Mindfulness-Based Cognitive Therapy (MBCT)

An in-depth examination of MBCT's foundations, program structure, evidence base, and limitations

What Is Mindfulness-Based Cognitive Therapy?

Mindfulness-based cognitive therapy (MBCT) is a structured, eight-week, group-based program that integrates intensive training in mindfulness meditation with elements of cognitive therapy. It occupies a distinctive niche among the therapies in this series: it was designed not to treat an active disorder but to prevent the return of one. Its original and best-evidenced indication is relapse prevention in recurrent major depressive disorder—specifically, for people currently in remission who have suffered multiple prior episodes and face a high statistical likelihood of another.

That design brief shaped everything about the program. Recurrent depression behaves less like a series of unlucky events and more like a kindled vulnerability: with each episode, the threshold for the next one drops, and relapses become progressively untethered from major life stressors. By three or more episodes, the lifetime risk of recurrence approaches 70–80 percent. The standard medical answer is indefinite maintenance antidepressant medication, which works but which many patients cannot tolerate, do not want, or quietly discontinue. MBCT was built as a psychological alternative: a time-limited training that would confer durable protection by changing not what people think, but how they relate to their thinking when the early weather of depression begins to gather.

Distinguishing features at a glance:

It is a class, not a therapy. MBCT is delivered to groups of roughly 8–15 participants in eight weekly two-to-two-and-a-quarter-hour sessions plus a daylong retreat, with a teacher who instructs and embodies rather than treats. There is no individual case formulation, no chain analysis, no thought records in the Beckian sense. Participants are "participants," not patients, and most of the work happens at home, in roughly 40–45 minutes of daily guided practice.

Meditation is the core technology. Unlike DBT, which extracted mindfulness into micro-skills, and ACT, which teaches present-moment contact without requiring formal practice, MBCT is built around sustained formal meditation—body scans, sitting meditation, mindful movement—on the premise that the capacity it trains cannot be acquired conceptually.

The cognitive therapy is in the framing, not the disputation. MBCT imported cognitive therapy's model—that relapse is driven by the reactivation of negative thinking patterns—and its psychoeducation, but deliberately discarded its central technique. Thoughts are not evaluated for accuracy or restructured; they are observed as passing mental events. The program's most quoted session title states the entire therapeutic claim: thoughts are not facts.

It targets a mechanism, not symptoms. The proximate target is cognitive reactivity—the ease with which small dips in mood reactivate old depressive thinking—and the ruminative processing style that turns a sad afternoon into a relapse. Mood improvement is welcome but is not the point; changed relationship to mood is.

Historical Development

The assignment

MBCT has an unusually well-documented origin: it was commissioned. In the early 1990s, Zindel Segal (Toronto), Mark Williams (Bangor, later Oxford), and John Teasdale (Cambridge) were asked to develop a maintenance version of cognitive therapy for depression—a group program that could protect recovered patients at scale. All three were cognitive scientists and clinicians steeped in the information-processing tradition, and their starting question was mechanistic: why does cognitive therapy prevent relapse, and could that ingredient be delivered without the full individual therapy?

The theoretical detour that built the program

The conventional answer—cognitive therapy works by changing the content of dysfunctional beliefs—did not survive their reading of the data. Belief-content measures improved with pharmacotherapy too, and did not convincingly mediate cognitive therapy's prophylactic advantage. Teasdale's alternative account, drawing on his Interacting Cognitive Subsystems (ICS) framework and on Ingram's and Segal's work on cognitive reactivity, proposed that what cognitive therapy really taught—almost incidentally, through hundreds of repetitions of catching and examining thoughts—was a decentered relationship to thinking: the ability to experience thoughts and feelings as passing events in the mind rather than as the self or as direct readouts of reality. On this view, vulnerability to relapse lay in the ease with which dysphoria reactivated old, well-rehearsed networks of self-critical, hopeless thinking (the differential activation hypothesis), which then locked in through rumination. Protection lay in detecting that reactivation early and disengaging from it—stepping out of the mental gears rather than arguing with their output.

