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What Is Mindfulness-Based Cognitive Therapy (MBCT)?

By Olivia Guy-Evans, published March 30, 2022

by Saul Mcleod, PhD


What is MBCT?

Mindfulness-based cognitive therapy (MBCT) is a type of psychotherapy that involves a combination of cognitive therapy, meditation, and mindfulness.

This therapy was designed specifically to help people who suffer from repeated episodes of depression, to help prevent depression from coming back.

MBCT usually takes the form of 8 weekly sessions, with a set of guided meditations accompanying the programme so that participants can practice skills at home throughout the course. 

What is mindfulness? 

Mindfulness is a type of meditation which involves focusing on being aware of any sensations and feelings in the present moment, without interpretation or judgement.

It is a compassionate type of awareness with a sense of knowing what is happening in the external and internal world as it is happening.

Mindfulness has grown in popularity over recent years and can involve breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress and anxiety. 

How was MBCT developed?

In the 1990s, psychologists Jon Teasdale and Phillip Barnard found that the mind had two main modes: the ‘doing’ mode and the ‘being’ mode.

The ‘doing’ mode is goal-orientated, triggered when the mind sees a difference between how things are and how it wants things to do. Whereas the ‘being’ mode isn’t focused on achieving specific goals, but rather accepting and allowing what is. 

It was found that the ‘being’ mode was the one that led to lasting emotional changes.

Therefore, the psychologists concluded that effective cognitive therapy would have to promote not just cognitive awareness, but also the ‘being’ mode of the mind, such as mindfulness offers.

Psychiatrists Zindel Segal and Mark Williams, as well as Jon Kabat-Zinn became involved and helped combine these new ideas about cognitive therapy with Kabat-Zinn’s 1979 mindfulness-based stress reduction program to create what is known as MBCT. 

The program was developed specifically for depression. What is known about depression is that it is a recurrent and episodic condition, with people more likely to continue having depressive episodes for years.

With MBCT, the idea is that the person with depression will learn skills to catch negative thought spirals as they are happening and be able to disengage from it before it develops into a depressive episode. 

MBCT vs CBT

Both MBCT and CBT help to recognise negative thoughts and involve learning that these thoughts aren’t facts but something one can take a wider view of.

They both aim to make the person feel less likely to be drawn into automatic reactions to thoughts, feelings, and events. Also, both CBT and MBCT are short to medium-term therapies, and both tend to work best for those with depression and anxiety.

The main difference between the two therapies is that MBCT uses mindfulness, so this involves recognising what is going on in the present moment, how an individual is thinking, feeling, and experiencing in the present moment.

CBT, on the other hand, uses cognition to understand negative thought processes – it is very analytical with clients charting their emotions and reactions as homework.

So, whilst MBCT encourages noticing what is going on around the person, CBT encourages the person to constantly notice their thoughts.

CBT also encourages the individual to push out negative thoughts, whereas MBCT involves letting negative thoughts drift through the mind without judgement. 

What are some of the techniques of MBCT?

Below are some of the techniques used in MBCT:

Meditation 

People may learn meditative techniques during MBCT. This can involve practising guided or self-directed meditation that helps them gain a greater awareness of their body, thoughts, and breathing. 

Body scan exercise

This exercise typically involves lying down in a comfortable position and focusing on the breath, noticing the rhythm and sensation of this.

Then, the individual will be asked to bring their awareness to different areas of their body, usually beginning at the toes and moving up through the body until they reach the top of the head.

During this awareness, they will be asked to note how each part of their body feels, the texture of clothing against their skin, any temperature or sensations they feel, and whether areas feel sore or heavy/light. 

Mindfulness practises

This involves becoming more aware of the present moment. It is something that can be practised during meditation but can also be incorporated into the everyday activities people complete.

For instance, mindfully making a cup of tea, mindfully washing up, and mindful cooking. 

Mindfulness stretching

This technique involves stretching the body in a mindful way to help bring awareness to the body and the mind.

Rushing straight into exercise can be a missed opportunity to prepare both the mind and body for physical exertion.

Mindfulness stretching can also add more benefits to exercise such as increased awareness and a sense of balance. 

Yoga

MBCT may also encourage people to practice yoga poses that can help facilitate mindful stretching of the body.

Some poses can help to open up the chest or other areas of the body, bring awareness to parts of the body, and incorporate working and moving with the breaths. 

3-minute breathing space

People in MBCT may be taught what is known as the 3-minute breathing space technique. This focuses on 3 steps, each one minute in duration:

  1. Observing the experience (the individual brings awareness to how they are doing in that moment).

  2. Focusing on the breath.

  3. Attending to the body and any physical sensations that might be experienced. 

These techniques of MBCT allow the individual to move away from automatic negative responses towards an understanding that there are other ways to respond to situations.

By developing a mindfulness meditation routine, individuals can use the techniques whenever they start to feel overwhelmed by negative emotions.

The idea is that when sadness occurs and starts to bring up all the usual negative associations that trigger depression, the individual is equipped with the tools that will help them replace negative thought patterns with positive ones. 

What can MBCT help with?

MBCT was developed for people with recurring episodes of depression or unhappiness, to prevent a relapse.

Though originally developed to address recurrent depression, MBCT can be a beneficial treatment for a wide range of concerns, including:

  • Anxiety disorders such as generalised anxiety disorder (GAD)

  • Addictions

  • Bipolar disorder 

  • Low mood 

  • Traumatic brain injury

  • Depression associated with medical illnesses

  • Treatment-resistant depression

What does the research say?

