Cognitive therapy with mindfulness practice, by video in Ontario
Mindfulness-based cognitive therapy (MBCT) joins two things. From cognitive therapy it takes the idea that thoughts and mood feed each other. From mindfulness it takes regular practice in noticing a thought, a feeling or a body sensation without being carried off by it. It was built for people who have had depression more than once and want to lower the chance of it coming back.
The method has roots in this province. One of its authors, Zindel Segal, gave the University of Toronto Scarborough as his department in the 2016 review described below, and the first MBCT trial is indexed with Ontario and England as its places.
Carolina Vintu, PhD, Registered Psychotherapist, lists MBCT among the approaches she uses. Her sessions are one to one and held by secure video for adults and adolescents in Ontario.
The same thought, met in two ways
MBCT grew out of cognitive behavioural therapy, so the two share a lot. The difference shows in what you do with a thought once you've noticed it. The three thoughts below are made-up examples.
| The thought | In CBT you might | In MBCT you might |
|---|---|---|
| "I always mess things up." | Write down what speaks for and against it, then look for a fairer sentence. | See it as a thought that came and will pass, give it a name ("the mess-up story again") and bring attention back to the breath. |
| "Tomorrow's meeting will go badly." | Treat it as a prediction and check it against how past meetings went. | Notice where the worry sits in the body, a tight jaw or a knot in the stomach, and stay with that feeling for a few breaths. |
| "I'm too tired to do anything tonight." | Plan one small activity and check afterwards how tired you really were. | Notice the tiredness and the thought about it as two separate things, then choose what to do next. |
Neither column is the right one. Carolina works with both, and the page on mindfulness-informed therapy describes how mindfulness sits beside CBT and ACT in her sessions.
What three studies of MBCT measured
- 2000
The first trial, 145 people
People who had recovered from depression that had already come back before were given either their usual treatment or usual treatment plus an MBCT group course. Over 60 weeks, MBCT lowered the risk of relapse for those with three or more past episodes. For those with two past episodes it did not. Teasdale and colleagues, 2000
- 2016
Nine trials pooled, 1,258 people
Over 60 weeks, people who took MBCT had a lower risk of relapse than people who did not (hazard ratio 0.69, where a number under 1 means fewer relapses over time). Against other active treatments, antidepressants among them, the figure was 0.79. The effect looked larger for people who still had more symptoms at the start. Kuyken and colleagues, 2016
- 2016
Group or one to one, 56 people
Adults with a long-term physical illness and depressive symptoms had MBCT either in a group or individually. Both groups improved on depression, anxiety and well-being, with no clear difference between the two formats. It was a small pilot with no control group, and the authors call the result preliminary. Schroevers and colleagues, 2016
These studies describe groups of people. They can't tell you how MBCT will feel for you, which is what a first conversation is for.
MBCT practice inside a 50-minute video session
In its original form MBCT is a group course: eight weekly sessions of about two and a half hours, with practice at home in between. Sessions at BridgeMinds are one to one, so the practices come into the hour at a pace that suits you. Ones you may meet:
a body scan, moving attention slowly from the feet up
sitting with the breath, and later with sounds and thoughts
the three-minute breathing space, a short practice for the middle of a busy day
doing one routine thing, like washing up, with full attention
a calendar of pleasant and unpleasant moments, noted during the week
An individual session is $180 for the standard 50 minutes. You get a detailed receipt to send to your insurer, as the FAQ explains.
What people bring when they ask about MBCT
Low mood that has come back
MBCT was designed for depression that returns. The page on depression therapy describes how Carolina works with low mood.
A mind that won't stop going over things
Persistent worry and overthinking are among the concerns Carolina works with. Read more on anxiety therapy.
Running on empty
Emotional exhaustion after months of pushing through is another reason people look for a quieter way of paying attention. See burnout therapy.
Practising in your own language
Carolina works in English, Russian and Romanian, so the practices can be guided in the language you think in. See therapy in Russian and therapy in Romanian.
Questions people ask before trying MBCT
No. In MBCT the practices are taught from the beginning, and the first ones are short. If closing your eyes feels uncomfortable, say so; many practices can be done with eyes open.
The course is taught to groups. Sessions at BridgeMinds are one to one by video, and Carolina brings MBCT practices and ideas into them alongside the other approaches she uses, such as CBT and ACT. How many sessions you have is something you talk about together.
Therapy and medication can go on at the same time. Any decision to change, lower or stop a medication is one to make with the doctor who prescribed it.
Mindfulness-informed therapy uses mindfulness skills inside other kinds of therapy. MBCT is a defined method with its own set of practices and its own research, built around low mood that keeps returning.
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