Mindfulness-Based Cognitive Therapy (MBCT)

Mindfulness-based cognitive therapy (MBCT) combines elements of mindfulness practice and cognitive behavioral therapy to help individuals develop greater awareness and acceptance of their thoughts, emotions, and experiences in order to cultivate resilience and prevent relapse in depression and anxiety.

This psychotherapy was designed to help people who experience repeated episodes of depression and to help prevent depression from returning.

MBCT usually takes the form of eight weekly sessions, each about two hours long, with guided meditations accompanying the program so participants can practice skills at home.

One extra session becomes a full, silent practice day. Homework follows every session.

It’s usually about 45 minutes of guided meditation a day.

The final weeks turn to relapse-prevention planning: spotting personal early-warning signs of low mood and rehearsing an action plan for when they appear. Planning happens near the end.

This article is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, therapist, or other qualified health provider with any questions you may have regarding a medical or mental health condition. Never disregard professional advice or delay in seeking it because of something you have read on this site.

What is Mindfulness?

Jon Kabat-Zinn, one of the founders of mindfulness-based therapies defines mindfulness as:

“Awareness that arises through paying attention, on purpose, in the present moment, non‑judgmentally… in the service of self‑understanding and wisdom.”

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.

Goals of mindfulness-based cognitive therapy

The MBCT website outlines three 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.

Psychologist Dr Francia Day explains that:

“Mindfulness-based cognitive therapy teaches that thoughts are not necessarily facts and noticing them, rather than reacting to them, can help shift your experience… It can help people feel empowered rather than victims of their experience.”

MBCT vs. CBT

MBCT and cognitive behavioral therapy (CBT) help recognize unhelpful thoughts and involve learning that these thoughts aren’t facts but something one can take a wider view of.

Similarities Between MBCT and CBT

MBCT and CBT share the same broad goal. They both start from the idea that unhelpful thoughts are not simply true reports of reality.

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

Key Differences

The two therapies diverge in method:

• Present-moment awareness vs. analysis: MBCT notices what’s happening in the present moment. CBT is analytical: clients chart their emotions and reactions as homework.
• Noticing vs. disputing: MBCT encourages noticing what is going on around the person, while CBT encourages constantly examining their thoughts.
• Allowing vs. pushing out: CBT encourages pushing unhelpful thoughts away. MBCT instead lets negative thoughts drift through the mind without judgment.

MBCT Techniques

MBCT uses a combination of mindfulness meditation, cognitive restructuring, and psychoeducation.

Together, these help individuals recognize and modify unhelpful thought patterns, increase self-compassion, and develop a more present-focused, accepting mindset.

Below are some of the techniques specifically used in MBCT:

Meditation

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

Sessions often build from simple breath-focused attention toward open awareness. In open awareness, whatever is most noticeable in the moment, a sound, a thought, an itch, becomes the focus of attention rather than the breath alone.

Body scan exercise

This exercise begins lying down in a comfortable position, focusing on the breath. Notice its rhythm and sensation.

Then, the individual is asked to bring awareness to different areas of their body. This usually begins at the toes and moves up through the body until it reaches the top of the head.

During this awareness, they note how each part of their body feels: the texture of clothing against their skin, and any temperature or sensations. They also notice whether areas feel sore, heavy, or light.

Mindfulness practices

This involves becoming more aware of the present moment. It is something that can be practiced 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 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 three steps, each one minute in duration:

1. Observing the experience (the individual brings awareness to how they are doing at that moment).
2. Focusing on the breath.
3. Attending to the body and any physical sensations that might be experienced.

These techniques help people step back from automatic, unhelpful reactions and respond to situations in new ways. They can be used anytime negative emotions feel overwhelming.

When sadness starts to trigger the usual negative associations behind a low mood, these tools offer an alternative. Instead of spiraling into old thought patterns, the individual can substitute them with more positive ones.

