Cognitive behavioral therapy that uses mindfulness was created to prevent depressive episodes. How does it work and is it effective?

Mindfulness-based cognitive behavioral therapy (MBCT) is a form of talk therapy that blends meditation and mindfulness alongside cognitive behavioral therapy (CBT).

MBCT was created as an intervention for people prone to recurrent depressive episodes.

MBCT uses elements of mindfulness to tackle unhelpful thought patterns and CBT to reframe those thoughts and behaviors.

Research shows that MBCT is effective in preventing recurrence among people who have depression. But more research on this type of therapy is needed, according to a 2018 review of studies.

Depression and depressive episodes are highly recurrent. MBCT can be helpful in preventing depression relapse.

Diana Vo, a licensed marriage and family therapist and the clinical director of Renaissance Recovery, says MBCT for depression is ideal because the recurrence of depressive episodes is often caused by specific thought patterns or “thinking traps.” The combination of elements in MBCT can reverse some of those trigger points, she says.

Addressing ‘thinking traps’

In addition to addressing cyclic episodes, Vo and Laura Sgro, a licensed clinical social worker, agree that MBCT is especially helpful for depression treatment.

“MBCT aims to break these unhelpful patterns of thinking that lead to depressed mood,” Sgro says, “and instead help folks develop a new relationship with themselves, their thoughts, and their experiences.”

Other facets of depression include what Kaylee Friedman, a licensed mental health counselor, calls thinking traps or cognitive distortions, which include:

  • black-and-white thinking
  • personalization
  • negativity bias

“Because MBCT helps folks change unhealthy thought patterns, they also learn how to interject more positive or helpful narratives into their everyday lives, which can help to improve mood,” Sgro says.

There are a few variations of behavioral therapy, including:

Any of these variations could be applied to treat depression or cyclic depressive episodes.

Many of these options focus on the relationship between our thoughts, feelings, and behaviors, according to Sgro. These therapies then focus on altering the unhelpful thoughts to decrease negative feelings or behaviors.

MBCT takes it a step further, Sgro says, because it “incorporates mindfulness practices to assist in observing and identifying their thoughts and helps folks separate themselves from their thoughts.”

“This separation allows folks to practice not judging themselves or their thoughts instead of becoming more upset,” she says. “And [it] also helps them cope with distressing emotions in the moment.”

If you’re new to mindfulness, a therapeutic intervention that focuses on meditation or mindfulness-based elements could feel like unknown territory.

While there’s no standard formula for how each of your sessions will occur, there are some commonalities.

Dedicated session and practice time are needed

In an MBCT therapy program, you’re engaging in 2-hour classes weekly in addition to weekly homework. The therapy plan typically lasts 8 weeks. Each of these classes and take-home assignments focus on different portions of the curriculum, including:

  • meditation strategies
  • understanding how our thoughts and feelings are related
  • practicing cognitive strategies to change our thought processes

Try to be patient with yourself and slow down

Engaging in a meditation-heavy practice may feel daunting. Try to give yourself the needed space to let your thoughts come as they are in order to address them in a productive way.

“Mindfulness requires intentionally slowing down and connecting with your thoughts, your body, and your surroundings,” Sgro says. “Mindfulness also requires someone to practice not judging or assigning meaning to their thoughts, which usually involves practice.”

Be prepared to uncover

Each session during an MBCT treatment plan can differ. But you can expect your therapist to work with you to discover and pull apart your negative thoughts. The goal is to rewire those thinking patterns.

If you’re interested in the MBCT modality but aren’t sure where to start, consider using your personal connections and network. You can also use online databases to sift through licensed professionals. Psych Central’s How to Find Mental Health Support resource can also be helpful.

It’s also important to consider searching for therapists or clinicians who specialize in experiences that align with yours, particularly if you navigate trauma.

“If you have a history of trauma, it is important to see a trauma-informed therapist,” Friedman says. “Mindfulness can be contraindicated or unsafe for people with conditions like PTSD or panic disorder if it is not facilitated by someone who is educated about trauma.”

Determine the level of structure

If you’re looking for someone to guide you through the full 8-week process, you can look for therapists offering local group MBCT sessions.

“Therapists who advertise specializing in both mindfulness and cognitive behavioral therapy (CBT) will likely incorporate both techniques into their practice in a less structured way than the formal group process,” Sgro says.

Credentials + personality = A match

The experts interviewed emphasize the importance of finding a therapist that feels like a fit.

“The most important aspect of finding a therapist is simply your level of comfort with that person,” Friedman says. “In order for therapy to be effective, it’s important that you ‘click’ with the therapist.”

If you’re navigating depression or recurrent depressive episodes, MBCT could be a useful resource. If you’re well-versed in meditation and mindfulness practices, then this is a merging of your practice and CBT-based psychotherapy.

If you’re new to mindfulness, CBT, or both, there could be an adjustment period. But there’s room for you to gain comfortability.

Remember that depression is lived differently by each person. What works for others may not work for you. But know that you have lots of options when it comes to managing symptoms of depression, and none of them have to be done alone.

Talk with a doctor or a mental health professional who can help you find the best treatment plan.

Learn more about depression, treatment options, how to help a loved one, and available resources in Psych Central’s Depression Resource Hub.