The Subjective Experience of Greek Women Attending a Mindfulness-Based Stress Reduction Program

Highlights

• Certified, experienced instructors and group dynamics play a pivotal role in participant engagement and the sustainability of mindfulness practice.

• Participants faced diverse barriers and facilitators to participation, reflecting individual differences despite common challenges.

• The online delivery format was strongly preferred for its convenience, though some benefits of in-person participation were also recognized.

• While many benefits of mindfulness practice were reported, challenges remain in maintaining these practices long-term. Future interventions could focus on enhancing ongoing support and addressing barriers to sustained adoption.

• This research contributes to culturally adapting mindfulness-based interventions in Europe, emphasizing cultural sensitivity as crucial for effective implementation and acceptance.

Introduction

Modern life, marked by rapid technological advancements and fast-paced lifestyles, has significantly contributed to increased stress levels, particularly in Western societies. Although contemporary humans are no longer threatened by wild animals, stressors such as digital overload, excessive screen time, work demands, work-life imbalance, economic concerns, high cost of living, urbanization, a sense of security, health concerns, relationships, and other social factors seem to place more pressure on individuals than ever before (American Psychological Association, (APA), n.d.). Under these conditions, psychology recognizes that focusing solely on treating psychopathology is insufficient for leading individuals to well-being and thriving, as mental health encompasses far more than merely the absence of illness (Hefferon & Boniwell, 2019; World Health Organization, n.d.). Furthermore, the limitations of managing chronic pain and various diseases solely with pharmacological interventions have led to a search for new approaches. In recent years, considerable emphasis has been placed on the so-called “third wave” of Cognitive Behavioral Therapy (CBT), of which mindfulness is a fundamental component (Hayes & Hofmann, 2021).

This study aimed to investigate the effectiveness of a mindfulness program for adult Greek women and the benefits that the introduction of such practices may bring to individuals’ daily lives. Its contribution is deemed significant, given that the study was conducted on populations or nationalities that have not been adequately studied, such as Greece. A literature review revealed no qualitative studies on this topic in the country. The utilization of mindfulness practices, both in CBT and Positive Psychology, as well as an extensive related literature in the last fifteen years, indicates research community acceptance and the importance of mindfulness as a research subject (American Mindfulness Research Association, 2024; Hayes & Hofmann, 2021; Hefferon & Boniwell, 2019).

Mindfulness: Definition and Conceptualization

Mindfulness refers to the conscious awareness of internal and external states, including sensations, thoughts, emotions, behaviors, and surroundings (APA, n.d.). This awareness arises from deliberately observing events and situations as they unfold in the present moment, adopting a stance of curiosity, openness, and non-judgment. Viewing situations through this lens and with a “beginner’s mind” allows individuals to more easily recognize dysfunctional thought and behavior patterns and gradually develop the ability to respond consciously, rather than react automatically and unconsciously (Kabat-Zinn, 2003).

The Mindfulness-Based Stress Reduction (MBSR) Program: History and Structure

As previously mentioned, mindfulness is a skill, and like all skills, it can be cultivated. One of the most well-known, structured mindfulness interventions is the “Mindfulness-Based Stress Reduction” program (MBSR) (Kabat-Zinn, 1990). The MBSR is an eight-week structured mindfulness protocol developed by Professor Jon Kabat-Zinn (1982) at the University of Massachusetts Medical Center (UMass Memorial Medical Center). Influenced by Buddhist philosophy, Kabat-Zinn aimed to introduce Buddhist practices (stripped of their religious elements) into the Western world, which until then primarily relied on pharmacotherapy as a therapeutic approach (Palaiologou, 2019).

The intervention began in 1979, with the goal of managing chronic pain through a ten-week pilot mindfulness program with 51 patients who could not find relief through traditional medical care (Kabat-Zinn, 1982). Beyond significant pain reduction (half of the participants reported up to a 50% decrease in pain), there was also notable improvement in mood and stress reduction. These encouraging preliminary findings laid the foundation for the development of the MBSR program and the finalization of the protocol as it is used today.

In the MBSR intervention, the structured protocol developed by Jon Kabat-Zinn is utilized (Santorelli et al., 2017). Groups are formed, and meetings lasting 2-2.5 hours are conducted consecutively over eight weeks. The program also includes a full-day practice meeting. More specifically, MBSR involves training in mindful breathing, mindful eating, active listening, introducing awareness into daily routine activities (open awareness), body scan meditation, mindful walking, mindful movement, loving-kindness meditation, psychoeducation, and group dialogue. After each meeting, participants receive the necessary weekly materials (instructions, structured recording journals, and audio meditations in MP3 format) for further practice throughout the week, aiming to incorporate the practices into their daily lives.

Mindfulness practices are divided into formal and informal practices. Formal practices refer to strictly structured activities for which one must dedicate specific extra time for practice, such as meditations, while informal practices are those that can be integrated into any activity, such as introducing awareness into daily routines, mindful walking, or mindful communication (Santorelli et al., 2017).

Adaptations and Applications of MBSR

The increasing popularity of MBSR has also led to modifications for better application in more specific contexts. Such variations include mindfulness interventions for school environments (Mindfulness-Based School Interventions), the MBCT-D program (Mindfulness-Based Cognitive Therapy for Depression), which is tailored for individuals with a history of depression, and the MBCT-L program (Mindfulness-Based Cognitive Therapy for Life), which is applied to healthy populations (Kabat-Zinn, 2003; Oxford Mindfulness Foundation, n.d.; Phan et al., 2022; Segal et al., 2012; Sibinga et al., 2016; UMass Memorial Health, n.d.). The structured nature of the MBSR protocol makes it suitable for scientific study compared to other therapeutic or empowerment methods, while its various adaptations underscore the necessity of introducing such interventions in multiple settings.

Literature

The purpose of this literature review is to synthesize existing research on Mindfulness-Based Stress Reduction (MBSR), focusing on its benefits, participation factors, and long-term effects, to provide a comprehensive understanding of its impact and applicability.

