Mindfulness-Based Stress Reduction (MBSR): How It Works, Cost, & What to Expect

What Is MBSR Therapy?

MBSR is an eight-week group course involving purposeful instruction and activities designed to help you develop and draw on your inner resources to respond to life’s challenges.² Through MBSR training, people learn to respond calmly and thoughtfully to difficulties rather than reacting in unhelpful ways or remaining stuck in them. Regardless of the setting, standardized courses are conducted by trained leaders with the same structure and content.

MBSR therapy programs involve:^4,5,6,7

• Eight weeks of classes either in person or live online, each two and a half hours in length
• One day-long retreat after the final class session
• Daily homework consisting of guided audio practices and a variety of exercises completed individually outside of the structured group class
• Approximately 10 to 40 participants per session, sometimes all experiencing the same challenge (such as anxiety) and other times involving a mix of problems
• Education in mindfulness, meditation, and the nature of difficulties
• Group discussions
• Yoga and other gentle stretching and mindful movement exercises

In helping people use mindfulness to see and accept things as they are rather than imposing negative judgments and worries about what might happen, or ruminations about things that have already happened, MBSR helps people change their relationship with their problems in order to live well.^4,9

What MBSR Therapy Can Help With

Research has revealed many benefits of MBSR, including improved overall health, decrease in psychological distress, and a reduction in suffering associated with medical symptoms.⁴ Through MBSR training, people learn to recognize their mental and physiological responses to stress before they become problematic.²

In becoming aware of problems and symptoms early and observing them neutrally and objectively rather than emotionally and negatively, people are empowered to choose their response. While a primary purpose of MBSR is to reduce symptoms of conditions like chronic pain, stress, anxiety, and depression, the program doesn’t claim to eliminate or medically treat problems; instead, it changes our emotional responses to a range of difficulties by shifting how we perceive and think about problems.⁸

MBSR has been found to help with such experiences as:^4,5

• Stress
• Anxiety
• Depression and mood disorders
• Sleep difficulties
• Mental health difficulties in chronic illnesses like cancer, diabetes, high blood pressure, arthritis, autoimmune disorders, and other medical conditions
• Chronic pain

Mindfulness Based Stress Reduction Techniques

During an MBSR course, participants learn and practice mindfulness, meditation, and yoga.⁹ Together, these research-backed approaches to wellness help people acknowledge and remain aware of challenges while separating themselves in order to live fully in each moment. During the eight-week course, people learn how to notice thoughts, emotions, and physical sensations while remaining calm and detached.¹⁰

Techniques used in MBSR include:

• Deep breathing: People learn to control and concentrate on their breathing as slow deep breathing helps deactivate the sympathetic nervous system, responsible for the fight-or-flight/stress response. Breathwork activates the parasympathetic nervous system, associated with a state of calm relaxation.¹³
• Mindful body scans: These are a key component of MBSR programs, helping people become aware of stress, tension, and pain held in the body and purposefully relaxing those areas and quieting the body’s stress reaction.
• Informal and formal mindfulness meditation: Formal mindfulness meditation and informal mindfulness practices both involve focused concentration on something in the present moment, such as a sound, sight, texture, physical sensation, or the breath; however, while mindfulness is a way of experiencing life “on the go,” meditation involves time spent intentionally devoted to focusing attention.¹⁴
• Seated and walking meditations: These help people calm their mind, relax their body, and shift their focus away from problems. In general, meditation helps people pause and remain calm in the face of challenges rather than instantly reacting with strong emotions.
• Stretching and mindful movement practices, including yoga: Yoga is a practice involving mindful movement, concentrating on the breath and postures to unite mind and body in order to increase both mental and physical health.¹⁵ Practicing yoga purposefully and mindfully helps people achieve and maintain a state of calm awareness and overall wellness.
• Group dialogue: Discussions in the group setting focus on ways to increase mindful attention in everyday life.
• Gratitude journaling: Writing down things you are grateful for each week, whether they are large or small, can increase mindfulness and happiness, and is a practice that is often incorporated into MBSR.

Is Mindfulness-Based Stress Reduction Effective?

