Meaning-Centered and Spiritual Interventions: What the Trials Report
Interventions promoting meaning in life had an effect of SMD 0.85 against passive control and 0.32 against active control (Manco 2021); meaning-centered therapies improved quality of life and reduced psychological stress (Vos 2018) and meaning therapies, one type of existential therapy, had large effects on positive meaning in life (Vos 2015); spiritual and religious interventions reduced anxiety, stress and depression (Gonçalves 2015); brief workplace formats showed no evidence of effectiveness (Ivandić 2017).
If the user feels persistently worse, direct to professional support.
- Persistent hopelessness, emptiness, or a sense that life is meaningless lasting more than two weeks: encourage contact with a licensed mental-health professional
- Any thoughts of self-harm or suicide, or feeling life is not worth living: direct the user to a crisis line or emergency services immediately
- Acute existential or spiritual crisis causing marked distress or inability to function: refer to a counselor, chaplain, or clinician
- Signs the user is using reflection to avoid unresolved grief, trauma, or clinical depression: recommend professional support
What the evidence says
The sources are meta-analyses and systematic reviews of meaning-centered, existential, spiritual and positive-psychology interventions. Manco 2021 (meta-analysis) reports interventions promoting meaning in life had an effect of SMD 0.85 against passive control and 0.32 against active control, with mindfulness largest against passive and narrative approaches largest against active controls, and concludes that several interventions, including brief ones not requiring licensed professionals, increase meaning in life; Vos 2018 (meta-analysis) reports meaning-centered therapies improved quality of life (g = 1.13) and reduced psychological stress (g = 1.21); Vos 2015 (meta-analysis) reports meaning therapies had large effects on positive meaning in life (d = 0.65) and moderate effects on psychopathology, with no significant effect on physical well-being. Spiritual and religious interventions: Gonçalves 2015 (meta-analysis, patients in mental-health care) reports reductions in anxiety, stress, alcoholism and depression; de Diego-Cordero 2021 reports workplace spiritual interventions improved workers' health outcomes with high heterogeneity and few studies; de Diego-Cordero 2022 (patients receiving nursing care) reports spiritual interventions associated with lower mental-health symptoms and greater well-being; Cho 2024 reports spiritual nursing education improved spiritual competency and well-being; Kuhn 2024 reports mantram repetition had a positive effect on spiritual well-being, larger with longer sessions; Captari 2018 reports religiously and spiritually adapted psychotherapy improved outcomes against no treatment and non-adapted therapies, especially spiritual well-being, with a minimal additive effect on distress. Weiss 2016 (meta-analysis) reports a moderate effect of behavioural interventions on psychological well-being (d = 0.44), and Koydemir 2020 (meta-analysis) reports positive psychological interventions increased well-being overall (d = 0.23; psychological well-being d = 0.08). Not all results are positive: Ivandić 2017 (systematic review) found no evidence of effectiveness for brief stress-management, relaxation, massage or mindfulness formats, with almost every brief-intervention study at high risk of bias, and Peters 2023 reports spirituality as a negative moderator of stress-intervention effects in one hospital-employee analysis.
- Purpose does not have to be singular or lifelong; it can evolve
- You do not need perfect prose - the reflection matters more than the writing quality
- A quiet or modest purpose is still a purpose
- Do not prescribe, rank, or endorse any specific religion, deity, faith tradition, or belief system
- Do not claim these practices cure, treat, reverse, or prevent any disease or mental illness
- Do not make claims about an afterlife, the soul, the supernatural, or any metaphysical truth
- Do not present correlational or observational findings as proof that the practice causes health outcomes
- Do not position these practices as a substitute for medical care or psychological treatment
- Agreement
- Direction recorded for 0 of 13 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- No source states a certainty rating.
- Authors
- Sources share authors: J. Vos (first author of 2 sources); R. Diego-Cordero (first author of 2 sources); Juan Vega-Escano (senior author of 2 sources).
- How the sources were read
- Some sources are based on abstracts, not full texts.
What each source measured and concluded (13)
- What it measured
- Improvement in meaning in life (MiL)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of RCTs
- Studies and participants, as stated
- 33 RCTs (k=35)
- Heterogeneity, as stated
- Effect size SMD=0.85 (95% CI 0.54-1.17) vs passive control and SMD=0.32 (0.09-0.55) vs active control; mindfulness largest vs passive (1.57), narrative largest vs active (0.61); considerable heterogeneity
- What it measured
- Quality of life and psychological stress
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis
- Studies and participants, as stated
- 60 trials (total N=3,713): 26 RCTs (N=1,975), 15 non-randomized controlled (N=709), 19 non-controlled pre/post (N=1,029)
- What it measured
- Meaning, psychopathology (anxiety/depression), self-efficacy, physical well-being
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of randomized controlled trials
- Studies and participants, as stated
- 15 studies included (of 21 eligible RCTs), total 1,792 participants
- What it measured
- Work-related health outcomes
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review and meta-analysis (of RCTs)
- Studies and participants, as stated
- 7 articles in review, 6 in meta-analysis (from 2,832 studies)
- Heterogeneity, as stated
- Spiritual interventions improved workers' health outcomes vs controls (SMD=-1.42, 95% CI -1.98 to -0.86, p<0.001, I2=96%); yoga effective and stress reduced
- Heterogeneity, as stated
- Workplace spiritual interventions seem effective in improving workers' health, though high heterogeneity and few studies limit robust conclusions
- What it measured
- Efficacy of religious/spiritual interventions on mental, physical, and spiritual health
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of clinical trials (PRISMA/CONSORT/Cochrane)
- Studies and participants, as stated
- 18 RCTs for systematic review; 9 for meta-analysis (from 1308 publications)
- What it measured
- Impact of religious/spiritual interventions (RSI) on mental health outcomes
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of randomized controlled trials
- Studies and participants, as stated
- 23 studies (from 4,751 papers)
- What it measured
- Spiritual care competency.
- How it measured it
- Self-report questionnaires.
- How it was read
- read in full text
- What the review says it includes
- Systematic review and meta-analysis of 9 studies
- Studies and participants, as stated
- N=460 participants across 6 studies (for spiritual care competency); N=317 participants across 4 studies (for spirituality and spiritual well-being); N=143 participants across 2 studies (for existential well-being and self-esteem); N=153 participants across 2 studies (for spiritual needs)
- Heterogeneity, as stated
- Small number of studies included in the meta-analysis, leading to large heterogeneity.
- What it measured
- Spiritual well-being
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of randomized or quasi-experimental studies
- Studies and participants, as stated
- 7 studies; total N=556 (MR=272, comparison=284)
- What it measured
- Efficacy of R/S-tailored psychotherapy on psychological and spiritual functioning
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of outcome studies
- Studies and participants, as stated
- 97 outcome studies (N=7,181)
- What it measured
- Psychological well-being (Ryff scales or MHC-SF)
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of randomized controlled trials
- Studies and participants, as stated
- 27 studies; 3,579 participants
- What it measured
- Subjective and psychological well-being
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Meta-analysis (of randomized controlled studies)
- Studies and participants, as stated
- 68 studies, 16,085 participants
- What it measured
- Effectiveness of brief mental health and well-being interventions
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review of RCTs and quasi-experimental studies
- Studies and participants, as stated
- 11 brief interventions and 9 corresponding common interventions
- What it measured
- Stress or mental well-being intervention outcomes
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review of moderators and mediators (RoB 2, ROBINS-I)
- Studies and participants, as stated
- 15 studies (22 moderators, 10 mediators)
Every source below is shown with its study design and links to the original study. This is the audit trail.
“Abstract only” means the review read that paper’s abstract, not its full text; “screened only” means it was included at re-screening and not extracted. Both stay in the trail with their DOI, because how a source was read is part of the audit.