Mindfulness in Adaptation to Bereavement: A Systematic Review

Abstract

Bereavement can precipitate mental health problems, including severe, persistent, and disabling grief, that is, prolonged grief. Cognitive behavioural therapy is the first choice for prolonged grief, but it does not benefit all clients. Mindfulness-based interventions have been proposed as an alternative treatment, yet a comprehensive review on the role of mindfulness in psychological adaptation to bereavement is lacking. Therefore, we searched PsycINFO, Web of Science and PubMed (last search: 24 February 2025; PROSPERO: CRD420251006282) to identify observational and intervention studies on the relationships of mindfulness with prolonged grief and secondary mental health problems (e.g., depression and posttraumatic stress symptoms) in bereaved adults. Thirteen studies (2097 participants) were selected. Study quality varied. Cross-sectional (n = 3) and longitudinal surveys (n = 2) consistently showed significant associations of self-reported mindfulness with levels of prolonged grief and secondary mental health problems. Self-reported mindfulness also predicted changes over time in secondary mental health outcomes but not in prolonged grief symptoms. Intervention studies, including pre-evaluations and post-evaluations (n = 3), nonrandomized trials (n = 4) and an RCT (n = 1), focused mostly on secondary mental health outcomes, with only three intervention studies also including a measure of prolonged grief. Results generally supported the effectiveness of mindfulness-based interventions for attenuating secondary mental health outcomes. Findings were mixed for prolonged grief symptoms. Altogether, findings indicated that mindfulness holds promise for improving mental health problems following bereavement. More research, including RCTs and intensive longitudinal studies, is needed to clarify the short- and long-term benefits of mindfulness in people with prolonged grief.

Keywords: anxiety; depression; mindfulness‐based interventions; posttraumatic stress disorder; prolonged grief disorder; self‐reported mindfulness.

FIGURE 1

PRISMA flow diagram.