DIAGNOSIS: Depression
2015 EST Status: Treatment pending re-evaluation
Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings
Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources
Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved
Insufficient Evidence: No meta-analytic study could be identified
Insufficient Evidence: Existing meta-analyses are not of sufficient quality
Treatment pending re-evaluation
1998 EST Status: Strong Research Support
Strong: Support from two well-designed studies conducted by independent investigators.
Modest: Support from one well-designed study or several adequately designed studies.
Controversial: Conflicting results, or claims regarding mechanisms are unsupported.
Strength of Research Support
Empirical Review Status
2015 Criteria
(Tolin et al. Recommendation)
(Tolin et al. Recommendation)
Very Strong
Strong
Weak
Insufficient Evidence
Treatment pending re-evaluation
Find a Therapist specializing in Mindfulness-Based Cognitive TherapyList your practice
Brief Summary
- Basic premise: Depression is associated with a network of negative modes of thinking and feeling. These modes can be reactivated during periods of remission leading to relapse.
- Essence of therapy: Mindfulness-Based Cognitive Therapy (MBCT) combines core concepts of cognitive therapy with training in mindfulness meditation as a means of decreasing cognitive reactivity. MBCT aims to cultivate mindfulness, encouraging patients to both become acquainted with depressive modes of thinking and feeling while at once developing a new (and less reactive) relationship with these experiences. This process involves meeting distressing internal experiences (i.e., thoughts, feelings) with patience, kindness, curiosity, and empathy. MBCT was originally designed to prevent relapse for patients in remission from depression, with an emphasis on detecting early signs of relapse through enhanced decentering. More recent work has investigated MBCT for reducing residual depressive symptoms and comorbid anxiety. A small body of evidence suggests MBCT may be effective for reducing current depressive symptoms.
- Length: 8 weekly 2-hour sessions, typically delivered in a group format (up to 16 patients). Patients are asked to engage in 45 minutes of home meditation practice. A full-day “retreat” between session 6 and 7 and post-intervention “booster” sessions may also be included.
Treatment Resources
Editors:Simon B. Goldberg, PhD; Zindel V. Segal, PhD
Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice
Treatment Manuals
Training Resources
Measures, Handouts and Worksheets
Self-help Books
Smartphone Apps
Video Demonstrations
Video Descriptions
Clinical Trials
Meta-Analyses and Systematic Reviews
Other Treatment Resources
Treatment Manuals / Outlines
Treatment Manuals
Books Available for Purchase Through External Sites
- Mindfulness-Based Cognitive Therapy for Depression (2nd ed.) (Segal, Williams, & Teasdale, 2013)
Training Materials and Workshops
Measures, Handouts and Worksheets
- The mindfulness-based cognitive therapy adherence scale: Inter-rater reliability, adherence to protocol and treatment distinctiveness (Segal et al., 2002)
Self-help Books
- The Mindful Way Workbook: An 8-Week Program to Free Yourself from Depression and Emotional Distress (Teasdale, Williams, & Segal, 2014)
- The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness (Williams, Teasdale, Segal, & Kabat-Zinn, 2007)
Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.
Smartphone Apps
Video Demonstrations
Videos Available for Purchase Through External Sites
- Mindfulness-based cognitive therapy for depression (Segal, 2005)
Video Descriptions
Clinical Trials
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy (Teasdale et al., 2000)
- Metacognitive awareness and prevention of relapse in depression: Empirical evidence (Teasdale et al., 2002)
- Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects (Ma & Teasdale, 2004)
- Mindfulness-based cognitive therapy to prevent relapse in recurrent depression (Kuyken et al., 2008)
- Antidepressant monotherapy versus sequential pharmacotherapy and Mindfulness-Based Cognitive Therapy, or placebo, for relapse prophylaxis in recurrent depression (Segal et al., 2010)
- The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: A randomized controlled trial (van Aalderen et al., 2012)
- Web-based Mindfulness-based Cognitive Therapy for reducing residual depressive symptoms: An open trial and quasi-experimental comparison to propensity score matched controls (Dimidjian et al., 2014)
- Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial (Huijbers et al., 2015)
- Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial (Kuyken et al., 2015)
- Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition (Shallcross et al., 2015)
- Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence (Dimidjian et al., 2016)
- Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial (Cladder-Micus et al., 2018)
Meta-analyses and Systematic Reviews
- The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis (Piet & Hougaard, 2011)
- Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials (Kuyken et al., 2016)
- Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: A meta-analysis (Goldberg et al., 2019)
Other Treatment Resources
- MBCT.com, contains resources for learning about MBCT, receiving MBCT, and training in MBCT
- ACCESS MBCT is an international listing of mental health professionals involved in the delivery of MBCT
- Bangor Centre for Mindfulness Research and Practice, contains free guided mindfulness meditation practices, information about training and research on mindfulness-based interventions (including MBCT)