The validation of an active control intervention for Mindfulness Based Stress Reduction (MBSR)

Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η2 = .18). There were significant improvements over time for general distress (η2 = .09), anxiety (η2 = .08), hostility (η2 = .07), and medical symptoms (η2 = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.

► We validate an active control for Mindfulness Based Stress Reduction (MBSR).
► Pre-post behavioral pain ratings are lower for MBSR compared to control.
► No group differences for changes in anxiety and hostility or medical symptoms.
► Group × Time for general mental distress and depression show improvements in control over MBSR.
► Control is first that allows rigorous test of MBSR, including mindfulness as active ingredient.