Skip to main content
SpringerLink
Log in

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

  • REVIEW
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

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

  • *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.

  • *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.

  • 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.

    Article  Google Scholar 

  • *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.

  • 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 

  • *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.

  • *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.

  • *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.

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bryman, A. (2006). Integrating quantitative and qualitative research: How is it done? Qualitative Research, 6, 97–113.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • 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 

  • *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.

    Article  Google Scholar 

  • *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.

  • *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.

  • *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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • *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.

  • *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.

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • *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.

  • Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33, 14–26.

  • Kabat-Zinn, J. (1990). Full catastrophe living: the program of the stress reduction clinic at the University of Massachusetts Medical Center. New York: Delta.

  • Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10, 144–156.

    Google Scholar 

  • *Keane, A. (2014). The influence of therapist mindfulness practice on psychotherapeutic work: a mixed-methods study. Mindfulness, 5, 689–703.

  • *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.

  • 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.

  • *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.

  • *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.

  • *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.

  • *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.

  • 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.

    Article  Google Scholar 

  • *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.

  • Morse, J. M. (1991). Approaches to qualitative-quantitative methodological triangulation. Nursing Research, 40, 120–123.

    Article  PubMed  Google Scholar 

  • *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.

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  Google Scholar 

  • *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.

  • 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.

    Article  Google Scholar 

  • Plano Clark, V. L., & Ivankova, N. V. (2016). Mixed methods research: a guide to the field. Thousand Oaks, CA: Sage Publications, Inc..

    Book  Google Scholar 

  • *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.

  • *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.

  • *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.

    Article  Google Scholar 

  • *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.

  • Schreier, M. (2012). Qualitative content analysis in practice. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • Segal, Z. V., Williams, J. M., & Teasdale, J. D. (2018). Mindfulness-based cognitive therapy for depression. New York: Guilford Publications.

  • 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.

    Article  Google Scholar 

  • *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.

  • *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.

  • Snelson, C. L. (2016). Qualitative and mixed methods social media research: a review of the literature. International Journal of Qualitative Methods, 15, 1–15.

    Article  Google Scholar 

  • Sweetman, D., Badiee, M., & Creswell, J. W. (2010). Use of the transformative framework in mixed methods studies. Qualitative Inquiry, 16, 441–454.

    Article  Google Scholar 

  • *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.

  • 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.

  • *Thomas, J. T. (2017). Brief mindfulness training in the social work practice classroom. Social Work Education, 36, 102–118.

  • *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.

  • 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.

    Article  PubMed  Google Scholar 

  • *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.

  • *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.

  • *Woolhouse, H., Knowles, A., & Crafti, N. (2012). Adding mindfulness to CBT programs for binge eating: a mixed-methods evaluation. Eating Disorders, 20, 321–339.

  • *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.

Download references

Funding

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

Author information

Authors and Affiliations

  1. Child, Youth and Family Studies, University of Nebraska-Lincoln, 205.1 Louise Pound Hall, 512 N 12 Street, Lincoln, NE, 68588-0236, USA

    Tuyen Huynh

  2. Child, Youth and Family Studies, University of Nebraska-Lincoln, 244 Louise Pound Hall, 512 N 12 Street, Lincoln, NE, 68588-0236, USA

    Holly Hatton-Bowers

  3. Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, 216 Mabel Lee Hall, Lincoln, NE, 68588-0236, USA

    Michelle Howell Smith

Authors
  1. Tuyen Huynh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Holly Hatton-Bowers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michelle Howell Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

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.

Corresponding author

Correspondence to Tuyen Huynh.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huynh, T., Hatton-Bowers, H. & Howell Smith, M. A Critical Methodological Review of Mixed Methods Designs Used in Mindfulness Research. Mindfulness 10, 786–798 (2019). https://doi.org/10.1007/s12671-018-1038-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-018-1038-5

Keywords

Search

Navigation