Mechanisms of change in mindfulness-based cognitive therapy

• Main Author: Bromley, Leslie Andrew
• Published: University of Exeter 2011
• Subjects: 616.891425
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.603474

Mindfulness-based Cognitive Therapy (MBCT) is an 8-week meditation-based group intervention program developed for preventing depressive relapse in people with recurrent depression. While recent studies have supported the efficacy of the therapy, there is a lack of data to support the mechanisms presented by theory. The thesis attempted to investigate MBCTs change processes through exploring patient's experiences during the program, their reflections after the course, and to assess practice, process, and outcome changes in the longer term. The thesis included six studies that used a triangulation of methodologies in an attempt to identify and measure MBCT change processes and assess whether they were associated with reductions in depressive symptoms and staying well in the long term. Findings from a qualitative analysis identified eight main themes that 11 MBCT patients felt had helped to bring about positive change following participation in MBCT, namely awareness, attention, skilful action, control, acceptance, group, difficulties, and transformation. A further study assessed change following participation in MBCT for 40 patients and showed reductions in depressive symptoms which were associated with increased self-compassion, self-kindness, common humanity, reversed over identification, mindfulness, nonjudging of inner experience, nonreactivity to inner experience, self-control, monitoring and control of mood, attributional style, goal setting, and reduced devaluative views of the self. A long term study investigated the effects of MBCT for 36 MBCT patients across 52 months after attending the programme. There was evidence to suggest that participants maintained meditation practice up to a 52 months follow up, that there was a decrease in depressive symptoms and this was associated with increased self-compassion, mindfulness, decreased devaluative views of the self, and a decreased tendency to experience a depressive episode. Participants who stayed well and did not experience a relapse were more likely to reportiess self•judgment, less over identification, and decreased devaluative views of the self. These findings offer preliminary support for some of the MBCT change processes that were assessed.