field. Thousand Oaks, CA: Sage Publications, Inc..CrossRefGoogle Scholar
  46. *Racey, D. N., Fox, J., Berry, V. L., Blockley, K. V., Longridge, R. A., Simmons, J. L., Janssens, A., Kuyken, W., & Ford, T. J. (2017). Mindfulness-based cognitive therapy for young people and their carers: a mixed-method feasibility study. Mindfulness, 9, 1–13.Google Scholar
  47. *Ramasubramanian, S. (2016). Mindfulness, stress coping and everyday resilience among emerging youth in a university setting: a mixed methods approach. International Journal of Adolescence and Youth, 22, 1–14.Google Scholar
  48. *Richard, V., Halliwell, W., & Tenenbaum, G. (2017). Effects of an improvisation intervention on elite figure skaters’ performance, self-esteem, creativity, and mindfulness skills. The Sport Psychologist, 31, 275–287.CrossRefGoogle Scholar
  49. *Rupprecht, S., Paulus, P., & Walach, H. (2017). Mind the teachers! The impact of mindfulness training on self-regulation and classroom performance in a sample of German school teachers. European Journal of Educational Research, 6, 565–581.Google Scholar
  50. Schreier, M. (2012). Qualitative content analysis in practice. Thousand Oaks, CA: Sage Publications.Google Scholar
  51. Segal, Z. V., Teasdale, J. D., Williams, J. M., & Gemar, M. C. (2002). The mindfulness-based cognitive therapy adherence scale: inter-rater reliability, adherence to protocol and treatment distinctiveness. Clinical Psychology & Psychotherapy, 9, 131–138.CrossRefGoogle Scholar
  52. Segal, Z. V., Williams, J. M., & Teasdale, J. D. (2018). Mindfulness-based cognitive therapy for depression. New York: Guilford Publications.Google Scholar
  53. Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013). Meditation Awareness Training (MAT) for improved psychological well-being: a qualitative examination of participant experiences. Journal of Religion and Health, 53, 849–863.CrossRefGoogle Scholar
  54. *Sibinga, E. M., Kerrigan, D., Stewart, M., Johnson, K., Magyari, T., & Ellen, J. M. (2011). Mindfulness-based stress reduction for urban youth. The Journal of Alternative and Complementary Medicine, 17, 213–218.Google Scholar
  55. *Sibinga, E. M., Perry-Parrish, C., Thorpe, K., Mika, M., & Ellen, J. M. (2014). A small mixed-method RCT of mindfulness instruction for urban youth. EXPLORE: The Journal of Science and Healing, 10, 180–186.Google Scholar
  56. Snelson, C. L. (2016). Qualitative and mixed methods social media research: a review of the literature. International Journal of Qualitative Methods, 15, 1–15.CrossRefGoogle Scholar
  57. Sweetman, D., Badiee, M., & Creswell, J. W. (2010). Use of the transformative framework in mixed methods studies. Qualitative Inquiry, 16, 441–454.CrossRefGoogle Scholar
  58. *Taylor, C., Harrison, J., Haimovitz, K., Oberle, E., Thomson, K., Schonert-Reichl, K., & Roeser, R. W. (2016). Examining ways that a mindfulness-based intervention reduces stress in public school teachers: a mixed-methods study. Mindfulness, 7, 115–129.Google Scholar
  59. Teddlie C. B. & Tashakkori, A. (2008). Foundations of mixed methods research: Integrating quantitative and qualitative approaches in the social and behavioral sciences. Thousand Oaks, CA: Sage.Google Scholar
  60. *Thomas, J. T. (2017). Brief mindfulness training in the social work practice classroom. Social Work Education, 36, 102–118.Google Scholar
  61. *van den Hurk, D. G., Schellekens, M. P., Molema, J., Speckens, A. E., & van der Drift, M. A. (2015). Mindfulness-based stress reduction for lung cancer patients and their partners: results of a mixed methods pilot study. Palliative Medicine, 28, 1–9.Google Scholar
  62. Van Dam, N. T., Sheppard, S. C., Forsyth, J. P., & Earleywine, M. (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders, 25, 123–130.CrossRefPubMedGoogle Scholar
  63. *Verweij, H., Waumans, R. C., Smeijers, D., Lucassen, P. L., Donders, A. R. T., van der Horst, H. E., & Speckens, A. E. (2016). Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care. British Journal of General Practice, 66, e99-e105.Google Scholar
  64. *Wongtongkam, N., Krivokapic-Skoko, B., Duncan, R., & Bellio, M. (2017). The influence of a mindfulness-based intervention on job satisfaction and work-related stress and anxiety. International Journal of Mental Health Promotion, 19, 134–143.Google Scholar
  65. *Woolhouse, H., Knowles, A., & Crafti, N. (2012). Adding mindfulness to CBT programs for binge eating: a mixed-methods evaluation. Eating Disorders, 20, 321–339.Google Scholar
  66. *Zhang, D., Chan, S. K. C., Lo, H. H. M., Chan, C. Y. H., Chan, J. C. Y., Ting, K. T., … & Wong, S. Y. S. (2017). Mindfulness-based intervention for Chinese children with ADHD and their parents: a pilot mixed-method study. Mindfulness, 8, 859–872.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Child, Youth and Family StudiesUniversity of Nebraska-LincolnLincolnUSA
  2. 2.Child, Youth and Family StudiesUniversity of Nebraska-LincolnLincolnUSA
  3. 3.Nebraska Center for Research on Children, Youth, Families and SchoolsUniversity of Nebraska-LincolnLincolnUSA

Personalised recommendations