- Mindfulness-Based Cognitive Therapy (MBCT)
- Development of MBCT
- How Does MBCT Work?
- Find a Therapist
- Techniques Used in MBCT
- Issues Treated with MBCT
- Training and Certification
- Limitations and Concerns
- CBT vs MBCT- What is the Difference?
- WHAT IS CBT?
- WHAT IS MINDFULNESS?
- SO LET’S ADD THEM TOGETHER- WHAT IS MBCT?
- SO THEN HOW EXACTLY ARE CBT AND MBCT DIFFERENT?
- HOW ARE CBT AND MBCT THE SAME?
- Mindfulness Based Cognitive Therapy (MBCT) |Zencare
- What can Mindfulness-Based Cognitive Therapy (MBCT) help with?
- Does Mindfulness-Based Cognitive Therapy (MBCT) work?
- How does Mindfulness-Based Cognitive Therapy (MBCT) work?
- How frequently are Mindfulness-Based Cognitive Therapy (MBCT) sessions held?
- How long does Mindfulness-Based Cognitive Therapy (MBCT) treatment last?
- How are Mindfulness-Based Cognitive Therapy (MBCT) sessions structured?
- What happens in a typical Mindfulness-Based Cognitive Therapy (MBCT) session?
- What should I look for in a Therapist for Mindfulness-Based Cognitive Therapy (MBCT)?
Mindfulness-Based Cognitive Therapy (MBCT)
Mindfulness-based cognitive therapy (MBCT) combines cognitive behavioral techniques with mindfulness strategies in order to help individuals better understand and manage their thoughts and emotions in order to achieve relief from feelings of distress.
Though originally developed to address recurrent depression, MBCT may be beneficial to people seeking treatment for a wide range of mental health concerns.
Development of MBCT
MBCT, which was developed by Zindel Segal, Mark Williams, and John Teasdale, is primarily derived from the earlier work of Teasdale, Jon Kabat-Zinn, and Phillip Barnard.
The approach, which is still relatively new—the first clinical trial was published in 2000—incorporates principles from Kabat-Zinn's mindfulness-based stress reduction modality, an 8-week program designed to help people cope with the mental and physical effects of health concerns, and Bernard and Teasdale's ICS (interactive cognitive subsystems) model. ICS is the premise that the human mind possesses different modes for receiving and processing data, the two primary modes of which are the “being” mode and the “doing” mode. The model also suggests mental health may be dependent on a person's ability to detach from one mode and move between other modes, what is present in the environment. The MBCT program emphasizes the “being” mode, as this mode is believed to promote lasting emotional change, specifically for individuals experiencing recurrent depressive episodes.
How Does MBCT Work?
In this therapy approach, people can learn how to use cognitive methods and mindfulness meditation to interrupt the automatic processes often triggering depression. Low mood, negative thoughts, and certain body sensations such as weariness and sluggishness often occur together during an episode of depression.
Even after the episode passes, connections may still exist between the different symptoms, and it is possible for a small negative stimulus to trigger a large downward spiral: Researchers have found when people with a history of depression experience a low mood, they may also experience negative memories and thoughts from the past, which may, in turn, lead to worry about the future and physical sensations such as fatigue.
Find a Therapist
MBCT helps participants learn how to recognize their sense of being and see themselves as separate from their thoughts and moods. This disconnect can allow people to become liberated from thought patterns in which the same negative messages may be replayed over and over.
After developing an awareness of the separation between thoughts, emotions, and the self, people in treatment may find that while the self and the emotions may exist simultaneously, they do not have to exist within the same dimension.
This insight can contribute to healing by helping individuals learn to interject positive thoughts into negative moods in order to disarm those negative moods.
In general, MBCT attempts to give participants the necessary tools to combat depressive symptoms as they arise. People who learn these skills may then be able to revert to these methods in times of distress or when faced with potentially overwhelming situations.
Techniques Used in MBCT
This therapy is delivered as a weekly group treatment program over the course of eight weeks. Each weekly session lasts for two hours, but completing a 45-minute homework assignment six days a week is also required.
For homework, participants listen to audio recordings and practice mindfulness meditation. People in treatment are also introduced to a technique called the three-minute breathing space.
This technique encourages participants to incorporate formal practice into their day-to-day life.
Though there is currently no consensus as to how mindfulness should be defined, the basic concept refers to the practice of developing, in a non-judgmental manner, a deeper awareness of what is happening within one’s mind and body from moment to moment.