  • Five mental health services from a range of regions in the United Kingdom contributed data to examine the impact of MBCT on depression. Of the group, 96% sustained their recovery across the treatment period.

    There was also a significant reduction in residual symptoms consistent with a reduced risk of a depressive relapse (Tickell et al., 2019). 

  • MBCT was shown to be an effective treatment at relieving anxiety and depressive symptoms in patients with panic disorder and GAD (Kim et al., 2009). 

  • A self-help method of MBCT was tested for effectiveness. It was found that participants showed significant interaction in favour of self-help on measures of depression, anxiety, stress, satisfaction with life, mindfulness, and self-compassion (Taylor et al., 2014). 

  • MBCT was compared to antidepressant treatment for depression. It was found that whilst 48% of those taking antidepressants did not relapse, 52% of those who undertook MBCT did not relapse.

    There was no big difference between these two types of treatment, suggesting that MBCT can be as effective at preventing relapses as antidepressants (Kuyken et al., 2015). 

Benefits of MBCT

In MBCT, individuals are taught cognitive concepts such as the association between thoughts and feelings, and they also have the opportunity to develop a deeper understanding of depression.

Rather than trying to avoid or eliminate sadness or other negative emotions, people learn to change their relationship with these emotions.

The skills learnt can be used whenever sadness occurs and the person will be prepared to handle their negative emotions.

How does mindfulness help reduce downward mood spirals? 

Mindfulness practice is thought to help us see more clearly when we have unhelpful patterns of the mind such as tunnel vision and learning how to recognise when our mood is beginning to go down.

This means that we are more likely to be able to catch it earlier than we would before. 

It can teach us a way in which we can get back in touch with the experience of being alive – learning to savour the simple pleasures that have been available all along but took for granted.

Mindfulness can help to stop the escalation of negative memories and thoughts from the past and teaches us to focus on the present moment, rather than reliving past experiences or pre-living the future. 

Practising mindfulness can help us enter an alternative mode of mind that includes thinking but is bigger than thinking.

It teaches us to shift from the mode of mind dominated by critical thinking which is likely to provoke downward mood spirals to another mode of mind where we experience the world directly, without judgement. 

Mindfulness helps develop our willingness to experience emotions and our capacity to be open to even painful emotions. It helps to give us the courage to allow distressing moods, thoughts, and sensations to come and go, without having to struggle with them.

We also discover that difficult and unwanted thoughts and feelings can be held in awareness and seen from a different perspective which brings with it a sense of compassion to the suffering we are experiencing. 

Goals of MBCT

The MBCT website outlines 3 ways in which mindfulness practice can help people:

  1. To help you understand what depression is.

  2. To help you discover what makes you vulnerable to downward mood spirals, and why you get stuck at the bottom of the spiral.

  3. To help you see the connection between negative thinking and downward spirals. This includes setting unrealistically high standards for yourself, feelings that you are simply not good enough, and ways you may lose touch with what makes life worth living. 

How to get the most out of MBCT

How can I seek MBCT?

It’s important to talk to your doctor about your symptoms to determine if this is the right approach for you. Talk to your doctor or consider searching an online therapist directory if you are interested in finding an MBCT therapist.

Finding classes may be challenging depending on the availability of trained MBCT therapists in your area. An MBCT therapist is a mental health professional who has additional training in mindfulness-based practises and techniques and is skilled in teaching these techniques to others. 

Mindfulness has become increasingly popular for promoting mental health, so even mental health professionals who are not specifically trained in MBCT may incorporate some aspects of mindfulness practises in their therapy sessions.

It may be worth contacting therapists and asking if this is something they offer in their treatment. 

What can I expect from MBCT sessions?

MBCT is a group intervention that lasts for 8 weeks. Each session lasts for about 2 hours and there is usually a one-day long class, typically after the 5th week.

Much of the work done in MBCT is completed outside of the sessions. Participants are asked to do homework, which includes listening to recorded guided meditations and trying to cultivate mindfulness in their daily lives.

These homework assignments are usually 45 minutes in length, six days a week. 

Things to consider before starting MBCT

  • Much of the research on MBCT is still ongoing as it is a relatively new practice, therefore the long-term effects are not as well known yet.

  • MBCT involves a lot of commitment, so you need to be prepared to attend the weekly sessions and complete the homework assignments to ensure you get the most out of the therapy. 

  • In addition to checking credentials, it's important to find an MBCT therapist who you feel comfortable with. 

Do you need mental health help?

USA

Contact the National Suicide Prevention Lifeline for support and assistance from a trained counselor. If you or a loved one are in immediate danger: https://suicidepreventionlifeline.org/

1-800-273-8255

UK

Contact the Samaritans for support and assistance from a trained counselor: https://www.samaritans.org/; email [email protected].

Availiale 24 hours day, 365 days a year (this number is FREE to call):

116-123

Rethink Mental Illness: rethink.org

0300 5000 927

Fact Checking
Simply Psychology content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication.

About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

How to reference this article:

Guy-Evans, O. (2022, March 30). What Is Mindfulness-Based Cognitive Therapy (MBCT)? Simply Psychology. www.simplypsychology.org/mindfulness-based-cognitive-therapy.html

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