Neil Stegall

Neil Stegall, LCSW - Serving individuals, couples and families.
1001 S. Capital of Texas Hwy, Bldg L, Suite 100, Austin, TX 78746
(512) 773-6810

Mindfulness-based Cognitive Therapy

Depression can too often recur, especially if untreated or undertreated for a period of time. Individuals become more sensitized to negative mood/feeling states and the worried thinking style that accompanies them. Typically, a person becomes stuck between regrets and despondency about the past and worrisome thoughts about the future. This can trigger an avalanche into a clearly depressed state.

Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are well demonstrated by research to be especially effective for acute depression, especially if combined with antidepressant medication for moderate to severe cases. However, researchers and practitioners have been interested in finding new approaches to lessen the severity and frequency of relapse.

MBCT was developed under grants from the John D. and Catherine T. MacArthur Foudation and National Institute of Mental Health. The researchers specifically investigated ways to reduce the recurrence and severity of depression. This treatment model was created from components of the acclaimed Stress Reduction program at the University of Massachusetts Medical Center developed by Jon Kabat-Zinn and elements of cognitive therapy.

This approach entails a structured eight-session course of group therapy that helps individuals develop inner resources to experience life with greater awareness and compassion towards themselves. Specifically, participants in this treatment program learn to recognize the immediate connection between difficult moods/feelings and negative thoughts through the meditative practices. They learn to encounter these experiences with an increasingly non-judgmental awareness that allows these states of feeling and thought to pass through like the days weather, rather than intensifying them through a constant internal battle to make it all go away or responding with despair. Specific cognitive exercises are also embedded in the program. Intersession assignments are given to expand and anchor awareness skills.

A randomized, controlled 60-week trial published in 2000 (Teasdale et al) studied MBCT among Canadian and British subjects with recurrent depression who had been off of medication for at least three months. The control group- whose subjects continued with their usual treatment- had a relapse rate of 66% compared to 37% for the MBCT group. The most robust response was among individuals with a history of three or more episodes of depression. In a British follow-up study published in 2004, Ma and Teasdale found similar results with a relapse rate of 78% for the control group and only 36% for the MBCT group among those with a lifetime history of three of more depressive episodes.

This research, and other links, can be accessed at the Oxford University site: http://cebmh.warne.ox.ac.uk/csr/mbct.html.

If You Think MBCT Would Be Useful to You

MBCT is an experiential program. As noted, its meditative exercises develop non-judgmental, moment-to-moment awareness of feelings and thoughts both during sessions and in daily life. Cognitive exercises enhance this awareness and provide useful skills. Overall, the group setting reduces personal isolation and creates the opportunity to experience a broader perspective of a life fully lived.

MBCT is simple in most every respect but a clear intention and consistent effort are necessary to realize its potential. In important ways, participants have to show up for their lives and learn important elements of self-care. This is an active form of treatment and, as such, can be a challenge.

This approach launches beyond glib self-help strategies condensed to bullet-pointed ideas. Participants encounter the ebb and flow of emotions/feelings and habits of thought and behavior that follow, some of which create the mire of depression, with a more expansive awareness and freedom of action.

Rather than something that happens outside the stream of your life, MBCT can become a way to experience the moments of your life, without self-judgment and fear.

This is the work of living.

Who will benefit:

- Adults who have experienced three or more episodes of major depression
- Patients with a history of prolonged rumination related to their condition
- Those who have significant mild to moderate anxiety in addition to depressive symptoms
- Individuals who have a chronic illness in addition to depression

What you will experience:

- Increased ability to relax
- Improved ability to cope with immediate and long-term stressors
- Renewed energy and motivation to engage life
- Reduction in depressive thinking experiences through use of skills
- Decrease of the severity and recurrence of depressive signs and symptoms

Your learning opportunities include:

- Guided meditation practices
- Daily intersession assignments to enhance awareness and thinking skills
- Group dialogue
- Inquiry exercises
- Individual coaching
- Printed guides and audio CD

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