What Can Mindfulness-Based Cognitive Therapy Help With? (And How It May Help)

Dr. Zindel Segal, one of MBCT’s founders expresses that:

“MBCT has its strongest evidence base associated with preventing depressive relapse or treating residual depressive symptoms.”

Over time, it has been explored as a supportive approach for a range of mental health conditions that involve patterns of negative thinking, emotional distress, or difficulty with regulation.

Areas Where MBCT May Be Helpful

MBCT was specifically designed to address the cyclical nature of depression, but it has also been applied in contexts such as:

• Generalized anxiety disorder (GAD) and other anxiety-related difficulties
• Obsessive-compulsive disorder (OCD)
• Addictions and substance use challenges
• Bipolar disorder
• Psychotic disorders
• Low mood and chronic stress
• Depression linked to chronic illness or brain injury (e.g., TBI)
• Treatment-resistant depression

While MBCT is not intended to replace clinical care, it may be used alongside other treatments to support emotional awareness and coping.

As with any psychological approach, its suitability can depend on individual needs and circumstances.

How MBCT May Support Mental Health

MBCT is not focused on eliminating difficult thoughts or emotions but instead offers tools to change the way individuals relate to their internal experiences.

The following benefits have been reported in research studies and clinical settings:

Responding to Negative Thinking

MBCT helps people recognize patterns such as rumination, tunnel vision, or automatic negative thoughts (ANTs).

Rather than trying to suppress these thoughts, mindfulness practices encourage a gentle awareness of them as mental events, not facts, that tend to come and go.

Psychologists call this skill decentring: learning to relate to a thought as “just a thought” rather than a fact. This creates distance. It stops one negative thought spiraling into self-criticism and low mood.

Mindfulness interventions have shown promise for improving OCD symptoms (Pseftogianni et al., 2023).

Supporting Recovery and Reducing Relapse

In a UK-based evaluation of MBCT across five mental health services, 96% of participants sustained their recovery during the treatment period. That is a striking result.

The same evaluation found a significant reduction in residual symptoms that are often linked to relapse (Tickell et al., 2020).

A separate trial comparing MBCT with antidepressant treatment found that 52% of participants in the MBCT group did not relapse, compared with 48% in the medication group.

Researchers suggested that MBCT may be similarly effective in preventing depressive relapse (Kuyken et al., 2015).

Strengthening Emotional Awareness and Regulation

Through techniques like body scans, mindful breathing, and the 3-minute breathing space, MBCT offers practical ways to become more aware of emotional shifts as they happen.

This can help reduce the likelihood of being overwhelmed by intense emotions or caught in reactive patterns.

Fostering Self-Compassion

Many mindfulness-based exercises used in MBCT emphasize kindness and acceptance toward oneself.

This includes developing a more balanced inner dialogue, especially during moments of sadness, frustration, or shame.

Building Everyday Coping Skills

The skills taught in MBCT can often be applied to daily life. These include grounding techniques, breathing exercises, and mindful movement practices like yoga or stretching.

With regular practice, individuals may find they are better equipped to handle moments of stress, uncertainty, or emotional discomfort.

Considerations and Limitations of MBCT

MBCT has potential limitations to consider. It may not be suitable for severe mental health conditions, and consistent commitment to mindfulness practice is necessary for its effectiveness.

Therapist training and competence are crucial for delivering MBCT successfully. Inadequate training or experience in mindfulness-based approaches can impact the quality of therapy and outcomes for individuals.

MBCT’s evidence for reducing relapse is strong, but not absolute. A meta-analysis pooling data from over 1,200 patients across nine trials found it roughly halved the risk of depressive relapse compared with not receiving it (Kuyken et al., 2016).

That advantage shrinks, though, against a genuinely active alternative. A large trial comparing MBCT with a matched program that dropped the meditation component found no overall benefit for the average patient. One subgroup did benefit more. People with a history of childhood trauma saw extra protection (Williams et al., 2014).

