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Mindfulness-based cognitive therapy (MBCT) is psychological therapy which blends features of cognitive therapy with mindfulness techniques of Buddhism. MBCT involves accepting thoughts and feelings without judgement rather than trying to push them out of consciousness, with a goal of correcting cognitive distortions. MBCT was founded by Zindel Segal, Mark Williams and John Teasdale, who based MBCT on a program developed by Jon Kabat-Zinn called mindfulness-based stress reduction (MBSR),  which was adapted for use with major depressive disorder. The aim of MBCT is not directly to relaxation or happiness in themselves, but rather, a "freedom from the tendency to get drawn into automatic reactions to thoughts, feelings, and events". MBCT programs usually consist of eight weekly two-hour classes with weekly assignments to be done outside of session. The aim of the program is to enhance awareness so clients are able to respond to things instead of react to them.

Background
In 1991 Barnard and Teasdale created a multilevel theory of the mind called “Interacting Cognitive Subsystems,” (ICS). The ICS model has a metacognitive framework that displays the relationship between psychopathology and how individuals process their environment. The ICS model is based on Barnard and Teasdale’s theory that the mind has multiple modes that are responsible for receiving and processing new information cognitively and emotionally. The modes of mind are constantly interacting with one another, exchanging processed information. Barnard and Teasdale’s (1991) theory associates an individual’s vulnerability to depression with the degree to which he/she relies on only one of the mode of mind, inadvertently blocking the other modes. The goal of Mindfulness Based Cognitive Therapy is to teach people how to become more aware of his/her current mode of mind at any time, and ways to engage or disengage helpful modes of mind.

The two main modes of mind include the “doing” mode and “being” mode. The “doing” mode is also known as the driven mode. This mode is very goal-oriented and is triggered when the mind develops a discrepancy between how things are versus how the mind wishes things to be. If the mind continuously dwells on these discrepancies, then negative feelings and emotions begin to arise leading to habitual patterns of the mind designed to reduce the gap between present and desired state form. The “doing” mode is constantly thinking about and analyzing if goals were or will be met in the past and the future, therefore places little focus on the present enhancing and maintaining unwanted feelings and emotions.

The second main mode of mind is the “being” mode. In most respect “being” mode is the opposite of “doing” mode. “Being” mode, is not focused on achieving specific goals, instead the emphasis is on “accepting and allowing what is,” without any immediate pressure to change it. The mind processes from moment to moment, enabling the person to be completely engaged in the present. Each thought is direct, immediate, intimate experience with the present moment. While in “doing” mode goals are developed to ensure good or bad feelings continue, “being” mode views thoughts and feelings simply as events that arise in the mind, become objects of awareness, and then pass out of the mind.

The central component of Barnard and Teasdale’s ICS is metacognitive awareness. Metacognitive awareness is the ability to experience negative thoughts and feelings as mental events that pass through the mind, rather than as apart of the self. Individuals with high metacognitive awareness are able to avoid depression and negative thought patterns more easily during stressful life situations, in comparison to individuals with low metacognitive awareness. Mainly, cognitive therapy is used to increase metacognitive awareness and is often successful. Metacognitive awareness is regularly reflected through an individual’s ability to decenter. Decentering is the ability to perceive thoughts and feelings as both impermanent and objective occurrences in the mind. An individual that is decentered is present-focused and nonjudgmental about his/her thoughts and feelings.

Based on Barnard and Teasdale’s (1991) model, mental health is related to an individual’s ability to disengage from one mode or to easily move among the modes of mind. Therefore, individuals that are able to flexibly move between the modes of mind based on the conditions in the environment are in the most favorable state. The ICS model theorizes that the “being” mode is the most likely mode of mind that will lead to lasting emotional changes. Therefore for prevention of relapse in depression cognitive therapy must promote this mode. This led Teasdale to the creation of MBCT, which promotes the “being” mode.

MBCT is an intervention program developed to specifically target vulnerability to depressive relapse. Throughout the program, patients learn mind management skills leading to heighten metacognitive awareness, acceptance of negative thought patterns and an ability to respond in skillful ways. During MBCT patients learn to decenter his/her negative thoughts and feelings, allowing the mind to move from an automatic thought pattern to conscious emotional processing.

Benefits
MBCT prioritizes learning how to pay attention or concentrate with purpose, in each moment and most importantly, without judgment. Through mindfulness, clients can recognize that holding onto some of these feelings are ineffective and mentally destructive. Mindfulness is also thought by Fulton et al. to be useful for the therapists as well during therapy sessions.

The UK National Institute of Clinical Excellence (NICE) recommends MBCT for patients that have suffered from three or more major episodes of depression. The specific goal of MBCT is to prevent relapse into a subsequent major depressive episode, this goal is supported by "wonderful clinical trials across three different continents."