If decentering was the active ingredient, the developers reasoned, why not train it directly? The search for a training method led them—initially with considerable skepticism, which they have written about candidly—to Jon Kabat-Zinn's mindfulness-based stress reduction (MBSR) program at the University of Massachusetts, then accumulating evidence in chronic pain and stress. Site visits convinced them that intensive mindfulness practice trained exactly the capacity their theory required, with one addition MBSR lacked: depression-specific cognitive content. MBCT was assembled as MBSR's eight-week chassis carrying a cognitive-theoretical engine—roughly, two-thirds meditation training, one-third cognitive therapy psychoeducation—and was manualized in Mindfulness-Based Cognitive Therapy for Depression (Segal, Williams & Teasdale, 2002; 2nd ed. 2013). Williams, Teasdale, Segal, and Kabat-Zinn later co-authored the participant book The Mindful Way Through Depression.

The first randomized trial (Teasdale et al., 2000) confirmed the design hypothesis in its moderated form: MBCT roughly halved relapse over 60 weeks—but only in patients with three or more prior episodes, the group whose relapses were presumed most automatized. That moderation finding, replicated by Ma and Teasdale (2004), defined the program's indicated population and remains one of the cleaner theory-to-trial stories in psychotherapy research. NICE first recommended MBCT for relapse prevention in recurrent depression in 2004, and it has remained in NICE depression guidance since.

The Theoretical Model

Modes of mind: doing versus being

MBCT's working model distinguishes two broad modes of mental processing. Doing (or driven-doing) mode is the mind's discrepancy-reduction machinery: it compares current state to desired state and works, largely verbally and automatically, to close the gap. It is indispensable for external problems and disastrous when turned on emotional life—because monitoring the gap between "how I feel" and "how I should feel" is rumination, and because the strategy of thinking one's way out of sadness continuously re-presents the sadness to be solved. Being mode processes experience directly and non-conceptually—allowing, sensing, and observing rather than evaluating and fixing. MBCT frames its entire curriculum as learning to recognize which mode the mind is in and to shift modes deliberately, especially at moments of lowering mood.

Cognitive reactivity and the relapse signature

The model's specific account of relapse: in recurrent depression, ordinary dysphoria—a gray morning, a slight, fatigue—reactivates entire networks of depressive thinking ("here we go again," "I'm useless," "nothing will change") with increasing automaticity across episodes. The reactivated thinking is met with ruminative analysis and experiential avoidance, which amplify and entrench it; within weeks the person is in episode. Empirically, cognitive reactivity (the magnitude of dysfunctional thinking induced by a sad-mood challenge in remitted patients) prospectively predicts relapse, and post-treatment decentering and reduced reactivity are among the better-supported mediators of MBCT's effect. Each participant ends the program by mapping their personal relapse signature—the idiosyncratic early warnings (withdrawing from calls, irritability, changed sleep, particular thought-forms)—and a written action plan keyed to it.

What mindfulness adds

Within this model, meditation practice is repetition training for three capacities: attention deployment (noticing where the mind is, early, hundreds of times per practice); decentering/metacognitive awareness (registering thoughts as events—"a thought is arising"—rather than from inside them); and approach instead of avoidance (turning toward difficult sensation and affect with curiosity, which interrupts the experiential avoidance that fuels rumination). The kindness tone of instruction is not decorative: self-attack in response to noticing one's own low mood is depressive fuel, and the program treats a gentler self-relation as load-bearing.

How MBCT Is Structured and Used

The eight-week program

MBCT follows a manualized session-by-session arc, each session pairing formal practice with inquiry and a theme:

Session 1 — Awareness and automatic pilot. The raisin exercise (eating a single raisin with full attention) demonstrates how much of life runs unattended; the body scan is introduced and assigned daily.

Session 2 — Living in our heads. The thoughts-and-feelings exercise (one ambiguous scenario, many interpretations, different emotions) delivers the cognitive model experientially; participants begin a pleasant-events calendar, noticing the sensory texture of good moments.

Session 3 — Gathering the scattered mind. Sitting meditation with breath as anchor; mindful movement and walking; the three-minute breathing space is introduced—MBCT's signature portable practice (1: acknowledge current experience; 2: gather attention on the breath; 3: expand to the whole body)—the hinge between formal practice and daily life.

