Mindfulness-Based Cognitive-Behavioral Therapy: A Review
Mindfulness-based cognitive therapy (MBCT) is a form of behavior therapy aimed at treating various different disorders, most commonly major depressive disorder. It developed from an interaction between cognitive therapy and behavior therapy, which is known as cognitive behavioral therapy (CBT). It adds the component of mindfulness, which is more than simply changing what a person perceives, but how those perceptions are made. The goal of MBCT is to increase awareness of thoughts and feelings, so that a person can accurately label his thoughts and separate them from self-image or self-perception. This paper will examine MBCT including: major tenets and historical developments; conceptual and philosophical foundations; therapeutic technique; human development; personality; psychopathology; presumed mode of therapeutic action; goals for treatment; strengths and limitations of the orientation; application in diverse and multi-cultural contexts; and review and critique of the scientific evidence.
Introduction
Mindfulness-based cognitive therapy (MBCT) is a form of behavior therapy aimed at treating various different disorders. It is most commonly used to help prevent relapses of depression, though it has other applications as well, particularly in relapse prevention in substance abuse. "The focus of MBCT is to teach individuals to become more aware of thoughts and feelings and to relate to them in a wider, decentered perspective as 'mental events' rather than as aspects of the self or as necessarily accurate reflections of reality" (Teasdale et al., 2000, p.616 para. 7). MBCT derives from cognitive behavior therapy (CBT) methods, but combines newer techniques with traditional CBT methods. As the name suggests, the largest difference between MBCT and CBT is the concept of mindfulness and how developing mindfulness can increase the efficacy of therapeutic CBT interventions. This paper will examine the development of MBCT, how it is used in treating individuals, possible future applications, and the strengths and weaknesses of the therapy.
Major Tenets and Historical Developments
In many ways, the history of MBCT is the history of behavior therapy and cognitive therapy, and the history of those two forms of treatment is in many ways the history of psychology. However, it would be inappropriate to suggest that MBCT has only been developing since the introduction of psychology as a science; many ancient philosophies focused on the notion of what is now referred to as mindfulness. While several different therapeutic approaches have developed in the relatively short history of psychology, two have become more widely accepted than other approaches: psychoanalysis and behavior therapy. Both have been used for decades, and behavior therapy became the preferred method for treating problem behaviors. Cognitive therapy is relatively new in comparison with the other two, having developed in the 1960s. Cognitive behavior therapy examines the role that thoughts play in behavior and disorders, and is premised on the notion that by changing thoughts, one can change behavior.
Cognitive therapy was developed primarily to treat depression, with the idea that cognitive therapy was more than a traditional talk therapy. Largely developed by Aaron Beck, cognitive therapy developed because the underlying thought patterns in those with depression did not match psychoanalytic theories, but instead revealed self-defeating thought processes. Therefore, rather than focus on a psychoanalytic approach, Beck hoped to change underlying thought patterns and undermine the negative thought bias that characterized those with depression. While Beck focused on the treatment of depression, "in the early 1960s, the systemic application of learning theory and principles to the modification of emotional disorders suggested enough in the way of positive outcomes and reliable clinical procedures to enable its codification as a distinct therapy" (Segal et al., 2004, p.45, para.1). Combinations of cognitive and behavioral approaches have been developing over the last half-century, and the addition of the mindfulness component is a relatively recent innovation.
Combining cognitive therapy with behavior therapy was a logical combination because disorders generally have two components: behavior and cognition. A therapeutic approach aimed at changing both behavior and cognition would focus on fixing both elements of a disorder. Therefore, "CBT is a commonsense approach that is based on two central tenets: 1) our cognitions have a controlling influence on our emotions and behavior; and 2) how we act or behave can strongly affect our thought patterns and emotions" (Wright et al., 2006, p.1, para. 2).
While all psychological interventions require some understanding of biology, cognitive therapy, and, therefore, by extension, CBT and MBCT require an understanding of cognitive neuroscience. While scientists...
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