Benefits and Outcomes of MBSR on Various Populations

As a prominent stress management intervention, MBSR is widely used for alleviating anxiety disorders. A qualitative study in Sweden investigated the program’s effectiveness through semi-structured interviews and thematic analysis. Emerging themes indicated that MBSR is an effective stress management practice, providing a sense of greater calm and ease, improving task engagement and completion (previously hindered by stress), leading to a more objective recognition of reality, and creating an overall sense of improvement (though not achieving the ultimate desired outcome by the program’s end). Most participants integrated the practices into their daily lives, reporting stress relief and a heightened sense of personal agency, with some also noting increased acceptance of anxiety and self-compassion (Schanche et al., 2020).

Beyond its classic application for stress management, MBSR has shown promising results in other contexts as well. A recent qualitative study used the program to alleviate post-traumatic stress disorder (PTSD) and depression symptoms among 18 Black immigrant women who were victims of domestic violence (Vroegindewey & Sabri, 2022). The study revealed elements of empowerment, with participants reporting benefits in self-compassion, self-realization, motivation for personal progress, and development of positivity and optimism. Additionally, participants experienced increased relaxation, self-care, self-awareness, self-control, and focused thinking.

Although MBSR has mostly been studied as an intervention for symptom relief in vulnerable groups, it is also suitable for application in healthy populations as an empowerment tool, increasing life satisfaction and other positive indicators (Flugel Colle et al., 2010). A meta-analysis by Chiesa & Serretti (2009) examined MBSR’s effectiveness among healthy individuals, finding general effects in stress reduction and spiritual enhancement. MBSR was also shown to reduce rumination and anxiety while increasing empathy and self-compassion. A later meta-analysis re-examined MBSR’s effectiveness in healthy populations (Khoury et al., 2015). Including 29 quantitative studies (N = 2.668), the results indicated a strong effect on stress reduction, moderate effects on anxiety, depression, distress, and quality of life, and a slight effect on occupational burnout. Another study among healthy volunteers attending a community clinic in the U.S. found significant reductions in stress and anxiety symptoms, alongside notable increases in mindfulness and awareness (Evans et al., 2011).

Mindfulness programs are also becoming increasingly popular in workplace settings. A recent study evaluated MBSR’s effectiveness in a work context, assessing its impact on social capital and safety perception within the workplace (Bonde et al., 2023). Results showed slight improvements in intra-group and employee-management connections, with greater improvement in interdepartmental collaboration. Partial improvement was noted in safety perception, which had been strained before the intervention.

Another workplace study focused on the benefits of MBSR for teaching staff. Among 36 high school teachers, MBSR completion led to significant benefits in self-regulation, self-compassion, and awareness skills, as well as improvements in sleep quality (Frank et al., 2015). Psychiatric nurses also experienced reductions in occupational stress, anxiety, depression, and other distressing emotions, with improvements in mental health outcomes (Yang et al., 2018).

Janssen et al. (2018) conducted a meta-analysis on MBSR in work settings, finding reductions in burnout, stress, depression, and job-related anxiety. Improvements were noted in mindfulness capacity, goal achievement, self-compassion, sleep quality, and tranquility. A subsequent study led by the same researcher on teachers showed sustained positive outcomes in mindfulness (greater observance and reduced reactivity), work engagement, sleep, mental health, and work-life balance, with long-term benefits. Although job perceptions and performance remained unchanged, teachers felt more equipped to manage their workload, finding that incorporating mindfulness allowed them to mentally disengage from work during rest hours, thus reducing psychological strain (Janssen et al., 2023). A study on nursing staff (N = 70) found that MBSR’s enhancement of focus and stress reduction also led to fewer errors on the job—a significant and encouraging finding for using the program in high-stress work environments (Daigle et al., 2018).

In an original study, Khaddouma et al. (2017) were the first to explore the improvement of romantic relationship quality following MBSR. Results showed that participants improved in all aspects of mindfulness and enhanced their communication skills, while their non-participating partners reported no significant improvement in these areas. Nevertheless, both partners experienced increased overall relationship satisfaction.

The COVID-19 pandemic spurred applications of MBSR for stress management. A quantitative study conducted among Italian women during the first lockdown (Accoto et al., 2021) found that participants in the MBSR group reported greater self-acceptance, recognition of life’s meaning, and improved interpersonal relationships compared to the control group. Higher mindfulness scores were associated with high psychological flexibility, which correlated positively with psychological well-being. The researchers concluded that MBSR was exceptionally supportive during the stressful and unpredictable context of the COVID-19 lockdown.

Although activities have largely returned to normal post-COVID-19, many businesses and educational institutions continue to offer online MBSR. A recent study compared the effectiveness of online versus in-person MBSR programs (Rice & Schroeder, 2021). Results showed high levels of trust in both formats, though in-person participants reported comparatively higher trust and satisfaction with the training. The researchers emphasized that trust-building is crucial in online environments.

Existing research consistently highlights the benefits of MBSR in reducing stress and enhancing psychological well-being across diverse populations. However, while these studies provide valuable evidence of positive outcomes, there remains a need for deeper understanding of how these benefits are experienced subjectively, particularly in specific cultural contexts such as the Greek population, which the current study aims to address.

Long-term Effects and Sustainability of Mindfulness Practice

The issue of maintaining mindfulness practices long-term and thus ensuring enduring benefits is a relevant one. Van Dijk et al. (2022) studied MBSR focusing on the long-term retention of mindfulness practices. Most of the 16 participants (who had completed MBSR two years earlier) continued to practice regularly, primarily through informal practices. From the thematic analysis, participants reported enhanced concentration and mindfulness during daily activities, changes in behavior, and greater enjoyment of everyday activities. Obstacles to initial integration included a lack of understanding of mindfulness benefits, while long-term maintenance barriers included practical, personal, and professional factors. This qualitative study extended the researchers’ quantitative study on the same sample (N=167), which had shown small to moderate improvements in mental health 20 months post-MBSR (van Dijk et al., 2017).

Lastly, a study by Cascales-Pérez et al. (2021) on healthcare professionals indicated that positive outcomes, such as a better quality of life, less burnout, improved mood, greater satisfaction, and a stronger sense of compassion towards patients, persisted 12 months after completing the program.

While long-term maintenance of mindfulness practices and their sustained effects have been explored in the reviewed literature, yet questions remain regarding the personal and contextual factors that support or hinder long-term adherence. This study contributes to this conversation by investigating the persistence of mindfulness practices and the factors influencing their sustainability within a specific cultural and social framework.

