A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression

Williams, Kate ORCID: https://orcid.org/0000-0001-8167-0951, Hartley, Samantha, Langer, Susanne ORCID: https://orcid.org/0000-0003-3036-430X, Manandhar-Richardson, Mizla, Sinha, Melissa and Taylor, Peter (2022) A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression. Clinical Psychology and Psychotherapy: an international journal of theory and practice, 29 (5). pp. 1494-1514. ISSN 1063-3995

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Abstract

Background MBCT is a relapse-prevention intervention for people experiencing major depression. Three qualitative meta-syntheses investigating experiences of taking part in MBCT and/or Mindfulness-based Stress Reduction (MBSR) across different diagnostic populations reported themes including control, choice, group processes, relationships, and struggles. As multiple studies have been published since, we aimed to update, systematically review, and synthesise the experiences of participants with depression taking part in MBCT. Methods Four databases were searched systematically (PsycInfo, Web of Science, Medline, CINAHL) up to and including the 12th November 2021. Twenty-one qualitative studies met the review criteria. All papers were rated as fair using a quality appraisal tool. Meta-ethnography was applied. Results Across 21 studies of participants with current or previous depression who had participated in MBCT, three overarching themes were developed: “Becoming skilled and taking action”, “Acceptance”, and “Ambivalence and Variability”. Participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective, and agency over their experiences. Participants developed acceptance towards their experiences, self, and others. There was variability and ambivalence regarding participants’ expectations and difficulties within mindfulness practices. Limitations Many studies were conducted in MBCT-research centres who may hold conflicts of interest. Many studies did not address the impact of the participant-researcher relationship thus potentially affecting their interpretations. Studies were skewed towards the experiences of female participants. Conclusions Our findings help to enhance participant confidence in MBCT, alongside understanding the processes of change and the potential for difficulties. MBCT is beneficial and provides meaningful change for many but remains challenging for some.