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A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression.

Kate Williams, Samantha Hartley, Susanne Langer, Mizla Manandhar-Richardson, Melissa Sinha, Peter Taylor

Clinical Psychology & Psychotherapy August 15, 2022 DOI: 10.1002/cpp.2773 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Meta-ethnography (qualitative meta-synthesis) Peer reviewed
Population People with current or previous depression who had participated in MBCT, drawn from 21 qualitative studies
Intervention Mindfulness-based Cognitive Therapy (MBCT)
Topics Depression Meditation
Keywords Humans Treatment outcome Anthropology, cultural Female Cognitive behavioral therapy Major depression Meta-ethnography Meta-synthesis Mindfulness-based cognitive therapy
Key findings Across 21 qualitative studies, participants with current or previous depression described becoming skilled and taking action, developing acceptance, and experiencing ambivalence and variability in MBCT. The authors conclude that MBCT is beneficial and provides meaningful change for many but remains challenging for some.

Abstract

Background: Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention intervention for people experiencing major depression. Three qualitative meta-syntheses investigating experiences of taking part in MBCT and/or Mindfulness-based Stress Reduction (MBSR) across different diagnostic populations reported themes including control, choice, group processes, relationships and struggles. As multiple studies have been published since, we aimed to update, systematically review and synthesize the experiences of participants with depression taking part in MBCT.

Methods: Four databases were searched systematically (PsycInfo, Web of Science, Medline and CINAHL) up to and including 12 November 2021. Twenty-one qualitative studies met the review criteria. All papers were rated as fair using a quality appraisal tool. Meta-ethnography was applied.

Results: Across 21 studies of participants with current or previous depression who had participated in MBCT, three overarching themes were developed: 'Becoming skilled and taking action', 'Acceptance' and 'Ambivalence and Variability'. Participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective and agency over their experiences. Participants developed acceptance towards their experiences, self and others. There was variability and ambivalence regarding participants' expectations and difficulties within mindfulness practices.

Limitations: Many studies were conducted in MBCT-research centres that may hold conflicts of interest. Many studies did not address the impact of the participant-researcher relationship thus potentially affecting their interpretations. Studies were skewed towards the experiences of female participants.

Conclusions: Our findings help to enhance participant confidence in MBCT, alongside understanding the processes of change and the potential for difficulties. MBCT is beneficial and provides meaningful change for many but remains challenging for some.

Comparable studies

Other qualitative studies on depression, most cited first.

Study Year Design Participants
Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression enrolled in an open-label trial of psilocybin 2017 Qualitative study n = 20
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
A qualitative study of mindfulness‐based cognitive therapy for depression Participants in mindfulness-based cognitive therapy in a mental-health context 2001 Qualitative study n = 7
Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency? 2017 Qualitative review
Abnormal Time Experiences in Major Depression: An Empirical Qualitative Study Patients affected by affective and schizophrenic disorders 2016 Qualitative study n = 550

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