The Experience of Participating in the MBSR Program: Barriers & Facilitators

Exploring participant experience, Parra et al. (2019) conducted a qualitative study with 41 elderly participants (aged 65-85, mostly women). Thematic analysis highlighted benefits from MBSR, such as increased awareness and self-observation, greater acceptance, and improved family and social relationships. Challenges included time management for personal practice, while motivators for participation included social benefits and group environment. Participants also expressed a tendency to revert to previous routines over time.

The literature highlights the significant role of MBSR teachers in the participants’ experience and satisfaction. Appropriate training and personal meditation practice are emphasized as essential qualities. Teachers with higher levels of training and more extensive meditation experience are associated with delivering more effective sessions. Additionally, the individual affinity between participants and instructors is noted as a contributing factor to the overall success of the program (Ruijgrok-Lupton et al., 2018).

Finally, Schellekens et al. (2016) conducted a qualitative study on women with breast cancer, examining benefits and challenges in participating with other patients in an MBSR program. Initially, patients feared facing the suffering of others, but most found the MBSR atmosphere to be safe and supportive. The researchers concluded that participants gained significant benefits from the supportive group atmosphere. Moreover, MBSR has been shown to be effective in reducing stress, anxiety and depression across various populations, including women with cancer, further supporting its broad applicability and therapeutic value.

Research into participation in MBSR demonstrates a range of barriers and facilitators influencing engagement, including practical challenges such as time constraints and motivational factors. Despite this, there is limited knowledge about how these factors interplay within different demographic groups and how they shape the overall experience of participants. The present study seeks to fill this gap by exploring these dynamics in a Greek sample.

The Current Study

Mindfulness has been practiced in the United States for 45 years (Kabat-Zinn, 1982). Its widespread appeal has attracted the interest of the global scientific community, which demonstrates an ever-increasing “mindfulness towards Mindfulness.” Notably, over the past five years, 1,200 to 1,500 related scientific articles are published annually (American Mindfulness Research Association, 2024).

However, in Greece, certified trainers are few, with their presence only about a decade old (Mindfulness Institute, n.d.). There is a noticeable research gap in the Greek literature, and the majority of the Greek public is not only unfamiliar with the term “Mindfulness” but also not acquainted with its Greek equivalent, called “Ensiniditotita”.

Furthermore, internationally, quantitative studies outnumber qualitative ones. Most studies tend to examine the benefits of mindfulness interventions without delving deeply into the lived experience of MBSR, and relatively few studies address the long-term maintenance of results. The sustainability of positive psychology interventions, in general, has been a major critique of the field, making it worthwhile to examine the long-term effectiveness of this specific intervention (Wong & Roy, 2018).

Taking all the above into consideration, this study on the experience of attending the MBSR program and the subsequent adoption of its practices in daily life among a Greek population is deemed significant. This study aims to delve into the individual, subjective experience of Greek women who attended the MBSR program, focusing on both their attendance experience and the benefits that emerged, as well as the introduction and maintenance of mindfulness practices in their subsequent lives.

The research questions this study seeks to answer are:

1. “What was the experience of participating in the MBSR program?”
2. “What emotional changes did participants experience with the introduction of mindfulness into their daily lives?”
3. “Which areas of life, and in what way, were affected by the introduction of mindfulness into daily life?”
4. “What was the experience of introducing and maintaining mindfulness practices in participants’ daily lives after the program ended?”

Methods

Design

This study examined the concept of mindfulness, defined as the intentional, present-moment awareness of one’s experiences, as previously explored in depth. Specifically, the research qualitatively investigated participants’ experiences in the structured and scientifically validated Mindfulness-Based Stress Reduction (MBSR) program, evaluating its effectiveness and the sustained integration of mindfulness practices into their daily lives. The methodology employed was Interpretative Phenomenological Analysis (IPA), a qualitative approach designed for an in-depth exploration and interpretation of subjective human experiences (Smith & Osborn, 2008). Rooted in phenomenology, IPA examines how individuals perceive, experience, and make sense of their lived realities. This approach necessitates a dual interpretative process wherein the researcher interprets participants’ accounts, which themselves are interpretations of their lived experiences (Smith et al., 2009).

This methodology was chosen to qualitatively analyze the experiences of a Greek population unfamiliar with mindfulness, filling a gap in existing research. The study aimed to identify domains beyond stress potentially influenced by MBSR interventions, as suggested by prior literature, while exploring participants’ long-term adherence to mindfulness practices.

Participants

The participants were women with prior experience in the MBSR program. Eligibility criteria required that participants be Greek, adult women residing in Greece, who had completed the MBSR program within the preceding six months, with no diagnosed psychopathology or severe physical illness. These criteria ensured a homogenous and healthy population for the study.

The focus on Greek origin and residency accounted for cultural and religious influences on mindfulness acceptance and efficacy, as research suggests that cultural familiarity significantly affects intervention outcomes (Gargiulo, 2023; Tse, 2022). A total of 12 women met the inclusion criteria; however, one participant was excluded due to professional involvement with yoga. . The exclusion of this participant was deliberate, as it was important for the study participants to have no prior experience or professional involvement with mindfulness, ensuring novel exposure to the intervention. Ultimately, 11 women aged 20 to 51 participated.

Respondents were recruited through purposive sampling strategies (Smith et al., 2009). Five participants were identified via convenience sampling through a Call for Interest disseminated on social media (e.g., Facebook groups). The remaining six were recruited via snowball sampling, with confirmed participants referring to other participants who had completed the same MBSR program and expressed interest in the study. The participants voluntarily took part in the study, with no compensation provided for their involvement. Notably, out of the eleven participants, seven had attended the MBSR program free of charge, which suggests that the majority did not have a financial incentive influencing their motivation. This factor enhances the credibility of the findings by indicating that participant motivation was likely driven by personal interest and commitment rather than external rewards.

Recruitment of participants for mindfulness interventions such as MBSR in Greece was particularly challenging, as mindfulness is not yet widely practiced or familiar in the Greek context. Recent studies indicate limited dissemination and low prevalence of mindfulness programs in the general population. Furthermore, women tend to participate in such interventions in much greater numbers than men, making male recruitment even more difficult. This gender difference in participation has been linked to traditional masculinity norms and men’s reduced likelihood to seek psychological help or engage in social support groups, often due to difficulties in sharing emotions and seeking help (McKenzie et al., 2018).

