Research has shown that people that suffer 3 or more episodes of depression are at higher risk of suffering further episodes. As such, there is a strong need for cost-effective interventions to help reduce the rate of relapse. Cognitive behaviour therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are two approaches that have been show to be effective at reducing depression relapse. However, CBT is not always available or easily accessible. MBCT was thus devised as a cost effective approach to prevent depression relapse, as it can be readily delivered in group format.
Professors John Teasdale, Mark Williams, and Zindel Segal developed the MBCT program. They have conjectured that MBCT (and mindful responding) may work by helping people change the way in which they respond to negative thoughts and feelings. This new mode is called distancing, and allows thoughts and feelings to be experienced as passing events, rather than experiences that reflect personally on one's sense of self-worth, or which require unhelpful reactions or behaviours. Individuals can then use mindfulness to disengage from unhelpful and somewhat automatic responses when negative moods and thinking arise, and engage in more helpful ways of responding which can help prevent the spiral of negative thinking and mood that can lead to depression.
A number of randomised controlled trials (listed below) provide strong scientific support for the efficacy of MBCT for helping to prevent depression relapse in adult populations once they have recovered or partially recovered from a depressive episode. At the present time this form of therapy is indicated for people that have experienced 3 or more depressive episodes. It is not recommended as a treatment for acute depression or single episode depression, and in some cases may be counterproductive. When depression occurs concentration reduces, making it difficult for patients to engage in MBCT effectively. However, some preliminary research suggests it may have some benefits for adults with treatment resistant depression, outpatients with mild to moderate mood problems, and for reducing depression and anxiety in bipolar patients that are stablised in mood. Although, much more research is needed before strong conclusions can be drawn.
Recommended Reading and Links:
- Williams, M., Teasdale, J., Segal, Z., & Kabat-Zinn, J. (2007). The mindful way through depression: freeing yourself from chronic unhappiness. New York: The Guilford Press.
- MBCT website: www.mbct.co.uk.
Technical References:
- Coffman, S. J., Dimidjan, S., & Baer, R. A. (2006). Mindfulness-Based Cognitive Therapy for Prevention of Depressive Relapse. In R. A. Baer (Ed), Mindfulness-based treatment approaches: Clinicians guide to evidence base and applications. Academic Press, Amsterdam.
- Eisendrath, S. D. et al. (2008). Mindfulness-based cognitive therapy for treatment resistant depression: a pilot study. Psychotherapy and Psychosomatics, 77, 319-320.
- Finucane, A. & Mercer, S. (2006). A exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry, 6, 14.
- Judd L. J. (1997). The clinical course of unipolar major depressive disorders. Archives of General Psychology, 54, 989-991.
- Kenny, M. A. & Williams J.M.G. (2007). Treatment resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy. Behaviour Research and Therapy, 45, 617-625.
- Kuyken W. et al. (in press). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology.
- Ma, S. H. & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31-40.
- Ree, M. & Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behaviour Change, 24 (2), 70-86.
- Teasdale, J. D. et al. (2000). Preventing relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychiatry, 68, 615-623.
- Williams J. M. G. (2008). Mindfulness, depression, and modes of mind. Journal Cognitive Therapy and Research, 32, 721-733.
- Williams J. M. G., et al. (2007). Mindfulness-based cognitive therapy in bipolar disorder: preliminary evaluation of immediate effects on between episode functioning. Journal of Affective Disorders.
- Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: The Guilford Press.