Further research is needed to explore its long-term effects, compare it to other treatments, and determine its efficacy for specific populations and conditions.

As Willem Kuyken, Professor of Clinical Psychology at the Oxford Mindfulness Centre and lead author of the 2016 meta-analysis, has said, MBCT is “not a panacea.” He calls it a safe alternative to CBT and antidepressants.

But he stresses that more research is still needed, not just to prevent relapse but to help prevent a first episode of depression earlier in life.

In a qualitative study of MBCT graduates, one participant said the course changed how they related to their own low mood long after it ended. Finishing the course was harder for some.

One graduate described the sudden loss of structure and support as “a little scary, to put those into practices by myself.” Support fades fast. Another graduate said the skills were easy to forget without ongoing support (Siwik et al., 2023).

These limitations highlight the importance of considering individual suitability and seeking professional guidance when using MBCT.

Please discuss MBCT with a trained healthcare professional for more information.

Further Information

• Sipe, W. E., & Eisendrath, S. J. (2012). Mindfulness-based cognitive therapy: theory and practice. The Canadian Journal of Psychiatry, 57(2), 63-69.
• MacKenzie, M. B., & Kocovski, N. L. (2016). Mindfulness-based cognitive therapy for depression: trends and developments. Psychology research and behavior management.

References

Bank, S., Burgess, M., Sng, A., Summers, M., Campbell, B., & McEvoy, P. (2020). Stepping Out of Social Anxiety. Perth, Western Australia: Centre for Clinical Interventions.

Kim, Y. W., Lee, S. H., Choi, T. K., Suh, S. Y., Kim, B., Kim, C. M., Cho, S. J., Kim, J. M., Yook, K., Ryu, M., Song, S. K. & Yook, K. H. (2009). Effectiveness of mindfulness‐based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and anxiety, 26(7), 601-606.

Kuyken, W., Hayes, R., Barrett, B., Byng, R., Dalgleish, T., Kessler, D., Lewis, G., Watkins, E., Brejcha, C., Cardy, J., Causley, A., Cowderoy, S., Evans, A., Gradinger, F., Kaur, S., Lanham, P., Morant, N., Richards, J., Shah, P., Sutton, H., Vicary, R., Weaver, A., Wilks, J., Williams, M., Taylor, R. S. & Byford, S. (2015). Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. The Lancet, 386(9988), 63-73.

Jaurequi, M. E., Kimmes, J. G., Seibert, G. S., Ledermann, T., & Roberts, K. (2023). The role of mindfulness between adult attachment and anxiety: A dyadic approach. Couple and Family Psychology: Research and Practice, 12(3), 132–145.

Lindsay, E. K., Young, S., & Creswell, J. D. (2025). Mindfulness training fosters a positive outlook during acute stress: A randomized controlled trial. Emotion, 25(4), 815–826.

Mindfulness Based Cognitive Therapy. (n.d.). Retrieved 2022, February 17, from: https://mbct.co.uk/about-mbct/

Parra-Delgado, M., & Latorre-Postigo, J. M. (2013). Effectiveness of mindfulness-based cognitive therapy in the treatment of fibromyalgia: A randomised trial. Cognitive therapy and research, 37(5), 1015-1026.

Pseftogianni, F., Panagioti, M., Birtwell, K., & Angelakis, I. (2023). Mindfulness interventions for obsessive–compulsive and related disorders: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology: Science and Practice, 30(3), 233–243. https://doi.org/10.1037/cps0000132

Taylor, B. L., Strauss, C., Cavanagh, K., & Jones, F. (2014). The effectiveness of self-help mindfulness-based cognitive therapy in a student sample: a randomised controlled trial. Behaviour Research and Therapy, 63, 63-69.

Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T. & Crane, C. (2020). The effectiveness of mindfulness-based cognitive therapy (MBCT) in real-world healthcare services. Mindfulness, 11(2), 279-290.