Mindfulness-Based Cognitive Therapy (MBCT) is a mental health treatment modality that is adapted from, the MBSR program. MBCT instructors are mental health providers who are licensed in their profession (medicine, psychology, social work, counseling, etc.), and they are also trained in MBCT and/or MBSR. MBCT was originally created for patients with a history of major depressive disorder; it is currently offered to people with a variety of mental health symptoms or conditions. In practice, the curriculum for MBSR and MBCT are very similar, but certainly not identical.
MBSR is an 8-week program that helps people learn to deal effectively with stressful situations and circumstances in their lives. It was originally developed by Jon Kabat-Zinn, at the University of Massachusetts (the Center For Mindfulness in Medicine, Health Care, and Society), nearly 30 years ago. Dr. Kabat-Zinn developed a way to teach his participants to use mindfulness (meditation) techniques to help them reduce their levels of internal conflict and struggle in their lives, and to begin living more fully, even in the midst of serious difficulties.
More than 17,000 people have completed the MBSR program at the Universitiy of Massachusetts. They have included individuals with chronic pain, serious illness, anxiety and panic, high blood pressure, heart disease, and stressful situations at home or at work. Research has thoroughly demonstrated the effectiveness of this program.
Here is an excerpt from an article called “Doctor’s Orders,” originally published in the LA Times (no longer available free online; it was excerpted on the Sharpbrains blog, here):
“It appears to work. In a new study, published in October in the journal Pain, Natalia Morone, an assistant professor of medicine at the University of Pittsburgh, tracked the effect of mindfulness meditation on chronic lower back pain in adults 65 and older. The randomized, controlled clinical trial found that the 37 people who participated in an eight-week mindfulness meditation program had significantly greater pain acceptance and physical function than a similar size control group. Subsequently, the control group took the same eight-week program and had similar results.
[One participant said]: ‘As a meditator, I learned the value of being present and how that allows clarity in processing our daily lives. [Our] clinical team sees children with chronic pain who are very difficult to treat and have been to many other specialists and feel discouraged by the time they come to us. I felt that learning to meditate would help the team feel a sense of balance and equanimity in the face of the anxiety and distress brought to them by these patients and their families.’
SCIENTISTS have studied the effects of meditation on pain for nearly three decades, ever since 1979, when MIT-trained microbiologist Jon Kabat-Zinn, professor emeritus and founder of the Center for Mindfulness at the University of Massachusetts Medical Center, used mindfulness meditation in a 10-week program to teach chronic pain patients how to cope. Kabat-Zinn’s 1990 bestseller, “Full Catastrophe Living,” described the technique he used — mindfulness-based stress reduction, or MBSR.”
Here is the brochure (click here) from the Center For Mindfulness (CFM), describing the MBSR program. The program at KC Mindfulness follows the same format.
And here is another informative website (click here) from a practice in California (Steve Flowers’ Mindful Living Programs) that offers MBSR.
2. Mindfulness-Based Cognitive Therapy (MBCT)
Very much like Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy (MBCT) is usually conducted in a group format, with 8 weekly sessions, each lasting 1.5 or 2 hours. There is also an all-day retreat, about half-way through the course of sessions. Participants are expected to engage in “homework” (see the page about homework, here) between sessions, which can consist of up to an hour of mindfulness practice and exercises, and some writing (and record-keeping) about their experiences.
MBCT may suitable and helpful for individuals who are experiencing a variety of uncomfortable mood (depression) and/or anxiety symptoms. An initial screening interview and orientation session is always scheduled before a potential patient is entered into a MBCT group. [Note: no participant is placed into a MBCT group without an initial screening to determine whether MBCT would be an appropriate form of treatment or intervention].
MBCT was originally developed as a method of preventing relapse, for people who have suffered from serious depression. The three psychologists who developed MBCT (Segal, Williams, and Teasdale) became convinced that there were ways to teach people to relate differently to the thoughts, emotional states, and physical sensations that sometimes precede a full-blown depressive episode. They believed that, by doing so, they could actually prevent the re-occurrence of depression (a very significant goal, since Major Depressive Disorder frequently is characterized by relapse). These scientists were well-versed in the prevailing model of cognitive therapy, in which people are taught to recognize and “restructure” inaccurate, counterproductive, and self-defeating thoughts; and they were also aware of Jon Kabat-Zinn‘s work with Mindfulness-Based Stress Reduction (MBSR). They were intrigued by the fact that the MBSR training model also teaches people to pay attention to their thoughts and emotional states… but without judging them, or trying to change them into something else.
Many psychologists and cognitive scientists have come to believe, based on emerging research, that it really is not possible to take a dysfunctional or inaccurate thought, and “re-structure” it, change it into a better thought, or substitute another thought for it. It is, however, possible to short-circuit the process of elaborating on one’s thoughts and emotions, to minimize the “rumination,” and the increasingly negative thought processes, that can spiral downhill into a full-blown episode of depression (or an anxiety disorder). And it could well be that the success of the cognitive therapy model results not from “restructuring” one’s thinking, but from recognizing that “thoughts are only thoughts”; they are not necessarily “reality,” and not necessarily all that important…
MBCT is now being used (and researched) for individuals currently suffering from symptoms of depression, as well as for people who are troubled by symptoms of anxiety disorders. The patients in a recent study (found online here) by Ferrando, Findler, Stowell et al. (“Mindfulness-based cognitive therapy for generalized anxiety disorder“) displayed “significant reductions in anxiety and depressive symptoms from baseline to end of treatment.” The researchers concluded that “MBCT may be an acceptable and potentially effective treatment for reducing anxiety and mood symptoms and increasing awareness of everyday experiences in patients with generalized anxiety disorder (GAD).”
MBCT has also been successfully adapted for patients with Bipolar Disorder: In a recent study, the authors state that “The results suggest that MBCT led to improved immediate outcomes in terms of anxiety which were specific to the bipolar group. Both bipolar and unipolar participants allocated to MBCT showed reductions in residual depressive symptoms relative to those allocated to the waitlist condition…” This study, in the Journal of Affective Disorders (click here for the abstract), suggests “an immediate effect of MBCT on anxiety and depressive symptoms among bipolar participants with suicidal ideation or behaviour, and indicates that further research into the use of MBCT with bipolar patients may be warranted.”