Session 4 — Recognizing aversion. The pull of attachment and the push of aversion as the mind's habitual reactions; psychoeducation on the territory of depression (diagnostic criteria, automatic negative thoughts) normalizes symptoms as the disorder's signature rather than personal truth.

Session 5 — Allowing/letting be. Deliberately bringing a difficulty to mind during meditation and practicing opening to its bodily imprint rather than fixing it—the program's pivot from attention training to acceptance.

Session 6 — Thoughts are not facts. The conceptual summit: thoughts, including the most charged ("I'm a burden"), observed as mental events with conditions and histories; alternative relationships to thinking (watching thoughts as clouds, naming thought-patterns) replace disputation.

All-day practice retreat (usually between sessions 6 and 7): a largely silent day consolidating practice.

Session 7 — How can I best take care of myself? Activity and mood; depleting versus nourishing activities; using activity deliberately when mood lowers (a clear behavioral-activation inheritance); construction of the personal relapse signature and action plan.

Session 8 — Maintaining and extending. Plans for continued practice; the program frames itself explicitly as the beginning of a practice, not a completed treatment. Many programs offer reunion/booster sessions.

Daily home practice of roughly 40–45 minutes (guided audio) is assigned throughout—the program is unapologetic that the dose is the point—and inquiry, the teacher-led dialogue after each practice about what participants actually noticed, is considered the pedagogical heart of the method, where private experience is connected to the relapse model.

Indications and extensions

• Core indication: relapse prophylaxis in recurrent major depression (≥3 episodes), in current remission or recovery—the population in the trials, the guidelines, and the theory.
• Current depression: later trials and meta-analyses support moderate benefit for active depressive symptoms, including treatment-resistant presentations, though the evidence is thinner than for prevention and MBCT was not designed for severe acute illness.
• Anxiety and health anxiety: adaptations show promising results for generalized anxiety and a notably strong UK trial in health anxiety in medical settings.
• Adaptations: MBCT for cancer, for chronic fatigue, for suicidality (incorporating safety planning), perinatal MBCT, MBCT-C for children, and self-help/digital formats (see Section 7).

Delivery formats

Standard delivery is the in-person eight-week group taught by a trained teacher with a personal meditation practice (a formal requirement in good-practice guidelines, on the logic that one cannot teach inquiry into practice one does not have). Evidence-supported variants now include teacher-supported self-help using the Mindful Way workbook, online teacher-led groups, and app/web-based courses—with the consistent pattern, familiar from iCBT, that supported digital delivery retains much of the effect while unsupported apps show smaller, less durable benefits and high attrition.

Common Practices and Techniques

The body scan. Thirty to forty minutes of guided, sequential attention through the body, practiced daily for the first weeks. Its functions: training sustained, deliberate attention deployment; re-grounding awareness in the body (where affect can be met as sensation rather than story); and providing thousands of repetitions of the core move—noticing the mind has wandered and returning without self-criticism. Participants who find it boring or sleep-inducing are told that noticing boredom and the reaction to it is the practice.

Sitting meditation. Breath, body, sounds, thoughts, and open awareness in expanding scope across the weeks; difficulties (pain, restlessness, intrusive thoughts) progressively included as objects of practice rather than obstacles to it.

Mindful movement and walking. Gentle stretching and slow walking with full attention—accessible entry points for participants for whom stillness is initially intolerable, and a statement that mindfulness is a quality of any activity.

The three-minute breathing space. The program's bridge to real life, assigned first at fixed times, then responsively—at the first detection of unpleasant feeling—where it functions as a deliberate mode-shift inserted exactly at the fork where rumination would begin. Clinically, many graduates identify this, not the long sits, as the skill they keep.

Cognitive elements. The thoughts-and-feelings (interpretation) exercise; pleasant/unpleasant events calendars (training granular awareness of experience and its bodily components); psychoeducation about depression and the relapse process; the thoughts-are-not-facts session; activity scheduling rebalanced toward nourishing and mastery activities; and the written relapse signature and action plan—which often includes "contact my prescriber" as an explicit step, a detail worth noting for psychiatric integration.

