Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Towards mechanism-focused and scalable resilience interventions

Nature Reviews Psychology (2026) Cite this article

Subjects

Abstract

Resilience interventions promote mental health by preparing individuals for adversity or building resilient outcomes during or after stress exposure. In this Review, we describe how currently available resilience interventions, focused on training individual psychosocial factors and lacking real-world implementation evidence, yield only small-to-medium favourable effects. Our synthesis of the literature supports a shift in resilience interventions research from training individual factors to training resilience mechanisms, in line with current theories of resilience. The effectiveness and reach of resilience interventions could be enhanced by targeting the mental, physiological and behavioural processes that occur during stressor exposure and by identifying the conditions under which different individuals benefit. We discuss an integrated approach for developing, testing and adapting resilience interventions in real-world settings.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Theoretical framework of resilience processes.
The alternative text for this image may have been generated using AI.

Similar content being viewed by others

References 

  1. Canaletti, E. F., Lun, P., Stutzman, L. D., Chan, M. & Cheung, F. Rising tide of stress: global trends and structural predictors over 18 years. Wellbeing Space Soc. 10, 100319 (2026).

    Article  Google Scholar 

  2. Diagnostic and Statistical Manual of Mental Disorders 5th edn (American Psychiatric Association, 2013).

  3. Gambhir, A. et al. A systemic risk assessment methodological framework for the global polycrisis. Nat. Commun. 16, 7382 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Liu, H. & Renn, O. Polycrisis and systemic risk: assessment, governance, and communication. Int. J. Disaster Risk Sci. 16, 526–549 (2025).

    Article  Google Scholar 

  5. Rakowski, J. J. et al. Characterizing the global polycrisis: a systematic review of recent literature. Annu. Rev. Environ. Resour. 50, 159–183 (2025).

    Article  Google Scholar 

  6. Benjet, C. et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol. Med. 46, 327–343 (2016).

    Article  PubMed  Google Scholar 

  7. Landolt, M. A., Schnyder, U., Maier, T., Schoenbucher, V. & Mohler-Kuo, M. Trauma exposure and posttraumatic stress disorder in adolescents: a national survey in Switzerland. J. Traum. Stress. 26, 209–216 (2013).

    Article  Google Scholar 

  8. McLaughlin, K. A. et al. Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. J. Am. Acad. Child Adolesc. Psychiatry 52, 815–830.e14 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Agorastos, A., Pervanidou, P., Chrousos, G. P. & Baker, D. G. Developmental trajectories of early life stress and trauma: a narrative review on neurobiological aspects beyond stress system dysregulation. Front. Psychiatry 10, 118 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Agorastos, A. & Chrousos, G. P. The neuroendocrinology of stress: the stress-related continuum of chronic disease development. Mol. Psychiatry 27, 502–513 (2022).

    Article  PubMed  Google Scholar 

  11. Crouse, J. J. et al. Patterns of stressful life events and polygenic scores for five mental disorders and neuroticism among adults with depression. Mol. Psychiatry 29, 2765–2773 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  12. Santomauro, D. F. et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 398, 1700–1712 (2021).

    Article  Google Scholar 

  13. Ahmed, N. et al. Mental health in Europe during the COVID-19 pandemic: a systematic review. Lancet Psychiatry 10, 537–556 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kessler, R. C. et al. Trauma and PTSD in the WHO World Mental Health Surveys. Eur. J. Psychotraumatol. 8, 1353383 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  15. Schäfer, S. K., Kunzler, A. M., Kalisch, R., Tüscher, O. & Lieb, K. Trajectories of resilience and mental distress to global major disruptions. Trends Cogn. Sci. 26, 1171–1189 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  16. Galatzer-Levy, I. R., Huang, S. H. & Bonanno, G. A. Trajectories of resilience and dysfunction following potential trauma: a review and statistical evaluation. Clin. Psychol. Rev. 63, 41–55 (2018). This meta-analysis of mental health and distress adaptation following major stressors highlights the variability of post-stressor trajectories — with resilience as the most common response.

    Article  PubMed  Google Scholar 

  17. Bonanno, G. A. Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? Am. Psychol. 59, 20–28 (2004).

    Article  PubMed  Google Scholar 

  18. Bonanno, G. A., Chen, S. & Galatzer-Levy, I. R. Resilience to potential trauma and adversity through regulatory flexibility. Nat. Rev. Psychol. 2, 663–675 (2023).

    Article  Google Scholar 

  19. Kalisch, R., Russo, S. J. & Müller, M. B. Neurobiology and systems biology of stress resilience. Physiol. Rev. 104, 1205–1263 (2024). This is an integrative overview of the neurobiological and systems-level mechanisms underlying resilience.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Schäfer, S. K. et al. A systematic review of individual, social, and societal resilience factors in response to societal challenges and crises. Commun. Psychol. 2, 92 (2024). This systematic synthesis of resilience factors identifies key protective elements that promote positive adaptation to societal challenges.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Fletcher, D. & Sarkar, M. Psychological resilience: a review and critique of definitions, concepts, and theory. Eur. Psychol. 18, 12–23 (2013).

    Article  Google Scholar 

  22. Southwick, S. M. & Charney, D. S. Resilience: The Science of Mastering Life’s Greatest Challenges (Cambridge Univ. Press, 2012).

  23. Hermans, E. J., Hendler, T. & Kalisch, R. Building resilience: the stress response as a driving force for neuroplasticity and adaptation. Biol. Psychiatry 97, 330–338 (2025).

    Article  PubMed  Google Scholar 

  24. Russo, S. J., Murrough, J. W., Han, M.-H., Charney, D. S. & Nestler, E. J. Neurobiology of resilience. Nat. Neurosci. 15, 1475–1484 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kalisch, R., Müller, M. B. & Tüscher, O. A conceptual framework for the neurobiological study of resilience. Behav. Brain Sci. 38, e92 (2015).