Mindfulness-based stress reduction has been shown to be effective for many different people and challenges. It is the most researched mindfulness program to date, and findings have been positive, with participants in numerous studies reporting improved wellness and diminished distress after completing a program.⁴

Here are some of the studies backing up MBSR as an effective treatment style:

• Report published in the Journal of Psychosomatic Research (2004): Researchers analyzed 20 different empirical studies examining the effectiveness of MBSR for general stress as well as a variety of clinical conditions, including cancer, heart disease, chronic pain, depression, and anxiety. Across the board, MBSR was found to help people develop and maintain healthy coping abilities.⁶
• Study by the Mayo Clinic (2010): Researchers followed 16 participants before and after completion of an MBSR program and concluded that this structured mindfulness-based program significantly improved quality of life, mental, physical, emotional, and spiritual well-being, and level of social activity. Further, participants reported positive changes in their ability to cope with pain, fatigue, external support, and financial or legal concerns.¹⁶
• Study review in Journal of Psychiatric Practice (2012): The analysis revealed overwhelming evidence that MBSR is effective in reducing anxiety, depression, and perceptions of pain. It also found that MBSR contributes to better stress management in both healthy individuals and those with mental or physical illness, boosting overall mental health in both populations.¹⁷
• Report and critical review of well-designed trials (2017): They found mindfulness-based interventions, including MBSR and its offshoot known as mindfulness-based cognitive therapy (MBCT) are helpful in improving stress, anxiety, depression, risk of depression relapse, chronic pain, and overall quality of life. MBSR was also revealed to be at least as effective as cognitive behavioral therapy (CBT) and more effective than health education, relaxation training, and non-evidence-based supportive psychotherapies.¹⁰

Are There Any Side Effects to Participating in MBSR?

An advantage of MBSR is that it is well-tolerated.¹⁰ There are no known unpleasant side-effects; therefore, people tend to comply with and complete the program. In addition to its lack of side-effects, MBSR is beneficial in boosting people’s ability to manage their symptoms and increase well-being.⁵

Risks of MBSR

While there are no known risks specific to the program, there are general risks involved with meditation and yoga, integral components of MBSR. As with any practice involving movement, yoga carries risk of injury. If you have been diagnosed with health conditions, including any type of back injury, severe osteoporosis, blood pressure issues, eye problems like glaucoma, balancing difficulties, or are pregnant, yoga may require modifications or not be safe to perform.^18,19

Meditation, too, is not without risk. Some people experience heightened anxiety, panic, or other negative emotional reactions to memories of past trauma that may surface as they develop heightened awareness of feelings and thoughts.^20,21,22 If such reactions happen in a group setting—and especially if the format is a live online class—it may be difficult for the leader to properly react and respond.²⁰

Criticisms of MBSR

While research into MBSR is largely positive and encouraging, some mental health professionals are concerned that the hype may be insubstantial. A primary concern is that mindfulness-based interventions like MBSR are being touted as miraculous antidotes to problems. Being aware of the particular risks and criticisms of MBSR can help you approach the program with openness and realistic expectations.

One report raised the following concerns about mindfulness-based interventions like MBSR:²⁰

• Not every study is a high-quality, randomized controlled clinical trial, thus weakening some of the evidence in favor of MBSR as an effective approach to well-being.
• While MBSR claims to be useful for a broad range of problems and experiences, in reality, there are individual differences that influence the effectiveness of any given intervention.
• What works great for some people may not work well for others. This caveat applies to any approach to mental or physical health, and MBSR is no exception.

A study appearing in 2020 in Clinical Interventions in Aging examined the effectiveness of mindfulness approaches for 28 people over the age of 55 who had been diagnosed with mild cognitive impairment (and thus at risk for dementia) and experiencing symptoms of depression. While MBSR improved many participants’ cognitive functioning and depression immediately following completion, the cognitive improvement did not last over time. The MBSR program was not completely useless as it did help with depression; however, it clearly has limitations.²³

Benefits of MBSR Therapy

Research has proven mindfulness to be incredibly beneficial. MBSR can be helpful for: 

• Pain relief: Mindfulness has been shown to significantly reduce pain in both experimental and clinical settings.²⁴
• Stress management: MBSR has been shown to be effective in reducing stress due to chronic illness and daily life challenges.²⁵
• Reducing anxiety & depression: Mindfulness-based interventions have been shown to be effective in reducing symptoms of anxiety and depression. Outcomes of MBSR therapy are comparable to CBT, a gold-standard intervention for treating anxiety and depression.²⁶
• Bias reduction: Mindfulness practice has been shown to help people release unhelpful belief systems, including biases based on age and race.²⁷
• Cognitive improvements: MBSR has been shown to improve long term memory and attention, making it a beneficial treatment for people with ADHD.²⁸

MBSR Examples

MBSR has been demonstrated to be helpful for different people living with a range of challenges, both diagnosed illnesses and general life experiences like stress.

The following examples provide an overview of MBSR in specific situations:

MBSR For Anxiety

Mindfulness-based stress reduction improves anxiety disorders like generalized anxiety disorder, social anxiety disorder, panic disorder, and agoraphobia.^4,8 MBSR changes the way people think about situations, helping them focus on the present instead of the past or future. It also heightens awareness of negative thought processes to help people identify anxious thinking and reactions early in order to detach and remain centered and calm.

