Mindfulness-based cognitive therapy

Domain II · Behavioural & cognitive · Segal, Williams, Teasdale · 2002

What it is

Caution on sources: Sources include the 2013 book's chapter structure (Guilford contents page) and the session components in published trial tables of MBCT protocols. The book text is not drawn on, so the step-level details below are paraphrased from the manual's known structure and corroborating…

Format

• Format: 8 weekly classes of about 2 to 2.5 hours, usually for groups of about 8 to 15. There is one individual pre-class interview and one day of mindful practice. The book places the practice day between Sessions 6 and 7; mbct.com says "between weeks 5 and 7". Home practice is about 45 minutes a…
• Overall arc: The book divides the programme into two halves:

Who practises it, and how they are trained or regulated

• Teacher requirements: The developers insist on an instructor's own sustained daily mindfulness practice plus formal MBCT teacher training. mbct.com lists a training pathway, and AccessMBCT lists instructors. Competence is commonly assessed with the MBI:TAC (Bangor, Exeter and Oxford; versions 2010, 2018 and 2021). The specific pathway requirements (retreats, hours, supervision) are not drawn on.
• What MBCT is: MBCT is a manualised 8-week group class. It combines mindfulness meditation training adapted from Kabat-Zinn's MBSR with elements of cognitive therapy for depression. It was designed mainly as relapse prevention for people who have recovered from recurrent depression. It is taught as a class with an instructor, not as individual therapy. Most of the work happens in daily home practice.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Over-intellectualising.
• All-or-nothing plans. Encourage small, realistic changes.
• Over-disclosure early on, and anxiety about "doing it right".
• Shame and avoidance. Normalise without lowering the expectation.
• Self-consciousness in a group. Arrange the room so people are not watched.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.