Certain meditation techniques—breathing meditations, sitting meditations, body scan meditations, walking meditations, and yoga—may help to improve a person’s mindfulness.
In MBCT, individuals in treatment are also taught cognitive concepts such as the association between thoughts and feelings, and they also often have the opportunity to develop a deeper understanding of depression.
Issues Treated with MBCT
Mindfulness is believed to promote good health, and many studies have associated mindfulness with decreases in depression and anxiety.
Thus, many mental health professionals have incorporated mindfulness-promoting activities into therapy sessions, and these activities have been shown to help reduce symptoms of depression, decrease stress, and improve emotional control, regardless of the specific issues being addressed.
MBCT in particular may be used as a primary treatment modality or in conjunction with other forms of therapy.
Individuals experiencing certain medical concerns may also obtain benefit from MBCT: In a 2013 study of 33 women with fibromyalgia, researchers found that those who were treated with MBCT demonstrated a significantly reduced impact of fibromyalgia, a significant decrease in depressive symptoms, and a slight decrease in the intensity of bodily pain when compared to those who did not receive MBCT. Researchers have also shown individuals with cancer, diabetes, chronic pain, and epilepsy who incorporate MBCT into treatment plans may see improvement in well-being.
Over the past 15 years, the results of numerous randomized controlled trials have demonstrated that MBCT can be a powerful intervention for people who have experienced clinical depression three or more times. Evidence indicates MBCT may reduce the rate of relapse for individuals with recurrent depression by 50%.
MBCT has also been applied to mood and anxiety concerns other than depression, with reported success.
A 2014 review of the usefulness of MBCT as a treatment modality for several health conditions found the approach may be effective when addressing issues such as depressive relapse, current depression, residual depression, bipolar, anxiety, food and eating issues, and psychosis, among others.
Training and Certification
Certification in MBCT is provided by a number of approved institutions around the world, including the UCSD Mindfulness-Based Professional Training Institute (United States), the Oxford Mindfulness Centre (England), the University of Geneva (Switzerland), The Centre for Mindfulness Studies (Canada), and Bangor University (Wales). Therapists who are interested in gaining certification as a teacher of MBCT are required to fulfill two training phases: teacher qualification and teacher certification.
The teacher qualification phase provides applicants with the necessary foundation for teaching MBCT. It consists of six steps:
- Satisfy the prerequisites for a five-day MBCT teacher training retreat
- Attend and participate in the retreat or acquire equivalent training
- Successfully complete either the MindfulNoggin Online MBCT course or the Participant Observer in Live MBCT course
- Apply for teacher-in-training status after successful completion of the program
- Receive a minimum of 20 hours of mentorship while teaching at least two MBCT courses, where each course lasts for eight weeks
- Submit application for teacher qualification
Once teacher qualification status has been achieved, applicants may present themselves as a “qualified teacher of MBCT” and begin phase two of the training process if they wish to pursue certification. Teacher certification involves the following five steps:
- Obtain teacher qualification
- Teach at least three additional eight-week MBCT courses after receiving teacher qualification
- Attend and complete the Advanced Teacher Training Intensive (ATTI)
- Receive a minimum of 10 hours of mentorship while teaching an MBCT course
- Submit application for teacher certification
Limitations and Concerns
The effectiveness of mindfulness based cognitive therapy is supported by considerable empirical evidence and has. according to research, generally produced positive results for people in treatment.
However, because it is a relatively new treatment modality, the long-term benefits of this approach may not yet be fully determinable.
A growing body of empirical evidence supports the approach, but further research may provide greater support for its effectiveness when treating bipolar, eating issues, psychosis, and other conditions.
Several critics have highlighted methodological shortcomings in some MBCT studies such as small sample size, a lack of control groups, and a lack of randomization, all of which have potential to affect the results obtained. More rigorous studies are needed to evaluate whether MBCT is more effective than other, more widely practiced forms of therapy, such as cognitive behavioral therapy.
- Mindfulness-based cognitive therapy. (n.d.). Retrieved from http://bemindful.co.uk/understanding-mindfulness/mindfulness-based-cognitive-therapy
- Metcalf, C.A., & Dimidjian, S. (2014). Extensions and mechanisms of mindfulness-based cognitive therapy: A review of the evidence. Australian Psychologist, 49(5), 271-279. DOI: 10.1111/ap.12074
- Depression in adults: Recognition and management. (2009). Retrieved from http://www.nice.org.uk/guidance/cg90/chapter/key-priorities-for-implementation#psychological-interventions-for-relapse-prevention
CBT vs MBCT- What is the Difference?