    Article  PubMed  Google Scholar 

  26. Joyce, S. et al. Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open 8, e017858 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  27. Schäfer, S. K. et al. Digital interventions to promote psychological resilience: a systematic review and meta-analysis. npj Digit. Med. 7, 30 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ang, W. H. et al. Digital training for building resilience: systematic review, meta-analysis, and meta-regression. Stress Health 38, 848–869 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  29. Blessin, M., Lehmann, S., Kunzler, A. M., van Dick, R. & Lieb, K. Resilience interventions conducted in Western and Eastern countries—a systematic review. Int. J. Environ. Res. Public Health 19, 6913 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  30. Chmitorz, A. et al. Intervention studies to foster resilience — a systematic review and proposal for a resilience framework in future intervention studies. Clin. Psychol. Rev. 59, 78–100 (2018). This systematic review proposes a framework that highlights the need for conceptual clarity, standardized outcome measures, and consideration of individual and contextual factors in fostering resilience.

    Article  PubMed  Google Scholar 

  31. Christensen, M. K. et al. The cost of mental disorders: a systematic review. Epidemiol. Psychiatr. Sci. 29, e161 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  32. Arias, D., Saxena, S. & Verguet, S. Quantifying the global burden of mental disorders and their economic value. eClinicalMedicine 54, 101675 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  33. Masten, A. S., Lucke, C. M., Nelson, K. M. & Stallworthy, I. C. Resilience in development and psychopathology: multisystem perspectives. Annu. Rev. Clin. Psychol. 17, 521–549 (2021).

    Article  PubMed  Google Scholar 

  34. Nestler, E. J. & Russo, S. J. Neurobiological basis of stress resilience. Neuron 112, 1911–1929 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  35. Page, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372, n71 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  36. Higgins, J. P. T. et al. in Cochrane Handbook for Systematic Reviews of Interventions version 6.5 (eds Higgins, J. P. T. & Thomas, J.) (Cochrane, 2024).

  37. Aromataris, E. et al. in JBI Manual for Evidence Synthesis (eds Aromataris, E. & Munn, Z.) (JBI, 2024).

  38. Morello, K. et al. Cognitive reappraisal in mHealth interventions to foster mental health in adults: a systematic review and meta-analysis. Front. Digit. Health 5, 1253390 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  39. Leppin, A. L. et al. The efficacy of resiliency training programs: a systematic review and meta-analysis of randomized trials. PLoS ONE 9, e111420 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  40. Pinto, T. M., Laurence, P. G., Macedo, C. R. & Macedo, E. C. Resilience programs for children and adolescents: a systematic review and meta-analysis. Front. Psychol. 12, 754115 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  41. Bastounis, A., Callaghan, P., Banerjee, A. & Michail, M. The effectiveness of the Penn Resiliency Programme (PRP) and its adapted versions in reducing depression and anxiety and improving explanatory style: a systematic review and meta-analysis. J. Adolesc. 52, 37–48 (2016).

    Article  PubMed  Google Scholar 

  42. Cai, C., Mei, Z., Wang, Z. & Luo, S. School-based interventions for resilience in children and adolescents: a systematic review and meta-analysis of randomized controlled trials. Front. Psychiatry 16, 1594658 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  43. Dray, J. et al. Systematic review of universal resilience-focused interventions targeting child and adolescent mental health in the school setting. J. Am. Acad. Child Adolesc. Psychiatry 56, 813–824 (2017).

    Article  PubMed  Google Scholar 

  44. Hodder, R. K. et al. Systematic review of universal school-based ‘resilience’ interventions targeting adolescent tobacco, alcohol or illicit substance use: a meta-analysis. Prev. Med. 100, 248–268 (2017).

    Article  PubMed  Google Scholar 

  45. Schäfer, S. K. et al. Transdiagnostic psychosocial interventions to promote mental health in forcibly displaced persons: a systematic review and meta-analysis. Eur. J. Psychotraumatol. 14, 2196762 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  46. Duagi, D. et al. Long-term effects of psychosocial interventions for adolescents on depression and anxiety: a systematic review and meta-analysis. eClinicalMedicine 68, 102382 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  47. Cuijpers, P. et al. Psychotherapy for depression across different age groups: a systematic review and meta-analysis. JAMA Psychiatry 77, 694–702 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  48. Schaubruch, L. M., Schäfer, C. G., Burmeister, C. F., Lieb, K. & Schäfer, S. K. The World Health Organization’s early adolescent skills for emotions: a systematic review on current evidence regarding effectiveness and implementation. Psychother. Psychosom. https://doi.org/10.1159/000549240 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  49. Ciren, Z., Tsui, H. K. H. & Chan, S. K. W. Effects of resilience interventions for adolescents and young adults without psychiatric diagnoses: a systematic review and network meta-analysis of randomized controlled trials. Adolesc. Res. Rev. https://doi.org/10.1007/s40894-025-00270-6 (2025).

    Article  Google Scholar 

  50. Forbes, S. & Fikretoglu, D. Building resilience: the conceptual basis and research evidence for resilience training programs. Rev. Gen. Psychol. 22, 452–468 (2018).

    Article  Google Scholar 

  51. Ferreira, M., Marques, A. & Gomes, P. V. Individual resilience interventions: a systematic review in adult population samples over the last decade. Int. J. Environ. Res. Public Health 18, 7564 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  52. Windle, G., Bennett, K. M. & Noyes, J. A methodological review of resilience measurement scales. Health Qual. Life Outcomes 9, 8 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  53. Díaz-García, A., Franke, M., Herrero, R., Ebert, D. D. & Botella, C. Theoretical adequacy, methodological quality and efficacy of online interventions targeting resilience: a systematic review and meta-analysis. Eur. J. Public Health 31, i11–i18 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  54. Kunzler, A. et al. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst. Rev. 7, CD012527 (2020).

    PubMed  PubMed Central  Google Scholar 

  55. Kunzler, A. M. et al. Psychological interventions to foster resilience in healthcare students. Cochrane Database Syst. Rev. 7, CD013684 (2020).

    PubMed  PubMed Central  Google Scholar 

  56. Peters, M. et al. Moderators and mediators of effects of interventions to reduce stress in hospital employees: a systematic review. Stress Health 40, e3314 (2024).

    Article  PubMed  Google Scholar 

  57. Canby, N. K. et al. Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression. PLoS ONE 20, e0318499 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  58. Weiler, L. M. & Taussig, H. N. The moderating effect of risk exposure on an efficacious intervention for maltreated children. J. Clin. Child Adolesc. Psychol. 48, S194–S201 (2019).

