What is mindfulness-based cognitive therapy and does it work?

Mindfulness-based cognitive therapy (MBCT) combines mindfulness techniques, like meditation, with cognitive techniques, such as thought reframing. The combination has helped those with recurrent mental health issues reduce relapse even when faced with stressful life events. 

In this blog, we define mindfulness-based cognitive therapy and how it’s used, examine MBCT’s effectiveness, review specific mindfulness and cognitive techniques, and illustrate a typical MBCT treatment program. We even show you how to find an MBCT therapist who can guide you or a loved one in developing your own mindfulness practices.

What is mindfulness-based cognitive therapy?

Mindfulness-based cognitive therapy (MBCT) is a form of psychotherapy, or talk therapy, that helps develop new ways of responding to emotional triggers. Its 2-pronged approach — mindfulness techniques and cognitive reframing — allows for improved emotional regulation. 

Being mindful means you’re able to observe your thoughts and feelings without judgment and without response. By practicing mindfulness techniques, you can learn to identify and accept your thoughts and feelings as a part of the self, not the whole self. Because we are more than just our thought patterns or emotional states.

The cognitive portion of MBCT examines how our thoughts impact how we feel and behave. Cognitive reframing teaches a person how to interrupt or replace negative, irrational thoughts with more positive, realistic ones. For example, feeling sad isn’t necessarily an indicator that you’re headed toward another depressive period, sadness is a normal human emotion experienced when we feel disappointed or discouraged.

What MBCT is used for

MBCT was developed in the early 2000s by psychologists Zindel Segal and John Teasdale as a treatment to help those with recurrent depressive episodes. It was adapted from mindfulness-based stress reduction, an approach developed by Dr. Jon Kabat-Zinn to improve well-being by increasing mindfulness. Segal and Teasdale found that some people with depression were more susceptible to relapse when their emotional states were triggered. 

While feelings of sadness, fatigue, and irritability are common depressive symptoms, they’re also appropriate emotions to life’s stressors. Segal and Teasdale discovered that increasing a person’s ability to be mindful and pay attention to the present moment’s thoughts and feelings without judgment increased a person’s ability to break old, automatic responses to difficult emotions. It also made room for more positive outlooks.

In addition to treating depression, MBCT has been used to treat other mental health issues, including anxiety, bipolar disorder, addictions, ADHD, and eating issues. MBCT has also been successful in helping people with emotional distress caused by physical health issues, such as vascular disease, chronic pain, fibromyalgia, and traumatic brain injury.   

Does mindfulness-based cognitive therapy work?

A review of multiple studies found that, on its own, MBCT is successful for reducing depressive symptoms and lowering a person’s potential for relapse.  When combined with other interventions, like cognitive behavior therapy (CBT) or medication, MBCT is even more effective. The success is related to MBCT’s 2-pronged approach — mindfulness techniques and cognitive reframing — and its ability to rebalance neural networks.

In clinical work, Segal and others found that those with depression or sad mood states had higher activation in the brain’s executive control network, which is focused on thinking and meaning-making, which is the way we interpret situations, events, objects, or spoken communication, in the light of their previous knowledge and experience. In other words, a depressed person may get stuck on thinking, judging, and reacting to their emotional state, sadness for example, and may get triggered when that feeling occurs. 

Mindfulness training helps build present-moment pathways in the brain, which activates the insula, or the region of the brain (located in the cerebral cortex) known for awareness, attention, and sensitivity in the moment. With the insula activated and more receptive, we now have another channel to help process our emotions. With the executive functioning and the insula channels activated, people have the opportunity for a more balanced neural response to difficult emotions. 

What’s the difference between MBCT and traditional CBT?

The biggest difference between mindfulness-based cognitive therapy and cognitive behavior therapy (CBT) is MBCT’s focus on mindfulness techniques. While mindfulness techniques may be used as one of many potential coping skills in CBT, they are integral to MBCT and are expected to be practiced on a daily basis. 

Another difference is the way the treatments are delivered. Traditional MBCT is conducted in groups over an 8-week period, while CBT is typically conducted individually on a weekly or bimonthly basis for several months.

Group MBCT is also more focused on psycho-education about meditation, depression, and cognitive distortions instead of emotional processing, which can be an important part of CBT. However, if you want the opportunity to explore your emotions in addition to the psycho-education, it’s possible to find a provider who offers MBCT on an individual basis.

What are the principles of mindfulness-based cognitive therapy? 

The core principles of MBCT are the use of: 

1. Mindfulness techniques to help you identify and experience emotions without judgment and reaction.
2. Cognitive reframing to replace negative thoughts with positive, realistic thoughts. 

The overall goal of MBCT is to learn how to manage difficult feelings and thoughts with calmness, compassion, and positive action in order to limit relapse.

The cornerstone of MBCT, mindfulness techniques can improve mental health in several ways. Mindfulness helps you: 

• Identify and observe thoughts and feelings in the moment
• Interrupt downward spirals in mood
• Replace judgment with compassionate
• Focus on the positive
• Deal with difficult emotions through observation and acceptance

How does mindfulness-based cognitive therapy work?

