Mindfulness-Based Cognitive Therapy
Reaction Paper
Denise Dugan
California Baptist University

Author Note This paper is being submitted to Dr. Kristen White in partial fulfillment for the requirements for MFT Counseling Techniques, PSY 525, on March 1, 2014.

Abstract
Mindfulness-based cognitive therapy (MBCT) is a group therapy approach that utilizes mindfulness techniques and cognitive therapy for depression relapse prevention. This paper will reflect the effectiveness of MBCT from a personal worldview. It will also discuss if MBCT can be utilized in different areas of psychological treatment including: marriage and family therapy, patients with anxiety, culturally diverse groups, and in working with religious patients.
Mindfulness-Based Cognitive Therapy Reaction Paper
Mindfulness-based cognitive therapy (MBCT) is a group therapy treatment that integrates mindfulness and cognitive therapy practices to help individuals that suffer from recurrent depression in the prevention of depression relapse. Zindel Segal, John Teasdale, and Mark Williams developed MBCT, which was adapted from the mindfulness-based stress reduction (MBSR) work of Jon Kabat-Zinn at the University of Massachusetts Medical Center for helping people with chronic physical illnesses (Sipe & Eisendrath, 2011). The core element of this treatment modality is mindfulness. MBCT teaches focus on the here and now and to be mindful of the thoughts that are taking place. Mindfulness stresses: paying attention on purpose, being in the present moment, and being nonjudgmental. Thoughts are viewed as running commentaries of the mind that are not judged as facts (Segal, Williams, & Teasdale, 2013) (Segal, Williams, & Teasdale, 2013).
Mindfulness-based cognitive therapy treatment is a group therapy program consisting of 8 consecutive weekly sessions approximately two hours in length with group sizes ranging from 10-12 people (Fennell & Segal, 2011). The sessions incorporate different types of formal and informal meditation practices that include: guided body scans, sitting and walking meditations, breathing spaces, mindful movement, and focused awareness (Sipe & Eisendrath, 2011). Through these exercises, participants are taught to recognize and to separate from the “doing” mode and to move into the “being” mode. MBCT is part of the third wave of behavioral therapy and has received empirical support in clinical settings to be an effective treatment for those suffering from recurrent depression (Bihari & Mullan, 2012).
MBCT and Personal Worldview
Mindfulness-based cognitive therapy places a great emphasis on mindfulness meditation practices. These mindfulness practices are derived from Buddhism. Buddhism teaches that suffering is an unavoidable part of life that comes as a result of materialism, and unimportant things like entertainment or food (Cockroft, 1999). Buddhists believe that the path to overcoming daily suffering, known as the fourth noble truth, is to cultivate wisdom, morality, and concentration and this is achieved through mindfulness (Gehart & McCollum, 2007). Buddhism is a non-theistic religion that teaches the only way to end suffering is by achieving nirvana, elimination of desire (Cockroft, 1999). The philosophy behind these mindfulness practices is not congruent to my Christian faith. Most of the literature attempts to distance MBCT from a religious practice and from Buddhism stating that mindfulness practices are ancient yoga practices that predate Buddha and most mindfulness interventions have removed references to Buddhism (Peck, 2014). As a Christian, I have to be vigilant and not buy into something simply because it is popular or because it works for some. As a Christian, my ultimate goal is not nirvana but a closer relationship with Jesus Christ and to live eternally with Him. Suffering is a part of life and in this I agree with Buddhism but the reasons why we suffer is where I disagree with the Buddhist philosophy. The Bible teaches that suffering is a result of the original sin of Adam and Eve. The cognitive aspect of MBCT is down played while the mindfulness aspect takes precedence.
Effective Aspects of MBCT There are some aspects of MBCT that are very effective. One aspect is helping participants to develop practices outside of therapy. The real world application is what will help an individual to recognize the automatic thoughts that come and to view them as information not as facts (Segal, Williams, & Teasdale, 2013). Participants learn that avoiding or resisting negative thoughts or feelings can exacerbate and perpetuate depression rather than resolve it. They also learn to identify the warning signs of thoughts or feelings that signal depression and steps to take when they occur (Sipe & Eisendrath, 2012).