    Article  PubMed  Google Scholar 

  59. Liu, J. J. W. et al. Comprehensive meta-analysis of resilience interventions. Clin. Psychol. Rev. 82, 101919 (2020).

    Article  PubMed  Google Scholar 

  60. Smith, B. W. et al. The brief resilience scale: assessing the ability to bounce back. Int. J. Behav. Med. 15, 194–200 (2008).

    Article  Google Scholar 

  61. Connor, K. M. & Davidson, J. R. T. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress. Anxiety 18, 76–82 (2003).

    Article  PubMed  Google Scholar 

  62. Kalisch, R. et al. The resilience framework as a strategy to combat stress-related disorders. Nat. Hum. Behav. 1, 784–790 (2017). This conceptual work by an international team of researchers presents a comprehensive framework of resilience and identifies critical open questions.

    Article  PubMed  Google Scholar 

  63. Ioannidis, K., Askelund, A. D., Kievit, R. A. & van Harmelen, A.-L. The complex neurobiology of resilient functioning after childhood maltreatment. BMC Med. 18, 32 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  64. Mayor-Silva, L. I. et al. The role of psychological variables in improving resilience: comparison of an online intervention with a face-to-face intervention. A randomised controlled clinical trial in students of health sciences. Nurse Educ. Today 99, 104778 (2021).

    Article  PubMed  Google Scholar 

  65. van der Meer, C. A. I., Bakker, A., van Zuiden, M., Lok, A. & Olff, M. Help in hand after traumatic events: a randomized controlled trial in health care professionals on the efficacy, usability, and user satisfaction of a self-help app to reduce trauma-related symptoms. Eur. J. Psychotraumatol. 11, 1717155 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  66. Lakin, D. P. et al. Psychological flexibility in South Sudanese female refugees in Uganda as a mechanism for change within a guided self-help intervention. J. Consult. Clin. Psychol. 91, 6–13 (2023).

    Article  PubMed  Google Scholar 

  67. Hendriks, T., Schotanus-Dijkstra, M., Graafsma, T., Bohlmeijer, E. & de Jong, J. Positive emotions as a potential mediator of a multi-component positive psychology intervention aimed at increasing mental well-being and resilience. Int. J. Appl. Posit. Psychol. 6, 1–21 (2021).

    Article  Google Scholar 

  68. Falon, S. L. et al. A clustered-randomized controlled trial of a self-reflection resilience-strengthening intervention and novel mediators. J. Occup. Health Psychol. 26, 1–19 (2021).

    Article  PubMed  Google Scholar 

  69. Yu, N. X., Lam, T. H., Liu, I. K. F. & Stewart, S. M. Mediation of short and longer term effects of an intervention program to enhance resilience in immigrants from mainland China to Hong Kong. Front. Psychol. 6, 1769 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  70. Petri-Romão, P. et al. Positive appraisal style predicts long-term stress resilience and mediates the effect of a pro-resilience intervention. Nat. Commun. 16, 10269 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  71. Küchler, A.-M. et al. Effectiveness, acceptability, and mechanisms of change of the internet-based intervention StudiCare Mindfulness for college students: a randomized controlled trial. Mindfulness 13, 2140–2154 (2022).

    Article  Google Scholar 

  72. Bosqui, T. J. & Marshoud, B. Mechanisms of change for interventions aimed at improving the wellbeing, mental health and resilience of children and adolescents affected by war and armed conflict: a systematic review of reviews. Confl. Health 12, 15 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  73. Hofmann, S. G., Curtiss, J. E. & Hayes, S. C. Beyond linear mediation: toward a dynamic network approach to study treatment processes. Clin. Psychol. Rev. 76, 101824 (2020). This work proposes adopting a dynamic network approach to better capture the complex, interacting processes underlying psychotherapy effects.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Hofmann, S. G. & Hayes, S. C. Therapeutic change processes link and clarify targets and outcomes. World Psychiatry 18, 287–288 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  75. Cuijpers, P. Targets and outcomes of psychotherapies for mental disorders: an overview. World Psychiatry 18, 276–285 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  76. Kalisch, R. et al. Deconstructing and reconstructing resilience: a dynamic network approach. Persp. Psychol. Sci. 14, 765–777 (2019).

    Article  Google Scholar 

  77. Bonanno, G. A. The resilience paradox. Eur. J. Psychotraumatol. 12, 1942642 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  78. Schäfer, S. K. et al. ResiMETA: A Living Database for Trajectory-Based Resilience Research https://osf.io/xcwtk (accessed 24 April 2026).

  79. Allen, L. et al. The correlation between social support and post-traumatic stress disorder in children and adolescents: a meta-analysis. J. Affect. Disord. 294, 543–557 (2021).

    Article  PubMed  Google Scholar 

  80. Wang, Y., Chung, M. C., Wang, N., Yu, X. & Kenardy, J. Social support and posttraumatic stress disorder: a meta-analysis of longitudinal studies. Clin. Psychol. Rev. 85, 101998 (2021).

    Article  PubMed  Google Scholar 

  81. Supke, M. et al. Current evidence and future directions for social and societal resilience factors in response to societal challenges and crises: an overview of systematic reviews and expert rating. BMC Public Health 25, 3816 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  82. Almedom, A. M. Resilience, hardiness, sense of coherence, and posttraumatic growth: all paths leading to “light at the end of the tunnel”? J. Loss Trauma 10, 253–265 (2005).

    Article  Google Scholar 

  83. Ajzen, I. Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. J. Appl. Soc. Psychol. 32, 665–683 (2002).

    Article  Google Scholar 

  84. Bandura, A. Self-efficacy: toward a unifying theory of behavioral change. Psychol. Rev. 84, 191–215 (1977).

    Article  PubMed  Google Scholar 

  85. Rotter, J. B. Generalized expectancies for internal versus external control of reinforcement. Psychol. Monogr. Gen. Appl. 80, 1–28 (1966).

    Article  Google Scholar 

  86. Broll, J. et al. Resilience factors in parents of children in need of care. J. Child. Fam. Stud. 34, 353–365 (2025).

    Article  Google Scholar 

  87. Schäfer, S. K. et al. Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints. Transl. Psychiatry 13, 328 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  88. Gerson, M. W. & Fernandez, N. PATH: a program to build resilience and thriving in undergraduates. J. Appl. Soc. Psychol. 43, 2169–2184 (2013).

