Mindfulness-Based Cognitive Therapy (MBCT)

Origins of MBCT 

While originally developed for treating recurrent depression, MCBT has been adapted for treating numerous mental health and physical health conditions, including anxiety, bipolar disorder, trauma, chronic pain, autoimmune disorders, substance use disorders, and more⁽¹⁾.

MCBT derives from Jon Kabat-Zinn, a professor and founder of the mindfulness-based stress reduction technique, a popular technique used in many mindfulness practices. Kabat-Zinn’s work was later expanded upon by psychologists John Teasdale, Mark Williams, Philip Barnard, and Zindel Segal⁽²⁾. 

MBCT consists of an 8-week group training course that combines stress reduction training with specific CBT techniques. Upon completion of the program, people can expect to:

• expand their capacity for engaging in the present moment
• become more neutral and accepting of negative thinking patterns
• increasingly accept difficult emotions without judgment or overreactions 

A trained therapist conducts each of the eight therapy sessions, and the content material builds upon each other. Throughout this time, clients learn various mindfulness meditation techniques and are encouraged to deepen their awareness of their thoughts, feelings, and behaviors. They are also generally assigned homework to reinforce certain skills and engage in more mindfulness in daily life. 

MBCT for Depressive Symptoms 

Although major depression is common, mental health treatment is rarely a straightforward process. This is particularly true in cases of treatment-resistant depression or recurrent depression. Furthermore, treatment often feels more complicated when there are several issues to address simultaneously. 

An MCBT program can help reduce the intensity or frequency of depression by:

• helping clients better understand their depression and identify triggers associated with downward spirals or repeated bouts of depressive episodes
• building a natural tolerance for negative emotions, including chronic unhappiness, heightened anxiety, and serious shame 
• embracing more mindfulness-based approaches when facing challenging circumstances in everyday life 
• equipping clients with a greater threshold for managing stress in adaptive and meaningful ways 

Core Interventions of Mindfulness and CBT 

Mindfulness-based cognitive therapy blends components of traditional CBT with mindfulness principles to help individuals manage negative thoughts and adaptively experience a wide range of emotions. This combination can be especially helpful when dealing with mood disorders, as people with depression can feel debilitated by their own emotional and cognitive states. 

Mindfulness meditation: MCBT integrates numerous meditative practices, including the ‘three-minute breathing space’ exercise, body scans, gentle and mindful stretching, and mindful tasks (mindfully doing the dishes or mindfully eating a meal) to heighten awareness of living in the present moment. 

Relapse prevention: A depressive relapse refers to experiencing unwanted symptoms and feeling like you’ve ‘regressed’ backward. The risk of relapse is ubiquitous with all mental health conditions. In MCBT, clients learn how to identify early depression warning signs (known as the downward mood spirals) and respond to their triggers constructively.

Decentering: Decentering refers to stepping back and viewing certain emotions or thoughts with a sense of detachment. Rather than perceiving something as a default truth (i.e. “I feel bad, and I am bad”), clients learn how to challenge or “sit with” uncomfortable thoughts, allowing for more gentle reframes to emerge (i.e. “I feel upset right now, and this will likely pass soon.”

Cognitive restructuring: Cognitive restructuring is a well-known CBT technique that focuses on reframing negative thoughts into more realistic ones. For example, let’s say that, when your depression feels elevated, you believe, “Things will never get better. It’s all hopeless.” Cognitive restructuring allows you to slow down, embrace mindfulness, and explore an alternative thought. This might sound like, “It’s really hard right now, but it’s definitely not hopeless. I know I will feel better if I take a walk or even a nap right now, and I’m going to choose one of those things to do.”

Behavioral activation: Behavioral activation refers to learning how specific behaviors impact emotional states. When it comes to depression, therapists typically focus on helping clients engage in meaningful activities rather than avoid discomfort, even when avoidance feels like the default choice. With that, regularly prioritizing positive behaviors tends to reinforce a consistently better mood⁽³⁾.

Finding an MBCT Program or MBCT Mental Health Professionals 

Many healthcare professionals now integrate mindfulness-based approaches throughout their work. With that, it’s become more and more mainstream for people to also implement meditation practices in all facets of life. 

You may be able to access MBCT in:

• local community mental health clinics
• university programs and university training institutes
• workplace wellness programs and EAPs 
• private practice clinicians 
• online group settings

MBCT can be a standalone treatment, but it also integrates well with other therapeutic modalities, including dialectical behavior therapy (DBT), interpersonal therapy, process group therapy, and EMDR. However, it may not be recommended for clients experiencing severe depression, psychosis, pervasive dissociation or acute substance use- in those cases, medical stabilization or trauma-informed care tends to be the top priority. 

When looking for a therapist, look for someone with specialized training in either MBCT (through the ACCESS MBCT website) or a professional who specializes in using other mindfulness-based approaches. Remember that it’s okay to ask questions and seek clarification about training or certifications. You have a right to be informed about the treatment you choose to engage in! 

Ultimately, the therapeutic relationship is one of the most important predictors of treatment success, so if you feel comfortable with your provider and feel safe sharing about your struggles, these are two signs indicating that you probably found the right fit. 

Final Thoughts

There’s no doubt that learning how to manage life in a more mindful way has tremendous benefits: it feels good to enjoy the present moment and it allows you to feel more engaged in your relationships, passions, and overall sense of being. 

Mindfulness-based therapy provides grounding, compassion, and structured support for depression and many other mental health challenges. Although MBCT is a relatively new modality, people have embraced the heart of mindfulness for many centuries. With that, fostering mindfulness with increased cognitive flexibility can strengthen your mental health and empower you to make meaningful changes in your life.

References

1. Does MBCT Work? MBCT.com. Retrieved on Dec 19, 2024 from: https://www.mbct.com/does-mbct-work/. 
2. History of Mindfulness-Based Cognitive Therapy Is Associated with Increased Cognitive Reappraisal Ability (2015, May 22). National Library of Medicine. Retrieved on Dec 19, 20204 from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4441334/. 
3. Behavioral Activation (2017). ScienceDirect. Retrieved on Dec 19, 2024 from: https://www.sciencedirect.com/topics/psychology/behavioral-activation.