Tag Archives: Mark Williams

MBCT Ushers in the Next Era with Second Edition and Two Innovative Training Opportunities

Mindfulness-Based Cognitive Therapy for DepressionFew psychological interventions have engendered so much promise and delivered on that promise with such impressive clinical outcomes and research findings as Mindfulness-Based Cognitive Therapy (MBCT). The skillful “marriage” of cognitive behavioral therapy and mindfulness practice, MBCT has emerged as an effective treatment to prevent relapse in depression and is yielding good initial results in other settings and with other populations as well. With the imminent publication of the Second Edition of Mindfulness-Based Cognitive Therapy  (Guilford Publications), MBCT has entered it’s next generation, incorporating the ongoing work of co-founders Zindel Segal, Mark Williams and John Teasdale, with the input and efforts of numerous clinicians and researchers worldwide.

Zindel Segal, Ph.D.

Zindel Segal, Ph.D.

“Ten years have passed since the publication of Mindfulness Based Cognitive Therapy,” noted Zindel Segal recently, “and in that time there has been a productive engagement and interchange with clinicians and researchers who have offered and studied the program with their own patients.  Mark, John and I have been fortunate to be involved in some of these discussions and have learned from many ‘early adopters’ as well as from the increasing volume of empirical work that has evaluated and stretched MBCT to novel populations.  The second edition of MBCT gives us an opportunity to embed this ‘crowd sourced’ wisdom and feedback into an updated and expanded version of the book that offers a few refinements to the 8-week program and grapples, more generally, with the question of how the delivery of mindfulness based interventions can be optimized.”

“Kindness and compassion are the ground from which we practice, the ground from which we teach, and the ground that participants may then use in cultivating their own practice.”                 (From the Second Edition)

Perhaps most notable in the new edition is a chapter solely dedicated to the topic of compassion in MBCT. Segal reports that “an oft-repeated question I hear is ‘what is the role of compassion training in MBCT?’  This reflects perhaps the pervasive interest in bringing compassion to patients who are suffering, as well as an enthusiasm for newer protocols that feature compassion training as a central intervention.  The answer with respect to MBCT is not as straightforward as checking whether formal compassion or loving kindness is or is not taught within the 8 weeks.  It revolves around the deeper question of what exactly compassion means in a clinical context and how it can help address the vulnerability or illness perpetuating factors that keep people locked into symptoms and distress.”

FREE CHAPTER PREVIEW!
In advance of the release of the Second Edition of MBCT, Chapter 8, entitled “Pausing for Reflection: Kindness and Self-Compassion in MBCT” is available for free by emailing the UC San Diego Center for Mindfulness at mindfulness@ucsd.edu and requesting a copy.

Book purchasers get access to a companion Web page featuring downloadable audio recordings of the guided mindfulness practices (meditations and mindful movement), plus all of the reproducibles, ready to download and print in a convenient 8 1/2″ x 11″ size. A separate web page for use by clients features the audio recordings only.

As innovative as the MBCT program itself, the 5-day MBCT teacher training offered through the UC San Diego Center for Mindfulness is a “wonderful opportunity to experience the intricate interweaving of mindfulness practice and cognitive therapy skills in the delivery of the 8 week program,” said Segal. “Our days are long and incorporate elements of personal practice and clinical training all held within a retreat framework that clarifies intention, observation and self-compassion in the learning process.  If you are interested in learning the MBCT program ‘from the inside’ this is the best vehicle for doing so.”

For those who already have experience teaching MBCT or Mindfulness-Based Stress Reduction (MBSR) UCSD is now offering an Advanced Training for MBCT and MBSR Teachers taught by experienced teachers and trainers Susan Woods and Char Wilkins. Intended to focus upon universal principles for teaching mindfulness-based interventions. As such, the focus for this training is less about teaching to the structure of MBCT and/or MBSR and more about intentionally embodying mindful presence and strengthening the facilitation of mindful inquiry.

What Are Your Thoughts? We would love to hear your thoughts on the approach of explicitly teaching compassion and lovingkindness practice within mindfulness-based interventions like MBCT, versus the more implicit approach described by Segal et al in the new 2nd edition of the MBCT book (free pdf copy of the chapter available upon request at  mindfulness@ucsd.edu ). Please share your thoughts and opinions below.

Shambhala Sun Features Mindfulness-Based Relapse Prevention (MBRP) in latest issue

One Moment at a Time, is the title of a recent item in David Swick’s column The Mindful Society published in the most recent edition of Shambhala Sunabout the relationship between mindfulness and substance use disorders. The article specifically highlights Mindfulness-Based Relapse Prevention (MBRP) and the work of the late G. Alan Marlatt, Sarah Bowen and colleagues at the Addictive Behaviors Research Center at the University of Washington. 

