MBCT for Depression: Relapse Prevention Evidence and Who It Suits
What mindfulness-based cognitive therapy is, what trials and NICE say about preventing depression relapse, who it suits, and why current severe depression needs a clinician first.
Content last updated . This page has not been medically reviewed.
If you are in crisis or thinking about harming yourself, call or text 988 in the US, or call 911 in an emergency. [1] This page is information only. It cannot tell you whether a course is right for you, and MBCT is not a replacement for care from a doctor or therapist.
What MBCT is
Mindfulness-based cognitive therapy (MBCT) integrates mindfulness practice with parts of cognitive behavioral therapy. [2] It is described as designed to help people who have repeated bouts of depression. [3] NICE (England) describes a group course with a programme specifically designed for people with depression, usually 8 regular sessions of 8 to 15 people. [4]
The focus is on concentrating on the present, observing and sitting with thoughts, feelings and body sensations, and breathing exercises, with an emphasis on recognizing thoughts rather than changing them. [4] Homework is part of it, including using mindfulness recordings between sessions. [4] For how MBCT differs from MBSR see the programs overview.
What research shows
The strongest evidence is for people who have recovered from depression and want to lower the chance of it returning. It is not evidence that MBCT treats everyone who feels low.
| Question | What the source found | Strength of evidence |
|---|---|---|
| Does MBCT lower relapse compared with usual care? | Individual data from 9 trials (1,258 people in full or partial remission): lower relapse risk over 60 weeks than in people who did not receive MBCT (hazard ratio 0.69) [5] | Established for this use |
| Compared with active treatments, including antidepressants | Hazard ratio 0.79 in the same analysis [5] | Promising to established |
| Compared directly with staying on antidepressants | PREVENT trial, 424 people with three or more past episodes: time to relapse did not differ over 24 months (hazard ratio 0.89) [6] | Similar results; no proof one is better |
| Earlier trial against medication and placebo | Toronto trial of 84 people in remission: among those with unstable remission, MBCT and maintenance medication each showed a 73% lower hazard than placebo [7] | Promising but limited; small |
Points to keep in mind:
- In PREVENT, the MBCT group got support to taper or stop antidepressants. [6] Do not stop antidepressants on your own. NICE lists continuing medication, MBCT or group CBT, or both as options to discuss. [4]
- Participants know which treatment they get, and PREVENT assessors, not participants, were masked. [6]
- In the Toronto trial, stable remitters showed no group differences, which suggests benefit may depend on how stable recovery is. [7]
- The NHS notes that NICE recommends mindfulness-based therapies for less severe depression. [8] Proper evidence not found, in the sources read, for MBCT as a stand-alone treatment of current severe depression.
What NICE says about relapse prevention
For people who have remitted on antidepressants alone and are at higher risk of relapse, NICE says to consider continuing medication, a course of group CBT or MBCT for people who do not wish to continue on antidepressants, or both. [4] It suggests a course with an explicit focus on relapse prevention skills, usually 8 sessions over 2 to 3 months, with option of added sessions in the next 12 months. [4]
Finding a qualified teacher
NICE says group mindfulness should preferably be led by 2 practitioners, at least one with therapy-specific training and competence. [4] Proper evidence not found for a US license specific to MBCT teaching; NCCIH advises asking about the instructor's training and experience. [2] Ask whether the teacher is a licensed mental health professional, how they handle low mood during the course, and whether they coordinate with your doctor. More on teacher standards and meditation for depression.
Frequently asked questions
Is MBCT the same as MBSR?
No. MBCT combines mindfulness with parts of cognitive behavioral therapy and was designed for depression, while MBSR teaches mindful meditation with discussion sessions. [2][3]
Can MBCT replace my antidepressant?
In the PREVENT trial it did about as well over 24 months, with support to taper under study conditions. Decide with your prescriber, never alone. [6][4]
How many sessions are there?
NICE describes usually 8 sessions, and 8 sessions over 2 to 3 months for relapse prevention. [4]
Can I do MBCT when I am depressed now?
Proper evidence not found, in the sources read, for stand-alone use in severe current depression. Ask your clinician. [4]
Is MBCT safe?
Most side effects were temporary, but some people had lasting bad effects. [9]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Who it may suit, and who should check first
NICE says the group approach may suit people who want a different perspective on negative thoughts, feelings or body sensations, and allows peer support. [4] It also says it may be difficult for people with intense or highly distressing thoughts, or who find focusing on the body difficult. [4]
Talk to a clinician before starting if you have current moderate or severe depression, recent suicidal thoughts, bipolar disorder, psychosis or trauma symptoms. A trained clinician can tell you whether to start now or wait. See who should check with a clinician before meditating.
Side effects
In a study of three MBCT variants (96 people), 83% reported at least one meditation-related side effect, and lasting bad effects occurred in 6 to 14%. [9] The authors concluded transient distress and negative impacts occurred at rates similar to other psychological treatments. [9] The PREVENT trial reported no adverse events attributable to the interventions. [6] See adverse effects of meditation.
References
- 988 Suicide & Crisis Lifeline. 988lifeline.org. Read 2026-10-22.
- National Center for Complementary and Integrative Health. Meditation and Mindfulness: Effectiveness and Safety. Read 2026-10-22.
- MBCT.com. Mindfulness-Based Cognitive Therapy. Read 2026-10-22.
- National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222), Recommendations. Published 29 June 2022. Read 2026-10-22.
- Kuyken W, et al. Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials. JAMA Psychiatry. 2016. Read 2026-10-22.
- Kuyken W, et al. Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT). Lancet. 2015. Read 2026-10-22.
- Segal ZV, et al. Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Arch Gen Psychiatry. 2010. Read 2026-10-22.
- NHS. Mindfulness. Read 2026-10-22.
- Britton WB, et al. Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clin Psychol Sci. 2021. Read 2026-10-22.