Deep Dive: Meditation Modalities—Comparing Approaches

Reading time: ~5 minutes
Prerequisite: Chapter 2.12 (Stress and Mental Health)


The Big Picture

"Meditation" encompasses many different practices with different techniques, traditions, and evidence bases. This overview helps you understand the main approaches and what the research says about each.


Major Modalities

1. Mindfulness-Based Stress Reduction (MBSR)

What it is: 8-week structured program combining mindfulness meditation, body awareness, and yoga.

Key features:
- Secular, standardized protocol
- Developed by Jon Kabat-Zinn at UMass
- Weekly classes + daily practice

Evidence: Strong for stress reduction, moderate for anxiety/depression, modest for pain.

2. Mindfulness-Based Cognitive Therapy (MBCT)

What it is: MBSR adapted for depression relapse prevention, combining mindfulness with cognitive therapy elements.

Evidence: Strong evidence for preventing depression relapse in those with 3+ episodes.

3. Transcendental Meditation (TM)

What it is: Mantra-based practice taught through standardized instruction.

Key features:
- 20 minutes twice daily
- Personalized mantra from certified instructor
- Proprietary (paid instruction required)

Evidence: Moderate for blood pressure reduction; mixed for other outcomes.

4. Focused Attention Meditation

What it is: Concentration on a single object (breath, mantra, visual object).

Evidence: Improves attention and concentration; mechanism for other benefits.

5. Open Monitoring/Awareness

What it is: Non-judgmental awareness of all experiences without specific focus.

Evidence: Associated with emotional regulation; different brain changes than focused attention.

6. Loving-Kindness/Compassion Meditation

What it is: Directed cultivation of positive feelings toward self and others.

Evidence: Increases positive emotions; may improve social connection; emerging evidence for pain.


What the Research Shows

Outcome Evidence Strength Best-Supported Modality
Stress reduction Strong MBSR, most mindfulness
Anxiety Moderate MBSR, MBCT
Depression Moderate (acute); Strong (relapse prevention) MBCT
Blood pressure Moderate TM, mindfulness
Pain Moderate MBSR
Attention Moderate Focused attention practices
Emotional regulation Moderate Various

Important Caveats:
- Many studies have methodological limitations
- Effect sizes are often modest
- "No worse than other interventions" is common finding
- Active practice matters more than specific technique


Practical Considerations

For Beginners

  • Start simple: breath awareness, 5-10 minutes
  • Apps can help (Headspace, Calm, Insight Timer)
  • Guided better than unguided initially
  • Consistency matters more than duration

For Different Goals

Goal Consider
General stress Basic mindfulness
Anxiety MBSR-style body awareness
Depression history MBCT (with qualified provider)
Blood pressure Consistent daily practice (any type)
Better focus Focused attention practice
Emotional warmth Loving-kindness

What This Means for Coaches

  • Any practice is better than none: Don't overcomplicate the choice.
  • Match to client: Some prefer structure (apps, programs); others prefer simplicity.
  • Start small: 5 minutes daily beats 30 minutes never.
  • Refer appropriately: MBCT for depression should involve trained providers.
  • Manage expectations: Meditation isn't magic. Modest effects, requires consistency.

Key Takeaway

Different meditation modalities have different evidence bases, but for most coaching purposes, any consistent practice produces benefits: the key is finding an approach the client will actually do regularly.


References

  1. Goyal M, et al. Meditation Programs for Psychological Stress and Well-being. JAMA Intern Med. 2014.
  2. Kuyken W, et al. MBCT vs. maintenance antidepressants for relapse prevention. Lancet. 2015.
  3. Brook RD, et al. Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure. Hypertension. 2013.
  4. Creswell JD. Mindfulness Interventions. Annu Rev Psychol. 2017.