Image from FlickrAfter I get moved into my new office space next month, I'll be offering Mindfulness-Based Cognitive Therapy (MBCT) in my psychotherapy practice. What is MBCT? Very much like Mindfulness-Based Stress Reduction (MBSR; see the page about MBSR, here), Mindfulness-Based Cognitive Therapy (MBCT) is usually conducted in a group format, with 8 weekly sessions, each lasting 1.5 or 2 hours. There is also an all-day retreat, about half-way through the course of sessions. Participants are expected to engage in "homework" (see my page about homework, here) between sessions, which can consist of up to an hour of mindfulness practice and exercises, and some writing (and record-keeping) about their experiences.
MBCT may suitable and helpful for individuals who are experiencing a variety of uncomfortable mood (depression) and/or anxiety symptoms. An initial screening interview and orientation session is always scheduled before a potential patient is entered into a MBCT group.
MBCT was originally developed as a method of preventing relapse, for people who have suffered from serious depression. The three psychologists who developed MBCT (Segal, Williams, and Teasdale) became convinced that there were ways to teach people to relate differently to the thoughts, emotional states, and physical sensations that sometimes precede a full-blown depressive episode. They believed that, by doing so, they could actually prevent the re-occurrence of depression (a very significant goal, since Major Depressive Disorder frequently is characterized by relapse). These scientists were well-versed in the prevailing model of cognitive therapy, in which people are taught to recognize and "restructure" inaccurate, counterproductive, and self-defeating thoughts; and they were also aware of Jon Kabat-Zinn's work with Mindfulness-Based Stress Reduction (MBSR). They were intrigued by the fact that the MBSR training model also teaches people to pay attention to their thoughts and emotional states... but without judging them, or trying to change them into something else.
Many psychologists and cognitive scientists have come to believe, based on emerging research, that it really is not possible to take a dysfunctional or inaccurate thought, and "re-structure" it, change it into a better thought, or substitute another thought for it. It is, however, possible to short-circuit the process of elaborating on one's thoughts and emotions, to minimize the "rumination," and the increasingly negative thought processes, that can spiral downhill into a full-blown episode of depression (or an anxiety disorder). And it could well be that the success of the cognitive therapy model results not from “restructuring” one’s thinking, but from recognizing that “thoughts are only thoughts”; they are not necessarily “reality,” and not necessarily all that important…
MBCT is now being used (and researched) for individuals currently suffering from symptoms of depression, as well as for people who are troubled by symptoms of anxiety disorders. The patients in a recent study (found online here) by Ferrando, Findler, Stowell et al. ("Mindfulness-based cognitive therapy for generalized anxiety disorder") displayed "significant reductions in anxiety and depressive symptoms from baseline to end of treatment." The researchers concluded that "MBCT may be an acceptable and potentially effective treatment for reducing anxiety and mood symptoms and increasing awareness of everyday experiences in patients with generalized anxiety disorder (GAD)."
MBCT has also been successfully adapted for patients with Bipolar Disorder: In a recent study, the authors state that "The results suggest that MBCT led to improved immediate outcomes in terms of anxiety which were specific to the bipolar group. Both bipolar and unipolar participants allocated to MBCT showed reductions in residual depressive symptoms relative to those allocated to the waitlist condition...” This study, in the Journal of Affective Disorders (click here for the abstract), suggests “an immediate effect of MBCT on anxiety and depressive symptoms among bipolar participants with suicidal ideation or behaviour, and indicates that further research into the use of MBCT with bipolar patients may be warranted."
5 comments:
I'd be really interested to know what the difference is between MBCT and MBSR.
Very good question! MBSR is a program for anyone who is undergoing difficult life circumstances and/or is just wanting to learn how better to cope with stress and stressful events. MBSR instructors come from all kinds of professional backgrounds (e.g., yoga instructors, psychotherapists, massage therapists, physicians, etc.), and they undergo specific training in MBSR, as well.
MBCT is a mental health treatment modality that is adapted from, the MBSR program. MBCT instructors are mental health providers who are licensed in their profession (medicine, psychology, social work, counseling, etc.), and they are also trained in MBCT and/or MBSR. MBCT was originally created for patients with a history of major depressive disorder; it is currently offered to people with a variety of mental health symptoms or conditions. In practice, the curriculum for MBSR and MBCT are very similar, but certainly not identical.
Does that answer your question?
I actually wanted to know what the differences were in the curricula but didn't word my question specifically enough :-)
OK, I see! Just very briefly, the primary difference in the actual curriculum for MBCT (as distinguished from MBSR) is that there is much more emphasis on teaching and talking about the processes within depression arises out of what are called "depressogenic" (or, depression-producing) thoughts, emotional states, sensations, etc. There is a relapse process that can happen for people with depressive disorders; and participants are taught (through mindfulness) to become more attentive of their own internal experience AND aware of how those internal experiences can, if they are over-elaborated upon, or if they are treated as valid reflections of reality, turn into a serious depressive episode.
The earlier one can catch this process, and the more effectively one can deal with the components of the relapse process, the more likely it is that one will be able to prevent a full-blown relapse into major depressive disorder.
Interesting! I actually am pursuing a Phd program at the Adler Institute in Minneapolis because I inadvertently stumbled on something that helped one of my college English students. I had a student approach me for help because she felt she was slipping back into self-destructive behavior, ie meth use, and I suggested she look into yoga as a stress reducer. And it worked!!
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