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References: Contemplation pathways

The key studies and reviews behind these pathways – organised by page, so you can see exactly what each claim on the site is based on.

Meditation

  • Kabat-Zinn, J. (1982). “An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results.” General Hospital Psychiatry, 4(1), 33–47. The founding paper behind what became the Mindfulness-Based Stress Reduction (MBSR) programme.
  • Kabat-Zinn, J., Massion, A.O., Kristeller, J., Peterson, L.G., Fletcher, K.E., Pbert, L., Lenderking, W.R. & Santorelli, S.F. (1992). “Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders.” American Journal of Psychiatry, 149(7), 936–943. An early clinical trial extending MBSR specifically to anxiety.
  • Chiesa, A. & Serretti, A. (2009). “Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis.” Journal of Alternative and Complementary Medicine, 15(5), 593–600. The meta-analysis behind the “solid evidence for reducing anxiety” claim, in non-clinical populations.
  • Sanada, K., Montero-Marin, J., Alda Díez, M., Salas-Valero, M., Pérez-Yus, M.C., Morillo, H., Demarzo, M.M.P., García-Toro, M. & García-Campayo, J. (2016). “Effects of Mindfulness-Based Interventions on Salivary Cortisol in Healthy Adults: A Meta-Analytical Review.” Frontiers in Physiology, 7:471. The main source behind the “lowers cortisol” claim.
  • Linardon, J. (2023). “Rates of attrition and engagement in randomized controlled trials of mindfulness apps: Systematic review and meta-analysis.” Behaviour Research and Therapy, 170, 104421. Pooled dropout rate of 24.7% across trials, rising to 38.7% in larger studies — the source behind this page’s note on the gap between starting and sustaining a practice.

Guided meditation

  • Galante, J., Friedrich, C., Dawson, A.F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I.R. & Jones, P.B. (2021). “Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials.” PLOS Medicine, 18(1), e1003481. A pooled analysis of 136 trials of mostly instructor-led, guided programmes, showing reduced anxiety, depression and stress against no intervention.
  • Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M. & Lee, C. (2019). “Efficacy of the Mindfulness Meditation Mobile App ‘Calm’ to Reduce Stress Among College Students: Randomized Controlled Trial.” JMIR mHealth and uHealth, 7(6), e14273. A trial of app-based guided meditation specifically among novice meditators, supporting the “gentler doorway” framing on this page.

Stoic practice

  • Beck, A.T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press. Beck’s own opening acknowledgement that the philosophical roots of cognitive therapy trace back to the Stoics, quoting Marcus Aurelius directly.
  • Robertson, D. & Codd, T. (2019). “Stoic Philosophy as a Cognitive-Behavioral Therapy.” The Behavior Therapist, 42(2). The main academic source for the direct line drawn on this page from Epictetus’s “dichotomy of control” to modern CBT.
  • Aldao, A., Nolen-Hoeksema, S. & Schweizer, S. (2010). “Emotion-regulation strategies across psychopathology: A meta-analytic review.” Clinical Psychology Review, 30(2), 217–237. The evidence base behind cognitive reappraisal — the modern name for the Stoic practice of examining and reframing a judgement — as one of the better-supported emotion-regulation strategies.

Prayer & religious practice

  • Benson, H., Dusek, J.A., Sherwood, J.B., Lam, P., Bethea, C.F., Carpenter, W., Levitsky, S., Hill, P.C., Clem, D.W. Jr., Jain, M.K., Drumel, D., Kopecky, S.L., Mueller, P.S., Marek, D., Rollins, S. & Hibberd, P.L. (2006). “Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer.” American Heart Journal, 151(4), 934–942. The large randomised trial behind this page’s statement that intercessory prayer does not improve medical outcomes — patients certain they were being prayed for had, if anything, a higher complication rate.
  • Smith, T.B., McCullough, M.E. & Poll, J. (2003). “Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events.” Psychological Bulletin, 129(4), 614–636. A meta-analysis of 147 studies (nearly 99,000 participants) finding a small but consistent inverse association between religiousness and depressive symptoms — the source behind the “quieter claim” this page treats as better supported.