MBCT is a relative newcomer to the psychotherapy scene, and it can be confusing to understand the differences between it and CBT. First of all, what do these acronyms stand for?
CBT= Cognitive Behavioural Therapy.
MBCT= Mindfulness Based Cognitive Therapy.
Does this imply that MBCT is just CBT with some meditation thrown in? Let’s take a look.
WHAT IS CBT?
Cognitive Behavioural Therapy (CBT) is a short- to medium-term talking therapy, with the client and therapist deciding on how many sessions will be involved- usually between six weeks and six months. The basic concept is that focussing on changing the way you think (cognition) will change the way you act (behaviour).
CBT looks at ‘negative spirals’ where your dysfunctional thoughts lead to feelings and physical sensations that then lead to actions. Changing these cycles means that anxiety and mild depression become more manageable. So CBT sets out to help you manage your problems in a more positive way by identifying and changing unhelpful thinking patterns.
A simplified example of CBT in action would be looking at the way you act when a friend says they can’t go out with you because they are busy.
You might think they actually don’t you and that’s the real reason they always say no to you lately, which leads to the more negative thought that ‘people almost never me’, which leads to you feeling sad and a bit tired and paranoid or anxious.
The result is you don’t go out at all and spend another Friday night in feeling bad about yourself.
CBT would encourage you to not accept this negative thought pattern, but to look at the ways your friend really might be busy, and to then identify the people who do you. The idea is to question all negative assumptions.
You might remember that the last time you went out with your colleagues from the office everyone said they enjoyed your company. This might make you feel more energetic, so you call up a workmate and go out with them, or bravely go to an open social gathering and meet new friends entirely.
So by changing your thought to one of possibilities, you changed your feelings and physical energy for the better, and this changed your actions and thus your mood.
CBT aims to help you begin to think in open-minded over negative thought loops more and more, until it becomes habitual to think with a wider and more positive perspective over always thinking the worst, or always indulging in the extremes of ‘black and white thinking’.
WHAT IS MINDFULNESS?
Mindfulness is a mental state and therapeutic technique attained by purposefully focusing your awareness on the present moment, while calmly and without judgement acknowledging your feelings, thoughts, and bodily sensations.
The concept of mindfulness is quite ancient, and part of Buddhist and other Eastern spiritual teachings which believe that a calm awareness of one’s body, feelings, and mind is an important part of the road to self actualisation.
Mindfulness was taken and developed in the 1970s as a psychological tool to manage anxiety, stress and chronic pain by Dr.
Jon Kabat-Zinn, who then set up a Stress Reduction Clinic at the University of Massachusetts Medical School to teach its principles.
Now mindfulness is a scientifically researched phenomenon recognised by the world’s leading doctors, scientists, and psychologists. In the 1990s it was further developed specifically to help depression.
Mindfulness has proved itself so useful as it helps combat the ‘auto-pilot’ it is so easy to live a busy modern life from.
We eat an entire bag of pretzels without realising it until we reach into the bag and find it empty, or walk all the way to a destination before realising we haven’t noticed a single thing we’ve walked by.
Why does this matter when it comes to depression? If we live our life in a spaced out way we are living life with our unconscious running the show, which leaves room for anxiety to take over.
And if we are distracted, challenges can take us unawares and we respond reactively, flying off the handle or saying something we regret.
If we have present moment awareness we can be calmer and respond with consideration. Mindfulness helps us consider our actions and respond in thoughtful ways.
And it helps us consciously choose what environments, people, and thoughts to be affected by, too.
In summary mindfulness creates room for us to make clearer choices, feel more in control of our lives, be calmer and make healthy decisions, and ultimately find more joy by noticing the positive details of our lives and relationships.
SO LET’S ADD THEM TOGETHER- WHAT IS MBCT?
By: Allan Ajifo
Mindfulness Based Cognitive Therapy (MBCT) combines the best aspects from both the above theories…and then some.