The sample included women representing a broad age range, diverse educational backgrounds, and varying socio-economic status. Given this heterogeneity, any potential biases related to group homogeneity were limited mainly to shared aspects of the group process—such as the significance of the instructor and group cohesion—rather than the essence or long-term benefits of the intervention itself.

Materials

Data collection involved semi-structured interviews guided by predetermined questions aligned with the study’s objectives. This format allowed the researcher flexibility to adapt, refine, or expand questions during the interviews (Willig, 2015). The interview guide included 18 questions, ranging from demographic and general health inquiries to more substantive explorations of mindfulness practices. Flexibility in question phrasing ensured the interviews flowed naturally. All interviews lasted between 30–45 minutes and were audio-recorded using dual recording devices to ensure reliability. Introductory questions gathered demographic data, while closing questions facilitated participant reflections and summarized key points.

Procedure

After obtaining ethics approval from the Research Ethics Committee of Metropolitan College, Athens – Greece (protocol no. 3113/Ζ, dated 26/04/2024), and completing a pilot study, participants were contacted to schedule interviews. The pilot study clarified question phrasing and adjusted interview length, leading to the inclusion of two additional questions. Participants were provided with an Information Sheet, a Consent to Participate Declaration, and a Recording Consent Form via email, outlining the study’s purpose, confidentiality, and recording terms. Participants provided their consent and signed documents were returned electronically. Interviews were conducted online in private, quiet settings chosen by participants. Recordings were securely stored on an external hard drive, inaccessible to others, to safeguard confidentiality. Data transcription was completed in Word documents, with all personally identifiable information replaced by coded identifiers. Transcriptions underwent IPA, and findings were anonymized and aggregated.

The IPA process involved a systematic and iterative approach through several stages:

1. Initial noting: Each transcript was read multiple times to capture descriptive, linguistic, and conceptual comments. This phase involved detailed, line-by-line examination focusing on content, language use, and emerging interpretations. For example, participants’ remarks about feeling anxious about the personal exposure in the group setting were recorded in detail.

2. Developing lower-order themes: From the initial notes, lower-order themes were identified that distilled the essential experiential qualities in the data. Themes such as “Importance of the group and instructor,” reflecting expressions of group trust and motivation by the instructor, and “Challenges in maintaining practice,” including difficulties in finding time for daily exercises, emerged prominently.

3. Searching for connections across lower-order themes: Lower-order themes within each case were clustered into higher-order themes, identifying patterns, divergences, and interrelations. For instance, experiences of emotional changes were connected with themes of increased self-awareness and positive emotional regulation.

4. Moving to the next case: Each participant’s transcript was analyzed independently to maintain idiographic focus before cross-case analysis.

5. Looking for patterns across cases: After individual analyses, patterns and shared higher-order themes across participants were identified and synthesized into a final thematic structure representing the overall experiential landscape. Themes such as the integration of mindfulness into daily life and the perceived benefits in personal and professional domains were highlighted.

Reflexive practices were maintained throughout, with ongoing self-reflection and bracketing by the researcher to mitigate bias (Smith et al., 2009). To enhance validity, final thematic interpretations were shared with participants for member checking.

The lead researcher took the primary role in conducting the data analysis and interpretation. Close collaboration and supervisory oversight from the other two co-authors provided ongoing feedback, critical reflection, and contributed to the verification of emerging themes, ensuring the rigor and validity of the analytical process.

Ethical Considerations

The study adhered to the British Psychological Society (BPS) (2021), research ethics protocol for engaging human participants. Anonymity was strictly maintained by coding participants’ data, and all identifiable information was removed during transcription. Participants could withdraw from the study at any time without consequence, although no such requests were made. All data will be securely stored for three years post-study completion before destruction, as per protocol.

Reliability

According to Smith et al. (2009), to minimize bias and maintain the reliability of the IPA process, the researcher consciously reflected on and bracketed personal perspectives. Supervisory oversight was provided to ensure analytical rigor and mitigate the potential for subjective interpretation.

The lead researcher, a trained MBSR instructor, brought personal experience and a deep understanding of mindfulness practice to the study. While recognizing the benefits observed through the MBSR program, conscious efforts were made to bracket pre-existing assumptions and minimize potential biases. Critical reflection was maintained regarding the extent to which the results may be sustained long-term, which aligns with concerns noted in existing literature. Collaborative discussions and continuous reflexivity within the research team supported the trustworthiness and rigour of the findings throughout the analysis.

Results

The interview data collected from the participants were analyzed line by line to identify recurring patterns. To enhance validity, the final narrative was returned to the participants for verification, allowing them to confirm that the interpretation of the interviews and observations was accurate. No misunderstandings were identified. Through the application of IPA (Smith & Osborn, 2008), a collective understanding emerged, enabling the development of a theoretical framework from which five higher-order themes were identified based on the words of several participants and are analyzed below. Table 1 depicts these themes, their respective lower-order supporting themes, and representative meaning units. In the following sections, each of the higher- and lower-order themes is discussed, with sample supporting quotes provided.

The experience of participating in the MBSR program

In the first higher-order theme, four lower-order themes emerged which reflect the experience of attending the MBSR program.

Participation Barriers

Most of the factors identified were primarily related to the participants’ lack of knowledge about the program, its structure, its requirements, and the level of personal exposure it would entail in a group setting. As one participant explicitly stated: “I had some thoughts. I was wondering, what is this about? I also felt anxious that I might somehow feel exposed.” There was also a concern about their commitment—not regarding the weekly sessions but rather the consistency required for daily practice throughout the program. One participant remarked: “I hesitated, wondering if I could commit, if I could follow through with what would be asked of me.” The final inhibitory factor was the only one that persisted after the program began: finding time for daily practice. Adhering to the weekly practices assigned by the instructor posed a significant challenge. Nevertheless, all participants, recognizing the benefits, sought to engage with the practices as much as their daily routines allowed. One participant specifically stated: “I am self-employed, so I don’t have a stable schedule or fixed working hours.” Finally, it is worth mentioning that two of the eleven participants reported encountering no inhibitory factors at all.

Participation Facilitators

The motivating factors for participation appear to have prevailed for these individuals, as they ultimately decided to enroll in the program. Two primary facilitators mostly drove the participants. The first facilitator, which was also identified as the main reported benefit, was the need to manage heightened stress levels, which in some cases had reached pathological levels. As one participant noted, “The stress had become dysfunctional, especially in the workplace… It was creating problems that I believed could be avoided”. The second facilitator was the need for greater self-awareness and personal development. In this regard, it was mentioned, “My personal quest to learn new things,” and similarly, “I wanted, as a person, to organize my thoughts and emotions”.

