Australasian Science: Australia's authority on science since 1938

Be Mindful of the Gap



By Tim Hannan

The lack of evidence for mindfulness as a therapeutic technique raises serious questions for health and education professionals.

In recent years, mindfulness has been promoted widely as a technique for improving mental and physical health, maximising everyday functioning and, well, getting in touch with one’s inner self. Its benefits are spruiked in schools, health services, businesses and correctional facilities, with training provided through clinics, wellness centres or even - for those short of time – via a mobile phone app. Yet despite the ubiquity of its presence in the community, many who have watched the adoption of mindfulness in fields of health and education have noted the striking lack of scientific evidence for many of its claimed benefits.

The idea of mindfulness is understood to have derived largely from Buddhist meditation practices, in which focused awareness of the present is viewed as one of the elements of the eightfold path to enlightenment. Various traditions employed and expanded upon these techniques with the aim of enabling the practitioner to improve the mind, control the body and reduce the impact of transitory emotions and impulses.

The association with traditional Buddhist beliefs and practices has been viewed by some as a powerful argument for its utility: if generations of peace-loving Buddhists have embraced mindfulness, it must be good. On the other hand, some promoters ­ such as the founder of the Mindfulness-Based Stress Reduction program ­– have deliberately de-emphasised its origins, apparently in the interests of promoting mindfulness as a modern, secular technique with a scientific basis, a strategy some ethicists have described as “intentional or unintentional lapses in transparency”.

Whatever its origins, in the present century mindfulness has moved from its place among those with certain types of spiritually or alternatively inclined lifestyles to become a feature of our modern health system, with psychologists, doctors and other health professionals advocating for the benefits of its incorporation as an adjunct or primary element in the treatment of mental health problems, chronic illnesses, substance abuse and various lifestyle issues. It has also been incorporated into school programs with the stated aim of improving students’ on-task behaviour. Though presented as an easy, positive approach accessible to all, it is this introduction into conventional health and educational practices that has prompted the question that may seem somewhat indelicate: does it actually work?

Of course, the answer to this question depends on what is being claimed: if the aim of mindfulness is to assist in some degree to improve mood, reduce stress or enhance the feeling of self-control, then it is likely that taking time out from daily activities to clear and focus one’s mind would be of benefit to many people. However, if mindfulness is proposed as a psychological therapy for specific problems, as suggested by advocates of mindfulness-based cognitive therapy, then it is reasonable to ask for the evidence for preferring these techniques over other well-supported therapies. And here there is a problem, for as reviewers continually point out, the evidence for its efficacy is extremely thin.

A 2014 review of 47 studies found no evidence of benefits in relation to substance abuse, sleep or controlling weight. Another review in 2015 noted that fewer than 10% of mindfulness studies employed a control group, and that large placebo-controlled studies found little effect. Another detailed review in 2017 highlighted the poor methodology in most empirical studies and, noting that only a minority attempted to monitor potential negative outcomes of mindfulness interventions, commented: “Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed”.

The lack of evidence does not prove that mindfulness is ineffective. The most sceptical of commentators acknowledge that many people report finding it helpful, and that it may be a useful adjunct to interventions for some physical and mental health conditions. However, in the absence of scientific evidence, the relentless contemporary promotion of the practice – labelled “McMindfulness” by one commentator – invites practical and ethical questions concerning its use by health and education providers who really should be focusing their minds more fully on their choice of interventions.

A/Prof Tim Hannan is Head of the School of Psychology at Charles Sturt University, and the Past President of the Australian Psychological Society.