Mindfulness-Based Cognitive Therapy

Written by BetterHelp Editorial Team
Medically reviewed by Dr. Andrea Cziffer Paul, MD, Julie Dodson, MA, LCSW, and Laura Angers Maddox, NCC, LPC

Overview

Mindfulness-based cognitive therapy (MBCT), developed by Zindel Segal and Mark Williams, is a form of group therapy designed to address vulnerabilities that may cause people with major depressive disorder to fall into depressive episodes. It combines aspects of cognitive behavioral therapy (CBT)1 and traditional mindfulness-based stress reduction (MBSR) practices.

Cognitive behavioral therapy is based on several core principles, specifically the idea that challenges with mental health can be attributed to learned patterns of thinking and unhelpful behaviors, and that people who experience these difficulties can learn better coping mechanisms2 that may relieve their symptoms.

Mindfulness-based stress reduction (MBSR) was initially developed to manage stress by Kabat Zinn but has evolved into a treatment approach for various physical and mental health disorders. It uses mindfulness3 meditation to alleviate stress. In mindfulness-based stress reduction sessions, mindfulness is used to help people disengage from their depression-related feelings and negative thinking to avoid having episodes of depression or recurrent depression. 

Mindfulness-based cognitive therapy was developed based on the idea that people with depressive relapses may have different patterns of thinking than those who do not, and that small negative mood shifts may cause relapses for people who have experienced them because these individuals can activate similar thinking patterns to previous episodes. Mindfulness-based cognitive therapy encourages people with MDD to become more aware of their own feelings, thoughts, and sensations and change how these individuals relate to these things, similar to cognitive behavioral therapy. Disengaging from automatic negative thoughts and behavioral patterns using mindfulness practices may reduce the risk of relapse and manage episodes when they do return.

How it works

Someone who has recovered from a depressive episode may experience another due to feelings of sadness. The idea behind mindfulness-based cognitive therapy (MBCT) is that people can learn to change how they react to these emotions by practicing mindfulness rather than avoiding sadness and other negative emotions. For example, mindfulness techniques like meditation can help people accept sadness, encouraging them to question their automatic response and experience other ways to respond to challenging emotions.

Mindfulness & positive emotions

Mindfulness-based cognitive therapy was designed to help people apply mindfulness skills to reduce how negative moods affect them. It works by reducing levels of rumination and worry and supporting increased positive emotions and a greater appreciation for daily-life experiences. Mindfulness-based cognitive therapy is focused on aspects of mindfulness-based stress reduction, which works to support clients in stress reduction and increasing positive emotions. 

By learning a routine meditation practice, people in mindfulness-based cognitive therapy have a technique to turn to when these individuals feel overwhelmed by negative thoughts or emotions. When sadness occurs, they have tools to help them manage their thoughts and feelings with compassion and calmness.

What to expect

Mindfulness-based cognitive therapy and mindfulness-based stress therapy often last for eight sessions and is delivered in a group setting. Weekly therapy sessions are led by a therapist who teaches meditation techniques and the relationship between how you think and feel. People in this type of therapy can also learn more about their condition. 

Therapy topics

While the topics covered in these therapy sessions may vary, some possible content includes mindfulness eating, associating mood and thoughts, being aware of the mind wandering, staying present, exploring challenges, having compassion for the self, identifying triggers, and maintaining momentum.

Mindfulness homework

On the days between therapy sessions, people in the group may have homework to do. Homework varies depending on the therapist, but it generally focuses on practicing the breathing exercises and meditation techniques covered during therapy sessions. Participants are also encouraged to apply the mindfulness techniques they’re learning to other parts of their lives, for example, as they’re showering, walking, or preparing and eating a meal.

Who it benefits

Mindfulness-based cognitive therapy, also called mindfulness-based cognitive counseling, was developed to help people with major depressive disorder avoid relapse and can be effective in people who have experienced three or more depressive episodes. This modality is similar to cognitive-behavioral therapy (CBT) and has a wide reach in the challenges it may support. 

Mindfulness-based cognitive therapy and other mindfulness-based interventions may help a variety of different groups, including people with:

Some recent research also shows that mindfulness-based cognitive therapy can effectively treat depression after a traumatic brain injury or in those with chronic pain. A recent study found that mindfulness-based cognitive therapy may also have small to moderate effects on depression, anxiety, pain, quality of life, sleep quality, and mindfulness for female patients with fibromyalgia.

Goals for mindfulness-based cognitive therapy

The goal of mindfulness-based cognitive therapy is to help people with major depressive disorder and other forms of depression learn mindfulness techniques that these individuals can use to manage periods of sadness to reduce the likelihood of a depressive episode. It aims to help people identify the earliest signs of depression so that these individuals can apply the mindfulness practice tools they learn in therapy to react to those feelings differently.

Research

Mindfulness and cognitive behavioral therapy share many similarities. The goal of both interventions is to improve mental health through a combination of behavioral and cognitive exercises. Mindfulness and cognitive behavioral therapy both encourage patients to view their feelings and thoughts as temporary and not apply any inherent meaning behind them. However, as this study explored, there are also many fundamental differences, the most evident of which is the focus on changing versus accepting negative thoughts.

Mindfulness vs. cognitive therapy goals

Traditional cognitive behavioral therapy works to challenge automatic thoughts and then change them and modify the resulting behaviors. Mindfulness, on the other hand, encourages a lack of engagement with thoughts and emotions. Another key difference is the goals of cognitive behavioral therapy and mindfulness-based cognitive therapy. CBT generally has patients identify primary treatment goals and helps them continue to progress toward those goals. Mindfulness does not have specific goals; in fact, it encourages an attitude of not striving for a goal and simply learning to work with thoughts and feelings in the moment. 

Mindfulness vs. cognitive therapy goals

Despite these differences, cognitive behavioral therapy and mindfulness have similar results: patients can change how they look at unpleasant feelings and thoughts and realize that these feelings and thoughts aren’t as powerful as they previously believed, which weakens the cycle of maladaptive behaviors. Although cognitive behavioral therapy and mindfulness have their differences, their similarities may be why these practices work so well together in mindfulness-based cognitive therapy.

Finding therapy

Knowing that you have options can be motivating if you’re interested in learning more about mindfulness-based cognitive therapy or want to speak to a licensed mental health professional for any other reason. Mindfulness-based cognitive therapy can be a helpful tool if you have a history of depressive episodes and want help learning how to manage or prevent them in the future, but if you’re currently having a depressive episode, you may need more urgent treatment.

Leaving home during a depressive episode can be challenging. Online therapy might be a good choice if you’re uncomfortable meeting a therapist in person. When you sign up for a platform like BetterHelp, you’re matched with a therapist within 48 hours in most cases, so you can find a qualified provider to help you.

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Updated on September 18, 2024.
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