The importance of the group and the instructor

The importance and value of the group and the program instructor emerged very strongly, leading to the decision to create a distinct third lower-order theme on this topic. Most participants had no prior experience with group settings, and those who did participated in therapeutic groups rather than psychoeducational ones, which do not require extensive personal disclosure. Without being specifically asked, all participants independently expressed how the interaction with the group and the instructor created a safe environment. In this space, they felt comfortable sharing, exchanging ideas, and expressing themselves freely without fear of judgment. This familiar and supportive atmosphere fostered a sense of belonging, making them feel that they were not alone in their experiences and that others were dealing with similar issues and concerns. The warm and pleasant climate of the group meetings played a crucial role in keeping participants motivated and committed to the process. It also made them eagerly anticipate each subsequent session. When discussing this aspect, participants often lit up with smiles, reminiscing fondly about the meetings. Regarding the group, participants shared: “I really enjoyed the group. I never felt awkward, even when expressing my own problems and issues. I looked forward to it every week” and “I wanted each meeting; I sought it out… how different we all are as people and how beautiful that is… The group dynamic unravels you, and over time you become one with the others… It makes you feel like you’re not alone”. On the significance of the instructor, a participant mentioned “For me, she was the best instructor because she helped us express ourselves freely and truly turned us into a group—essentially a family, I would say”, while another one stated that “The instructor was a huge push for me. She encouraged me in such a wonderful way. I think she struck a chord, as if she truly understood my needs”.

Building on these reflections, it is important to note that the MBSR programs were delivered by certified and experienced mindfulness teachers. The significance of the instructor’s role and the level of their training emerged not only as a key theme in the qualitative findings but also as a factor influencing participant engagement and outcomes. The teachers’ expertise in facilitating group dynamics and delivering the program content was deemed crucial by participants, highlighting the importance of properly trained instructors in mindfulness interventions.

The benefits of the online class

While some participants mentioned the advantages of in-person participation, all participants ultimately expressed a strong and clear preference for the online format. The atmosphere created and the quality of interaction, as previously discussed, outweighed the negative aspects typically associated with the online environment. As a result, the positives and the convenience offered by this modality prevailed. A participant noted: “I felt as if we were in-person, all together in one room, yet I had the comfort of being at home”. Another participant said, “Since the rest of the group was in Athens, I wouldn’t have been able to participate otherwise” a third one acknowledged that “The camera offers a sense of security in a way, allowing you to open up gradually”.

Emotional changes by introducing greater mindfulness into everyday life

The MBSR program may primarily aim to reduce dysfunctional stress, but the literature also highlights its benefits in enhancing positive emotions. Accordingly, in the second higher-order theme, two lower-order themes emerged, as all participants observed both a decrease in distressing emotions and, conversely, an increase in positive ones.

Reduction of negative emotions

The reduction in distressing emotions primarily concerned decreased stress, anxiety and irritability. Participants appeared to have developed an improved ability to recognize stress reactions, reevaluate challenging moments, and manage or accept them more effectively. Additionally, the belief that they now are in possession of the necessary tools to manage stress, gave them a sense of security, making them feel more confident and capable of facing any challenges that may arise. Specifically, a participant noted: “There are significant differences in my stress levels. I definitely recognize difficult moments more easily and accept them. They don’t scare me as much as they used to”, while another one mentioned: “Stress has become more manageable. Insecurity, fear, and irritability have decreased”.

Increase of positive emotions

Regarding positive emotions, participants reported significant improvements in enjoyment, gratitude, inner peace, and self-compassion. They appeared to be more capable of savoring and drawing positive energy from small, everyday moments and events that they previously overlooked. This shift contributed to increased inner calm and an overall uplift in their mood. Specifically, they stated “The sense of love for myself has grown—self-respect, love, and protection” and “I’m calmer. I focus on the present and savor everything, major or minor, that comes my way, something I didn’t do before. I’m also working a lot on gratitude”.

Fields of life affected by the implementation of mindfulness

It became evident that the development of mindfulness qualitatively influenced all aspects of the participants’ lives. Four lower-order themes emerged from the analysis of the interviews.

Benefits at workplace

Firstly, significant emphasis was placed on the benefits within the professional domain. Participants specifically reported marked improvements in workplace communication, which stemmed from their enhanced ability to observe and better understand what their interlocutors were expressing. They were also able to avoid internalizing negative elements and to create a mental space between stimulus and response. This allowed them to respond more skillfully, choosing functional reactions over impulsive ones. As a participant noted “I no longer react impulsively. In situations where I would have responded immediately before, I now pause, think, process, and discuss it with my partner”, while another one mentioned “The work domain was certainly impacted, which was the main focus and goal from the beginning. I feel significantly less stressed”. Beyond communication, participants were able to perceive their professional obligations more realistically and manage their time more effectively. This led to a reduction in workplace stress and an increase in productivity. They shared “I managed to organize myself better and evaluate and set boundaries for my use of social media. My work relies on social media, but I don’t spend as much time on them now”. Additionally, participants engaged in more artistic professions found themselves being more creative and enjoying their work more deeply. Specifically, they said: “The way I work now is quite different from the past and I experience my roles [as an actress] more meaningfully” and “It helps me in my work because, in theater, we strive for the truth of the role”.

Benefits in interpersonal relationships and communication

In this domain as well, improved communication through the use of mindfulness techniques and tools appears to have significantly contributed to enhancing the quality of familial, friendly, and romantic relationships. Participants reported an increased ability to understand and empathize with their loved ones, enabling more harmonious interactions. A key benefit of introducing mindfulness seemed to be achieving a balance between professional and personal life. Work-related stress ceased to intrude upon and burden participants during their free time, allowing them to feel lighter and more carefree throughout the remainder of their day. One participant specifically noted “In my free time, I no longer let work-related issues consume me or occupy space that doesn’t belong to them. In my personal communications, I am now able to manage my emotions and reactions in the moment, which allows situations and interactions to flow more smoothly”. Another participant mentioned “My relationship with my family has improved significantly, including with my parents and my broader social circle. I started setting boundaries; I refuse to be drawn into their chaos”. It was also acknowledged that “My family relationships were positively influenced. Even deeply ingrained dynamics that are usually difficult to change started shifting. Gradually, step by step, the relationship with my mother and sister began to transform”.

