"You almost always feel you cannot control the important things in your life," she says, "that difficulties are piling up so high you cannot overcome them."
Researchers separated the workers into four groups: a control group, a group using only Stress Free Now online or on a CD, and two groups that also had a one-hour meditation and discussion group in the workplace, based on material provided in the program. One of these groups had a peer leader; the other had an outside expert.
The study found that, in the group using only the Cleveland Clinic's mindfulness program online or on a CD, workers had much lower stress and much higher vitality and emotional well-being, compared to the control group. They were also less emotionally exhausted, but only slightly.
But the two groups that participated in weekly meetings at work saw the most dramatic change. Their perceived stress dropped from very high to the national average. (While trying to collect debt, remember.)
Results of the study suggest these groups did better because their participation rates were higher; each week they meditated more than twice as often as the group that used the program only online or on a CD.
"It's difficult for people who are highly stressed," says lead author Didier Allexandre, a biomedical engineer with the Kessler Foundation. "They're under a lot of commitments at home, at work; it's difficult for them to take time away. So if you're providing a way for them to practice without taking time away, such as practicing during work time, it helps."
In particular for the workers who participated in group practice, the benefits continued after the 8-week program, so that one year later, workers' perceived stress and emotional exhaustion were still lower than at the beginning of the program (though stress did rise above the national average again), and vitality and emotional well-being were higher.
"What this paper taught me," Hunter says, "is if an employer is willing to invest and give employees time to engage in a program that’s substantive, not only does it work, but you get sustained benefit."
This question of how to get people engaged is a big one for digital therapeutics, says Dr. Judson Brewer, director of research at the University of Massachusetts Medical School's Center for Mindfulness. For 30 years, he says, mindfulness training has been offered in 8-week sessions with 2.5 hour weekly meetings and an all-day silent retreat.
Now there's an explosion of mindfulness apps offering to lower your stress in short sessions, even down to zero minutes of meditation.
"People call it McMindfulness," Brewer says. "There's a lot of hype."
Brewer says it's critical that medical research develop treatments based on what kinds of digital mindfulness programs actually have a therapeutic benefit.
One question for bosses who may be considering trying a mindfulness program for employees is whether it's worth it to invest in an online/CD program alone, given that workers in the Cleveland Clinic study got such lower stress levels with the support of a weekly group meeting.
"If you can organize group support I would definitely encourage an employer to do this," Allexandre says. "That said, they still, all of them, improved."
Certainly American workers need something to help lower stress. Hunter says the vast majority of employees she's worked with on training -- roughly 8,000 workers in a wide range of industries -- score high or very high on stress. And fully 95 percent say they don't know what to do to change that.
While salaries and workloads are at the top of workers' lists of stressful conditions, the useful thing about mindfulness, Hunter says, is it can help people respond to a bad situation with less stress, even if the situation doesn't change.
"We've got the best treatment outcomes in medicine," she says. "The issue is as a society we don't value 'being.' We are a society of doers, we don't value spending time in 'being.'"