Another effective aspect of MBCT is helping the client to shift from the “doing” mode to the “being” mode. MBCT helps individual to recognize which mode the mind is operating in. The “doing” mode is where the mind ruminates, sets goals, and tries to get things done. The goals that the mind sets can be external and internal. This is the mode that a person turns to when things are not how he or she would like for them to be. The doing mode is what causes problems but is where problems can formulate. Often times, the “doing” mode volunteers for a job that it cannot do, which is where problems start (Segal, Williams, & Teasdale, 2013). For example, thinking about a problem that you have no control over but continue to formulate in your mind ways to make it different. The mind continues to rehearse the information going around and around dwelling on how we need things to be instead of how things are. The “being” mode is somewhat opposite of doing. The “being” mode focuses on accepting and allowing without trying to change or feeling pressure to change. There are no goals or achievements to be reached in being mode (Segal, Williams, & Teasdale, 2013). The goal of MBCT is to help participants to learn to disengage from one mode to another mode that will involve moving from a focus of content to a focus on process. In other words switching from automatic pilot to being aware of the present moment (Bihari & Mullan, 2012). Having this ability gives the client the ability to recognize negative triggers and to respond more skillfully to negative emotions (Segal, Williams, & Teasdale, 2013).
Least Effective Aspects of MBCT
The aspects that I found least effective were the mindfulness training skills. I found the skills to be tedious and somewhat confusing in their what was to be taken from the exercises. Sitting still for over 30-40 minutes was uncomfortable and in my mind stressful. In the book, Mindfulness-Based Cognitive Therapy, the authors mentioned that during their own training they found it challenging (Segal, Williams, & Teasdale, 2014 p. 54). These exercises take time, energy, and commitment, which can be difficult to fit in with a busy schedule. Patients even thought the practices to be “stressful” (p 55). Also the group therapy aspect may not be ideal for every patient.
MBCT for Marriage and Family Therapy
Using mindfulness practices has been shown to promote attunement, connection and closeness in relationships. Research has offered that mindfulness-based interventions to be beneficial in processes and outcomes that help improve interpersonal relationships (Bihari & Mullan, 2012).
MBCT for Depression and Anxiety
MBCT was originally developed for depression relapse prevention. In a brief report by Coelho, Canter, and Ernst (2013), found evidence to suggest that MBCT has an additive benefit to usual care for patients with three or more previous depressive episodes. Using MBCT for treatment for anxiety has had very little research, but because anxiety, like depression, deals with pathogenic information processing that involves avoidance of undesired outcomes it may be modified in treating anxiety (Sipe & Eisendrath, 2012).
MBCT Use for Religious Clients
Because of MBCT’s Buddhism foundation, many Christians may not be comfortable with mindfulness techniques. According to Knabb (2012), Christians may prefer to turn to their own religious heritage to deal with depression relapse. Centering prayer can be an alternative to the Buddhism techniques taught in MBCT. Centering prayer has some overlaps to the mindfulness practices in that it allows individuals to get in touch with their center of being beyond reason or logic, being with God in the present moment, and to relate differently with their thoughts (Knabb, 2012).
MBCT for Culturally Diverse Groups The philosophy behind MBCT may not be for everyone, but there is no evidence that this modality could not be useful to a diverse population. MBCT could be used for range of culturally diverse groups and can even integrate aspects of their own spirituality.
Conclusion
MBCT is still in its infancy as a treatment modality and further research will be needed to assess its effectiveness in other areas of disorders. The core component of helping clients to be more mindful and staying in the present moment can help anyone dealing with thoughts that are trying to take over. While I have some problems with certain mindfulness training techniques, overall there are many useful components. The main one being that thoughts cannot hurt you but how you deal with the thoughts can hurt you.

References
Cockroft, M. (1999). What you need to know about world religions. Campus Life, 58, 48-52.
Fennell, M., & Segal, Z. (2011). Mindfulness-based cognitive therapy: Culture clash or creative fusion?. Contemporary Buddhism, 12(1), 125-142. doi:10.1080/14639947.2011.564828
Knabb, J. (2012). Centering prayer as an alternative to mindfulness-based cognitive therapy for depression relapse prevention. Journal Of Religion & Health, 51(3), 908-924. doi:10.1007/s10943-010-9404-1
Peck, A. (2014, January 14). The use of mindfulness-based interventions for the treatment of anxiety disorders. In emergenceearth.com. Retrieved March 1, 2014, from Google.
Segal, Z. V., Williams, J. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York, NY US: Guilford Press.
Sipe, W. B., & Eisendrath, S. J. (2012). Mindfulness-based cognitive therapy: Theory and practice. The Canadian Journal Of Psychiatry / La Revue Canadienne De Psychiatrie, 57(2), 63-69.