Adapting Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression
Open accessAbstract
Major depressive disorder (MDD) is currently ranked the third leading cause of disability in the world. Treatment-Resistant Depression (TRD) causes the majority of MDD's disability. Strikingly, 50% of individuals with MDD will fail to remit with two adequate trials of antidepressant medications, thus qualifying as treatment resistant. Current pharmacological and psychotherapeutic treatment strategies for TRD are limited in effectiveness so new interventions are needed. Mindfulness-Based Cognitive Therapy (MBCT) is a new psychotherapeutic treatment with established efficacy in preventing relapse of depression for individuals in complete remission. MBCT is a group-based, 8-week intervention that uses mindfulness meditation as its core therapeutic technique. It teaches people to have a different relationship to depressive thoughts and feelings. Strategies are focused on decreasing rumination, enhancing self-compassion, increasing acceptance and decreasing avoidance. This modified version of MCBT, which includes the use of metaphor and adaptations of the original intervention will be discussed through the clinical case of a woman with long-standing TRD. A brief review of the current MBCT literature and future directions for the treatment of TRD are discussed.
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“…an enormous number of research-based articles about its effectiveness for preventing stress, anxiety, and depression (Chiesa and Serretti 2011; Eisendrath, Chartier, and McLane 2011; Teasdale, Segal, and Williams 1995, 2003) and for improving physical health (Cassidy et al. 2012), but has…”
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Strauss, B. M. (2021) · Psychotherapeut · doi:10.1007/s00278-021-00510-9 · Cited by 8 · see citing works
Mindfulness-Based Cognitive Therapy for Combat-Related Posttraumatic Stress Disorder
King, A. P. J., & Favorite, T. (2016) · Springer eBooks · doi:10.1007/978-3-319-29866-5_15 · Cited by 7 · see citing works
Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression
Deen, S. R., Sipe, W. E. B., & Eisendrath, S. J. (2016) · Springer eBooks · doi:10.1007/978-3-319-29866-5_12 · Cited by 7 · see citing works
Self-citationRodrigues, M. F., Quagliato, L. A., Appolinário, J. C., & Nardi, A. E. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1412483 · Cited by 5 · see citing works
“Additionally, our observations are consistent with those of Eisendrath et al. (2011), and Cladder-Micus et al. (2018), who noted improvements in depressive symptoms among TRD patients following MBCT, further affirming the value of mindfulness-based approaches.”
BackgroundResultThérapie cognitive basée sur la pleine conscience : état actuel et applications futures
Irving, J. A., & Segal, Z. V. (2014) · Santé mentale au Québec · doi:10.7202/1023990ar · Cited by 6 · see citing works
Who experiences depressive symptoms following mindfulness-based stress reduction and why?
Dobkin, P. L., Zhao, Q., & Monshat, K. (2017) · International Journal of Whole Person Care · doi:10.26443/ijwpc.v4i1.123 · Cited by 6 · see citing works
Apolinário-Hagen, J., & Salewski, C. (2018) · Springer eBooks · doi:10.1007/978-981-10-6577-4_22 · Cited by 5 · see citing works
Cognitive Behavioral Therapy for Depression
Nyer, M., Fisher, L. B., & Farabaugh, A. H. (2015) · Springer eBooks · doi:10.1007/978-1-4939-2605-3_6 · Cited by 5 · see citing works
Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression
Sipe, W. E. B., & Eisendrath, S. J. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-416031-6.00003-7 · Cited by 5 · see citing works
Self-citationDepression and Music: Approaching Health Equity Through Therapeutic Choir Singing
Robertson-Gillam, K. (2017) · Palgrave Macmillan UK eBooks · doi:10.1057/978-1-349-95284-7_5 · Cited by 4 · see citing works
Ladari, R. B., Arani, A. M., Bakhtiari, M., Zarghami, M., Nouri, R., & Hosseini, S. H. (2018) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs.10742 · Cited by 5 · see citing works
Fowers, B. J., Anderson, A. R., Lefevor, G. T., & Lang, S. F. (2015) · The Counseling Psychologist · doi:10.1177/0011000014568202 · Cited by 3 · see citing works
“Similarly, Eisendrath, Chartier, and McLane (2011) suggested that “the core component of mindfulness based cognitive therapy (MBCT) has been associated with enhanced emotional regulation” (p. 364) and that MBCT is designed to “help individuals to engage more fully with their lives and experience…”
BackgroundRodrigues, M. F., Junkes, L., Appolinário, J. C., & Nardi, A. E. (2025) · Personalized Medicine in Psychiatry · doi:10.1016/j.pmip.2025.100148 · Cited by 2 · see citing works
Kardel, K. R., Iversen, P. O., Kaaya, A. N., Muhoozi, G. K. M., Veierød, M. B., Wangen, K. R., Børøsund, E., & Atukunda, P. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06056-9 · Cited by 2 · see citing works
“Negative cognitive processes make individuals prone to depression and are a primary driver of persistent depressive symptoms [41].”
BackgroundUse of psychotherapy in treatment-resistant depression
Moukaddam, N., Hashmi, A. M., & Nguyen, P. (2016) · Psychiatric Annals · doi:10.3928/00485713-20160217-01 · Cited by 1 · see citing works
Mindfulness-based cognitive therapy and depression
Ewais, T. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817933-8.00042-6 · Cited by 1 · see citing works
Cognitive Behavioral Therapy for Depression
Nyer, M., Fisher, L. B., Pittman, M. A., Matthews, J., & Farabaugh, A. H. (2023) · Current clinical psychiatry · doi:10.1007/978-3-031-29368-9_9 · Cited by 1 · see citing works
Reshadat, S., Morovati, F., Zakiei, A., & Gilan, N. R. (2019) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 1 · see citing works
The Role of Psychotherapy in the Management of Treatment‐resistant Depression
Thase, M. E. (2013) · doi:10.1002/9781118556719.ch8 · Cited by 1 · see citing works
Sivak, K. (2013) · UVic’s Research and Learning Repository (University of Victoria) · Cited by 1 · see citing works
Efficacy of Mindfulness-Based Cognitive Therapy on Depressed Mothers with Cerebral Palsy Children
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The Effect of Varying Levels of Depressive Symptoms on Mindfulness Acquisition: An Exploratory Study
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Depression: Third Wave Case Conceptualization
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Psychological aspects and psychotherapy for TRD
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Prediction of Social Anxiety Based on Mindfulness and Bias in Facial Emotion Processing
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- Authors
- Eisendrath, S., Chartier, M., & McLane, M.
- Affiliations
- National Institutes of Health (US)
- San Francisco VA Medical Center (US)
- University of California, San Francisco (US)
- Corresponding author
- Eisendrath, Stuart
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 18
- Issue
- 3
- Pages
- 362-370
- ISSN
- 1077-7229 (ISSN-L)
- PMC
- PMC3247069
- OpenAlex
- W2002199974
- Cited by
- 60
- References
- 74
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 8 · 2015: 4 · 2014: 6 · 2013: 6 · 2012: 3
- FWCI
- 3.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01at004572-04)
- National Center for Complementary and Integrative Health (R01AT004572.)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- mindfulness-based cognitive therapy, treatment-resistant depression, major depressive disorder, relapse prevention, mindfulness meditation, rumination, self-compassion, acceptance, avoidance, metaphor, psychotherapy adaptation, antidepressant-refractory depression
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