Hope as a Therapeutic Resource: Systematic Evidence of its Impact on Mental, Physical, and Spiritual Health

Hope is a multidimensional construct that plays a fundamental role in the human experience and in the processes of health and illness. Previous research has demonstrated its association with greater resilience, improved coping, and better treatment adherence; however, evidence regarding the effectiveness of interventions designed to promote hope remains heterogeneous. Therefore, this study aims to analyze the effect of hope-based interventions on health outcomes. To this end, a systematic review was conducted using the databases PsycInfo, Scopus, PubMed, and Web of Science (2015-2025), with no language restrictions. Randomized controlled trials and controlled studies evaluating interventions designed to foster hope in adult populations with various health conditions were included. Predefined inclusion and exclusion criteria were applied, and two independent reviewers performed study selection, data extraction, and synthesis. From an initial sample of 967 records, 36 studies met the inclusion criteria. The results indicated that cognitive-behavioral, positive psychology, mindfulness, narrative, and spiritual care interventions showed significant improvements in hope levels, accompanied by reductions in depression, anxiety, and hopelessness. Moreover, combined psychotherapeutic and spiritual interventions yielded broader effects on psychological and spiritual well-being; nevertheless, some studies reported inconclusive or delayed clinical effects. In conclusion, interventions focused on promoting hope have a positive and clinically relevant impact on mental, spiritual, and physical health outcomes. Their effectiveness depends not only on the techniques applied but also on individual, contextual, and professional factors, including the clinician's competencies and ability to foster realistic expectations. Thus, hope emerges as both a cross-cutting indicator of change and a key therapeutic objective for holistic, person-centered care.