What MBCT deliberately does not do: no disputation of thought content, no exposure hierarchies, no individual formulation, no processing of trauma material. Teachers redirect analytical discussion back to direct experience—a feature that participants expecting "therapy" sometimes need prepared for.

MBCT Among Its Neighbors

Versus MBSR. Same chassis (eight weeks, same core practices, daylong retreat), different payload: MBSR is a generic stress-reduction program for heterogeneous groups; MBCT adds the cognitive model of depressive relapse, depression psychoeducation, the breathing space's responsive use, and the relapse-signature work, and is taught to a diagnostically defined group. For depression-related indications MBCT is the tested vehicle.

Versus Beckian CBT. Shared model of cognition's role in depression, opposite tactics: CBT engages thought content (examine, test, restructure); MBCT changes the relationship to thinking (observe, allow, decenter) and explicitly avoids content engagement. CBT is the acute-phase treatment with the deeper evidence base; MBCT is the maintenance-phase program. They are commonly sequenced rather than chosen between.

Versus ACT. Strong conceptual kinship—decentering ≈ defusion, allowing ≈ acceptance, both target rumination/avoidance—but ACT is an individual, formulation-driven therapy with values and committed action at its center and no required meditation; MBCT is a standardized class with formal practice at its center and behavior change at its periphery.

Versus DBT mindfulness. DBT atomizes mindfulness into brief skills for in-the-moment regulation in a high-acuity population; MBCT trains sustained formal practice for relapse prevention in a remitted one. The populations, doses, and purposes barely overlap.

The Research Evidence

The core prevention trials

The foundational finding—MBCT roughly halves relapse risk in patients with three or more prior episodes—has held up across two decades of increasingly stringent tests:

• Teasdale et al. (2000) and Ma & Teasdale (2004): MBCT + usual care versus usual care; relapse over ~60 weeks reduced from roughly two-thirds to around one-third in the ≥3-episode majority; no benefit (or numerically worse outcomes) in the two-episode minority—the moderation that defined the indication.
• Against maintenance antidepressants: Segal et al. (2010) and Kuyken et al. (2008, and the definitive PREVENT trial, 2015, n=424) tested MBCT with tapering of antidepressants against continued maintenance medication. PREVENT found no significant difference in relapse over two years (44% MBCT-taper vs 47% maintenance)—establishing MBCT as a viable alternative route to staying well for patients who want to discontinue medication, rather than a superior one.
• Kuyken et al. (2016), individual-patient-data meta-analysis (9 trials, n=1,258): MBCT reduced relapse risk versus non-MBCT comparators (hazard ratio ≈ 0.69, ~31–34% relative risk reduction) and was comparable to active treatments including maintenance ADM, with effects consistent across age, sex, education—and larger in patients with more severe residual symptoms and, in several analyses, those with childhood trauma. The treatment appears to work best in precisely the higher-risk patients.

Mechanism

The mediation literature is, by psychotherapy standards, respectable: increases in mindfulness skills and decentering, and reductions in cognitive reactivity and rumination, mediate relapse prevention in multiple trials; amount of home practice shows a dose–response relationship with outcome in pooled analyses. Less flattering: some studies find comparable mediator movement in active control conditions, and dismantling evidence is thin—the question of how much the meditation itself adds beyond structure, group support, and psychoeducation has been directly tested only rarely (Williams et al., 2014, found MBCT no better than a matched psychoeducation control overall, with MBCT's advantage emerging specifically in the childhood-trauma subgroup—a finding that both qualifies and sharpens the claims).

Beyond prevention

Meta-analyses support moderate effects of MBCT on current depressive symptoms and on anxiety; NICE includes group MBCT among options for less severe depression and for relapse prevention; the strongest single non-depression trial is arguably McManus/Tyrer's health-anxiety work. Claims beyond these uses—and the broader mindfulness literature MBCT sits inside—should be read with Section 8's cautions in hand.

Criticisms and Controversies

Specificity: is it the mindfulness?

