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Mindfulness-Based Cognitive Therapy (MBCT)

Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Child Welfare Relevance Level:
Medium

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Mindfulness-Based Cognitive Therapy (MBCT) program has been rated by the CEBC in the area of: Depression Treatment (Adult).

  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: Adults (between 18-70 years old) who have suffered three or more prior episodes of major depression.

MBCT is based on Jon Kabat Zinn’s Stress Reduction program at the University of Massachusetts Medical Center, which was developed to help people suffering with chronic physical pain and disease. It includes simple meditation techniques to help participants become more aware of their experience in the present moment, by tuning in to moment-to-moment changes in the mind and the body. Participants learn the practice of mindfulness meditation through a course of eight weekly classes (the atmosphere is that of a class, rather than a therapy group) and through daily practice of meditation skills while listening to tapes at home. MBCT also includes basic education about depression and suicidality, and a number of exercises derived from cognitive therapy. These exercises demonstrate the links between thinking and feeling and demonstrate ways that participants can care for themselves when they notice their mood changing or a crisis threatens to overwhelm them.

Essential Components

  • Unlike cognitive therapy, the mindfulness approach makes no attempt to change the content of negative thinking.
  • MBCT encourages participants to change their relationship to their own thoughts, feelings, and body sensations, so that they have an opportunity to discover that these are fleeting events in the mind and the body which they can choose to engage with – or not.
  • Repeated practice in noticing and observing with interest and compassion helps participants to realize that their thoughts, emotions and sensations are just thoughts, emotions, and sensations, rather than ‘truth’ or ‘me.’
  • The participant learns to see more clearly the patterns of the mind, and to recognize when his/her mood is beginning to dip without adding to the problem by falling into analysis and rumination.
  • MBCT helps break the old association between negative mood and the negative thinking it would normally trigger.
  • Participants develop the capacity to allow distressing emotions, thoughts, and sensations to come and go, without feeling that they have to suppress them, run away from them, or do battle with them. The goal is that they learn to stay in touch with the present moment, without being driven to dwell on the past or worry about the future.

Child Component

Mindfulness-Based Cognitive Therapy (MBCT) was not designed with a child component.

Parent / Caregiver Component

Mindfulness-Based Cognitive Therapy (MBCT) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Depression.

Group Format

Mindfulness-Based Cognitive Therapy (MBCT) was designed to be conducted in a group setting, and has been tested for use in a group setting.

Recommended group size:

12

Testing References:

Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V., Soulsby, J., & Lau, M. (2000). Reducing risk of recurrence of major depression using Mindfulness-Based Cognitive Therapy. Journal of Consulting & Clinical Psychology, 68, 615-623.

Ma, J., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting & Clinical Psychology, 72, 31-40.

Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holen, E., White, K., … Teasdale, J. (2008). Mindfulness-based Cognitive Therapy to Prevent relapse in Recurrent Depression. Journal of Consulting and Clinical Psychology, 76, 966-978.

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Hospital
  • Outpatient Clinic

Homework

Mindfulness-Based Cognitive Therapy (MBCT) includes a homework component:

CDs of meditation practices, to be practiced daily six days per week.

Languages

Mindfulness-Based Cognitive Therapy (MBCT) has materials available in languages other than English:

Dutch, French, Italian, Japanese, Korean, Polish, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Room that is large enough for 12-14 chairs, preferably able to have 12-14 yoga mats for mindful movement practices.

Minimum Provider Qualifications

Registered practitioners in their own field with some experience in that field before undertaking this work, a personal mindfulness practice, and training in experiencing and teaching the intervention.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contacts:
Training is obtained:

Varies by site, please contact training contact closer to your location for information.

Number of days/hours:

Varies by site, please contact training contact closer to your location for information.

Implementation Information

Since Mindfulness-Based Cognitive Therapy (MBCT) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Assessments

There are no pre-implementation assessments to measure organizational or individual provider readiness.

Implementation Tools — for the program (e.g., implementation guides or manuals)

There is a manual for Mindfulness-Based Cognitive Therapy (MBCT): Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002) Mindfulness-Based Cognitive Therapy for depression: A new approach to preventing relapse. Guilford Publications, New York.

Fidelity Measures

There is an adherence measure called the Mindfulness-Based Cognitive Therapy Adherence Scale. There is a competency measure called the Mindfulness-Based Interventions Teacher Rating Scale (MBI-TRS). To obtain these measures, please contact Mark Williams at mark.williams@psych.ox.ac.uk.

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Teasdale, J. D., Segal, Z .V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by Mindfulness-Based Cognitive Therapy. Journal of Consulting and Clinical Psychology, 68(4), 615-623.

