Mindfulness-Based Cognitive Therapy

Agenda & Learning Objectives

Competencies of MBCT

Foundations of MBCT

• Mindfulness-Based Stress Reduction (MBSR)
• Original MBCT trials
• Evidence base for MBCT
• Neurological evidence

Principles

• Adaptation and expansion of CBT principles
• Decenter from strong and persistent negative thoughts
• Leading mindfulness exercises skillfully
• Mindful inquiry

MBCT Curriculum & Core Therapeutic Tasks

Awareness and Automatic Pilot

• Raisin exercise – distinguish thinking and feeling
• Body scan – foundation to build attention
• Mindfulness of daily activities

Living in Our Heads

• ABC model for linking thoughts and emotions
• Pleasant events calendar to foster attention to the positive
• Mindful breathing for stress and focus

Gather the Scattered Mind

• Mindful stretching for working with discomfort
• Mindful walking for dynamic mindfulness
• Unpleasant events calendar to relate differently to difficulty
• 3-Minute breathing space

Recognize Aversion

• Mindfulness of breath, body, sounds to deepen awareness
• Working with difficulties without struggle

Allow/Let Be

• Exposure to difficult thoughts and feelings to transform them
• Notice thoughts without getting lost in them

Thoughts are Not Facts

• Purposefully exposing to strong thoughts and feelings
• Techniques for working wisely with difficult thoughts

How Can I Best Take Care of Myself?

• Recognize relapse signatures to prevent future problems
• Develop self-care action plans

Maintaining and Extending New Learning

• Personalize mindfulness practices for individual clients
• Maintain momentum of positive gains

Clinical Issues – Advanced Strategies for Working with
Challenging Clients:

Adaptations of MBCT for:

• Depression
• Stress
• Anxiety
• Chronic Pain
• PTSD
• Substance Use Disorders
• Children & Adolescents

Limitations of the Research and Potential Risks

• Most research has been done in group settings
• Best when clients have the cognitive capacity to engage in the practices
• Adaptations must be made for acute conditions and special populations
• Mindfulness involves moving into experiences, which may cause a temporary exacerbation of symptoms

Evaluations 

Learning Objectives

1. Compile the underlying mechanisms that make mindfulness techniques effective for stress, depression, anxiety, trauma, pain, and addiction.

2. Breakdown the role of thoughts in perpetuating symptoms of stress, anxiety, and depression as it relates to ruminating thoughts and behaviours in clients.

3. Describe the brain changes associated with mindfulness practice to explain to clients the scientific effectiveness of practicing mindfulness.

4. Connect how mindfulness builds upon and refines the evidence-based principles of Cognitive-Behavioural Therapy (CBT).

5. Incorporate mindfulness practices into traditional CBT thought records to help alleviate clients of intrusive, obsessive compulsive thoughts.

6. Utilize specific mindfulness-based techniques to help clients disengage from the narrative of negative thoughts and emotions.

7. Organize the eight session structure used MBCT program in your own clinical setting.

8. Differentiate between the group process in MBCT vs. CBT to avoid clients’ cycles of struggling with distressing thoughts and feelings.

9. Practice guiding a client through a 3-minute mindfulness exercise to improve the consistency of conscious choices rather than automatic reactions when distressed.

10. Explore the use of decentering skills with a client, in a session, in the reduction of worry and ruminations.

11. Apply the three steps of the mindful inquiry process, after the mindfulness exercise is over, to help clients more quickly internalize the skills and attitudes that allows them let go of struggle and make conscious choices.

12. Adapt the MBCT curriculum to different client populations, including children, as it relates to treatment considerations.