MBCT's trials mostly compared the program to usual care or medication-taper conditions; trials against structurally matched active controls are few, and their results are humbling. When the group format, home practice, credible rationale, and depression psychoeducation are equalized, MBCT's overall margin shrinks toward zero, with benefits concentrating in high-vulnerability subgroups. The fair summary: MBCT works; why it works—and whether meditation is the indispensable ingredient or one effective vehicle among several for delivering decentering, structure, and self-care—remains genuinely open. The dose–response practice data argue for the meditation; the matched-control data argue for caution.

The wider mindfulness literature problem

MBCT is among the best-tested corners of a research field with documented quality problems: small trials, researcher allegiance, inconsistent definitions of "mindfulness," outcome switching, and demonstrated publication bias (Coronado-Montoya et al. found a striking excess of positive published mindfulness trials relative to registered ones). MBCT's flagship trials (PREVENT, the IPD meta-analysis) largely escape these criticisms, but the halo of the broader literature inflates public expectations beyond what MBCT's specific evidence supports—and a psychiatry website does patients a service by separating the two.

Meditation is not benign for everyone

Contemplative practice has adverse effects—a fact long minimized and now systematically studied (Britton, Lindahl and colleagues; Farias's reviews). Meta-analytic estimates suggest roughly 8% of meditators experience some adverse event, mostly transient (anxiety spikes, low mood), with rarer reports of depersonalization, derealization, traumatic memory intrusion, and—particularly in intensive retreat contexts or predisposed individuals—psychotic or dissociative episodes. For MBCT's population the practical cautions are concrete: trauma histories warrant trauma-sensitive teaching (titrated practices, eyes-open options, emphasis on choice—Treleaven's framework is the standard reference); active psychosis, mania, and acute severe depression are generally contraindications or require modification; and informed consent should mention that turning toward experience can transiently intensify it. The original developers' guidance already excluded patients in acute episode crisis; commercial app culture observes no such screening.

The "McMindfulness" and dilution critiques

Mindfulness's commercial explosion—apps, corporate programs, a wellness industry—has drawn a now-canonical critique (Purser and others): stripped of ethical context and structural awareness, mindfulness becomes a technology for adjusting individuals to conditions that should change, sold with claims its evidence cannot carry. MBCT is partially insulated—it is a defined clinical program with a defined indication and trial base—but it suffers collateral damage in two ways: patients arrive equating it with a meditation app (and an app is not MBCT, any more than a CBT workbook PDF is CBT), and the term "mindfulness-based" is applied in routine care to interventions bearing little resemblance to the manualized program. Teacher integrity compounds the problem: MBCT outcomes in trials were produced by trained teachers with personal practice and supervision under published good-practice guidelines; community delivery is far more variable, teacher competence demonstrably affects outcomes, and no jurisdiction regulates the title.

Dose, demand, and reach

Forty-five minutes of daily practice for eight weeks is a substantial ask—comparable to DBT's diary-card burden in spirit—and home-practice adherence is incomplete in trials and worse outside them. The program's group format, scheduling, and cultural register (silence, body-focus, retreat days) fit some patients poorly; dropout and selective uptake limit reach; and access to qualified teachers is geographically thin. Digital and brief adaptations address reach at uncertain cost to dose—the live question for the field.

The two-episode boundary and frame creep

MBCT's evidence is strongest for a specific clinical situation: remitted, recurrent depression. Its weaker or null results in fewer-episode patients, its modest acute-phase evidence, and its thin record in severe or psychotic depression argue against the frame creep—"mindfulness for everything"—that the surrounding culture encourages. The program's own developers have been notably disciplined on this point; clinics adopting it should be too.

What Patients Can Expect, and Practical Considerations

Who it is for. The strongest candidates: adults with three or more lifetime depressive episodes, currently in remission or substantially recovered, who want an active strategy for staying well—particularly those who wish to taper maintenance antidepressants (with prescriber involvement), those with residual symptoms, and those with early-adversity histories, who appear to benefit most. It is not an acute treatment for severe depression and is not a substitute for crisis care.

What it feels like. A class with homework, not group therapy: minimal personal-history disclosure, substantial silence, guided practice, and discussion focused on the texture of attention rather than the content of problems. The early weeks commonly feel tedious or pointless—the manual predicts this—and benefit is expected to consolidate late and after the course, with continued practice.