Type of Study: Randomized controlled trial
Number of Participants: 145

Population:

  • Age range — 18 to 65
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Patients recruited from community health care facilities and media announcements.

Location / Institution: U.K.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Volunteers were included if they met Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria for recurrent depression and had a history of treatment with antidepression medication (ADM), but were in remission and not taking ADM at the time the study began. They were randomly assigned to continue treatment as usual (TAU) or to receive Mindfulness-Based Cognitive Therapy (MBCT) training in addition to TAU. Measures included the Hamilton Rating Scale for Depression (HRSD) and the Beck Depression Inventory (BDI). Participants were also assessed bimonthly during the follow-up period for recurrence of a major depressive episode. Results showed that participants in the MBCT condition had half the rate of relapse and recurrence of depression as those in the TAU condition. The authors note that MBCT was designed to prevent relapse and would not be likely to be effective as a primary treatment for depression.

Length of post-intervention follow-up: 1 year.

Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-Based Cognitive Therapy for depression: Replication and exploration of differential relapse prevention rates. Journal of Consulting and Clinical Psychology, 72(1), 31-40.

Type of Study: Randomized controlled trial
Number of Participants: 75 intervention participants and 55 control participants

Population:

  • Age range — 44.5 years on average
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Patients recruited through general practitioners and the media.

Location / Institution: U.K.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Patients in remission or recovery from major depression were randomly assigned to receive treatment as usual (TAU) or TAU plus MBCT. They were assessed at baseline using the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory. Participants also completed the Measure of Parenting Style describing their mother’s and father’s behaviors toward them up to age 16. In addition, participants were assessed for relapse or recurrence of depression at 3-month intervals and were asked whether the episodes were brought on by specific life events. Results showed a relapse rate of 36% in patients with 3 or more previous episodes of depression who received MBCT, compared to 78% in the TAU group. The treatment was most effective in preventing relapses that were not associated with significant life events and was less effective for those patients with only 2 recent relapse episodes.

Length of post-intervention follow-up: 1 year.

Kenny, M. A., & Williams, J. M. G. (2007). Treatment-resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy. Behavior Research and Therapy, 45, 617-625.

Type of Study: Pretest/Posttest
Number of Participants: 79

Population:

  • Age range — 17 to 61 years
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Patients referred to the study by their psychiatrists.

Location / Institution: Australia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Participants were included if they met diagnostic criteria for 3 or more episodes of major depression, bipolar affective disorder, depressed phase, or dysthymia. During the study, patients also continued with treatment by antidepressant medications as prescribed by their physicians. Depression was assessed over the course of the study using the Beck Depression Inventory (BDI). Patients who were currently depressed and had not responded fully to treatment showed significant improvement on BDI scores after receiving MBCT.

Length of post-intervention follow-up: None.

Barnhofer, T., Crane, C., Hargus, E., Amarasinghe, M., Winder, R., & Williams, J. M. G. (2009). Mindfulness-based Cognitive Therapy as a treatment for chronic depression: A preliminary study. Behavior Research and Therapy, 47, 366-373.

Type of Study: Randomized controlled trial
Number of Participants: 28

Population:

  • Age range — 42 years on average
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Participants recruited through local mental health practitioners and the media.

Location / Institution: U.K.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Individuals with a history of at least 3 episodes of major depression, a current diagnosis of major depression, a history of suicidal ideation, and absence of co-occurring disorders were eligible for the study. Participants were randomly assigned to receive either MBCT or treatment as usual (TAU). Depression was assessed before and after treatment using the DSM-IV Structured Clinical Interview, the Beck Depression Inventory (BDI), and the Beck Scale for Suicide Ideation (BSS). Results showed that symptoms were reduced from severe to mild for those in the MBCT group, but remained unchanged for the control group. There were not group differences in suicidal ideation.

Length of post-intervention follow-up: 1 month or less after treatment.

References

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for depression: A new approach to preventing relapse. Guilford Press, New York.

Williams, J. M. G., Duggan, D. S., Crane, C., & Fennell, M. V. (2006). Mindfulness-Based Cognitive Therapy for prevention of recurrence of suicidal behavior. Journal of Clinical Psychology, 62, 201-210.

Williams, J. M. G., Teasdale, J. D., Segal, Z. V., & Kabat-Zinn, J. (2007). The mindful way through depression: Freeing yourself from chronic unhappiness. New York, Guilford Press.

Contact Information

Name: Mark Williams, MA, MSc, PhD, DSc
Agency/Affiliation: University of Oxford
Department: Department of Psychiatry
Website: www.mbct.com
Email:
Phone: +44 1865 613151

Date Reviewed: March 2010