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The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services

A. Tickell, S. Ball, P. Bernard, W. Kuyken, R. Marx, Stuart Pack, C. Strauss, Timothy Sweeney, C. Crane

Mindfulness January 12, 2019 DOI: 10.1007/s12671-018-1087-9 (opens in new tab) via Semantic Scholar

Summary

AI-generated from the abstract

Mindfulness-based cognitive therapy (MBCT) is delivered effectively and safely in routine mental health services, even though its use has expanded beyond the originally intended population. Across five UK mental health services with 1,554 participants, 47% entered with non-depressed scores, and 96% of those remained non-depressed after treatment. Among the 53% who entered with depressed scores, 45% recovered to non-depressed range, and overall depression severity significantly decreased. Reliable deterioration was low (3%), comparable to other psychotherapies.

Study at a glance

Characteristics Observational cohort Randomized Peer reviewed
Sample size 1,554
Population Adults attending UK mental health services for MBCT
Intervention Mindfulness-based cognitive therapy
Keywords Medicine Psychology
Key finding MBCT is delivered effectively and safely in routine clinical settings, with 96% of non-depressed participants sustaining recovery and 45% of depressed participants recovering.

Abstract

Depression is common with a high risk of relapse/recurrence. There is evidence from multiple randomised controlled trials (RCTs) demonstrating the efficacy of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence, and it is included in several national clinical guidelines for this purpose. However, little is known about whether MBCT is being delivered safely and effectively in real-world healthcare settings. In the present study, five mental health services from a range of regions in the UK contributed data (n = 1554) to examine the impact of MBCT on depression outcomes. Less than half the sample (n = 726, 47%) entered with Patient Health Questionnaire (PHQ-9) scores in the non-depressed range, the group for whom MBCT was originally intended. Of this group, 96% sustained their recovery (remained in the non-depressed range) across the treatment period. There was also a significant reduction in residual symptoms, consistent with a reduced risk of depressive relapse. The rest of the sample (n = 828, 53%) entered treatment with PHQ-9 scores in the depressed range. For this group, 45% recovered (PHQ-9 score entered the non-depressed range), and overall, there was a significant reduction in depression severity from pre-treatment to post-treatment. For both subgroups, the rate of reliable deterioration (3%) was comparable to other psychotherapeutic interventions delivered in similar settings. We conclude that MBCT is being delivered effectively and safely in routine clinical settings, although its use has broadened from its original target population to include people experiencing current depression. Implications for implementation are discussed.

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