Mindfulness-based cognitive therapy
In practical work, elements of cognitive therapy for depression are linked to mindfulness-based units of a stress reduction program. In two studies from the years 2000 and 2004, the efficacy of the therapy, which was achieved with max. twelve participants in each of eight meetings.
What is mindfulness-based cognitive therapy?
Mindfulness-Based Cognitive Therapy, abbreviated to MBCT in its Anglo-Saxon term Mindfulness Based Cognitive Therapy, is based on the combination of two well-developed and proven pillars.
Elements of cognitive therapy for treating depression are combined with a mindfulness-based stress reduction program. It is a relatively new therapeutic approach developed by the psychotherapists Teasdale, Segal and Williams in the mid to late 1990s. An essential element of therapy is the training of your own mindfulness.
In accordance with generally accepted cognitive therapy procedures, patients learn to detach themselves from their own centeredness and view the causative events from a different perspective. The relatively strong link between certain events and the resulting negative depressive mood or the conviction that no way out is possible, is broken with the therapy.
Function, effect & goals
The problem after initially successful treatment of depression by medication, psychotherapy or both is the high rate of relapse. Mindfulness-based cognitive therapy was originally developed specifically to prevent recurrent depression following successful treatment.
An essential core element of MBCT is to bring patients out of their central view and to provide them with a view from the outside via mindfulness training. This implies that they feel more and more self-responsibility and are motivated by this kind of sense of achievement to overcome their previous perspective. Mindfulness means attentive and conscious perception with the willingness to allow changes in one's own perspective through what is observed, to enter into a dialogue with the environment as it were. One of the key therapeutic goals is therefore to close the link between certain events or situations and suffered depression.
This is achieved through increased awareness of oneself and the social environment. A very important training element is the mindfulness-based meditation, which runs like a red thread through the group therapy. Participants learn to develop an improved awareness of their own body sensations and mental processes. They recognize leading indicators that point to an imminent relapse into depression and, thanks to their changed perspective, can mentally change the process in order to avoid relapse.
Eight to twelve people attend a MBCT course and meet once a week for a joint mindfulness training with the therapist or trainer. The weekly sessions last about two to two and a half hours. The entire group course lasts for a total of eight weeks. The training consists not only of the weekly sessions, but also homework and daily 60-minute meditation exercises and home-based training six days a week. The "home training" includes at least 45 minutes each. At the beginning of a MBCT course, the main thing is to practice attention and concentration.
Patients learn to accept their current situation, including their emotions and thoughts, which gradually change themselves through a changed view. The patients feel thereby a colossal liberation and relief, which means first steps in the direction of the healing process. The special value of the MBCT lies in its sustainability. A drug treatment of acute depression is - apart from some serious side effects - also effective, but lacks sustainability. This means that the likelihood of falling back to depression after stopping medication is very high.
While the MBCT directly addresses the mindset responsible for triggering depression, and thus acts to combat the causes, drug treatment is more like suppression of symptoms. The MBCT shows a way out of depression.
Risks, side effects & dangers
In contrast to drug treatments for acute depression with antidepressants, mindfulness-based cognitive training has no direct side effects.
The biggest "dangers" involved are the failure to achieve the goals and that a potentially suicidal patient remains at risk. While the success of MBCT largely depends on the patient's active involvement, drug treatment is independent of the patient's activity or passivity. The great advantage of MBCT is that it helps the patient to overcome depression. The patient can only be helped if he not only shows willingness to admit his or her own, but also supports his / her own pathway in community therapy.
This means that the greatest advantage of the MBCT at the same time carries the greatest risk of failure, especially in participants who are suffering from an acute episode of depression. In such constellations, it may be necessary to administer antidepressants in parallel to mindfulness-based cognitive training or to advance the drug treatment of acute depression. Participation in MBCT with concomitant use of antidepressants is of limited value, however, because the drug strongly interferes with the psyche and complicates the patient's active participation in mindfulness-based cognitive training.