The commitment. Eight weekly sessions of ~2¼ hours, one full day, and ~40–45 minutes of daily home practice. Patients should decide with that number in view; a version without home practice is a different (and untested) product.

Medication decisions. The PREVENT result supports MBCT as a route to discontinuing maintenance antidepressants with comparable two-year relapse risk—as a structured, supervised substitution, not as a reason to stop medication and download an app. Tapering should be coordinated with the prescriber and keyed to the relapse-signature plan.

Conclusion

MBCT is the most theory-disciplined therapy in this series: built backward from a mechanistic question about why cognitive therapy prevents relapse, targeted at a defined high-risk population, and validated where its theory predicted it would work—including a credible head-to-head draw with maintenance antidepressants and replicated signals that the highest-risk patients benefit most. It brought meditation into psychiatry's evidence-based mainstream and, in decentering, named a change process now recognized across therapies. Its honest limits: an open specificity question against matched controls, a demanding practice dose, dependence on scarce well-trained teachers, real if usually mild adverse-effect potential, and a surrounding mindfulness culture whose claims and products routinely exceed the program's evidence.

For a psychiatric practice, the synthesis: offer MBCT as a first-class relapse-prevention option for recurrent depression—especially for patients seeking an alternative or adjunct to maintenance medication—delivered in its full, taught form by qualified teachers, with trauma-sensitive screening and sober informed consent; sequence it after acute-phase treatment rather than instead of it; and resist, on the website as in the clinic, the temptation to let "mindfulness" mean more than the trials say.

Selected References and Further Reading

1. Segal, Z.V., Williams, J.M.G., & Teasdale, J.D. (2013). Mindfulness-Based Cognitive Therapy for Depression (2nd ed.). Guilford Press.
2. Williams, M., Teasdale, J., Segal, Z., & Kabat-Zinn, J. (2007). The Mindful Way Through Depression. Guilford Press.
3. Teasdale, J.D., et al. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623.
4. Ma, S.H., & Teasdale, J.D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40.
5. Kuyken, W., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76(6), 966–978.
6. Segal, Z.V., et al. (2010). Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry, 67(12), 1256–1264.
7. Kuyken, W., et al. (2015). Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): A randomised controlled trial. The Lancet, 386(9988), 63–73.
8. Kuyken, W., et al. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565–574.
9. Williams, J.M.G., et al. (2014). Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial. Journal of Consulting and Clinical Psychology, 82(2), 275–286.
10. Teasdale, J.D., et al. (2002). Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology, 70(2), 275–287.
11. Segal, Z.V., et al. (2006). Cognitive reactivity to sad mood provocation and the prediction of depressive relapse. Archives of General Psychiatry, 63(7), 749–755.
12. van der Velden, A.M., et al. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review, 37, 26–39.
13. Goldberg, S.B., et al. (2019). Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: A meta-analysis. Cognitive Behaviour Therapy, 48(6), 445–462.
14. Coronado-Montoya, S., et al. (2016). Reporting of positive results in randomized controlled trials of mindfulness-based mental health interventions. PLOS ONE, 11(4), e0153220.
15. Britton, W.B., et al. (2021). Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clinical Psychological Science, 9(6), 1185–1204.
16. Farias, M., Maraldi, E., Wallenkampf, K.C., & Lucchetti, G. (2020). Adverse events in meditation practices and meditation-based therapies: A systematic review. Acta Psychiatrica Scandinavica, 142(5), 374–393.
17. Treleaven, D.A. (2018). Trauma-Sensitive Mindfulness. W.W. Norton.
18. Crane, R.S., et al. (2017). What defines mindfulness-based programs? The warp and the weft. Psychological Medicine, 47(6), 990–999.
19. Purser, R.E. (2019). McMindfulness: How Mindfulness Became the New Capitalist Spirituality. Repeater Books.
20. Parsons, C.E., et al. (2017). Home practice in mindfulness-based cognitive therapy and mindfulness-based stress reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes. Behaviour Research and Therapy, 95, 29–41.