Mindfulness Based Cognitive Therapy (MBCT)

Mindfulness meditation has been found to be helpful in coping with depression among people with brain injuries [1]. Canadian studies have shown it can help lessen the symptoms of depression and anxiety, decrease pain, increase energy, and improve quality of life [2].

Mindfulness meditation is often taught as an 8-week program in Mindfulness-Based Stress
Reduction and taught in clinical or community settings [3]. Mindfulness-Based Cognitive Therapy (MBCT) [4] has been adapted and tested in the traumatic brain injury population to treat depression in people of all severity levels [1,5]. Some hospitals and clinicians offer this program.

Since 2000, several clinical trials in MBCT have been conducted in the field of brain injury. Initially in two smaller pilot studies, the researchers found a 59% statistically significant reduction in depression symptoms, as well as improvements in anxiety, pain, energy, and quality of life [6] and at the one-year follow-up, the participants maintained improvements [6].

Another study in Ottawa found MBCT significantly reduced depression symptoms on all scales used. Similarly, it reduced pain intensity and increased energy levels [7]. The groups met for 1.5 hours a week over 8 – 12 weeks to learn modified mindfulness meditation, breathing practices, body scans, walking meditation, yoga, and reflective inquiry. It was recommended that participants meditate for 20 – 30 minutes daily.

The same research team conducted a randomized controlled trial in Thunder Bay, Ottawa, and Toronto where participants learned modified mindfulness meditation, breathing practices, body scans, walking meditation, yoga, and reflective inquiry. The groups met for 1.5 hours over 10 weeks with the recommendation to practice mindfulness meditation at home for 20-30 minutes daily. The results found a statistically significant 26% reduction in depression symptoms as measured by the Beck Depression Index-ll (BDI-ll) compared with the control group (results from larger RCTs often differ from smaller studies [1]. Three-months after the research trial finished, researchers completed follow-up tests where depression scores were shown to continue to improve. Interestingly, tests showed greater mindfulness was found to be associated with improvements in depression symptoms suggesting that MBCT for TBI may be the mechanism for improvement in symptoms [8].

Following these studies, MBCT for TBI has been accepted as a best practice and included in two Canadian clinical guidelines [9, 10]. Other research [11] has brought important insights to how mindfulness changes the brain. Following an 8-week Mindfulness-Based Stress Reduction program like the program adapted for people with brain injuries found:

  • Increased volume in the hippocampus, as structure important for learning & memory
  • Increased volume in the cingulate cortex, as structure associated with self-awareness, compassion & introspection

See sources