Mindfulness-Based Cognitive Therapy

The Mindfulness-Based Cognitive Therapy is a group therapy primarily designed to prevent relapses into depression.

In the practical work, elements of cognitive therapy against depression are linked with mindfulness-based units of a stress reduction program. In two studies from 2000 and 2004, the effectiveness of the therapy, which started with max. twelve participants in eight sessions each.

What is Mindfulness-Based Cognitive Therapy?

Mindfulness-based cognitive therapy, according to its Anglo-Saxon name Mindfulness Based Cognitive Therapy With MBCT is abbreviated, is based on the combination of two already developed and proven pillars.

Elements of cognitive therapy for the treatment of depression are combined with a mindfulness-based stress reduction program. It is a relatively new therapeutic approach developed by psychotherapists Teasdale, Segal, and Williams in the mid to late 1990s. An essential element of the therapy consists in training your own mindfulness.

According to generally recognized cognitive therapy methods, the patients learn to break free from their own centeredness and to look at the causative events from a different point of view. The relatively firm connection between certain events and the resulting negative depressive mood or the conviction that there is no way out is broken with the therapy.

Function, effect & goals

The problem after successfully treating depression with medication, psychotherapy or both is the high relapse rate. Mindfulness-based cognitive therapy was originally developed specifically to prevent recurrent depression after successful treatment.

An essential core element of the MBCT is to get the patient out of their centered way of looking at things and to enable them to gain an external perspective through mindfulness training. This means that they feel more and more personal responsibility and are motivated by this kind of sense of achievement to overcome their previous point of view. Mindfulness means attentive and conscious perception with the willingness to allow changes in one's own point of view through what is observed, as it were to enter into a dialogue with the environment. One of the main therapy goals is therefore to break the close connection between certain events or situations and the depressions suffered.

This is achieved through increased awareness of yourself and the social environment. A very important training element is mindfulness-based meditation, which runs like a red thread through group therapy. Participants learn to develop an improved awareness of their own body sensations and thought processes. They recognize early indicators that point to an impending relapse into depression and, thanks to their changed perspective, can mentally change the process to avoid the relapse.

Eight to twelve people take part in an MBCT course and meet once a week for a joint mindfulness training session with the therapist or trainer. The weekly sessions last about two to two and a half hours. The entire group course extends over a total of eight weeks. The training consists not only of the weekly sessions, but also of homework and daily 60-minute meditation exercises and training sessions carried out at home six days a week. The "home training" consists of at least 45 minutes each. The main thing at the beginning of an MBCT course is to practice alertness and concentration.

The patients learn to accept their current situation including their emotions and thoughts, which gradually change themselves through a changed perspective. The patients feel a colossal liberation and relief, which means the first steps towards the healing process. The particular value of the MBCT lies in its sustainability. Drug treatment of acute depression is - apart from some serious side effects - also effective, but lacks sustainability. This means that the likelihood of relapsing into depression after stopping the medication is very high.

While the MBCT directly addresses the mindset responsible for triggering the depression and thus combats the causes, the drug treatment is more like suppressing the symptoms. The MBCT shows a way out of depression.

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Risks, side effects & dangers

In contrast to drug treatments for acute depression with antidepressants, mindfulness-based cognitive training has no direct side effects.

The greatest "dangers" associated with this are failure to achieve goals and the risk of a potentially suicidal patient remaining at risk. While the success of the MBCT largely depends on the active cooperation of the patient, the drug treatment works independently of the patient's activity or passivity. The great advantage of the MBCT is that it takes the patient along on the path to overcoming depression. The patient can only be “taken along” if he not only shows willingness to allow the patient to be taken along, but also supports the path taken on his own initiative in community therapy.

This means that the greatest benefit of the MBCT also carries the greatest risk of failure, especially for participants who are suffering from an acute flare-up of depression. In such a constellation, it could be necessary to administer antidepressants in parallel to mindfulness-based cognitive training or to use medical treatment for acute depression. Participation in an MBCT while taking antidepressants at the same time is of limited value, however, because the drug has a strong psychological impact and makes it difficult for the patient to actively participate in mindfulness-based cognitive training.