Effectiveness of Individual and Group Counseling in Reducing Depression Through Mindfulness

Abstract

This meta-analytic study aimed to estimate the overall effect size of individual and group psychological counseling programs in reducing depression, while testing the mediating role of mindfulness as the psychological mechanism linking therapeutic intervention with measurable emotional improvement.

Following the PRISMA 2020 protocol, over 1,200 primary studies were screened from Scopus, PubMed, PsycINFO, ERIC, and Dar Al-Mandhumah databases, covering the period from 2015 to 2026. After applying rigorous PICOS-based inclusion and exclusion criteria, 53 experimental and quasi-experimental studies were included in the final analysis, encompassing a total sample of over 4,800 participants from diverse cultural settings.

Results revealed a large overall effect size for counseling programs in reducing depression (Hedges' g = 0.87, 95% CI [0.74, 1.01], p < 0.001), alongside a moderate effect in enhancing mindfulness levels (g = 0.63, [0.51, 0.75]). Meta-analytic structural equation modeling (MASEM) confirmed that 41.3% of the total counseling effect on depression was mediated through changes in mindfulness (indirect effect β = −0.31, p < 0.001). Subgroup analyses indicated that group-based mindfulness counseling demonstrated stronger mediation pathways compared to individual counseling (g = 0.94 vs. g = 0.79), though both remained statistically significant. These findings mandate the integration of mindfulness techniques as a structural — not supplementary — component of counseling protocols