Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse

Rating:
Summary: Depression researcher
Review: A fantastic book explaining the basics behind previous research and how we've come to arrive at the new mindfulness-based concept. Highly recommended for new clinicians wanting to further expand their understanding to a brief background of the cognitive aspect of relapse of depression as well as the direction future research appears to be heading.

Rating:
Summary: A good presentation of a treatment and its develpment
Review: A very well-written, comprehensive, clinician-friendly account of a treatment that appears to capture much of the essence of mindfulness and its benefits. Straight forward enough so that clinicians from all theoretical orientations should be able to appreciate the nature of the approach. It is very nice to see, in the past 15 years or so, psychologists finally trying to take a serious scientific stab at traditionally Eastern approaches like mindfulness and acceptance. The only drawback of the book, for me, was the relative lack of a serious scientific technical analysis of the approach, as the description of how the treatment theoretically works is largely discussed in metaphorical and somewhat lay-language. This may simply be because the book is aimed primarily at practicing clinicians, rather than academic psychologists and other researchers. Readers intrigued by this approach should also read Acceptance & Commitment Therapy (1999), by Hayes, Strosahl, & Wilson.

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Summary: Cognitive Therapy meets Mindfulness Meditation
Review: If your interests include psychotherapy (especially cognitive therapies), or meditation (especially Mindfulness Based Stress Reduction), or if you are interested in research on depression, then I suspect that you will find this book as compelling as I did.

Here is what I found profound about this book, from a cognitive therapy perspective. Cognitive therapists have long known that automatic thoughts are related to various psychopathologies, but they typically theorized that CHANGING those thoughts was the royal road to psychological health. The alternative studied and developed by the authors is that carefully ATTENDING to cognitions fully as they arise and fall is itself healing. Rather than focusing on cognitive restructuring of thoughts and thinking, this cognitive therapy postulates that observing thoughts, feelings, perceptions, bodily sensations, and world events in a compassionate, "non-attached" manner liberates one from the suffering that accompanies them. The authors have begun to collect outcome data consistent with this unusual cognitive theory.

I found the authors' review of the depression literature quite informative, and the evidence in support of MBCT is described clearly. At the same time, I couldn't help noting that the MBCT approach is specifically designed to target recovering depressives, with an eye toward preventing relapse. So although MBCT is "for depression, " it is not currently intended to treat depression per se, and it is intended as an adjunct to other treatments (e.g., medication, individual psychotherapy, etc.). So, the authors focus, at least for now, on a narrowly defined population. This is not a criticism of the book or MBCT. But for now, MBCT is quite limited in scope by its infancy. I expect that someone eventually will attempt to systematize a form of MBCT for depression in general, for individuals, or for other clinical populations.

I'm always tempted to buy another book on meditation and psychotherapy. I have to be careful here. There is a glut of excellent, relevant books (e.g., books by Mark Epstein, Daniel Goleman, Ken Wilber). Buying or reading yet another book is the easy, habitual behavior when books are your drug of choice, and your cluttered house is screaming at you with volumes of printed matter. Practicing mindfulness continuously, noticing a habitual tendency, and attending fully to the present moment, presents itself as the mindful, non-habitual alternative choice. Did I really need yet another book?

Well, I'm glad I read yet another book on this topic. This book shares many elements with Mindfulness-Based Stress Reduction (MBSR), an influential meditative approach that has considerable empirical support and is finding its way into many medical and psychological settings (seeJon Kabat-Zinn's "Full Catastrophe Living"). Initially the authors attempted to bolt MBSR approaches onto previously existing variants of Cognitive Therapy. But as their methods and awareness evolved, MBCT increasingly came to resemble Kabat-Zinn's MBSR. Their current MBCT approach is an 8-week group program that strongly resembles the UMASS MBSR program, with some elements of traditional cognitive therapy added. I think that the MBCT variant of MBSR will be valuable in that it provides additional tools and strategies for running Mindfulness-based groups in a clinical setting. Additionally, I think MBCT nicely integrates empirically-validated components of CT with empirically-validated components of MBSR. It is worth noting that the MBCT approach is specifically psycho-educational, and takes place in a group setting. This could be the beginning of a beautiful psychotherapy.

Rating:
Summary: A Suprisingly Readable and Useful Book
Review: This is a fantastic book for a variety of audiences: (1) practicing psychologists and therapists who want to learn about a useful -- and empirically supported -- skill for treating depression; (2) people who think may suffer from sad moods -- even if not full-blown depression -- and who want a medicine-free and therapy-free way to feel better; (3) academic researchers who want to know more about varieties of meditation and how to adapt meditation programs to more specific goals; (4) people interested in mindfulness meditation who want to see a psychological angle on why it works so well; (5) academic researchers who want to know more about some theories about why cognitive-behavioral therapy works so well.

Whew! So many good things to say:

The book actually reads very well -- not just by the minimal standards of academic writing, but by popular standards as well. It's clear, unpretentious and has a surprising amount of drama to it.

Many people now try to adapt some kind of mindfulness a la John Kabat-Zinn to a variety of needs for people to overcome this or that disorder, pain, etc. Nearly all assume that one can just take the whole Kabat-Zinn plan and just throw anyone into it. As someone who has taken a class based on the Kabat-Zinn program, and someone who has tried to adapt it to teaching law students and others about negotiation, I can tell you this does not work too well. Among other things, few people really manage to meditate 45 minutes a day.

The book explains how the researchers tried to adapt the program to a more specific need: preventing people from getting depressed again after they've been treated. They explain how they changed their thinking about meditation and how to teach it.

One of the most beautiful parts of the book is how frankly the authors admit how their first attempts fell short. They also frankly explain how they needed to meditate themselves before they could teach it.

Highly recommended!

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Summary: Excellent Book Used in My Dialectical Behavior Therapy Class
Review: We are using this book in my dialectical behavior therapy (DBT) class and it has been extremely helpful in understanding mindfulness. I highly recommend this as an addition to DBT for consumers of borderline personality disorder and bipolar disorder. Wonderful!