Modalities / Cognitive-Behavioral

MBCT

Segal / Williams / Teasdale · 2002
Key text: MBCT (2002)
Cognitive-Behavioral Focus: Skill + Experiential Short (8-week) Group

Core Mechanism

Mindful awareness of depressive cognitive patterns enables decentering and prevents ruminative relapse spirals

Ontology

Depressive relapse maintained by reactivation of ruminative cognitive patterns triggered by low mood

Therapeutic Voice

"Notice the thought arriving — not as truth, but as a mental event. Thoughts are not facts."

View of the Person

A ruminative mind that can learn to observe its own patterns without being captured by them


Evidence

NICE: recommended for recurrent depression. APA Div 12: Strong Research Support

10+ RCTs

Kuyken et al. (2016) IPD meta-analysis

Very strong evidence for preventing relapse (3+ episodes). Comparable to maintenance antidepressants.

Depression & Mood Disorders
Effect: HR = 0.69 vs TAU
~30-40% additional relapse prevention
Kuyken et al., 2016 (2016)

Conditions

Epistemology

EmpiricistContemplative

Blind Spots

Primarily relapse prevention — not first-line for acute depression; requires meditation capacity some clients lack

Contraindications

Acute depressive episode (designed for remission, not acute phase), active suicidality, active psychosis, severe dissociation where mindfulness may trigger depersonalization, acute trauma


Training

Licensed clinician with CBT competency. Personal mindfulness practice (1+ year daily practice) and MBCT participation as prerequisite. Training through Oxford Mindfulness Centre, UC San Diego, or equivalent.

Oxford Mindfulness Centre, UC San Diego, and other recognized programs offer teacher training and certification pathways.

6–12 months formal teacher training; prerequisite: 1+ year personal mindfulness practice + MBCT group participation

$3K–8K for teacher training; retreat costs additional


Philosophical Roots

Buddhist psychology (mindfulness, non-attachment to thoughts); Husserl (epoché — suspending natural attitude); Kabat-Zinn (secularized dharma); Teasdale (interacting cognitive subsystems)

Related Modalities

Test Yourself

How does MBCT prevent relapse?

Show answer

Recognizing early warning signs; relating to thoughts as mental events rather than entering ruminative spirals.


Sources