How does mindfulness-based cognitive therapy work?☆
Section snippets
Design
This mechanisms study was embedded in an RCT comparing MBCT (with discontinuation of ADM) to mADM (Kuyken et al., 2008). MBCT was delivered as a manualized, group-based training program designed to enable patients to learn mindfulness and other skills that prevent depression recurrence (Segal et al., 2002). The MBCT program involved a one-to-one orientation session with the therapist followed by eight weekly two hour sessions over approximately two months and four follow-up sessions spread out
Results
For the treatment-adherent sample (N = 114) and cognitive reactivity sub-sample (n = 80), descriptive information at baseline is in Table 1, and outcomes at post-treatment and 15-month follow-up are in Table 2. These outcome profiles were comparable to the ITT sample (Kuyken et al., 2008).
Discussion
This study provides the first evidence of what mediates MBCT’s treatment effects. Consistent with MBCT’s theoretical premise, increases in mindfulness and self-compassion across treatment mediated the effect of MBCT on depressive symptoms at 15-month follow-up. Furthermore, MBCT changed the relationship between post-treatment cognitive reactivity and depression outcome. In patients receiving mADM, greater reactivity predicted poorer outcome, replicating previous findings (Segal et al., 2006).
Acknowledgements
We are grateful to the patients who participated in the trial, the physicians and other health care staff who enabled the trial, Anna Rabinovich and Helene Kraemer who advised on and assisted with the analyses, Becca Crane and Trish Bartley at the Bangor Centre for Mindfulness Research and Practice for their input to the MBCT therapist training, the independent members of the Trial Steering Committee (comprising John Campbell [Chair], Emer O’Neill, Richard Moore, Paul Lanham, and Andy
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Cited by (0)
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This paper was written by Willem Kuyken and Tim Dalgleish on behalf of the Exeter MBCT Trial team. Sarah Byford, Rod Taylor & Ed Watkins were co-investigators, Emily Holden and Kat White were research staff, Alison Evans was a trial therapist, Sholto Radford completed his MSc on archival data and John Teasdale advised on the design, conduct and analysis of this study.