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Mindfulness
Can Mindfulness Improve Well-Being in the Workplace?
Our new review shows promising results.
Posted November 20, 2018
Work can be stressful, for many reasons – some directly relating to occupational dynamics (e.g., long hours, lack of control), and some extending beyond the workplace (e.g., poor remuneration, work-life balance)1. Such stress is relatively prevalent: 22 percent of European workers report experiencing work-related stress, with many more exposed to the psychosocial risks of such stress2. Moreover, indications are that work-related challenges are becoming increasingly demanding. In the United Kingdom, for instance, while the prevalence of mental illness in the general population has not significantly increased in the last 20 years3, the number of sick days lost to mental ill-health has increased by 24 percent since 20094. Such trends are a serious problem – obviously for the sufferers themselves, and for their employers and the wider economy (and in that latter respect it is estimated that, in the United States alone, workplace stress may cost up to $190 billion dollars, or around eight percent of national spending on healthcare)5.
Given this context, a nexus of intersecting interests is converging to develop programs to ameliorate work-related mental health issues. These are generally (though not uniformly) effective: a recent analysis examined a range of initiatives and calculated their net economic benefits over a 1-year period to range between €0.81 and €13.62 for every €1 of expenditure in the program (via reducing pressures on healthcare systems, social welfare systems, employers, and the economy as a whole)6. And among the most prominent of these work-related programs are those based around mindfulness.
Mindfulness-Based Interventions
Mindfulness can refer to both: (1) a state or quality of mind; and (2) a meditation practice designed to foster this. The pre-eminent operationalization of mindfulness as a state/quality is Jon Kabat-Zinn’s definition: “the awareness that arises through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment”7. Then, as per the second meaning of mindfulness, there are meditation practices which facilitate this state. Such activities are thought to help people “retrain” awareness, providing more choice in how they relate and respond to their subjective experience, rather than habitually responding in unhelpful ways8.
In this context, we’ve seen the development of a wealth of mindfulness-based interventions (MBIs). Initially, these were mainly designed for clinical contexts and issues. For instance, Kabat-Zinn’s prototypical Mindfulness-Based Stress Reduction program was designed for the treatment of chronic pain9, before being adapted for other physical and mental health conditions, such as anxiety10. However, over recent years, there has been increasing interest in the development and deployment of MBIs in occupational contexts, not only for staff suffering mental health issues, but for workers “in general” (e.g., as a protective measure against future issues).
Reviewing the literature
To assess the literature in this area, we conducted an inclusive systematic review of the impact of MBIs in the workplace, spanning all aspects of wellbeing and all occupational contexts, which we published last year11. For this, we identified 153 peer-reviewed articles that met our criteria, and overall, MBIs were associated with positive outcomes in relation to most indices of wellbeing. However, to gain a more rigorous sense of their impact, we then conducted a meta-analysis on a small subset of these studies, which we have just published in the Journal of Positive Psychology12. Specifically, we focused on the highest quality studies in the broader data set, namely randomized controlled trials, of which there were 35 for which data were available.
Overall, the results were encouraging, but variable. MBIs had significant moderate effects on deficit-based outcomes such as stress (SMD [standardized mean difference] = −0.57), anxiety (SMD = −0.57), distress (SMD = −0.56), and burnout (SMD = −0.36), and significant moderate-to-small effects on asset-based outcomes like health (SMD = 0.63), job performance (SMD = 0.43), compassion and empathy (SMD = 0.42), mindfulness (SMD = 0.39), and positive wellbeing (SMD = 0.36), while no significant effects were observed for depression or emotional regulation.
Conclusions
Thus, the results are relatively positive, but not consistently so. Moreover, various issues with the research base limit the conclusions that can be drawn. First, studies are of variable quality, with many also giving insufficient details about the design. Second, there is considerable heterogeneity in the designs – including with respect to type of MBI, and outcome measures used – which makes it difficult to draw meaningful conclusions about the literature as a whole. Third, most studies failed to deploy an active control group – i.e., a non-MBI intervention that might also be beneficial, such as exercise – which hinders us from determining the extent to which any positive results are due to mindfulness per se.
As such, more work is needed to fully establish the efficacy of MBIs in the workplace. Nevertheless, evidence is building that they can have at least some positive effect, and are worth trialling. Having said that, MBIs should ideally not be used as a 'sticking plaster' for toxic or otherwise challenging work environments; as helpful as MBIs may be, they are no substitute for seeking to structurally create safe and supportive occupational contexts. It's also worth acknowledging that not everyone responds well to mindfulness meditation13, and for some people at certain times, it can even be harmful14, and so some sensitivity and caution is needed in implementing MBIs in any context. But with these caveats in mind, work can certainly be hard, and anything that can help ease people’s burdens is surely to be welcomed.
References
[1] Goh, J., Pfeffer, J., & Zenios, S. A. (2015). The relationship between workplace stressors and mortality and health costs in the United States. Management Science, 62(2), 608-628.
[2] Eurofound — European Foundation for the Improvement of Living and Working Conditions (2012). Fifth European working conditions survey. Publications Office of the European Union: Luxembourg. Available at: http://www.eurofound.europa.eu/surveys/ewcs/2010/
[3] Office for National Statistics (2014). Full Report: Sickness Absence in the Labour Market. London: Office for National Statistics.
[4] Davies, S. (2014). Annual Report of the Chief Medical Officer 2013, Public Mental Health Priorities: Investing in the Evidence. London: Department of Health.
[5] Goh, J., Pfeffer, J., & Zenios, S. A. (2015). The relationship between workplace stressors and mortality and health costs in the United States. Management Science, 62(2), 608-628. doi: 10.1287/mnsc.2014.2115
[6] Matrix (2013). Economic analysis of workplace mental health promotion and mental disorder prevention programmes and of their potential contribution to EU health, social and economic policy objectives. Luxembourg: Executive Agency for Health and Consumers.
[7] Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144-156.
[8] Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clinical Psychology Review, 29(6), 560-572.
[9] Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33-47.
[10] Vøllestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4), 281-288.
[11] Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., Hart, R., & Eiroa-Orosa, F. J. (2017). The impact of mindfulness on wellbeing and performance in the workplace: An inclusive systematic review of the empirical literature. European Journal of Work and Organizational Psychology, 26(4), 492-513.
[12] Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., & Eiroa-Orosa, F. J. (2018). Mindfulness-based interventions in the workplace: An inclusive systematic review and meta-analysis of their impact upon wellbeing. Journal of Positive Psychology. doi: 10.1080/17439760.2018.151958
[13] Lomas, T., Cartwright, T., Edginton, T., & Ridge, D. (2015). A qualitative analysis of experiential challenges associated with meditation practice. Mindfulness, 6(4), 848-860.
[14] Dobkin, P. L., Irving, J. A., & Amar, S. (2012). For whom may participation in a mindfulness-based stress reduction program be contraindicated? . Mindfulness, 3(1), 44-50.