    Article  Google Scholar 

  89. Kreienkamp, M., Wheatley, D. & Ndobo, A. Assessing the efficacy of a resilience training intervention for long-term improvements in well-being and resilience. Appl. Psychol. Health Well Being 16, 1197–1223 (2024).

    Article  PubMed  Google Scholar 

  90. Zalta, A. K. et al. Examining moderators of the relationship between social support and self-reported PTSD symptoms: a meta-analysis. Psychol. Bull. 147, 33–54 (2021).

    Article  PubMed  Google Scholar 

  91. Schäfer, S. K., Becker, N., King, L., Horsch, A. & Michael, T. The relationship between sense of coherence and post-traumatic stress: a meta-analysis. Eur. J. Psychotraumatol. 10, 1562839 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  92. Schäfer, S. K. et al. The relationship between sense of coherence and mental health problems from childhood to young adulthood: a meta-analysis. J. Affect. Disord. 325, 804–816 (2023).

    Article  PubMed  Google Scholar 

  93. Gallagher, M. W., Long, L. J. & Phillips, C. A. Hope, optimism, self-efficacy, and posttraumatic stress disorder: a meta-analytic review of the protective effects of positive expectancies. J. Clin. Psychol. 76, 329–355 (2020).

    Article  PubMed  Google Scholar 

  94. Bachem, R. & Maercker, A. Development and psychometric evaluation of a revised Sense of Coherence Scale. Eur. J. Psychol. Assess. 34, 206–215 (2016).

    Article  Google Scholar 

  95. Liu, Z. et al. Reciprocal relationship between resilience and depression: a 3-year longitudinal study during the COVID-19 pandemic. Curr. Psychol. 43, 11343–11351 (2023).

    Article  Google Scholar 

  96. Pellerin, N., Raufaste, E., Corman, M., Teissedre, F. & Dambrun, M. Psychological resources and flexibility predict resilient mental health trajectories during the French COVID-19 lockdown. Sci. Rep. 12, 10674 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  97. Chen, S. & Bonanno, G. A. Psychological adjustment during the global outbreak of COVID-19: a resilience perspective. Psychol. Trauma. 12, S51–S54 (2020).

    Article  PubMed  Google Scholar 

  98. Ahrens, K. F. et al. Impact of COVID-19 lockdown on mental health in Germany: longitudinal observation of different mental health trajectories and protective factors. Transl. Psychiatry 11, 392 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  99. Bonanno, G. A., Chen, S., Bagrodia, R. & Galatzer-Levy, I. R. Resilience and disaster: flexible adaptation in the face of uncertain threat. Annu. Rev. Psychol. 75, 573–599 (2024). This paper conceptualizes flexible adaptation as a core mechanism that enables individuals to cope effectively with major stressors.

    Article  PubMed  Google Scholar 

  100. Hyland, P. et al. Trajectories of change in internalizing symptoms during the COVID-19 pandemic: a longitudinal population-based study. J. Affect. Disord. 295, 1024–1031 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  101. Fluharty, M., Bu, F., Steptoe, A. & Fancourt, D. Coping strategies and mental health trajectories during the first 21 weeks of COVID-19 lockdown in the United Kingdom. Soc. Sci. Med. 279, 113958 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  102. Iacoviello, B. M. & Charney, D. S. in Stress Resilience (ed. Chen, A.) 23–31 (Academic Press, 2020).

  103. Joyce, S., Shand, F., Bryant, R. A., Lal, T. J. & Harvey, S. B. Mindfulness-based resilience training in the workplace: pilot study of the internet-based resilience@work (RAW) mindfulness program. J. Med. Internet Res. 20, e10326 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  104. Ryan, A. K., Pakenham, K. I. & Burton, N. W. A pilot evaluation of a group acceptance and commitment therapy-informed resilience training program for people with diabetes. Aust. Psychol. 55, 196–207 (2020).

    Article  Google Scholar 

  105. Meichenbaum, D. in The Evolution of Cognitive Behavior Therapy (ed. Hofmann, S. G.) 101–124 (Routledge, 2017).

  106. Jawahar, N., Jawahar, B., Sayal, K. & Auer, D. P. Post-intervention neuroimaging effects of psychosocial interventions aimed at promoting resilience in children and adolescents under psychological stress: a systematic review. Neurosci. Biobehav. Rev. 174, 106196 (2025).

    Article  PubMed  Google Scholar 

  107. Gee, D. G., Sisk, L. M., Cohodes, E. M. & Bryce, N. V. Leveraging the science of stress to promote resilience and optimize mental health interventions during adolescence. Nat. Commun. 13, 5693 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  108. Von Boros, L. et al. Digital interventions to foster resilience in working populations – a systematic review and meta-analysis. Work Stress https://doi.org/10.1080/02678373.2026.2618071 (2026).

  109. Vanhove, A. J., Herian, M. N., Perez, A. L. U., Harms, P. D. & Lester, P. B. Can resilience be developed at work? A meta-analytic review of resilience-building programme effectiveness. J. Occup. Organ. Psychol. 89, 278–307 (2016).

    Article  Google Scholar 

  110. Wang, Q. et al. Effects of resilience-promoting interventions on cancer patients’ positive adaptation and quality of life: a meta-analysis. Cancer Nurs. 46, E343–E354 (2023).

    Article  PubMed  Google Scholar 

  111. Hannibal, S. et al. Effectiveness of and mechanisms of change in a self-help web- and app-based resilience intervention on perceived stress in the general working population: randomized controlled trial. J. Med. Internet Res. 28, e78335 (2026).

    Article  PubMed  PubMed Central  Google Scholar 

  112. Yousaf, O., Grunfeld, E. A. & Hunter, M. S. A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychol. Rev. 9, 264–276 (2015).

    Article  PubMed  Google Scholar 

  113. Kirkbride, J. B. et al. The social determinants of mental health and disorder: evidence, prevention and recommendations. World Psychiatry 23, 58–90 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  114. McGinty, E. E. et al. The Lancet Psychiatry Commission: transforming mental health implementation research. Lancet Psychiatry 11, 368–396 (2024). This report outlines a roadmap for transforming mental health implementation research based on equity-driven, context-sensitive, and nonlinear approaches.

