Recommendations for conducting mindfulness based cognitive therapy trials.

Abstract

We read with interest the article ‘‘Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and metaanalysis’’ (Chiesa and Serretti, 2011), which we note is currently ranked as the most downloaded paper in Psychiatry Research. The authors used strong and appropriate methodology and concluded that augmentation of Mindfulness-Based Cognitive Therapy (MBCT) to standard care (treatment as usual: TAU) could result in significantly lower relapse/recurrence rates in people experiencing depression when compared with standard care alone. They further concluded that relapse rates at 1 year for MBCT plus gradual discontinuation of maintenance anti-depressants did not differ significantly from the antidepressant continuation control. We wholeheartedly welcome comprehensive reviews such as these in relation to MBCT because (1) the theory and practice of MBCT is still in its infancy and relatively little is known about its efficacy, and (2) empirical examination of MBCT produces very important data of which clinicians, researchers, commissioners of services, and potential MBCT clients should be aware. However, we do not think that Chiesa and Serretti’s (2011) critique of the methodology employed in MBCT trials to date goes far enough, and we would strongly caution against the assumption that third wave therapies like MBCT are unequivocally superior to first or second wave therapies; to do so may be ‘getting ahead of the data’ (Corrigan, 2001, p. 192). Instead, we believe it is important that third wave therapies are held to account and challenged to an equal degree (using the same principles of empirical validation) as the previous two waves, particularly given the fact that the use of MBCT seems to be growing very rapidly, and it is being been rolled out across the world to treat an array of psychological problems. For example, in the UK, there already appears to be strong confidence at a national level in the efficacy of MBCT, as MBCT is advocated in the clinical guidelines of the National Institute for Health and Clinical Excellence (NICE) as the treatment for individuals who are currently well but who have a history of three or more previous episodes of depression. Clinical experience and peer discussions at international conferences also strongly suggest that clinicians are increasingly turning away from existing empirically supported treatments towards third wave therapy models, presumably assuming that third wave therapies are superior given their more recent inception. With this context in mind, we would like to suggest some additional methodological considerations for future MBCT trials to address. Chiesa and Serretti (2011) noted that the original MBCT programme has been adapted in some trials. MBCT was developed specifically to try and prevent relapse in depression rather than as

DOI: 10.1016/j.psychres.2012.12.030

Cite this paper

@article{Siddaway2013RecommendationsFC, title={Recommendations for conducting mindfulness based cognitive therapy trials.}, author={Andy P Siddaway and Alex M. Wood}, journal={Psychiatry research}, year={2013}, volume={207 3}, pages={229-31} }