Increase in self-awareness

Although participants were not explicitly asked about this, nearly all of them reported an improvement in their ability to observe themselves and recognize their thoughts, emotions and automatic reactions. This enhanced self-observation, framed within an attitude of understanding and self-love, significantly reduced feelings of self-doubt and self-criticism, while fostering greater self-compassion. Participants acknowledged previously unrecognized aspects of themselves and felt more capable of confronting life’s challenges. Regarding this, one stated: “You reach another level of awareness, a deeper understanding of your emotions and of what you are experiencing”, while another one noted “…to see aspects of myself that I didn’t know existed. I feel a deep awareness of the present moment and my actions on a personal level, enabling me to create a safer future for myself”.

Cognitive implications

Finally, the introduction of mindfulness, combined with education on its theoretical framework, also led to cognitive advancements. Upon completing the program, participants were able to understand how the stress mechanism functions, more easily identify dysfunctional patterns, employ coping strategies, observe situations with greater detachment, and ultimately be more present in their own lives. As one specifically stated: “I have gained clearer knowledge about stress, how it works, and what kind of mechanism it is. It’s something that arises from within and can be controlled”. Another participant noted "I now have the tools, and I believe the most important is that I possess this knowledge".

Maintaining mindfulness practices in everyday life

While not diminishing the importance of the other research questions concerning the experience and benefits derived from participating in the MBSR program, the most significant aspect for the research—and especially for the participants’ subsequent lives—was whether, and to what extent, mindfulness and its practices were ultimately integrated into their daily lives in the long term. In this fourth higher-order theme, two lower-order themes emerged.

Mindfulness as a way of life

Mindfulness was described with enthusiasm by the participants, who referred to it verbatim as a “way of life.” All participants reported having incorporated mindfulness into their daily lives, not only as a formal practice but also more experientially, as a lens through which they view and respond to both internal and external circumstances. Their exact words were: “…I believe it will be there forever”, “I firmly believe that mindfulness is a philosophy of life that I have adopted and continue to integrate more and more into my life as time goes by” and "This is now the meaning of life… mindfulness is a tremendous gift you can give yourself to truly experience living".

Facing difficulty in finding time for longer practices daily

Despite recognizing the importance of approaching life in a mindful way, participants expressed difficulty in finding time for the daily practice of formal mindfulness exercises. The fast pace of life appeared to prevent them from engaging in longer practices as often as they would like. Specifically, one participant mentioned: “When I get carried away by the pace of life… I’m not as consistent as I would like to be” and another participant stated “There are always things emerging that throw me off schedule… but regardless, if I can’t practice one day, I make sure I practice the next one”.

Perceptions of the benefits of applying mindfulness in many contexts

The analysis of the interviews revealed an additional higher-order theme, highlighting participants’ perspectives on the broader benefits that could arise from the application of mindfulness in various contexts. All participants strongly supported the idea of raising public awareness about mindfulness and implementing related interventions across different settings.

Mindfulness Schools Interventions

The significance of introducing mindfulness programs in the school context was particularly emphasized. Specifically, participants stated that: “It should absolutely be taught from childhood. And to parents too… in the family environment as well” and “Since I’m a teacher myself, I believe that incorporating mindfulness into schools is a top priority”.

Homes and Open Care Centers for the Elderly

A second context that emerged was the potential significant contribution of mindfulness interventions to the elderly, particularly within nursing homes or community centers for senior citizens. One participant highlighted: “… illnesses, hospitals, losses, aging, death etc. In many of these situations, it’s beneficial to have a method that provides relief and helps you cope with everything”. Another one stated: "These people might feel like life is over, after moving in a nursing home. Mindfulness could help them enjoy the years they have ahead and find new meaning in life".

Discussion

This study aimed to delve into the individual, subjective experiences of Greek women participating in the MBSR (Mindfulness-Based Stress Reduction) program, focusing on their experience of attendance, the benefits that emerged, and the integration and maintenance of mindfulness practices in their daily lives thereafter. Building upon the study’s primary aim to explore the subjective experiences of Greek women participating in the MBSR program, it is important to situate this research within the broader context of counselling psychology in Europe. Given that much of the existing MBSR research has focused on Western populations, this study contributes valuable insights regarding cultural adaptation and applicability of mindfulness-based interventions within the Greek sociocultural framework. This cultural specificity not only enriches the understanding of mindfulness practice but also highlights the necessity of tailoring counselling approaches to diverse European contexts, thereby expanding the impact and relevance of MBSR in clinical and community settings across Europe.

Through the analysis of the interviews, five thematic categories emerged that addressed the four research questions posed. Participation in the MBSR mindfulness program was a transformative and highly enjoyable experience for all participants, with minimal inhibiting factors. Following their attendance in the program and the subsequent introduction of mindfulness into their lives, the participants experienced both emotional and cognitive changes, positively influencing all major areas of their lives. While all participants were convinced of the benefits and integrated mindfulness into their daily routines, they reported challenges in maintaining formal practices (meditations) that require more time for practice. Finally, the participants highlighted the importance of raising awareness of mindfulness among the general public and implementing mindfulness interventions in various social contexts.

Addressing the first research question, which explored the experience of participating in the MBSR program, most related studies focus on the outcomes of the intervention, with few examining the experience of the program itself. Hence, it was decided to investigate this aspect as well. More specifically, in the first thematic category, “The experience of participating in the MBSR program,” participants discussed both inhibiting and motivating factors for their participation.

The participation barriers included a lack of awareness about the program, a finding consistent with the study by van Dijk et al. (2022), which reported that participants initially had insufficient understanding of the program’s benefits. This is expected, given that the concept and term “mindfulness” are relatively unfamiliar to the Greek public. Another inhibiting factor was the limited time available for practice, a finding that aligns with the research by Parra et al. (2019), which highlighted challenges related to managing and finding time for individual practice. This issue is further examined in greater detail later.

As for the participation facilitators, this study identified the need for self-improvement and elevated stress levels as key drivers for participation. These findings differ from Parra et al. (2019), where motivating factors were primarily the social benefits and group environment. However, it is worth noting that their study was conducted with older adults, a demographic often experiencing isolation and loneliness.