In the 1990s research by psychologists Jon Teasdale and Philip Barnard found the mind had two main modes, the ‘doing’ mode and the ‘being’ mode. The ‘doing’ mode is goal oriented, triggered when the mind sees a difference between how things are and how it wants things to be. The ‘being’ mode isn’t focused on achieving specific goals but rather accepting and allowing what is.
It was discovered that the ‘being’ mode was the one that lead to lasting emotional changes. So they concluded that effective cognitive therapy would have to promote not just cognitive awareness CBT, but also the ‘being’ mode of the mind, such as mindfulness offered.
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 mindfulness-based stress reduction program. MBCT was born.
CBT, the goal is to develop consistent awareness of your thoughts and reactions so you notice when you are becoming triggered into negativity.
But MBCT teaches that the best way to notice these triggers and to manage stress and anxiety is to develop ongoing awareness and acceptance of the present moment.
Instead of trying too hard to understand the thought, MBCT would promote accepting the thought without judgement and letting it drift from your mind without attaching too much meaning to it.
The greater and more consistent your awareness of the present moment, the more ly it is you will catch the negative thought spirals and choose to disengage from distressing moods or worries.
SO THEN HOW EXACTLY ARE CBT AND MBCT DIFFERENT?
CBT helps you recognise and reframe the negative thought patterns that lead to anxiety and depression.
To reiterate, MBCT also helps you recognise negative thoughts, and, CBT, to learn that thoughts are not facts but something you can take a wider view of. But MBCT then uses mindfulness – recognising what is going on for you in the present moment, how you are thinking and feeling and experiencing things right now – to help you be less caught up in mental loops in the first place.
CBT uses cognition to understand negative thought processes. In other words it’s a ‘thinking’ therapy. It is analytical, with clients tasked with charting their emotions and reactions as homework. Although it does take note of the body’s reaction to stress and negative thoughts, it could be called a ‘head-based’ therapy. The focus is on mentally ‘pushing out’ negative thoughts.
The tools used in a series of MBCT sessions are quite different, and might integrate things breath focus (where you spent a few minutes putting your attention on your breathing), body scans (observing the tension and sensations in the body) and sitting meditation.
In this way, it can be a ‘feeling’ process. It can be seen as experiential, not just analytical, and although it still involves a lot of work with recognising thought patterns it is much more ‘body-based’ than CBT.
The focus is on accepting thoughts as they arise, and letting them go.
HOW ARE CBT AND MBCT THE SAME?
As mentioned, they both work to help you recognise and change negative thought patterns and help you control your thoughts and therefore your moods. They both aim to make you less ly to be drawn into automatic reactions to thoughts, feelings and events.
They are also both short- to medium-term therapies. And they both work best with mild depression and anxiety over being the sole therapy for issues trauma and abuse that might better suit a longer-term talking therapy.
Note, though, both these forms of therapy can be beneficial if used after successful treatment of a talking therapy, with MBCT in particular being useful to help clients who have dealt with long term depression and need a way to manage ongoing mild depressive episodes. It’s been proven that even after therapy the link in your brain between negative thoughts and negative moods still exists and is ready to be reactivated. So being able to monitor and contain reactivation, which mindfulness aids with, is invaluable.
Both CBT and MBCT have been proven in studies to be effective ways of treating depression, and if you are choosing between the two it is really a personal choice.
If you are not sure which type of therapy would suit you best you could always try to source a therapist who offers both options.
And keep in mind when choosing a therapist that it’s not just the type of therapy that matters, but that sometimes what’s even more important is that the therapist is someone you feel you can connect and work with.
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Mindfulness Based Cognitive Therapy (MBCT) |Zencare
Mindfulness-based cognitive therapy (often called MBCT) is a therapy that combines aspects of cognitive behavioral therapy and mindfulness practices.
On the cognitive side, this kind of therapy involves learning to change and recognize the unhelpful thought patterns that may be affecting your mood. On the mindfulness side, you’ll learn new perspectives on your moods, thoughts, and experiences, with the goal of developing a more accepting view of yourself and your life.
MBCT is always conducted as group therapy, so you work with both your therapist and other members of the group to improve your well-being.
What can Mindfulness-Based Cognitive Therapy (MBCT) help with?
MBCT was developed specifically for people dealing with depression. It is designed as a way to avoid relapses into depressive episodes, and most evidence about its effectiveness focuses on its use with depression.
That said, some early studies also suggest that MBCT can also be helpful for other mental health concerns, including anxiety and substance use issues.
