3rd Wave: Mindfullness/acceptance based - MBCT

Question 1

Why were 3rd wave therapies developed?

Answer 1

Westbrook + Kirk (2005)

• only 50% of people who have CBT significantly improve
• those with more complex co-morbid diagnoses respond less well

Vittengl et al (2007) looked at those treated with CBT

• 29% relapsed in 1st year
• 54% relapsed in 2 yrs

Question 2

Hayes et al (2004)

Answer 2

recognition that it is not the content of personal experience that may affect psychological difficulties but how an individual relates to those thoughts

Question 3

what doe Mace (2007) say mindfulness does?

Answer 3

sustain an accepting awareness towards all experiences

Question 4

Jon-Kabat-Zinn (1994)

Answer 4

definition of mindfulness

the awareness that arises through paying attention in a particular way: on purpose, in the present and non-judgmentally

Question 5

Segal, Williams and Teasdale (2002) - what does mindfulness integrate?

Answer 5

MBCT integrates elements of CBT for depression with mindfulness

Question 6

why was MBCT developed and how is it taught

Answer 6

originally developed to reduce relapse
- combines psycho-education on relapse in depression with mindfulness and gentle yoga practice

taught in an 8 week programmes

Question 7

Key Features of MBCT

Answer 7

originally developed to reduce relapse rates in depression
MBCT taught when depression is in remission
Includes CB-based psycho-education warning signs for relapses
focuses on specific vulnerabilities
focuses on what you do when you have an unhelpful thought/patterns of thinking

Question 8

What does MBCT for relapse in depression target?

Answer 8

acceptance of thoughts and feelings as part of human experience and not letting them be dominant

use mindfulness to develop a more ‘stepped-back’ approach accepting relationship to symptoms, thoughts and about self/emotions

teaches individuals skills which help them disengage from habitual, automatic dysfunctional cognitive routines to prevent relapse

Question 9

Chiesa and Serretti (2011)

Answer 9

review and meta analysis of published MBCTs trials for psychiatric disorders

4 RCTS showing MBCT + TUA are significantly better at recuding relapse in depression than TAU alone for 3+ episodes of depression 32 vs 60%

recommend continuing TAU with 8 weeks of MBCT

Question 10

Bondolf et al (2010)

Answer 10

relapse rates better for MBCT than TAU

Question 11

Kuyken et al (2008)

Answer 11

RCT comparing MBCT + reducing dosage of ADM with continued ADM

only one to suggest that MBCT is comparable to an established treatment (ADM)

treated patients with depression with ADM until base line then randomised into different control groups

relapse rates at 15 month follow up
MBCT = 47% ADM = 60%

Question 12

Kuyken et al (2008) - what are the mechanisms of change?

Answer 12

mindfulness and self-compassion

reactivating the network of negative thoughts + feelings can lead to a depressive episode

Question 13

Who suggests the components of mindfulness?

Answer 13

Mace (2007)

Question 14

What are the two primary components of mindfulness?

Answer 14

a capacity to direct and maintain receptive awareness

sustaining an acceptable attitude towards all experiences