MBCT/Mindfulness-based cognitive therapy
Developed by: Zindel Segal, Mark Williams and John Teasdale, based on Jon Kabat Zinn’s MBSRP in 1979.
Application areas: Transdiagnostic.
Mindfulness-based cognitive therapy (MBCT) is an empirical approach which combines mindfulness meditation and cognitive therapy.
Randomised clinical trials have demonstrated that it can reduce relapse rates in depression by 50%.
Since its original inception, it has proved to be a trans-diagnosis intervention which can help more broadly with, inter alia, mood dysregulation, anxiety, pain, and chronic fatigue syndrome.
The basics of MBCT
Treatment aims at identifying and forming a new healthier relationship with the ‘modes of mind’ associated with depression.
According to Segal, depression is a chronically relapsing condition for many people. In addition to treating acute symptoms of depression, patients need help to stay healthy (relapse prevention).
For this, triggers/risk factors need to be identified and pathological influences undone. A memory, for example, may trigger sadness, which puts the individual into a negative thinking pattern and a critical view of themselves and the world. This could easily lead to a downward spiral of mood, reactivating the whole depressive package.
In MBCT, the focus is on developing a healthier relationship to depressive symptoms, so that one does not become caught up and carried away with them, but is able to see them clearly and remain present with them until they pass. Mindfulness arises when we pay attention non-judgementally to things as they are. When applied to depressive phenomena such as sadness, it means learning to be with and experience it, rather than trying to avoid or suppress.
In fact, attempting to avoid difficult emotional experiences which are already present is a major risk factor for relapse in depression. So in the MBCT programme, one learns to attend and be with sadness or pain, rather than thinking about it or avoiding it. (The experience of chronic pain has been proven to change by taking this approach.)
MBCT is a practical group-based brief intervention for emotion regulation. Groups meet once-weekly for 8 weeks and participants are asked to do home practice between sessions. The goals of the programme are not just to alleviate depression or anxiety, but to facilitate a way in which individuals can look after themselves more skilfully in general.
Participants learn to see more clearly the pattern of mind. Thus, they become more aware of, and relate more constructively to bodily sensations, feelings and thoughts. With mindfulness, individuals develop the freedom to respond to events (including internal events such as thoughts, feelings, sensations) rather than react automatically in ways that leave them vulnerable.
There is strong evidence for its efficacy in helping people manage anxiety and depression (Khoury et al., 2013) and improving positive mood and compassion for self and others (Eberth & Sedlmeier, 2012; Khoury, Sharma, Rush, & Fournier, 2015). There is preliminary evidence that practicing mindfulness leads to measurable changes in the brain (Tang, Holzel, & Posner, 2015).