Approaches / Acceptance and mindfulness
Mindfulness-based cognitive therapy (MBCT)
A group programme combining mindfulness practice with ideas from cognitive therapy, developed to support people prone to relapse in depression.
Overview
Mindfulness-based cognitive therapy is an eight-session group programme that brings together mindfulness meditation and elements of cognitive therapy. It was developed for people who have had repeated episodes of depression.
Core ideas
The programme teaches people to notice thoughts, feelings and bodily sensations and to relate to them differently, rather than to argue with them. The aim is to change how a person responds when low mood begins.
What a session can involve
Sessions in a group usually include guided mindfulness practices, discussion, and some cognitive therapy exercises. Participants are asked to practise at home between sessions, often using recordings.
Formats and settings
MBCT is usually delivered in groups of around eight to fifteen people over eight weeks. Online groups and adaptations exist.
How it relates to other approaches
MBCT adapts the mindfulness-based stress reduction programme created by Jon Kabat-Zinn and adds ideas from cognitive therapy. It shares mindfulness with dialectical behaviour therapy and acceptance with acceptance and commitment therapy.
Limits and open questions
A 2016 analysis combined individual data from nine randomised trials involving 1,258 adults whose recurrent depression was in full or partial remission. Across the trials, MBCT was associated with a lower risk of relapse over 60 weeks than the combined comparison treatments. The comparison groups differed, and the result does not establish that MBCT is best for every person or setting. Some trials did not formally record adverse events.
Mindfulness practice can be difficult for some people, including those who find focusing on the body distressing, and teachers need appropriate training. NICE includes group MBCT among options for some adults at higher risk of depression relapse; its recommendations have specific conditions and apply in England and Wales. Guidance differs by country and condition.
History
Kabat-Zinn established a stress reduction clinic in 1979. Zindel Segal, Mark Williams and John Teasdale published the MBCT manual in 2002.
Key people
Jon Kabat-Zinn, Zindel Segal, Mark Williams and John Teasdale are the names most linked with MBCT.
Sources and inspection notes
NICE, Depression in adults: treatment and management (NG222)
Supports: The guideline describes group mindfulness for depression and gives conditional recommendations for MBCT in relapse prevention (England and Wales).
Supports: Publisher record names the authors and lists the first edition as © 2002; this is bibliographic evidence, not an assessment of effectiveness.
Supports: Individual participant data from nine trials; relapse results over 60 weeks, comparison treatments and adverse-event reporting.