Exploring the effectiveness of mindfulness-based and third wave interventions in addressing self-stigma, shame and their impacts on psychosocial functioning: A systematic review

Self-stigma and shame are overlapping experiences that can have significant negative effects on many areas of life. This systematic review aimed to determine the effectiveness of mindfulness-based and third wave interventions in addressing self-stigma and shame and the impact of these interventions on psychosocial functioning areas including community participation, quality of life, wellbeing, vocational achievement, help-seeking behavior, relationships and psychological health. Adverse effects were also reviewed. A search was completed using six electronic databases, two trial registries, contact with subject matter experts and a hand search of reference lists of included studies to identify randomized controlled trials of relevant studies. Twenty nine studies were included in the review, comprising 2051 participants, the majority of whom identified as female (73.4%), white and adults less than 40 years of age. Most studies took place in North American or European countries. The majority of studies were assessed as having high risk of bias using the Cochrane Risk of Bias tool. Caution is therefore advised in interpretation. Results suggested that interventions aiming to enhance self-compassion or those based on acceptance and commitment therapy may have particular utility in addressing self-stigma and shame. Mindfulness-based and third wave interventions may also have a positive impact on quality of life and aspects of psychological health. Implications for practice and future research are discussed.