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What is Mindfulness-Based Cognitive Therapy (MBCT)?
Very much like Mindfulness-Based
Stress Reduction (MBSR; see the page about MBSR, here), 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."