    Article  PubMed  Google Scholar 

  115. Schäfer, S. K. et al. Barriers and facilitators for the implementation of preventative mental health interventions among secondary schools in high-income countries: a systematic review. Eur. Child Adolesc. Psychiatry https://doi.org/10.1007/s00787-025-02796-5 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  116. Scheuch, I. et al. Resilience training programs in organizational contexts: a scoping review. Front. Psychol. 12, 733036 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  117. Brown, C. H. et al. An overview of research and evaluation designs for dissemination and implementation. Annu. Rev. Public Health 38, 1–22 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  118. Thornicroft, G., Lempp, H. & Tansella, M. The place of implementation science in the translational medicine continuum. Psychol. Med. 41, 2015–2021 (2011).

    Article  PubMed  Google Scholar 

  119. Drolet, B. C. & Lorenzi, N. M. Translational research: understanding the continuum from bench to bedside. Transl. Res. 157, 1–5 (2011).

    Article  PubMed  Google Scholar 

  120. Durlak, J. A. & DuPre, E. P. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am. J. Community Psychol. 41, 327 (2008).

    Article  PubMed  Google Scholar 

  121. Buchanan, G. J. R., Filiatreau, L. M. & Moore, J. E. Organizing the dissemination and implementation field: who are we, what are we doing, and how should we do it? Implement. Sci. Commun. 5, 38 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  122. Mahdiani, H. & Ungar, M. The dark side of resilience. Adversity Resilience Sci. 2, 147–155 (2021).

    Article  Google Scholar 

  123. Hart, A. et al. Uniting resilience research and practice with an inequalities approach. SAGE Open https://doi.org/10.1177/215824401668247 (2016).

  124. Ang, W. H. D. et al. Effectiveness of resilience interventions for higher education students: a meta-analysis and metaregression. J. Educ. Psychol. 114, 1670–1694 (2022).

    Article  Google Scholar 

  125. Baumann, A. A. & Cabassa, L. J. Reframing implementation science to address inequities in healthcare delivery. BMC Health Serv. Res. 20, 190 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  126. Rose, G. Strategy of prevention: lessons from cardiovascular disease. BMJ 282, 1847 (1981).

    Article  PubMed  PubMed Central  Google Scholar 

  127. Rose, G. Sick individuals and sick populations. Int. J. Epidemiol. 30, 427–432 (2001).

    Article  PubMed  Google Scholar 

  128. Jiao, S., Slemon, A., Guta, A. & Bungay, V. Exploring the conceptualization, operationalization, implementation, and measurement of outreach in community settings with hard-to-reach and hidden populations: a scoping review. Soc. Sci. Med. 309, 115232 (2022).

    Article  PubMed  Google Scholar 

  129. Ulrich, S. M., Walper, S., Renner, I. & Liel, C. Characteristics and patterns of health and social service use by families with babies and toddlers in Germany. Public Health 203, 83–90 (2022).

    Article  PubMed  Google Scholar 

  130. Proctor, E. et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Admin. Policy Ment. Health 38, 65–76 (2011).

    Article  Google Scholar 

  131. Proctor, E. K. et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Admin. Policy Ment. Health 36, 24–34 (2009).

    Article  Google Scholar 

  132. Lau, N. et al. Mobile app promoting resilience in stress management for adolescents and young adults with cancer: protocol for a pilot randomized controlled trial. JMIR Res. Protoc. 13, e57950 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  133. Mealer, M. et al. Feasibility and acceptability of a resilience training program for intensive care unit nurses. Am. J. Crit. Care 23, e97–e105 (2014).

    Article  PubMed  Google Scholar 

  134. Myers-Coffman, K., Krater, C., Shanine, M. & Bradt, J. Feasibility and acceptability of the resilience songwriting program for adolescent bereavement. Arts Psychother. 71, 101724 (2020).

    Article  Google Scholar 

  135. Ekbäck, E. et al. Training for Awareness, Resilience and Action (TARA) for medical students: a single-arm mixed methods feasibility study to evaluate TARA as an indicated intervention to prevent mental disorders and stress-related symptoms. BMC Med. Educ. 22, 132 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  136. Mar, J. et al. Cost–utility analysis of the UPRIGHT intervention promoting resilience in adolescents. BMC Psychiatry 23, 178 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  137. Weisz, J. R. et al. Are psychotherapies for young people growing stronger? Tracking trends over time for youth anxiety, depression, attention-deficit/hyperactivity disorder, and conduct problems. Persp. Psychol. Sci. 14, 216–237 (2019).

    Article  Google Scholar 

  138. Bonanno, G. A. & Burton, C. L. Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Persp. Psychol. Sci. 8, 591–612 (2013).

    Article  Google Scholar 

  139. Aldao, A., Sheppes, G. & Gross, J. J. Emotion regulation flexibility. Cogn. Ther. Res. 39, 263–278 (2015).

    Article  Google Scholar 

  140. Haines, S. J. et al. The wisdom to know the difference: strategy-situation fit in emotion regulation in daily life is associated with well-being. Psychol. Sci. 27, 1651–1659 (2016).

    Article  PubMed  Google Scholar 

  141. Kalisch, R. & Kampa, M. in Multisystemic Resilience: Adaptation and Transformation in Contexts of Change (ed. Ungar, M.) 135–152 (Oxford Univ. Press, 2021).

  142. Cheng, C., Lau, H.-P. B. & Chan, M.-P. S. Coping flexibility and psychological adjustment to stressful life changes: a meta-analytic review. Psychol. Bull. 140, 1582–1607 (2014).

    Article  PubMed  Google Scholar 

  143. Doorley, J. D., Goodman, F. R., Kelso, K. C. & Kashdan, T. B. Psychological flexibility: what we know, what we do not know, and what we think we know. Soc. Personal. Psychol. Compass 14, e12566 (2020).

    Article  Google Scholar 

  144. Chen, M. S., Bi, K., Han, X., Sun, P. & Bonanno, G. A. Emotion regulation flexibility and momentary affect in two cultures. Nat. Ment. Health 2, 450–459 (2024).

    Article  Google Scholar 

  145. Hemi, A. et al. Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic — a longitudinal investigation of mental health trajectories. Psychol. Trauma. 16, 961–970 (2024).

