Mindfulness-Based Cognitive Therapy at University of Iowa

“People are yearning for a deep connection with themselves in a way that nurtures and heals.”–Jon Kabat-Zinn, PhD.

And here’s a heads up about the next upcoming session of Mindfulness-Based Cognitive Therapy at The University of Iowa Hospitals and Clinics.

When: Wednesdays, October 3-November 28, 2012, 5:30-7:30 PM; The group won’t meet on November 21 due to the Thanksgiving holiday. There will be an extended session (part of MBCT program) on Saturday, November 10 from 9:00 AM to 93:00 PM.

Who to Contact for Intake:

Email: mindfulness@uiowa.edu

Phone: 319-384-5089

Website: Mindfulness Programs

Where: Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa

The Announcement: MBCT is a method that integrates mindfulness meditation cognitive therapy. Scientific research supports that it is effective, when practiced consistently, for prevention of depression relapse and, for some, reduced use or elimination of antidepressant medication. Participants will develop present-focused attention that engages the body, mind and heart and relating more effectively to patterns of thoughts, emotions, bodily sensations individual reactive behaviors that contribute to depressive relapse. Learning to acknowledge one’s internal and external experiences with acceptance, and exploring them with curiosity and compassion supports greater access to inner wisdom and the creation of new patterns of skillful responses. This eight-week program includes one extended session.

Who may benefit from MBCT?

People who have a diagnosis of recurring depression and are in at least partial remission, as well as those who experience chronic anxiety. To benefit fully from MBCT, a desire to be an active persistent in caring for oneself, and commitment to consistent home practices are essential. Interested participants must do an intake session with the facilitator in the Department of Psychiatry at UIHC (See contact information for scheduling). MBCT and the required intake session are paid for by most insurance plans with mental health and group therapy coverage. Participants must have a diagnosis of depression and/or anxiety.
The video suggests patients may not respond to MBCT if they’ve had fewer than 2-3 previous episodes of major depression. One of the studies below (Geschwind and colleagues) seems to contradict that, although more studies are needed.

Another Website for MBCT: MBCT Home

Chiesa, A. and A. Serretti (2011). “Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis.” Psychiatry Research 187(3): 441-453.
Mindfulness- based Cognitive Therapy (MBCT) is a meditation program based on an integration of Cognitive behavioural therapy and Mindfulness-based stress reduction. The aim of the present work is to review and conduct a meta-analysis of the current findings about the efficacy of MBCT for psychiatric patients. A literature search was undertaken using five electronic databases and references of retrieved articles. Main findings included the following: 1) MBCT in adjunct to usual care was significantly better than usual care alone for reducing major depression (MD) relapses in patients with three or more prior depressive episodes (4 studies), 2) MBCT plus gradual discontinuation of maintenance ADs was associated to similar relapse rates at 1 year as compared with continuation of maintenance antidepressants (1 study), 3) the augmentation of MBCT could be useful for reducing residual depressive symptoms in patients with MD (2 studies) and for reducing anxiety symptoms in patients with bipolar disorder in remission (1 study) and in patients with some anxiety disorders (2 studies). However, several methodological shortcomings including small sample sizes, non-randomized design of some studies and the absence of studies comparing MBCT to control groups designed to distinguish specific from non-specific effects of such practice underscore the necessity for further research.

Fjorback, L. O., M. Arendt, et al. (2011). “Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy – a systematic review of randomized controlled trials.” Acta Psychiatrica Scandinavica 124(2): 102-119.
Fjorback LO, Arendt M, Ørnbøl E, Fink P, Walach H. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy – a systematic review of randomized controlled trials. Objective:  To systematically review the evidence for MBSR and MBCT. Method:  Systematic searches of Medline, PsycInfo and Embase were performed in October 2010. MBSR, MBCT and Mindfulness Meditation were key words. Only randomized controlled trials (RCT) using the standard MBSR/MBCT programme with a minimum of 33 participants were included. Results:  The search produced 72 articles, of which 21 were included. MBSR improved mental health in 11 studies compared to wait list control or treatment as usual (TAU) and was as efficacious as active control group in three studies. MBCT reduced the risk of depressive relapse in two studies compared to TAU and was equally efficacious to TAU or an active control group in two studies. Overall, studies showed medium effect sizes. Among other limitations are lack of active control group and long-term follow-up in several studies. Conclusion:  Evidence supports that MBSR improves mental health and MBCT prevents depressive relapse. Future RCTs should apply optimal design including active treatment for comparison, properly trained instructors and at least one-year follow-up. Future research should primarily tackle the question of whether mindfulness itself is a decisive ingredient by controlling against other active control conditions or true treatments.

Geschwind, N., F. Peeters, et al. (2012). “Efficacy of mindfulness-based cognitive therapy in relation to prior history of depression: randomised controlled trial.” The British Journal of Psychiatry.
Background:There appears to be consensus that patients with only one or two prior depressive episodes do not benefit from treatment with mindfulness-based cognitive therapy (MBCT). Aims:To investigate whether the effect of MBCT on residual depressive symptoms is contingent on the number of previous depressive episodes (trial number NTR1084). Method:Currently non-depressed adults with residual depressive symptoms and a history of depression (⩽2 prior episodes: n = 71; ⩾3 episodes: n = 59) were randomised to MBCT (n = 64) or a waiting list (control: n = 66) in an open-label, randomised controlled trial. The main outcome measured was the reduction in residual depressive symptoms (Hamilton Rating Scale for Depression, HRSD-17).Results:Mindfulness-based cognitive therapy was superior to the control condition across subgroups (β = –0.56, P<;;;0.001). The interaction between treatment and subgroup was not significant (β = 0.45, P = 0.16). Conclusion:Mindfulness-based cognitive therapy reduces residual depressive symptoms irrespective of the number of previous episodes of major depression.

Manicavasgar, V., G. Parker, et al. (2011). “Mindfulness-based cognitive therapy vs cognitive behaviour therapy as a treatment for non-melancholic depression.” Journal of Affective Disorders 130(1–2): 138-144.
Aim To examine the comparative effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behaviour Therapy (CBT) as treatments for non-melancholic depression. Method Participants who met criteria for a current episode of major depressive disorder were randomly assigned to either an 8-week MBCT (n = 19) or CBT (n = 26) group therapy condition. They were assessed at pre-treatment, 8-week post-group, and 6- and 12-month follow-ups. Results There were significant improvements in pre- to post-group depression and anxiety scores in both treatment conditions and no significant differences between the two treatment conditions. However, significant differences were found when participants in the two treatment conditions were dichotomized into those with a history of four or more episodes of depression vs those with less than four. In the CBT condition, participants with four or more previous episodes of depression demonstrated greater improvements in depression than those with less than four previous episodes. No such differences were found in the MBCT treatment condition. No significant differences in depression or anxiety were found between the two treatment conditions at 6- and 12-month follow-ups. Limitations Small sample sizes in each treatment condition, especially at follow-up. Conclusions MBCT appears to be as effective as CBT in the treatment of current depression. However, CBT participants with four or more previous episodes of depression derived greater benefits at 8-week post-treatment than those with less than four episodes.