BY VAALPARK MHU | August 12, 2021

Blog By

Dr Melané van Zyl
Psychiatrist

WHAT IS MBCT?

Mindfulness-based cognitive therapy is a group program that was designed to delay or prevent the recurrence of depression. So, although we now include patients who are acutely depressed, the program was originally intended for patients who struggled with depression in the past, and they want to try to prevent the depression from returning. Patients often ask if it is possible to stop their antidepressants, and MBCT offers an extremely effective alternative to antidepressants in the maintenance phase.

Patients that can benefit from MBCT therefor include:

• Patients who are currently well, but have suffered from depression in the past (one or more episode)
• Patients who are currently depressed
• Treatment resistant depression
• Patients with residual depressive symptoms

It is an 8-week group program where we teach the following skills:

• Mindfulness meditation
• Mindfulness movements
• The body scan
• And other skills such as the 3-min breathing space, mindful eating and walking

How is MBCT different from CBT?

CBT (Cognitive Behaviour Therapy) is probably the best known, most evidence based and most used psychotherapy. It says, “Your thoughts determine how you will feel and react when something triggers you”. Therefor maladaptive thoughts and behaviour causes psychopathology. If you can adapt your thoughts, you will feel and react better.
MBCT is a MBI (Mindfulness Based Intervention) which brings mindfulness into the program. Mindfulness is purposeful, non-judgmental attention to the present moment. Mindfulness is a skill that is practiced by doing mindfulness meditation and other mindfulness activities.
To change our thoughts and behaviours, we must be aware of them first. Mindfulness practices helps us to cultivate this awareness e.g., what were my thoughts before I did…. We often act without being aware of our thoughts, this is called being on auto- pilot.
Ultimately MBCT gives us the skill to be aware of our thoughts, feelings, emotions, and behaviours in such a way that we can handle the symptoms of depression more effectively.

For whom is it indicated?

MBCT is an effective program to prevent depression from returning. So, the typical patient who will benefit is someone who has had an episode of depression in the past, and who’s symptoms are in remission. This program will be useful for patients who have recovered from depression and want to stop their antidepressants.

For whom is it contra-indicated?

If the following symptoms are present, an MBCT will not be the first treatment of choice:

• Poor concentration
• Complicated PTSD (Post Traumatic Stress Disorder) or unresolved trauma
• Patients struggling to “sit” with emotions such as anxiety and depression.

How does the program work?

• Acceptance into the program after evaluation
• 8-week program, 2-hour session (face to face) or 1,5-hour session (online)
• Home practice

Dr Melané van Zyl