Being mindful — observing our thoughts and feelings without judgment — isn’t an easy task. That’s why a big part of MBCT is psycho-education and daily practice of mindfulness techniques, which include:

• Present moment awareness: Stopping to observe your thoughts and feelings in the here and now.
• Meditation: Sitting quietly, even for just 5 minutes, to let your thoughts and feelings come and go without judgment.
• Breathing exercises: One of the most popular is the 3-minute breathing space, which allows 1 minute for present moment awareness, 1 minute to focus on breath, and 1 minute for expanding your awareness to the whole body. Find more breathing exercises.
• Body scan exercises: Lying flat, acknowledge the thoughts and feelings that come up as you scan your body from head to toe.   
• Yoga or mindful stretching: A yoga practice is a great way to be present and focused on your physical self.
• Daily mindfulness: Focusing on the detailed steps you take in your daily routines, for example, showering, eating breakfast, or making your bed.

Benefits of mindfulness-based cognitive therapy 

In addition to improving mood and overall functioning, there are other benefits to MBCT.

Increased positivity

With a focus on limiting the negative impact that difficult emotions have on our psyche, MBCT opens up our ability to feel more positive emotions. For many, this influx of positivity is an immediate reward in practicing mindfulness.

More resilience

Mindfulness practices can help you see that you’re not your thoughts or feelings. While difficult thoughts and feelings are a part of you, they don’t define you, and aren’t necessarily an indication of a bigger problem. With this acceptance, a person can become more resilient to difficult, but normal, emotional states and find more positive ways to cope. 

Improved decision-making

When you’re in the moment, and aware of how you’re thinking and feeling, you can better assess your needs. This can have a positive impact on decision-making and problem-solving. Instead of reacting based on old habits or impulsivity, you can make decisions that are thoughtful and logical instead of rash and inconsequential.

Heightened creativity

Many credit meditation with increasing creativity, and we’re not just referring to artistic endeavors. We are creative when we solve problems or make dinner or play with the dog. By attuning ourselves to the present moment and fostering a sense of calm, we reduce the noise in our heads and bodies that can dampen creativity. When we are mindful, we’re inherently creative, which can positively impact our relationship with ourselves and others. 

What to expect from MCBT

A typical course of MBCT includes 8 weeks of group therapy with meetings held once a week for 2 hours and a full-day session in the fifth week. The focus of the sessions includes psycho-education about meditation techniques, depression, and the correlation between thoughts and feelings. In addition, group members are expected to do about an hour of homework every day where they practice mindfulness techniques. 

If group work isn’t for you, it is possible to find an MBCT therapist who offers individual therapy. A therapist who practices MBCT can help you identify the thoughts and feelings that trigger you and guide you in mindfulness and cognitive techniques. You’ll also be able to process emotional content. As in group therapy, daily homework will be a part of individual MBCT.

MBCT can be used in combination with medication and has been found to be more effective than medication alone for people with major depressive disorder. As always, you should seek the help of a psychiatrist when considering medication and let your therapist know what medications you’re taking. 

Side effects of mindfulness-based cognitive therapy

MBCT is a relatively new form of mental health treatment, so the long-term impacts are unknown and there’s room for more rigorous studies. While most current studies show its effectiveness, particularly with depression and chronic physical ailments, there are a few case studies highlighting the possible negative side effects of meditation. 

Some case studies have found that meditation brings up an increased awareness of difficult feelings and psychological problems, which could be particularly troubling for those who are predisposed to depression or psychosis. 

Another case study found that meditation revealed forgotten trauma. While processing trauma is usually considered a healthy step, it should be something a person chooses to do. If you’re not conscious of trauma, remembering it through meditation may have a devastating effect. 

Can mindfulness-based cognitive therapy be practiced at home?

MBCT can be practiced at home and, in fact, homework is a required part of the treatment. 

A study by the National Library of Medicine highlighted that higher levels of practicing mindfulness techniques at home led to more successful and positive therapeutic results. Another study comparing MBCT and CBT, found that MBCT was more effective than CBT, in part, because of the daily mindfulness practice component. 

Because there are risks to any therapeutic intervention, it’s best to start with a professional trained in MBCT techniques and practices. Working with a professional gives you support as you learn new things about yourself and also ensures you have a resource available if your needs change. 

Key takeaways 

As you continue your healing journey to find a therapeutic approach that suits your needs, here are the main things to consider with MBCT:

• Being mindful means observing your thoughts and feelings without judgment.
• Mindfulness techniques help you change your relationship with difficult emotions and thereby change your reaction to them.
• Mindfulness techniques include meditation, body scans, yoga, breathing exercises, and present moment awareness.
• Cognitive reframing helps you identify and replace negative thought processes with more positive and realistic ways of thinking.
• MBCT has been effective in treating depression, anxiety, bipolar disorder, addiction, ADHD, and chronic physical conditions, such as vascular disease, traumatic brain injury, and fibromyalgia.
• Traditional MBCT is in a group setting lasting for 8 weeks, but there are therapists who offer MBCT for individuals.
• Daily homework of mindfulness techniques is a part of either group or individual MBCT.
• A core principle of MBCT is developing mindfulness practices that help you get well and stay well. 

Practice MBCT with a licensed professional 

At Klarity, we make it easy for you to find a mental health provider who specializes in MBCT treatment. Whether you’re looking for a therapist or a psychiatrist to prescribe medications, find the provider you need on Klarity and start feeling better today.

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.