"there is strength in the differences between us.
I know there is comfort where we overlap."
- Ani DiFranco
MBCT-L or MBCT
As an adaptation of MBCT, MBCT-L retains much of the root and branch of Mindfulness-based Cognitive Therapy, however there are differences of emphasis. You can find various sources that contrast MBCT and Mindfulness Based Stress Reduction (MBSR), but I've found none that set out the contrast between MBCT-L and MBCT. The key features of MBCT are referenced while those of MBCT-L are my opinion.
MBCT-L
Designed to help the full spectrum of people from those who may experience depression through languishing to flourishing in some but not all areas of their lives. More universal vulnerabilities, more specific potentialities.
Looks at life and asks both how mindfulness can help you stay well but also move towards flourishing.
Allows accumulation of mindfulness experience to give insight into both negative mind states and more positive or appreciative ones. Examines habits of mind.
Can shift the relationship to experience by recognising patterns of mind and emotion.
Emphasises the element of choice in how to respond.
Involves unpacking of thought mechanisms.
Includes explicit compassion practice.
More emphasis on embodiment through mindful movement.
MBCT-L is taught within a cognitive understanding and framework, perhaps even more explicitly than MBCT.
MBCT-L has an explicit focus on turning toward negative thoughts early in the program so that participants gain experience with recognising these symptoms and confidence in their ability to respond skilfully.
Manualised (developed from MBCT and Finding Peace / M-FP).
MBCT
Designed to prevent depressive relapse, particularly those who deal with chronic or acute depression and/or mild-to-moderate anxiety (1). MBCT tends to target specific conditions or vulnerabilities (3).
Looks at the ‘illness’ of depression / anxiety and asks – how mindfulness can help you stay well (1).
Allows accumulation of mindfulness experience to give insight into the negative mind states associated with depression / anxiety (1). Examines habits of mind, recurrent negative thoughts (2).
Can shift the relationship to suffering by recognizing patterns of mind and emotion (1).
Emphasises the element of choice in how to respond to states (1).
Involves unpacking of thought mechanisms (2).
Has less emphasis on compassion practice (2).
Does not emphasise embodiment (2).
MBCT is taught within a cognitive understanding and framework (3).
The key difference in MBCT is an explicit focus on turning toward low mood and negative thoughts early in the program so that participants gain experience with recognizing these symptoms and confidence in their ability to respond skillfully (5).
Manualised (developed through RCT) (4).
References for MBCT
(1) Centre for Mindfulness Studies, Toronto. Understanding Mindfulness-Based Programs (MBPs). Available online at: https://www.mindfulnessstudies.com/understanding-mbps/
(2) Johnson, D., Mullen, D., Smith, I., & Wilson, A. (2016). Mindfulness in addictions. BJPsych Advances, 22(6), 412-419. doi:10.1192/apt.bp.114.014142. Available online at: https://www.cambridge.org/core/journals/bjpsych-advances/article/mindfulness-in-addictions/40A1A7E8A761A48F74172A24A113D50A
(3) Centre for Mindfulness Research and Practice, Bangor University. What is Mindfulness? Available online at: https://www.bangor.ac.uk/mindfulness/what-is-mindfulness.php.en#:~:text=The%20key%20differences%20between%20MBSR%20and%20MBCT&text=MBCT%20tends%20to%20target%20specific,including%20physical%20or%20mental%20illness
(4) MantraCare. Mindfulness-based Therapies For OCD: MBCT And MBSR For OCD. Available online at: https://mantracare.org/ocd/mbct-for-ocd/
(5) UMass Memorial Medical Centre. MBCT and MBSR: The Differences. Available online at: https://www.ummhealth.org/umass-memorial-medical-center/services-treatments/center-for-mindfulness/mindfulness-programs/mbct-and-mbsr-the-differences-0
Williams, M., Segal, Z., Williams, J. M. G., Teasdale, J. (2012). Mindfulness-Based Cognitive Therapy for Depression, Second Edition. United Kingdom: Guilford Publications.
MBCT-L differences with MBCT for each session:
Waking up from automatic pilot
Introduces the 10 finger gratitude practice from M-FP, emphasis on turning a good fact into a good experience
Handout is more explicit about gratitude and appreciation
Body scan guidance is 8.5 minutes shorter (30.29)
Another way of being: keeping the body in mind
Theme is more specifically about body compared to 'Living in our heads'
Introduces the 50:50 attention exercise from M-FP
Experiences calendar uses 4 part model so now includes focus on impulses / behaviours
Gathering the scattered mind
Mindful movement at the start of the session not the end, lying down or standing, or doing lying down first and then stretch and breath at end.
8 minutes more time given to the movement aspect in the guidance (18 mins vs 10)
Postural images for mindful movement in handouts
Stretch and breath 3 minutes shorter overall (30.37)
Mindful movement 7 mins shorter (31.51)
Experiences calendar uses 4 part model so includes impulses or behaviours
Recognising reactivity
Theme relates to reactivity rather than only aversion, aversion is posited to be at root of depressive relapse while reactivity is broader concept
It isn't suggested to read ‘Wild Geese’ after sitting practice
Vicious flower exercise instead of defining territory of depression
Only the longest of 3 sitting practices is almost 8 minutes shorter (29.56)
Breathing space with self compassion
Allowing and letting be
Befriending practice in the session (not home practice)
Random acts of kindness in home practice
Home practice alternates sitting practice and being with difficulty (which is 6 minutes shorter at 19.58) rather than alternating working with difficulty practice and guiding self through it. Wording of “being with” rather than “working with” suggests less striving.
Breathing space with additional wording
Responding skillfully: thoughts are not facts
Emphasis on positive aspects of experience in initial sitting practice rather than just on how we relate to thoughts
Responding skillfully exercise, in home practice and title of session.
How can I best take care of myself
Emphasis on discoveries, delights and difficulties in initial sitting practice
Not suggested to read ‘the summer’s day’ poem
Mindfulness for life
Reading the poem ‘pick more daisies’
Emphasis on life rather than maintaining and extending.
Overall the practices are shorter, there’s more emphasis on positive psychology, more gratitude, embodiment and compassion, also more of a more general CBT focus because of 4 part model, vicious flower and responding skillfully exercise. But it’s all bits of flavour, it's still very much MBCT.