Mindfulness-Based Cognitive Therapy, Acceptance and Commitment Therapy, and Positive Psychotherapy for Major Depression
Open accessAbstract
Objective: In the past two decades, newer psychotherapy treatments have emerged for the treatment of major depression. This review aimed to comprehensively synthesize the evidence for mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and positive psychotherapy (PPT) in treating a current episode of major depression. Methods: A systematic search of the Ovid MEDLINE, Embase, PsycINFO, and Cochrane databases was conducted for randomized controlled trials of MBCT, ACT, and PPT for major depression. Standardized mean differences were calculated with Hedges’ g to complete random-effects meta-analysis. Heterogeneity was assessed with the Cochran Q statistic and I2 statistic. Subgroup analysis was conducted to further investigate heterogeneity. Results: A random-effects meta-analysis of 15 studies (MBCT, N=7; ACT, N=4; PPT, N=4) revealed that all three therapies showed efficacy in reducing symptoms of depression with a small favorable effect, compared with all control conditions (N=946; Hedges’ g=0.34; 95% confidence interval=0.14, 0.54; p<0.001). Cochrane’s Q statistic (Q=32, df=15, p=0.007) suggested significant heterogeneity (I2=53%). A mixed-effects model test for subgroup differences showed significant differences between active controls and treatment-as-usual controls (χ2=15.3, df=1, p<0.001). Overall quality of evidence and publication bias were low. Conclusions: Meta-analysis shows that MBCT and ACT may be superior to inactive or treatment-as-usual controls and that PPT may be comparable to active controls for reducing symptoms of major depression after an acute course of therapy. However, the quality of the evidence was low. High-quality studies are needed to confirm the efficacy of these interventions.
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Mindfulness and acceptance-based therapy methods hold potential to yield reductions in depression and anxiety and improve overall quality of life across various groups of individuals.
“the evidence suggests that these approaches hold potential to yield reductions in depression and anxiety and improve overall quality of life across various groups of individuals [28–30], including amongst college students [31–33].”
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- Authors
- Seshadri, A., Orth, S. S., Adaji, A., Singh, B., Clark, M. M., Frye, M. A., McGillivray, J., & Fuller-Tyszkiewicz, M.
- Affiliations
- Mayo Clinic (US)
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Seshadri, Adaji, Singh, Clark, Frye); Department of Psychiatry and Psychology, Mayo Clinic Health System, Austin, Minnesota (Seshadri, Orth); Department of Psychiatry, Olmsted Medical Center, Rochester, Minnesota (Orth); Department of Psychiatry, Monash Health–Casey Hospital, Berwick, Australia (Adaji); School of Psychology, Deakin University, Geelong, Australia (McGillivray, Fuller-Tyszkiewicz).
- Venue
- American Journal of Psychotherapy
- Published
- 2021-03-01
- Volume
- 74
- Issue
- 1
- Pages
- 4-12
- ISSN
- 0002-9564 (ISSN-L)
- 2575-6559
- OpenAlex
- W3088500430
- Cited by
- 42
- References
- 36
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 12 · 2023: 6 · 2022: 6
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- American Journal of Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mindfulness-based cognitive therapy, acceptance and commitment therapy, positive psychotherapy, major depressive disorder, depression treatment, psychotherapy efficacy, active control
- MeSH terms
- Depression, Major Depressive Disorder, Humans, Psychotherapy, Cognitive Behavioral Therapy, Mindfulness, Acceptance and Commitment Therapy
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