Mindfulness Training Cuts Stress and Rumination While Boosting Resilience in Major Depression: German Trial
Germany: A German clinical trial has shown that mindfulness-based emotion regulation training (MBERT) not only reduces stress and rumination in patients with major depressive disorder (MDD) but also strengthens resilience against stress triggers in everyday life.
The findings, published in Scientific Reports, suggest that improvements in self-efficacy, self-kindness, and mindful distancing act as key drivers of change, working together to lower stress levels and reduce vulnerability to negative thoughts, even in the face of stressful situations.
The study, led by Hendrik Laicher and colleagues from the Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, used ecological momentary assessment (EMA) to capture real-time data on patients’ daily experiences. This approach enabled the researchers to track how psychotherapy-related changes unfolded outside the clinical setting, offering a clearer picture of how treatment works in daily life rather than just before-and-after comparisons.
The trial included 40 adults with diagnosed MDD who either received an eight-session MBERT or continued with treatment as usual (TAU) before switching groups. Each session lasted about 60 to 90 minutes and involved a structured four-step strategy—focused attention, benevolent acceptance, cognitive reappraisal, and mindful distancing. Over the course of the intervention, participants recorded their levels of stress, rumination, self-efficacy, self-kindness, mindful distancing, and sleep quality twice daily using EMA. A total of 4,925 data entries were analyzed.
The following were the key findings of the study:
- MBERT was more effective than TAU in reducing rumination and stress.
- The intervention led to notable improvements in self-efficacy, self-kindness, and mindful distancing.
- Sleep quality improved more during MBERT compared with TAU.
- The psychological resources of self-efficacy, self-kindness, and mindful distancing reinforced each other, creating a ripple effect that predicted lower stress in subsequent assessments.
- Patients became less sensitive to stress-inducing factors, including internal worries and difficult social interactions, as therapy progressed.
The temporal patterns observed highlighted that the cultivation of self-kindness, self-efficacy, and mindful distancing preceded and predicted reductions in stress levels. This finding, according to the researchers, positions these variables as “motors of change” in psychotherapy. In practical terms, strengthening these skills could offer patients enduring protection against relapse and sustained improvement in daily functioning.
Laicher and his team emphasized that the effectiveness of MBERT lies in its ability to extend benefits beyond clinical sessions into patients’ everyday lives. By reinforcing healthier ways of responding to stress and reducing the cycle of rumination, the intervention provides an evidence-based pathway to enhance psychotherapy for depression.
"The study highlights the value of integrating mindfulness-based strategies into treatment for MDD. With its real-world approach, the research offers a compelling case for therapies that not only address symptoms during structured sessions but also equip patients with tools to navigate daily challenges more effectively," the authors concluded.
Reference:
Laicher, H., Woloszyn, L., Wiegand, A., Kroczek, A., Sippel, D., Lawyer, G., Torka, F., Nieratschker, V., Rubel, J., Fallgatter, A., Ehlis, A., & Rosenbaum, D. (2025). Temporal dynamics of CBT emotion regulation training in patients with major depression using ecological momentary assessment. Scientific Reports, 15(1), 1-17. https://doi.org/10.1038/s41598-025-16344-3
