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Newer variations of cognitive-behavioral therapy: Behavioral activation and mindfulness-based cognitive therapy

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Abstract

Recent innovations in the treatment and prevention of depression that build on the foundation of cognitivebehavioral therapy represent promising directions for clinical practice and research. Specifically, behavioral activation and mindfulness-based cognitive therapy have been a recent focus of attention. Behavioral activation is a brief, structured approach to treating acute depression that seeks to alleviate depression by promoting an individual’s contact with sources of reward through increasing activation, improving problem solving, and decreasing avoidance and other barriers to activation. Mindfulness-based cognitive therapy is a brief group intervention that seeks to prevent depressive relapse by promoting mindful attention, acceptance, and skillful action to help individuals interrupt habitual cognitive and affective patterns associated with risk of relapse. Each approach is supported by at least two large-scale, randomized clinical trials; however, many important questions remain. We examine current research on both approaches by addressing the robustness of findings, the extension to novel populations, and the processes by which clinical benefit is achieved.

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References and Recommended Reading

  1. Beck AT, Rush AJ, Shaw BF, Emery G: Cognitive Therapy of Depression. New York: Guilford Press; 1979.

    Google Scholar 

  2. Butler AC, Chapman JE, Forman EM, Beck AT: The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev 2006, 26:17–31.

    Article  PubMed  Google Scholar 

  3. Jacobson NS, Martell CR, Dimidjian S: Behavioral activation treatment for depression: returning to contextual roots. Clin Psychol Sci Pract 2001, 8:255–270.

    Article  Google Scholar 

  4. Segal ZV, Williams JMG, Teasdale JD: Mindfulness-based Cognitive Therapy for Depression: A New Approach for Preventing Relapse. New York: Guilford Press; 2001.

    Google Scholar 

  5. Linehan MM: Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press; 1993.

    Google Scholar 

  6. Hayes S, Strosahl K, Wilson K: Acceptance and Commitment Therapy: An Experimental Approach to Behavior Change. New York: Guilford Press; 1999.

    Google Scholar 

  7. Jacobson NS, Dobson KS, Truax PA, et al.: A component analysis of cognitive-behavioral treatment for depression. J Consult Clin Psychol 1996, 64:295–304.

    Article  CAS  PubMed  Google Scholar 

  8. Gortner ET, Gollan JK, Dobson KS, Jacobson NS: Cognitive-behavioral treatment for depression: relapse prevention. J Consult Clin Psychol 1998, 66:377–384.

    Article  CAS  PubMed  Google Scholar 

  9. Ferster CB: A functional analysis of depression. Am Psychol 1973, 28:857–870.

    Article  CAS  PubMed  Google Scholar 

  10. Lewinsohn PM: A behavioral approach to depression. In The Psychology of Depression: Contemporary Theory and Research. Edited by Friedman RJ, Katz MM. Oxford: Wiley & Sons; 1974:157–178.

    Google Scholar 

  11. Dimidjian S, Hollon SD, Dobson KS, et al.: Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. J Consult Clin Psychol 2006, 74:658–670.

    Article  PubMed  Google Scholar 

  12. Martell CR, Addis ME, Jacobson NS, eds: Depression in Context: Strategies for Guided Action. New York: Norton; 2001.

    Google Scholar 

  13. Coffman SJ, Martell CR, Gallop R, et al.: Extreme nonresponse in cognitive therapy: can behavioral activation succeed where cognitive therapy fails? J Consult Clin Psychol 2007, 75:531–541.

    Article  PubMed  Google Scholar 

  14. Dobson KS, Dimidjian S, Kohlenberg RJ, et al.: Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. J Consult Clin Psychol 2008, 76:468–477.

    Article  PubMed  Google Scholar 

  15. Hopko DR, Lejuez CW, LePage JP, et al.: A brief behavioral activation treatment for depression-a randomized pilot trial within an inpatient psychiatric hospital. Behav Modif 2003, 27:458–469.

    Article  PubMed  Google Scholar 

  16. Cuijpers P, van Straten A, Warmerdam L: Behavioral activation treatments of depression: a meta-analysis. Clin Psychol Rev 2007, 27:318–326.