MBSR For Chronic Pain & Illness

While MBSR does not treat or cure mental or physical illness, the strategies and lifestyle changes learned in the course do help people cope with chronic conditions. The program has been shown in studies to improve the quality of life for people living with chronic pain, immune disorders, cancer, diabetes, fibromyalgia, arthritis, and other long-term health issues.^4,5

Yoga also helps reduce physical symptoms, while meditation and mindfulness information and exercises help people distance themselves from their symptoms and use present-moment awareness to shift focus. In increasing coping skills and movement, MBSR helps people with chronic pain and/or illness be more active and live life more fully.

MBSR For Veterans

Anxiety, pain, and depression are common experiences among veterans, but medication is not always 100% effective and, in the case of opioid painkillers, can carry the risk of addiction. Fortunately, researchers looking for helpful ways to improve military veterans’ physical and mental health found MBSR to be effective.²⁹ Participants in a 2014 study experienced decreased anxiety, depression, and suicidal ideation and reported improved overall mental health.²⁹ MBSR is convenient and easily implemented in VA settings so is truly a viable option to offer veterans to boost quality of life.

MBSR For Stress

Stress is a pervasive global health problem that contributes to mental health disorders and medical illnesses; however, MBSR can effectively decrease stress in both otherwise-healthy individuals and people living with diagnosable mental or medical illness.⁹ Mindfulness training, meditation, yoga, and educational information about stress learned during MBSR courses helps people reduce negative symptoms of stress (physical, emotional, and cognitive) and changes the way they think about problems in order to improve overall well-being.

How to Find a Mindfulness-Based Stress Reduction Program

MBSR programs are offered in hundreds of hospitals in the US and worldwide. Such programs are also offered in clinics, universities, community organizations, and online organizations. When offered online, MBSR programs consist of live group instruction and interaction via a platform like Zoom. Most MBSR programs are open to the public.

Additionally, MBSR workbooks are available for independent, home study. While these can be helpful, they’re not designed to completely replace formal MBSR instruction as there are many benefits gained from the interactive group format.

What to Look for in an MBSR Course

Consider looking for an MBSR course that:

• Is facilitated by a certified instructor
• Holds regular group meetings, including group discussion
• Emphasizes the importance of incorporating mindfulness practices into daily life
• Has a moderate class size that allows participants to experience the benefits of the group dynamics as well as the individualized attention of the facilitator
• Is educationally-focused, rather than therapeutic

Does Online MBSR Work?

Online MBSR can be a valuable resource, especially for those who have limited financial resources or who live in areas where in-person MBSR groups are not available. By engaging with an MBSR group virtually, you can connect with people from all over the world for video-conferencing groups, and have flexibility to watch course videos and guided meditations online.

However, online MBSR might not be for everyone. Some people might find it difficult to feel engaged and connected virtually, and prefer in-person interactions. Others find it more challenging to complete an online course, without personal accountability and social relationships spurring them on.

Cost of Mindfulness-Based Stress Reduction

The cost of a structured MBSR group program is set by the hospital, clinic, or other organization offering it. In general, it ranges from about $300 to $650 for the entire 8-week program, including the final retreat and course materials.

A few examples of programs with pricing listed online include:

• Full cost of $650 and discounted cost of $555 (for certain health plan members) at the University of Massachusetts (UMASS)³⁰
• Full cost of $620 and discounted cost of $570 (if payment is made in full 30 days before the start of the program) at the the University of California San Diego (UC San Diego)³¹
• Full cost of $300 or $100 with a financial need-based scholarship at the University of Arkansas³²
• $567 standard cost, $297 for low income participants, or $723 for people who wish to contribute to a scholarship for low income participants plus and options $149 additional fee for a 45-minute one-on-one coaching session at MindfulLeader.org³³

History of MBSR

MBSR is the original, secular, structured group program teaching mindfulness, meditation, and yoga as a way of coping with difficulties and improving well-being and quality of life, laying the foundation for similar programs like mindfulness-based cognitive therapy.⁴ Jon Kabat-Zinn, largely credited with introducing mindfulness to the Western world, developed the program in the 1970s at the University of Massachusetts Medical Center.⁵

Final Thoughts on MBSR

Whether you are living with a mental health condition, chronic illness or pain, or are otherwise healthy but experiencing stress, a structured MBSR program (in person or online) can make a positive difference in your well-being. It puts you in charge of your thoughts, feelings, actions, and experiences so you can take control back from stress, anxiety, depression, pain, or other illness and disease.