    Article  PubMed  Google Scholar 

  146. Chen, S., Bi, K., Sun, P. & Bonanno, G. A. Psychopathology and resilience following strict COVID-19 lockdowns in Hubei, China: examining person- and context-level predictors for longitudinal trajectories. Am. Psychol. 77, 262–275 (2022).

    Article  PubMed  Google Scholar 

  147. Bonanno, G. A., Papa, A., Lalande, K., Westphal, M. & Coifman, K. The importance of being flexible: the ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychol. Sci. 15, 482–487 (2004).

    Article  PubMed  Google Scholar 

  148. Haim-Nachum, S. & Levy-Gigi, E. The tension between cognitive and regulatory flexibility and their associations with current and lifetime PTSD symptoms. Front. Psychol. 12, 615289 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  149. Nizri, H., Hemi, A. & Levy-Gigi, E. Regulatory flexibility and school climate moderate the relationship between stress exposure and depression severity in school educators. Sci. Rep. 14, 11543 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  150. Harel, O., Hemi, A. & Levy-Gigi, E. Emotional regulatory flexibility mitigates effects of school-related stress. Sci. Rep. 15, 25455 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  151. Veer, I. M. et al. Psycho-social factors associated with mental resilience in the Corona lockdown. Transl. Psychiatry 11, 67 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  152. Zerban, M. et al. What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic. Front. Psychol. 14, 1272199 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  153. Notebaert, L. et al. The role of positive appraisal style and positive expectations in student emotional resilience. Pers. Individ. Dif. 250, 113536 (2026).

    Article  Google Scholar 

  154. van der Heide, A. et al. Predictors of stress resilience in Parkinson’s disease and associations with symptom progression. npj Parkinsons Dis. 10, 81 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  155. Bögemann, S. A. et al. Psychological resilience factors and their association with weekly stressor reactivity during the COVID-19 outbreak in Europe: prospective longitudinal study. JMIR Ment. Health 10, e46518 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  156. Bögemann, S. A. et al. Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study. BMC Psychol. 11, 245 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  157. Pusey, M., Wong, K. ok, Wai & Rappa, N. A. Resilience interventions using interactive technology: a scoping review. Interact. Learn. Environ. 30, 1940–1955 (2022).

    Article  Google Scholar 

  158. Michela, A. et al. Preparing the heart for duty: virtual reality biofeedback in an arousing action game improves in-action voluntary heart rate variability control in experienced police. IEEE Trans. Affect. Comput. https://doi.org/10.1109/TAFFC.2025.3619161 (2025).

  159. Michela, A. et al. Deep-breathing biofeedback trainability in a virtual-reality action game: a single-case design study with police trainers. Front. Psychol. 13, 806163 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  160. Dawson, K. S. et al. Problem Management Plus (PM+): a WHO transdiagnostic psychological intervention for common mental health problems. World Psychiatry 14, 354–357 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  161. Dawson, K. S. et al. Improving access to evidence-based interventions for young adolescents: Early Adolescent Skills for Emotions (EASE). World Psychiatry 18, 105–107 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  162. Jordans, M. et al. Evaluation of the Early Adolescent Skills for Emotions (EASE) intervention in Lebanon: a randomized controlled trial. Compr. Psychiatry 127, 152424 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  163. Hamdani, S. U. et al. Effectiveness of a group psychological intervention to reduce psychosocial distress in adolescents in Pakistan: a single-blind, cluster randomised controlled trial. Lancet Child Adolesc. Health 8, 559–570 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  164. Schaeuffele, C. et al. A systematic review and meta-analysis of transdiagnostic cognitive behavioural therapies for emotional disorders. Nat. Hum. Behav. 8, 493–509 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  165. Oliver, D. The future of preventive psychiatry is precise and transdiagnostic. Neurosci. Biobehav. Rev. 160, 105626 (2024).

    Article  PubMed  Google Scholar 

  166. Barlow, D. H. et al. The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a randomized clinical trial. JAMA Psychiatry 74, 875–884 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  167. Dindo, L. et al. Development and evaluation of an 1-day acceptance and commitment therapy workshop for veterans with comorbid chronic pain, TBI, and psychological distress: outcomes from a pilot study. Contemp. Clin. Trials 90, 105954 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  168. Troy, A. S. et al. Psychological resilience: an affect-regulation framework. Annu. Rev. Psychol. 74, 547–576 (2023).

    Article  PubMed  Google Scholar 

  169. Gibson, K. et al. Piloting a scalable, post-trauma psychosocial intervention in Tuvalu: the Skills for Life Adjustment and Resilience (SOLAR) program. Eur. J. Psychotraumatol. 12, 1948253 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  170. Riello, M. et al. Effectiveness of Self-Help Plus (SH+) in reducing anxiety and post-traumatic symptomatology among care home workers during the COVID-19 pandemic: a randomized controlled trial. R. Soc. Open Sci. 8, 210219 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  171. Fietta, V. et al. World Health Organization evidence-based Self-Help Plus intervention for stress management via chatbot: protocol for adaptation to a tech-enabled model. JMIR Res. Protoc. 14, e69644 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  172. Schäfer, S. K., Thomas, L. M., Lindner, S. & Lieb, K. World Health Organization’s low-intensity psychosocial interventions: a systematic review and meta-analysis of the effects of Problem Management Plus and Step-by-Step. World Psychiatry 22, 449–462 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  173. Masten, A. S. & Wright, M. O. in Handbook of Adult Resilience (eds Reich, H. W. et al.) 213–237 (Guilford Press, 2010).

  174. Infurna, F. J. Utilizing principles of life-span developmental psychology to study the complexities of resilience across the adult life span. Gerontologist 61, 807–818 (2021).

    Article  PubMed  Google Scholar 

  175. Malhi, G. S., Das, P., Bell, E., Mattingly, G. & Mannie, Z. Modelling resilience in adolescence and adversity: a novel framework to inform research and practice. Transl. Psychiatry 9, 316 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  176. Cicchetti, D. Resilience under conditions of extreme stress: a multilevel perspective. World Psychiatry 9, 145–154 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  177. Masten, A. S. & Barnes, A. J. Resilience in children: developmental perspectives. Children 5, 98 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  178. Masten, A. S. Resilience of children in disasters: a multisystem perspective. Int. J. Psychol. 56, 1–11 (2021). This review examines how adaptive capacities emerge from interactions across individuals, families, communities and societal systems.

