Introduction

The Basics

What is Mindfulness-Based Cognitive Therapy (MBCT)?

Mindfulness-Based Cognitive Therapy (MBCT) is a therapeutic approach that combines elements of cognitive behavioral therapy (CBT) with mindfulness and meditation practices.

Goal

What is the goal of Mindfulness-Based Cognitive Therapy (MBCT)?

The primary goal of MBCT is to help individuals develop a different relationship with their thoughts and feelings, particularly negative or distressing ones. Rather than trying to change or eliminate difficult thoughts, MBCT teaches people to observe them with acceptance and non-judgment.

The ultimate aim is to break the cycle of rumination and negative thinking that can trigger depression and anxiety, helping people respond to challenges with greater awareness and flexibility rather than reacting automatically.

Uses

Who could benefit from Mindfulness-Based Cognitive Therapy (MBCT)?

While Mindfulness-Based Cognitive Therapy (MBCT) was originally developed to prevent depressive relapse in people with recurrent depression (its strongest evidence base), research has shown it can also benefit:

• Anxiety disorders
• Bipolar disorder (in combination with medication)
• Chronic pain
• Insomnia
• Substance use challenges
• General stress and emotional regulation difficulties

When MBCT May Not Be Appropriate

• MBCT is most suitable for individuals who are not currently in an acute depressive episode.
• It is not recommended for people experiencing active suicidal ideation or certain severe mental health conditions without additional support.

Subtypes

Are there any subtypes of Mindfulness-Based Cognitive Therapy (MBCT)?

The core 8-week program remains standard, but several adaptations have emerged that are beneficial in integrating core principles and practices of MBCT for individuals in a one-on-one format and with lifelong depression (for ongoing maintenance rather than relapse prevention).

Effectiveness

Origins

Who developed Mindfulness-Based Cognitive Therapy (MBCT) and when?

MBCT was developed in the 1990s by psychologists Zindel Segal, J. Mark Williams, and John Teasdale, who sought to create a targeted, evidence-based approach to preventing depressive relapse. They skillfully integrated Jon Kabat‑Zinn’s Mindfulness‑Based Stress Reduction (MBSR) program with cognitive therapy principles grounded in the work of Aaron Beck.

The earliest formulation took shape in the late 1990s, culminating in their group-based MBCT program designed specifically for individuals with recurrent depression. It combined knowledge of how recurring negative thoughts trigger depression with mindfulness techniques that teach patients to notice thoughts without reacting.

Evidence Base

Is Mindfulness-Based Cognitive Therapy (MBCT) evidence-based?

Yes, MBCT has substantial research support and is considered an evidence-based treatment. The research shows that MBCT can reduce the risk of depressive relapse by approximately 40–50% in people who have experienced three or more previous episodes of depression.

How It Works

Techniques Used

How does Mindfulness-Based Cognitive Therapy (MBCT) work?

MBCT combines mindfulness practices with cognitive therapy insights to shift how people relate to their thoughts, feelings, and behaviors.

• Training attention and awareness
  • Mindfulness practices help individuals stay present and notice what’s happening in their mind and body.
  • Instead of being “caught in the storm,” you learn to observe like a weather watcher—recognizing when negative thoughts start to gather without being swept away.
• Recognizing mental traps
  • Individuals practice identifying when their mind slips into negative thought patterns.
  • Skills are developed to step back and observe these patterns without being overwhelmed.
• Changing relationship to thoughts
  • MBCT teaches that thoughts are mental events, not facts.
  • This builds metacognitive awareness—the ability to “think about thinking.”
  • With this awareness, you become more like the vast sky watching clouds drift by, rather than identifying with each cloud as it passes.

What to Expect in a Session

What can I expect from a Mindfulness-Based Cognitive Therapy (MBCT) session?

A typical MBCT session lasts about 2 hours and usually includes:

• Guided mindfulness practices
  • Body scans
  • Breathing exercises
  • Mindful movement
• Group discussion
  • Sharing experiences with the practices
  • Asking questions and learning from others
• Psychoeducation
  • Understanding patterns of depression and anxiety
  • Learning how mindfulness can interrupt these cycles
• Homework assignments
  • Daily mindfulness practice outside of sessions
  • Applying skills in real-life situations

Sessions are structured but flexible, balancing guided practices with time for sharing. They typically occur weekly, with independent practice expected between sessions.

Treatment Length & Structure

How long does Mindfulness-Based Cognitive Therapy (MBCT) take?

MBCT typically follows an 8-week group program structure, with weekly sessions lasting about 2–2.5 hours. There’s also usually a full-day retreat around week 6. The program follows a specific curriculum that progressively builds mindfulness skills:

• Week 1: Awareness and Automatic Pilot—Introduces the concept of “automatic pilot”, which describes how we often operate unconsciously.
• Week 2: Dealing with Barriers—Focuses on recognizing when the mind wanders and learning to gently redirect attention.
• Week 3: Mindfulness of the Breath—Deepens breathing awareness as an anchor for attention.
• Week 4: Staying Present—Explores how to remain present with difficult experiences rather than avoiding them.
• Week 5: Acceptance and Allowing—Teaches the difference between acceptance and resignation.
• Week 6: Thoughts Are Not Facts—Addresses the relationship between thoughts, moods, and depression.
• Week 7: How Can I Best Take Care of Myself?—Focuses on self-care and developing a personal action plan.
• Week 8: Using What Has Been Learned—Reviews the entire program and helps participants develop a sustainable daily practice.

Participants of the group are expected to practice at home daily (typically for 30–45 minutes), using things like guided audio recordings, as a way to reinforce skills learned in the sessions.

Getting Care

Finding a Therapist

How do I find a therapist trained in Mindfulness-Based Cognitive Therapy (MBCT)?

Alma’s directory has many therapists who are trained in Mindfulness-Based Cognitive Therapy (MBCT), including: