Mindfulness-integrated CBT

Domain II · Behavioural & cognitive · Cayoun, Francis, Shires · 2001

What it is

MiCBT is a manualised, transdiagnostic therapy. It combines Burmese Vipassana meditation (the Ledi Sayadaw, U Ba Khin and Goenka lineage, with heavy use of body scanning) with CBT, especially exposure. It is meant for acute and chronic conditions and for comorbidity, not for a single diagnosis.

Format

• Format. MiCBT is delivered individually or in groups, and a pilot found the two formats similarly effective. The handbook gives separate individual and group guidance for every session.
• Group (8-week RCT version): 2-hour weekly sessions with 8–13 people.

Who practises it, and how they are trained or regulated

• Version followed: the 10-session, four-stage programme in Cayoun, Francis & Shires, The Clinical Handbook of MiCBT (Wiley, 2018/19), as shown in its published table of contents, the MiCBT Foundation-course outline (UCSD, taught by MiCBT Institute trainers) and the developers' 2024 review (Francis, Shawyer, Cayoun, Grabovac & Meadows). Two other versions exist. The original protocol is Cayoun (2011),…
• Training equanimity toward body sensations (feeling them fully without reacting) removes the reinforcement for reactive habits. It restores the balance between perception, evaluation, interoception and response, and it lets beliefs about experience be reappraised.

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?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• 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

• Rushing through blank areas; seeking pleasant flow.
• Diaries that list only thoughts; prompt for body sensations.
• Hierarchies with big gaps between items; add intermediate steps.
• Abrupt cessation of practice after therapy ends; plan booster sessions.
• Practice dropping without the audio; let the client mix guided and unguided sessions.

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.