    Article  PubMed  Google Scholar 

  17. Ekers D, Richards D, Gilbody S: A meta-analysis of randomized trials of behavioural treatment of depression. Psychol Med 2008, 38:611–623.

    Article  CAS  PubMed  Google Scholar 

  18. Hopko DR, Sanchez L, Hopko SD, et al.: Behavioral activation and the prevention of suicidal behaviors in patients with borderline personality disorder. J Pers Disord 2003, 17:460–478.

    Article  PubMed  Google Scholar 

  19. Pagoto S, Bodenlos JS, Schneider KL, et al.: Initial investigation of behavioral activation therapy for co-morbid major depressive disorder and obesity. Psychotherapy 2008, 45:410–415.

    Google Scholar 

  20. Mulick PS, Naugle AE: Behavioral activation for comorbid PTSD and major depression: a case study. Cogn Behav Pract 2004, 11:378–387.

    Article  Google Scholar 

  21. Jakupcak M, Roberts LJ, Martell C, et al.: A pilot study of behavioral activation for veterans with posttraumatic stress disorder. J Trauma Stress 2006, 19:387–391.

    Article  PubMed  Google Scholar 

  22. Wagner AW, Zatzick DF, Ghesquiere A, Jurkovich GJ: Behavioral activation as an early intervention for posttraumatic stress disorder and depression among physically injured trauma survivors. Cogn Behav Pract 2007, 14:341–349.

    Article  Google Scholar 

  23. Armento MEA, Hopko DR: Behavioral activation of a breast cancer patient with coexistent major depression and generalized anxiety disorder. Clin Case Stud 2009, 8:25–37.

    Article  Google Scholar 

  24. McCauley E, Schloredt K, Martell C, et al.: Adolescents taking action presentation made as part of symposium: treatment of depression in children and adolescents-addressing controversies: component analyses and innovative strategies for adolescent depression. Paper presented at the International Society for Research in Child and Adolescent Psychopathology. Seattle, WA; June 17–20, 2009.

  25. Meeks S, Looney SW, van Haitsma K, Teri L: BE-ACTIV: a staff-assisted behavioral intervention for depression in nursing homes. Gerontologist 2008, 48:105–114.

    PubMed  Google Scholar 

  26. Santiago-Rivera A, Kanter J, Benson G, et al.: Behavioral activation as an alternative treatment approach for Latinos with depression. Psychotherapy 2008, 45:173–185.

    Google Scholar 

  27. Houghton S, Curran J, Saxon D: An uncontrolled evaluation of group behavioural activation for depression. Behav Cogn Psychother 2008, 36:235–239.

    Article  Google Scholar 

  28. Dimidjian S, Dimeff L, Hubley S, et al.: Steps toward dissemination of behavioral activation: development and use of online training. Paper presented at the Association for Behavioral and Cognitive Therapies. Orlando, FL; November 13–16, 2008.

  29. Gaynor SI, Harris A: Single-participant assessment of treatment mediators-strategy description and examples from a behavioral activation intervention for depressed adolescents. Behav Modif 2008, 32:372–402.

    Article  PubMed  Google Scholar 

  30. Hopko DR, Mullane CM: Exploring the relation of depression and overt behavior with daily diaries. Behav Res Ther 2008, 46:1085–1089.

    Article  PubMed  Google Scholar 

  31. Dichter GS, Felder JN, Petty C, et al.: The effects of psychotherapy on neural responses to rewards in major depression. Biol Psychiatry 2009 Sep 1 (Epub ahead of print).

  32. Kabat-Zinn J, ed: Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Delta; 1990.

    Google Scholar 

  33. Teasdale JD, Segal ZV, Williams JM, et al.: Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000, 68:615–623.

    Article  CAS  PubMed  Google Scholar 

  34. Ma SH, Teasdale JD: Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. J Consult Clin Psychol 2004, 72:31–40.

    Article  PubMed  Google Scholar 

  35. Williams JM, Russell I, Russell D: Mindfulness-based cognitive therapy: further issues in current evidence and future research. J Consult Clin Psychol 2008, 76:524–529.