Additionally, the findings of the present study can be interpreted as being indirectly aligned with existing literature. Considering that the program’s primary objective is stress reduction, it is reasonable to deduce that stress management constitutes a significant motivational factor for the majority of participants. Likewise, the pursuit of self-improvement can be regarded as a compelling incentive for individuals within the general population who choose to engage in such a program.

Regarding the value of the group and the instructor, a subtheme that emerged strongly across all participants, the present study aligns with the existing literature. In the study by Rice & Schroeder (2021), the results demonstrated high levels of trust in the instructor and the rest of the group, leading the researchers to emphasize the importance of building trust in group training and the high priority that should be placed on this aspect. Similarly, the research by Ruijgrok-Lupton et al. (2018) highlighted the importance of the group’s acceptance of the instructor, which appeared to be influenced by both the instructor’s training and the degree of personal affinity toward them. The significance of the instructor, as the orchestrator of the process, is also strongly emphasized in this study. The instructor is tasked with creating a group from individuals, cultivating the appropriate environment for the process to thrive, and ensuring that members feel comfortable sharing and interacting. Therefore, the instructor plays a crucial role in the quality of the experiential experience, particularly in online settings, which are inherently more distant. Finally, the research by Schellekens et al. (2016) agrees with the present study, highlighting the importance of the group, as it was found that, beyond the program itself, participants also benefitted from the interaction and sharing within a safe and supportive framework.

Regarding the clear preference expressed by participants in this study for the online format, this finding contrasts with the research by Rice & Schroeder (2021), where participants in the in-person experience reported significantly higher levels of trust and satisfaction with the training compared to those in the online format. However, this study also emphasized the importance of the instructor in both conditions. This data may lead to the conclusion that, when in-person participation is an option, it should be preferred. Nonetheless, it also suggests that the location of the program may be of secondary importance, as it is evident that the online experience provides significant benefits as well.

In response to the second research question, which explored the emotional changes resulting from the introduction of greater mindfulness into daily life, the findings revealed both a reduction in negative emotions and an increase in positive ones, findings that are consistent with existing literature. More specifically, regarding the reduction of negative emotions, this study found a significant decrease in stress, anxiety, and anger, along with an overall improvement in emotional regulation of difficult and stressful situations. These results align with the existing literature, which strongly emphasizes the emotional dimension (Chiesa & Serretti, 2009; Evans et al., 2011; Janssen et al., 2018; Khoury et al., 2015; Schanche et al., 2020; Yang et al., 2018).

Regarding the increase in positive emotions, participants in this study reported an increase in calmness, enjoyment, self-compassion, joy, self-love, gratitude, and an overall improvement in mood. The data collected aligns with existing literature, which frequently underscores not only the reduction of negative emotions but also the significant enhancement of positive emotions. (Accoto et al., 2021; Cascales-Pérez et al., 2021; Chiesa & Serretti, 2009; Flugel Colle et al., 2010; Frank et al., 2015; Janssen et al., 2018; Schanche et al., 2020; van Dijk et al., 2022; Vroegindewey & Sabri, 2022). To some extent, the reduction of negative emotions creates space for the cultivation and development of positive ones. The ability of being mindful naturally leads to focusing on the present, so the mind does not race to the future, creating negative, anxious scenarios, nor does it slip into the past, revisiting mistakes that provoke sadness and guilt (Kabat-Zinn, 1990). Focusing on the present through a lens of curiosity and non-judgmental observation creates the necessary distance between stimulus and response. This detached and more objective observation (not in the sense of cold detachment, but rather without letting emotions, past experiences, or beliefs distort reality) enables individuals to perceive events in their true proportions, rather than magnified, and respond functionally rather than reactively, leading, by its nature, to better mental balance.

In response to the third research question, which examined the life domains affected by the introduction of mindfulness, the results indicated that mindfulness had a multifaceted impact on the lives of participants, affecting nearly all aspects of their lives. In the professional domain, participants reported better organization of their tasks, as well as improved communication and interaction with colleagues in the workplace. Additionally, those engaged in creative professions noted increased creativity, enjoyment, and productivity. These findings align with the reviewed literature (Bonde et al., 2023; Cascales-Pérez et al., 2021; Frank et al., 2015; Janssen et al., 2018, 2023). However, this study did not report a decrease in errors during work, as was observed in the study by Daigle et al. (2018).

Interpersonal relationships and communication emerged as another significant area impacted by the introduction of mindfulness. Participants noted less tension and absoluteness in their communications with close ones, as well as an increased ability to express themselves and to listen and understand others. The improvement in their communication skills, in conjunction with better emotional balance (as previously discussed), led to enhanced family and friendship relationships. The results are consistent with existing literature (Khaddouma et al., 2017; Parra et al., 2019). Furthermore, the introduction of mindfulness into daily life enabled participants to mentally disengage from work during rest periods and to achieve a better balance between professional and personal domains, a finding that also aligns with the existing literature (Janssen et al., 2018, 2023; van Dijk et al., 2017).

Mindfulness training led participants to engage in better self-observation, allowing them to gain a deeper understanding of various aspects of themselves, including thoughts, emotions, and automatic reactions. These findings are consistent with the studies reviewed, which also show an increase in self-awareness, combined with greater acceptance of both themselves and the events around them (Parra et al., 2019; van Dijk et al., 2022; Vroegindewey & Sabri, 2022).

The benefits of participating in the program also had cognitive implications for the participants. The theoretical components of the training empowered participants by teaching them coping strategies, awareness, and self-regulation, which impacted all aspects of their daily activities. This finding is also consistent with existing literature (Evans et al., 2011; van Dijk et al., 2022; Vroegindewey & Sabri, 2022).

In response to the fourth research question, which explored whether and to what extent participants integrated and maintained mindfulness practices in their daily lives, the results showed that, overall, participants introduced mindfulness into their everyday routines, not only as techniques but also more profoundly as a way of life, a perspective, and an approach to both internal and external situations. In terms of practice, participants tended to maintain more informal practices, while the formal practices, requiring more time, were used less frequently or only when they felt a genuine need for them. This finding is consistent with the literature reviewed, where most participants in other studies also incorporated and maintained the practices learned, with a greater emphasis on informal practices (Cascales-Pérez et al., 2021; Janssen et al., 2018; Schanche et al., 2020; van Dijk et al., 2017, 2022). However, it is important to note that the participants in this study were interviewed just 1 to 3 months after completing the program, whereas data from the other studies were collected 6 to 20 months later.

