Mindfulness-based cognitive therapy (MBCT)

The task the programme was created for

Depression tends to return. After one episode the likelihood of another rises noticeably; after three it becomes high. The reason is that each episode entrenches a mechanism: a small dip in mood sets off a familiar chain of thoughts about being inadequate and about hopelessness, and the chain itself winds the state up into a full episode.

MBCT works precisely with that transition — with the moment when ordinary sadness starts turning into depression.

How it is put together

Recognising the early signal. Participants learn to notice the very beginning of a downturn — bodily signs, a shift in thinking, a narrowing of activity — before the process gathers strength.

Getting out of rumination mode. Chewing over thoughts (“why am I like this”, “what is wrong with me”) is experienced as an attempt to work things out, but in fact it holds the state in place. Mindfulness practice offers an alternative: switching from thinking about an experience to directly observing it.

Disidentifying from thoughts. The key skill: seeing the thought “I am good for nothing” as a mental event rather than as a report on reality. This weakens its power without requiring you to argue with it.

An individual plan. By the end of the programme every participant draws up their own set of early warning signs and actions for when they appear.

Format

Eight weekly group meetings plus daily independent practice. The structure is close to MBSR, but the content is adapted to working with depression: cognitive elements are added, and the practices are arranged with an eye to how attention behaves in low mood.

When the programme fits

It fits: after coming out of a depressive episode, as prevention; where there is a tendency to prolonged rumination; where there are recurrent episodes in the history.

It does not fit as the main treatment in an acute episode of depression. In that period daily practice is hard to sustain, and the first step should be treatment of the acute state and, if needed, medication prescribed by a doctor.

At the centre

MBCT is one of the centre’s programmes. Group enrolment will be announced; elements of the approach are used in individual work with clients who have come out of a depressive episode.