Does Mindfulness-Based Cognitive Therapy (MBCT) work?
Yes, a number of studies have shown that MBCT is often very helpful for people suffering from recurring episodes depression. For example, one study in the U.K.
found that people with depression who went through MBCT sessions were 43% less ly to experience a relapse.
Another review of several scientific studies on MBCT found that it may even be as effective as antidepressants for some people.
Most evidence for MBCT has to do with depression. However, that same review reported some preliminary evidence that MBCT might also be helpful for people suffering from other common mental health conditions.
How does Mindfulness-Based Cognitive Therapy (MBCT) work?
MBCT works in a few different ways:
- First, the cognitive aspect of this therapy gives you tools for better understanding your own thought processes and how they affect your mood. The idea is that moods essentially come from thoughts, so by learning ways to correct thoughts that are inaccurate or unhelpful, you can stop your thoughts from having a negative impact on your feelings.
- Second, the mindfulness aspect of MBCT works by helping you gain a more accepting, less judgmental perspective on your life. Mindfulness exercises focus on becoming more present in the moment and learning to separate your sense of self from what’s going on around you. These techniques can help you maintain a sense of peace even in the face of difficult emotions.
- Finally, MBCT works through helping you form connections with otherpeople facing similar challenges. Because MBCT is a group therapy, it gives you a chance to practice healthy relationships and learn to rely on the support of others.
How frequently are Mindfulness-Based Cognitive Therapy (MBCT) sessions held?
MBCT sessions occur once a week, with each session lasting for about two hours. There is also one intensive, day-long session that occurs midway though the treatment.
How long does Mindfulness-Based Cognitive Therapy (MBCT) treatment last?
MBCT lasts for eight weeks in total. Additionally, MBCT includes weekly homework assignments, many of which offer real-world wellness techniques that you can keep using after the formal treatment ends.
How are Mindfulness-Based Cognitive Therapy (MBCT) sessions structured?
MBCT has a relatively formal structure. It is always a group therapy, and it always occurs over the course of eight weeks.
Additionally, there is a single day-long session built into the structure of the treatment. This intensive session usually occurs after the fifth week of regular sessions.
Finally, much of the important work of MBCT treatment takes place outside of sessions. Participants are expected to complete substantial homework assignments on their own during the week.
Usually, this homework includes practicing meditation and other mindfulness exercises, with the goal of building a regular meditation practice that will continue to support participants even after treatment ends.
What happens in a typical Mindfulness-Based Cognitive Therapy (MBCT) session?
MBCT sessions can include a wide range of techniques and exercises. Some of the core components of most MBCT sessions include:
- Psychoeducation: Particularly in earlier sessions, you’ll learn more about your mental health condition and symptoms, as well as their neurological underpinnings. In most versions of MBCT, this process focuses on learning about depression and how it tends to affect people.
- Meditation: You’ll ly learn several different kinds of meditation, including seated meditation, movement-based meditations, and body scan techniques for reducing physical tension.
- Other mindfulness activities: Sessions often include breathing exercises, visualization, and stress reduction techniques.
- Cognitive exercises: You’ll learn techniques identifying thought patterns and replacing negative thoughts with positive ones.
- Group discussion: An important aspect of MBCT is building connections with other individuals in your therapy group. This can be a way to gain solidarity through others’ experiences, practice healthy relationships, and learn to rely on each other for support.
- Going over homework: Because at-home practice is such a key part of MBCT, it’s common to spend some time in sessions discussing how this practice is going for the members of the group.
What should I look for in a Therapist for Mindfulness-Based Cognitive Therapy (MBCT)?
Therapists who lead MBCT groups may be social workers, psychologists, psychiatrists, or another kind of mental health professional. No matter what kind of therapist you choose to work with, make sure that they meet the following criteria:
- An advanced degree in a mental health field;
- Licensure to practice in the state where you live;
- Additional experience and/or training using MBCT;
- If applicable, experience working with people who share your specific concerns (if you’re dealing with a certain mental health condition) or identity (if you feel that any aspect of your identity may be relevant to treatment).
There are also several different organizations that offer training and certification for practitioners to use MBCT. Two of the most prominent are the UCSD Center for Mindfulness and the Oxford Mindfulness Centre. Therapists who have this certification are required to have extensive training and experience with MBCT, so they’re often a great place to start your search.
New to therapy? Learn about how to find a therapist here.