Psychology › Therapy & treatment › Cognitive behavioral therapy (CBT; Beck, Ellis)
Mindfulness-based therapies
MBSR 1979; MBCT 2002· Therapy or method
Mixed evidenceSome support; effects smaller or less consistent than once thought.
Programs that train calm, nonjudgmental attention to the present moment, adapted from Buddhist meditation for medical and psychological care.
See it on the Psychology map →What it says
In 1979 Jon Kabat-Zinn started Mindfulness-Based Stress Reduction (MBSR) at the University of Massachusetts Medical School: an eight-week course of meditation, body scans and gentle yoga, first for patients with chronic pain and stress. In the 1990s Zindel Segal, Mark Williams and John Teasdale combined it with CBT as Mindfulness-Based Cognitive Therapy (MBCT; manual 2002), teaching people with past depression to notice sad thoughts without being swept along. Apps such as Headspace later spread simplified versions widely.
Why it matters
It brought meditation into hospitals, schools and workplaces, and gave people with repeated depression a tested relapse-prevention option besides long-term medication.
The evidence
Status: mixed overall. Relapse prevention for depression is well supported. For stress, anxiety and pain, effects are modest and often no better than other active treatments; many early studies were small and poorly controlled.
Open questions
How much benefit comes from meditation itself versus expectation and group support, and why a minority of people find meditation increases their distress.
Connections (3)
▸Mindfulness-based therapies modestly reduce Stress, cortisol and fight-or-flightMixed evidence
The connection
MBSR was built for stress. Participants practice noticing body sensations and thoughts without reacting, which may weaken the worry loop that keeps the fight-or-flight system switched on. Many report feeling less stressed after eight weeks, though objective measures such as cortisol shift less consistently.
Who showed it and when
Jon Kabat-Zinn's Stress Reduction Clinic at the University of Massachusetts Medical School in Worcester, from 1979; later tested in hospitals, schools and workplaces worldwide.
How solid is it?
A 2014 Johns Hopkins review led by Madhav Goyal, covering 47 trials, found moderate evidence for anxiety, depression and pain, weaker evidence for stress, and no edge over exercise.
Open questions
Whether gains come from meditation itself or from expectation, time out and group support; studies of cortisol and brain changes have been small and inconsistent.
▸Dialectical behavior therapy (DBT) shares mindfulness skills with Mindfulness-based therapiesWell replicated
The connection
Mindfulness is DBT's first and core skill module: noticing thoughts and feelings without judging or acting on them. Linehan drew it from her own Zen practice, not from MBSR, so DBT and the mindfulness-based therapies share techniques and goals but grew from separate roots.
Who showed it and when
Linehan trained with Zen teachers, including Willigis Jäger in Germany, in the 1980s, building mindfulness into DBT before MBCT existed.
The evidence
Linehan's 1993 skills manual names mindfulness as the core skill; studies find DBT patients' gains in mindfulness track reductions in symptoms.
Open questions
How much mindfulness contributes to DBT's results, compared with its other skills, has not been isolated in trials.
▸Mindfulness-based therapies help prevent relapse of Depression and mood disordersWell replicated
The connection
MBCT is for people who have recovered from repeated depression. It trains them to notice early low moods and ruminative thinking without spiraling into a new episode. For people with three or more past episodes, it lowers relapse risk about as well as staying on antidepressants.
Who showed it and when
Designed by Zindel Segal (Toronto), Mark Williams (Bangor, later Oxford) and John Teasdale (Cambridge); the first trial was published in 2000.
The evidence
A 2016 meta-analysis led by Willem Kuyken, nine trials and 1,258 patients, found MBCT cut relapse risk over 60 weeks by about 31 percent versus those not given MBCT.
Open questions
Benefit is clearest for people with three or more past episodes; whether it helps those with fewer, and whether mindfulness itself is the active ingredient, is less clear.