Psychological Medicine
July 13, 2026
Thorsten Barnhofer, Barnaby D. Dunn, Clara Strauss et al.
Mindfulness-based cognitive therapy (MBCT) was developed for relapse prevention in people with remitted depression but is increasingly used for those with difficult-to-treat depression (DTD). A key question regarding this broader application is whether ongoing depressive symptoms constrain therapeutic responsiveness or disrupt MBCT's proposed mechanism, decentering. We explored whether baseline...
Psychotherapy and Psychosomatics
June 12, 2026
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
1 citation
INTRODUCTION: Around a third of patients with major depressive disorder experience persistent symptoms despite usual treatments. Identifying scalable, psychological treatment options is critical to reduce the burden associated with difficult-to-treat depression (DTD). We examined the efficacy of mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU) and other active...
BMJ Open
December 8, 2025
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
Introduction: About 30% of depressed patients suffer from a protracted course in which the disorder continues to cause significant burden despite treatment efforts. While originally developed for relapse prevention, mindfulness-based cognitive therapy (MBCT) has increasingly been investigated in depressed patients with such 'difficult-to-treat' courses. This is a protocol for an individual...
medRxiv
June 9, 2025
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
preprint
ABSTRACT: Introduction: About 30% of depressed patients suffer from a protracted course in which the disorder continues to cause significant burden despite treatment efforts. While originally developed for relapse prevention, Mindfulness-Based Cognitive Therapy (MBCT) has increasingly been investigated in depressed patients with such ‘difficult-to-treat’ courses. This is a protocol for an...
The Lancet Psychiatry
June 1, 2025
Thorsten Barnhofer, Barnaby D. Dunn, Clara Strauss et al.
9 citations
Non-remission after psychological therapy for major depressive disorder is common, yet there are no established further-line treatments. In the UK National Health Service (NHS) Talking Therapies programme, about 50% of patients with depression who come to the end of the stepped care pathway do not show remission of symptoms. We aimed to investigate whether mindfulness-based cognitive therapy...
Trials
January 19, 2023
Thorsten Barnhofer, Barnaby D. Dunn, Clara Strauss et al.
Background Major depression represents a pressing challenge for health care. In England, Increasing Access to Psychological Therapies (IAPT) services provide evidence-based psychological therapies in a stepped-care approach to patients with depression. While introduction of these services has successfully increased access to therapy, estimates suggest that about 50% of depressed patients who...