Despite the acceptance of mindfulness and the adoption of its practices, participants in this study faced issues of consistency in practicing the formal techniques (primarily meditation), which require additional time. In the study by Parra et al. (2019), a tendency to relax and return to old routines was observed, while in the research by van Dijk et al. (2022), a few participants discontinued their practices long-term, citing difficulty in incorporating changes into their daily lives, with practical, personal, and professional barriers. These findings are somewhat premature to compare directly with the current study, as the interviews in this research took place only 1-3 months after program completion.

Although no corresponding research question was posed, participants, having experienced the practical value of mindfulness, shared their thoughts on the effectiveness of applying such interventions in various settings, particularly in the school environment and for elderly individuals in nursing homes and day centers. Only three of the eleven participants were mothers, so the mention of the school context did not arise solely from parenthood. It is hypothesized that these two contexts emerged because people of these age groups may lack either the maturity to assess the importance of mindfulness or the resources to stay informed about related initiatives. Therefore, it is difficult for such individuals to pursue this internally, and they may need external assistance. Additionally, participants mentioned that the development of skills that aid concentration and enhance emotional intelligence is an important life tool, and they expressed a strong desire to have been introduced to mindfulness earlier. Opinions from those who have participated in the MBSR program regarding future applications and extensions are a largely unexplored area in the research but represent a valuable aspect, as they come directly from individuals who have had this experience. This finding also aligns with the study by Parra et al. (2019), where participants similarly recognized the importance of and suggested ways to expand and apply mindfulness within community settings.

Beyond the effectiveness of any intervention, genetic factors play a significant role. It seems that some individuals have an innate tendency toward greater awareness (Worthen & Cash, 2024). These individuals, even without formal training, tend to experience less stress and depression and generally have better physical health. This type of mindfulness (trait mindfulness) may arise from genetic predisposition. A preliminary epidemiological study in adolescent twins revealed that mindfulness had a 32% genetic origin, while 66% was attributed to environmental factors, leading to the optimistic conclusion that mindfulness is a skill that can be cultivated (Waszczuk et al., 2015).

Conclusions

In conclusion, this study demonstrates that the Mindfulness-Based Stress Reduction (MBSR) program provided significant benefits for the participants. Despite initial reservations, the experience of participating in the program and the teachings received were widely embraced. As a result, participants enthusiastically integrated and maintained mindfulness practices in their daily lives, even though challenges related to formal practice persistence arose. The findings enrich existing literature and help address research gaps in mindfulness interventions.

However, several limitations should be acknowledged. First, the qualitative data analysis may include some degree of subjectivity, despite the researcher’s efforts to remain unbiased and the re-examination of themes by the other two researchers to enhance reliability. Additionally, the broad age range of participants (20-51) and the fact that they paid for the program, which may have led to higher motivation and commitment, may limit the generalizability of the findings. Furthermore, interviews were conducted only 1-3 months after program completion, limiting the ability to study the long-term sustainability of the observed benefits. Finally, all participants attended the full eight sessions of the MBSR program, demonstrating strong commitment and engagement. While their reported experiences were overwhelmingly positive, it is possible that individuals with neutral or negative experiences were less inclined to volunteer. This potential bias should be considered when interpreting the findings, as it may limit the diversity of perspectives captured.

Given the growing body of evidence supporting the effectiveness of mindfulness interventions, including MBSR, it is recommended to conduct more extensive qualitative and quantitative studies in Greece to capture the experiences of diverse populations that have not been adequately studied. Greece, geographically situated at the crossroads of East and West, possesses a distinct cultural identity that influences various aspects of life. Culture has been shown to play a significant role in shaping both the acceptance and effectiveness of interventions, including mindfulness-based programs (Tse, 2022). Future research should include male participants, different age groups (such as children and the elderly), and various settings (workplaces, refugee camps, etc.), as well as specialized populations (e.g., women survivors of abuse, cancer patients). Additionally, follow-up measures for the current participants would provide valuable insight into their long-term progress, while meta-analyses could identify key trends by consolidating results from similar studies.

Further adaptations, such as shorter meditation durations, could make the program more accessible to individuals with busy schedules. For instance, offering 10–15 minute practices rather than requiring participants to commit daily for more than 30 minutes, could prevent them from skipping their home practice entirely.

A comprehensive understanding of mindfulness’ benefits can significantly raise public awareness of its importance and diverse applications. Given the universal relevance of mindfulness, it is crucial to foster awareness and encourage participation in mindfulness programs. The MBSR program holds great potential, both as a therapeutic intervention for individuals with a history of anxiety and other vulnerable populations, and as a preventive tool to promote empowerment and enhance the quality of life in the general population.

As the world becomes increasingly fast-paced, the value of pausing to reflect on ourselves and the world around us becomes immeasurable. As one participant insightfully stated, “perhaps in doing so, we can truly live rather than merely exist.” This study highlights the profound significance of mindfulness in cultivating a deeper, more meaningful engagement with life.

Greater recognition of mindfulness and the MBSR program could serve as a catalyst for mobilizing policymakers and stakeholders to integrate such programs into various societal contexts - including educational institutions, elder care facilities, municipal services, and community organizations. Furthermore, this recognition may inspire the development of new, tailored MBSR models designed to meet the specific needs of diverse and specialized populations, thus maximizing accessibility and impact.

Ultimately, the potential for mindfulness practices to transform lives, improve well-being, and foster deeper connections to the present moment is immense. As society continues to face complex challenges, integrating mindfulness into various aspects of life can offer a powerful tool for enhancing mental health, resilience, and collective well-being, leading to a more balanced and fulfilling future for all.

Human Ethics and Consent to Participate Declarations

This study received ethics approval from the Research Ethics Committee of Metropolitan College (Athens, Greece) under protocol no. 3113/Ζ, dated 26/04/2024. Informed consent was obtained from all participants prior to their participation.

Funding Declaration

No funding was received for this research.

Clinical Trial Registration

Clinical trial number: Not applicable.

Consent to Publish Declaration

Consent to Publish declaration: Not applicable.

Competing Interest Declaration

The authors declare that they have no competing financial or non-financial interests.