    Article  PubMed  Google Scholar 

  179. Masten, A. S. Resilience from a developmental systems perspective. World Psychiatry 18, 101–102 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  180. Masten, A. S. Ordinary Magic: Resilience in Development (Guilford Press, 2025).

  181. Birnie, M. T. & Baram, T. Z. The evolving neurobiology of early-life stress. Neuron 113, 1474–1490 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  182. Bringmann, L. F. Person-specific networks in psychopathology: past, present, and future. Curr. Opin. Psychol. 41, 59–64 (2021).

    Article  PubMed  Google Scholar 

  183. Fritz, J., Fried, E. I., Goodyer, I. M., Wilkinson, P. O. & van Harmelen, A.-L. A network model of resilience factors for adolescents with and without exposure to childhood adversity. Sci. Rep. 8, 15774 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  184. Brinkhof, L. P. et al. The interplay between quality of life and resilience factors in later life: a network analysis. Front. Psychol. 12, 752564 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  185. Koehler, F., Schäfer, S. K., Lieb, K. & Wessa, M. Differential associations of leisure music engagement with resilience: a network analysis. Int. J. Clin. Health Psychol. 23, 100377 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  186. Chen, X.-Y., Li, C. & Fan, F. Posttraumatic stress disorder symptoms in mothers and adolescents after the Wenchuan earthquake: a cross-sectional and longitudinal network analysis. J. Affect. Disord. 368, 555–563 (2025).

    Article  PubMed  Google Scholar 

  187. Li, G. et al. Understanding the protective effect of social support on depression symptomatology from a longitudinal network perspective. BMJ Ment. Health 26, e300802 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  188. Hayes, S. C., Ciarrochi, J., Hofmann, S. G., Chin, F. & Sahdra, B. Evolving an idionomic approach to processes of change: towards a unified personalized science of human improvement. Behav. Res. Ther. 156, 104155 (2022).

    Article  PubMed  Google Scholar 

  189. Rauschenberg, C. et al. A compassion-focused ecological momentary intervention for enhancing resilience in help-seeking youth: uncontrolled pilot study. JMIR Ment. Health 8, e25650 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  190. IJntema, R. C., Schaufeli, W. B. & Burger, Y. D. Resilience mechanisms at work: the psychological immunity-psychological elasticity (PI-PE) model of psychological resilience. Curr. Psychol. 42, 4719–4731 (2023).

    Article  PubMed  Google Scholar 

  191. Smith, H. L., Summers, B. J., Dillon, K. H. & Cougle, J. R. Is worst-event trauma type related to PTSD symptom presentation and associated features? J. Anxiety Disord. 38, 55–61 (2016).

    Article  PubMed  Google Scholar 

  192. Malykhin, N., Serrano, J., Pietrasik, W. & Hegadoren, K. Effects of duration and intensity of psychological stressors on mental health outcomes. J. Psychiat. Res. 187, 211–222 (2025).

    Article  PubMed  Google Scholar 

  193. Ahrens, K. F. et al. Resilience to major life events: advancing trajectory modeling and resilience factor identification by controlling for background stressor exposure. Am. Psychol. 79, 1076–1091 (2024).

    Article  PubMed  Google Scholar 

  194. Seery, M. D., Leo, R. J., Lupien, S. P., Kondrak, C. L. & Almonte, J. L. An upside to adversity? Moderate cumulative lifetime adversity is associated with resilient responses in the face of controlled stressors. Psychol. Sci. 24, 1181–1189 (2013).

    Article  PubMed  Google Scholar 

  195. von Boros, L. et al. resiLIR HCP: a self-guided digital resilience intervention for healthcare professionals focusing on self-care and self-compassion — a randomized controlled trial. Preprint at SSRN http://ssrn.com/abstract=6293647 (2025).

  196. Cheng, T. W., Mills, K. L. & Pfeifer, J. H. Revisiting adolescence as a sensitive period for sociocultural processing. Neurosci. Biobehav. Rev. 164, 105820 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  197. Chen, M. S. et al. Emotion regulation and mental health across cultures: a systematic review and meta-analysis. Nat. Hum. Behav. 9, 1176–1200 (2025).

    Article  PubMed  Google Scholar 

  198. Ford, B. Q. & Mauss, I. B. Culture and emotion regulation. Curr. Opin. Psychol. 3, 1–5 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  199. Cheng, C., Ying, W., Ebrahimi, O. V. & Wong, K. F. E. Coping style and mental health amid the first wave of the COVID-19 pandemic: a culture-moderated meta-analysis of 44 nations. Health Psychol. Rev. 18, 141–164 (2024).

    Article  PubMed  Google Scholar 

  200. Hall, G. C. N., Ibaraki, A. Y., Huang, E. R., Marti, C. N. & Stice, E. A meta-analysis of cultural adaptations of psychological interventions. Behav. Ther. 47, 993–1014 (2016).

    Article  PubMed  Google Scholar 

  201. Kalter, J. et al. Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer: an individual patient data meta-analysis of 22 RCTs. Psychooncology 27, 1150–1161 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  202. Hua, H. et al. One-stage individual participant data meta-analysis models: estimation of treatment-covariate interactions must avoid ecological bias by separating out within-trial and across-trial information. Stat. Med. 36, 772–789 (2017).

    Article  PubMed  Google Scholar 

  203. Whitehead, L. A., Slovic, S. H. & Nelson, J. E. Re-invigorating HIBAR research for the 21st century: enhancing fundamental research excellence in service to society. Technol. Innov. 21, 153–167 (2020).

    Article  Google Scholar 

  204. Braithwaite, J., Churruca, K., Long, J. C., Ellis, L. A. & Herkes, J. When complexity science meets implementation science: a theoretical and empirical analysis of systems change. BMC Med. 16, 63 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  205. Eckert, M. et al. Acceptability and feasibility of a messenger-based psychological chat counselling service for children and young adults (“krisenchat”): a cross-sectional study. Internet Interv. 27, 100508 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  206. Kohls, E., Hug, J., Wundrack, R., Eckert, M. & Rummel-Kluge, C. Junge Menschen in psychischen Krisen–Aktuelle Forschungsergebnisse zum 24/7 Chat-Beratungsangebot‚ krisenchat. Psychother. Psychosom. Med. Psychol. https://doi.org/10.1055/a-2763-8145 (2026).