By Blair Buckman

Most of us are looking for magical solutions to solve our problems instantaneously. Some of us turn to indulgences like ice cream for a quick fix, and others habitually turn to more harmful addictive substances, like alcohol or drugs. Addiction affects millions of individuals and their families each year and can be an insurmountable obstacle for many. Dr. Lawerence Peltz, a Massachusetts psychiatrist, describes mindfulness as “the microscopic version of One Day at a Time,” adding “it’s One Moment at a Time.”

Much of the research on mindfulness and addiction is conducted at the Addictive Behaviors Research Center at the University of Washington in Seattle, established by the late Alan Marlatt. Dr. Sarah Bowen and her colleagues there have conducted a number of studies on the topic, including a study examining mindfulness implementation among previously imprisoned drug and alcohol offenders. She found that by learning mindfulness practices, they were able to recognize internal triggers without responding to them, therefore reducing the likelihood of returning to drug and alcohol use as compared to control subjects that did not receive mindfulness training. Their MBRP program was modeled after Segal, Teasdale and Williams’ Mindfulness-Based Cognitive Therapy (MBCT) program and Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR). MBRP assists people in developing awareness of what their triggers and habits are, in addition to changing how we respond to physical and emotional discomfort. Furthermore, MBRP assists in developing a compassionate and nonjudgmental mindset.

The program emphasizes meditation practices and implementation of mindfulness practices in daily life in order to regain control of our attention and actions. Bowen and colleagues will be integrating mindfulness meditation practices and utilizing demonstration, role-play, simulated exercises, and inquiry to teach MBRP in a 5-day intensive retreat training through the UCSD Center for Mindfulness at the EarthRise Retreat Center in Petaluma, California in April 2012. More information about the training is available through the UCSD Center for Mindfulness.

We invite you to read the full text of David Swick’s article, in the November issue of the Shambhala Sun, available on newsstands now.

 

Mindfulness Based Cognitive Therapy 10 Years and Onwards: A Personal Reflection by Zindel Segal

Zindel Segal, Ph.D.

Zindel Segal, Ph.D.

Zindel Segal is one of the co-founders and developers (along with John Teasdale and Mark William) of Mindfulness-Based Cognitive Therapy (MBCT). Dr. Segal, along with Sarah Bowen and Steven Hickman, will be leading a 5-Day Professional Retreat Training in MBCT on February 19-24, 2012 at the EarthRise Retreat Center in Petaluma, California. Registration is now open for this experiential training event.

With the 10-year anniversary of the publication of Mindfulness Based Cognitive Therapy for Depression nearly upon us, it is a good time to perhaps stop and reflect on where the field stands at this juncture.

Mindfulness-Based Cognitive Therapy for DepressionFor the past decade John, Mark and I have been largely concerned with reaching the first milestone of treatment development – reliable evidence for MBCT’s effectiveness.   Data from 6 Randomized Controlled Trials and 2 meta-analyses (Hoffman, 2010; Piet & Hoogard, 2011) now indicate that Mindfulness Based Cognitive Therapy is associated with a 50% reduction in depressive relapse risk as well producing symptom relief in  anxiety disorders for both adults (Kim et al., 2010) and children (Semple & Lee, 2011).

Having addressed the efficacy question, we are still left to ponder how exactly this multi-modal treatment achieves its benefits.  For example, what is the relative contribution of cognitive therapy principles versus mindfulness practice to outcome?  What about the role of kindness and compassion, both of which are implicit in the program and, as Willem Kuyken’s work suggests, may be one of the consistent gains reported by participants?

Clarifying mechanisms of action is of more than just academic interest, as it will likely inform the approach taken to training the next generation of MBCT practitioners.  The fact that these are questions being asked shows how far we have come from the early days when MBCT was described as a form of attentional control training.

It is always hard to predict what the next 10 years will bring, but my bet is that efforts to disseminate MBCT via online technologies will start to have an impact.  Online approaches may be a response to the fact that there are still far too few MBCT instructors and too many patients seeking care.  The challenge for online MBCT will be to adapt to an internet friendly format, while holding onto the practice dimension, which however you slice it, always comes down to being a personal, non-electronically mediated experience.  It should all make for a very interesting ride.

References
Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010 Apr;78(2):169-83.
Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clin Psychol Rev. 2011 Aug;31(6):1032-40.
Geschwind N, Peeters F, Drukker M, van Os J, Wichers M. Mindfulness training increases momentary positive emotions and reward experience in adults vulnerable to depression: A randomized controlled trial. J Consult Clin Psychol. 2011 Jul 18. [Epub ahead of print] 
Kim B, Lee SH, Kim YW, Choi TK, Yook K, Suh SY, Cho SJ, Yook KH Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder. J Anxiety Disord. 2010 Aug;24(6):590-5. Epub 2010 Apr 3.
Semple R & Lee, J (2011).  Mindfulness Based Cognitive Therapy for Anxious Children.  New Harbinger:  Oakland.