    Article  PubMed  Google Scholar 

  36. Kuyken W, Byford S, Taylor RS, et al.: Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. J Consult Clin Psychol 2008, 76:966–978.

    Article  PubMed  Google Scholar 

  37. Finucane A, Mercer SW: An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry 2006, 6:14.

    Article  PubMed  Google Scholar 

  38. Kenny MA, Williams JM: Treatment-resistant depressed patients show a good response to mindfulness-based cognitive therapy. Behav Res Ther 2007, 45:617–625.

    Article  CAS  PubMed  Google Scholar 

  39. Kingston T, Dooley B, Bates A, et al.: Mindfulness-based cognitive therapy for residual depressive symptoms. Psychol Psychother 2007, 80:193–203.

    Article  PubMed  Google Scholar 

  40. Eisendrath SJ, Delucchi K, Bitner R, et al.: Mindfulness-based cognitive therapy for treatment-resistant depression: a pilot study. Psychother Psychosom 2008, 77:319–320.

    Article  PubMed  Google Scholar 

  41. Barnhofer T, Crane C, Hargus E, et al.: Mindfulness-based cognitive therapy as a treatment for chronic depression: a preliminary study. Behav Res Ther 2009, 47:366–373.

    Article  PubMed  Google Scholar 

  42. Williams JMG, Duggan DS, Crane C, Fennell MJV: Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior. J Clin Psychol 2004, 62:201–210.

    Article  Google Scholar 

  43. Williams JM, Alatiq Y, Crane C, et al.: Mindfulness-based cognitive therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning. J Affect Disord 2008, 107:275–279.

    Article  CAS  PubMed  Google Scholar 

  44. Miklowitz D, Alatiq Y, Goodwin GM, et al.: A pilot study of mindfulness-based cognitive therapy for bipolar disorder. Int J Cogn Ther 2009 (in press)

  45. Evans S, Ferrando S, Findler M, et al.: Mindfulness-based cognitive therapy for generalized anxiety disorder. J Anxiety Disord 2008, 22:716–721.

    Article  PubMed  Google Scholar 

  46. Craigie MA, Rees CS, Marsh A, Nathan P: Mindfulness-based cognitive therapy for generalized anxiety disorder: a preliminary evaluation. Behav Cogn Psychother 2008, 36:553–568.

    Article  Google Scholar 

  47. Yook K, Lee SH, Ryu M, et al.: Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders—a pilot study. J Nerv Ment Dis 2008, 196:501–503.

    Article  PubMed  Google Scholar 

  48. Baer RA, Fischer S, Huss DB: Mindfulness and acceptance in the treatment of disordered eating. J Ration Emotive Cogn Behav Ther 2005, 23:281–300.

    Article  Google Scholar 

  49. Heidenreich T, Tuin I, Pflug B, et al.: Mindfulness-based cognitive therapy for persistent insomnia: a pilot study. Psychother Psychosom 2006, 75:188–189.

    Article  PubMed  Google Scholar 

  50. Dimidjian S, Goodman SH: Adapting MBCT for the prevention of perinatal depressive relapse and recurrence. Paper presented at the Integrating Clinical and Neuroscience Perspectives on Mindfulness Training in Health and Disease Conference. Toronto, Ontario, Canada; December 2008.

  51. Williams JM, Teasdale JD, Segal ZV, Soulsby J: Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. J Abnorm Psychol 2000, 109:150–155.

    Article  CAS  PubMed  Google Scholar 

  52. Crane C, Barnhofer T, Duggan DS, et al.: Mindfulness-based cognitive therapy and self-discrepancy in recovered depressed patients with a history of depression and suicidality. Cogn Ther Res 2008, 32:775–787.

    Article  Google Scholar 

  53. Farb N, Anderson A, Mayberg H, et al.: Minding one’s emotions: mindfulness training alters the neural expression of sadness. Emotion 2009 (in press).

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Dimidjian, S., Davis, K.J. Newer variations of cognitive-behavioral therapy: Behavioral activation and mindfulness-based cognitive therapy. Curr Psychiatry Rep 11, 453–458 (2009). https://doi.org/10.1007/s11920-009-0069-y

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