    Article  PubMed  Google Scholar 

  207. American Psychological Association, Presidential Task Force on Evidence-Based Practice. Evidence-based practice in psychology. Am. Psychol. 61, 271–285 (2006).

  208. Gates, K. M. & Molenaar, P. C. M. Group search algorithm recovers effective connectivity maps for individuals in homogeneous and heterogeneous samples. NeuroImage 63, 310–319 (2012).

    Article  PubMed  Google Scholar 

  209. Johnson, C. et al. The impact of patient choice on uptake, adherence, and outcomes across depression, anxiety, and eating disorders: a systematic review and meta-analysis. Psychol. Med. 55, e32 (2025).

    Article  PubMed  Google Scholar 

  210. de Graaff, A. M. et al. Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis. BMJ open. 12, e058101 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  211. van Zyl, C., Badenhorst, M., Hanekom, S. & Heine, M. Unravelling ‘low-resource settings’: a systematic scoping review with qualitative content analysis. BMJ Glob. Health 6, e005190 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  212. Ungar, M., Theron, L. & Höltge, J. Multisystemic approaches to researching young people’s resilience: discovering culturally and contextually sensitive accounts of thriving under adversity. Dev. Psychopathol. 35, 2199–2213 (2023). This conceptual work emphasizes the importance of culturally and contextually sensitive frameworks to understand how young people thrive despite adversity.

    Article  PubMed  Google Scholar 

  213. Mastorci, F., Lazzeri, M. F., Vassalle, C. & Pingitore, A. The transition from childhood to adolescence: between health and vulnerability. Children 11, 989 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  214. Cohen, J. Statistical Power Analysis for the Behavioral Sciences (Routledge, 1988).

  215. Ungar, M. (ed) The Social Ecology of Resilience: a Handbook of Theory and Practice (Springer, 2012).

  216. Norris, F. H., Stevens, S. P., Pfefferbaum, B., Wyche, K. F. & Pfefferbaum, R. L. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am. J. Community Psychol. 41, 127–150 (2008).

    Article  PubMed  Google Scholar 

  217. Patel, S., Rogers, B., Amlôt, R. & Rubin, G. What do we mean by ‘community resilience’? A systematic literature review of how it is defined in the literature. PLoS Curr. 9, ecurrents.dis.db775aff25efc5ac4f0660ad9c9f7db2 (2017).

  218. Hobfoll, S. E., Stevens, N. R. & Zalta, A. K. Expanding the science of resilience: conserving resources in the aid of adaptation. Psychol. Inq. 26, 174–180 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  219. Fu, Q., Zheng, Z., Sarker, M. N. I. & Lv, Y. Combating urban heat: systematic review of urban resilience and adaptation strategies. Heliyon 10, e37001 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  220. Masten, A. S., Tyrell, F. A. & Cicchetti, D. Resilience in development: pathways to multisystem integration. Dev. Psychopathol. 35, 2103–2112 (2023).

    Article  PubMed  Google Scholar 

  221. Ceccarelli, C. et al. Implementation outcomes in psychosocial intervention studies for children and adolescents living in low- and middle-income countries: a systematic review. Clin. Psychol. Rev. 107, 102371 (2024).

    Article  PubMed  Google Scholar 

  222. Sanders, E. B.-N. & Stappers, P. J. Co-creation and the new landscapes of design. CoDesign 4, 5–18 (2008).

    Article  Google Scholar 

  223. Hickey, G., Richards, T. & Sheehy, J. Co-production from proposal to paper. Nature 562, 29–31 (2018).

    Article  PubMed  Google Scholar 

  224. Leminen, S., Westerlund, M. & Nyström, A.-G. Living labs as open-innovation networks. Technol. Innov. Manag. Rev. 2, 6–11 (2012).

    Article  Google Scholar 

  225. Akasaka, F., Mitake, Y., Watanabe, K. & Shimomura, Y. A framework for ‘configuring participation’ in living labs. Des. Sci. 8, e28 (2022).

    Article  Google Scholar 

  226. Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. Implementation Research: a Synthesis of the Literature (Univ. South Florida, 2005).

Download references

Acknowledgements

The authors thank R. Kalisch for valuable feedback on resilience mechanisms and S. Mrugalla for assistance in verifying the information presented in Tables 1 to 3 of this Review article.

Author information

Authors and Affiliations

  1. Leibniz Institute for Resilience Research, Mainz, Germany

    Sarah K. Schäfer, Jutta Stoffers-Winterling & Klaus Lieb

  2. Clinical Psychology and Psychotherapy for Children and Adolescents, Technische Universität Braunschweig, Braunschweig, Germany

    Sarah K. Schäfer

  3. Clinical Psychology and Psychotherapy for Children and Adolescents, RPTU University Kaiserslautern-Landau, Landau, Germany

    Sarah K. Schäfer

  4. Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany

    Jutta Stoffers-Winterling & Klaus Lieb

  5. German Center for Mental Health (DZPG), partner site München-Augsburg, München-Augsburg, Germany

    Klaus Lieb

Authors
  1. Sarah K. Schäfer
    View author publications

    Search author on:PubMed Google Scholar

  2. Jutta Stoffers-Winterling
    View author publications

    Search author on:PubMed Google Scholar

  3. Klaus Lieb
    View author publications

    Search author on:PubMed Google Scholar

Contributions

S.K.S. led the writing and development of the core theses, with major contributions from J.S.-W. and K.L. All authors approved the final draft of this manuscript.

Corresponding author

Correspondence to Sarah K. Schäfer.

Ethics declarations

Competing interests

The authors declare no competing interests.

Peer review

Peer review information

Nature Reviews Psychology thanks Mark Shuquan Chen, Alexander C. McFarlane and Christian Rauschenberg for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schäfer, S.K., Stoffers-Winterling, J. & Lieb, K. Towards mechanism-focused and scalable resilience interventions. Nat Rev Psychol (2026). https://doi.org/10.1038/s44159-026-00573-y

Download citation

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s44159-026-00573-y

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing