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THERAPIES & TRADITIONS · GUIDE

Online vs In-Person Meditation Courses: Trial Evidence

What trials show about online mindfulness courses compared with in-person ones, including live video and self-guided programs, dropout, and who may do better face to face.

Content last updated . This page has not been medically reviewed.

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Quick answer
Online mindfulness courses help on average, and in two trials live video courses worked about as well as in-person ones. Self-guided online courses are less well supported and many people stop early. This is promising but limited: only a few trials compare online and in-person directly. If you are in crisis, call or text 988 (US), or call 911.

Evidence labels: established, promising but limited, mixed, insufficient evidence.

Online versus no course

A 2016 meta-analysis of 15 trials found online mindfulness programs had small benefits for depression, anxiety and wellbeing, and a moderate benefit for stress [1]. Programs with a guide had larger effects on stress and mindfulness than unguided ones [1]. A 2026 meta-analysis of 38 trials of online programs that followed a structured curriculum found the largest effect for depression (SMD -0.51) [2]. Participants cannot be blinded to a course, so expectation may play a part; see placebo and active controls.

Head-to-head: online versus in person

2 findings · 2 supportedThe colour follows the evidence label on each card.

  1. Live video MBSR vs in-person MBSR, adults with anxiety disorders

    Promising but limited

    Video MBSR was non-inferior to in-person MBSR; social anxiety improved more in person [3]

  2. Internet MBCT vs group MBCT, 245 distressed cancer patients

    Promising but limited

    Both reduced distress more than usual care and were similarly effective [4]

The anxiety study began as a trial of in-person care; after the COVID-19 pandemic began it added video delivery, so some comparisons were randomized and some naturalistic [3]. It was funded by the Patient-Centered Outcomes Research Institute [3]. In the cancer trial the comparison group received usual care [4].

Self-guided apps and websites

Self-guided programs have no teacher. A review of self-guided digital mindfulness for health workers found short-term benefits, low to very low certainty evidence, and adherence ranging from 19% to 56% [5]. A review of 15 trials of web and app mindfulness for people with cancer found less anxiety, depression and distress, but no clear change in fear of recurrence [6]. See meditation apps: what trials show and apps vs teachers vs retreats.

What may differ in practice

  • Social anxiety. In the anxiety trial, social anxiety improved more with in-person care; the reasons were not tested [3].
  • Access and cost. Online reduces travel barriers. Costs vary and we do not list prices.
  • Safety monitoring. A live teacher may notice distress; a self-guided program cannot. NCCIH says few studies have examined harms [7].

Choosing a format

Frequently asked questions

Is an online mindfulness course as good as in person?

In two trials, live online delivery was about as effective as in-person delivery [3][4]. That is limited evidence.

Are self-guided courses effective?

Guided online programs did better than unguided ones for stress and mindfulness [1]. Self-guided results have low-certainty evidence and variable adherence [5].

Who might do better in person?

People with social anxiety did better in person in one trial [3].

Are online courses safe?

Few studies measure harm [7]. If a practice distresses you, stop and see when to stop or pause.

Does a recorded course count as online MBSR?

Not necessarily. The 2026 review pooled programs that followed a structured curriculum [2]; a loose set of recordings is not the same thing.

References
  1. Spijkerman MPJ, Pots WTM, Bohlmeijer ET. Effectiveness of online mindfulness-based interventions in improving mental health: a review and meta-analysis of randomised controlled trials. Clin Psychol Rev. 2016. Read 2026-10-22.
  2. Effectiveness of online mindfulness-based interventions based on the structured curriculum framework in improving mental health: a meta-analysis. Gen Hosp Psychiatry. 2026. Read 2026-10-22.
  3. Hoge EA, et al. A randomized controlled trial comparing mindfulness to escitalopram for anxiety: in-person and remote, synchronous delivery pre and post COVID. J Affect Disord. 2025. Read 2026-10-22.
  4. Compen F, et al. Face-to-face and internet-based mindfulness-based cognitive therapy compared with treatment as usual in reducing psychological distress in patients with cancer. J Clin Oncol. 2018. Read 2026-10-22.
  5. Sasaki N, et al. Effects of self-guided digital mindfulness interventions on the mental health of health care workers: systematic review and meta-analysis. JMIR Mhealth Uhealth. 2026. Read 2026-10-22.
  6. Wang T, et al. Effectiveness of web-based mindfulness-based interventions for patients with cancer: systematic review and meta-analyses. J Med Internet Res. 2024. Read 2026-10-22.
  7. NCCIH (NIH). Meditation and Mindfulness: Effectiveness and Safety. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.