Mindfulness programmes: what MBSR and MBCT are

Most people meet mindfulness through an app, a video or a short exercise. Two other things go by the same name: structured group programmes called mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). They are taught over several weeks by trained instructors, and most of the strongest research on mindfulness concerns programmes of this kind. This page explains what they are, how they are organised, and what a national guideline says about them. It does not recommend any provider.

Mindfulness-based stress reduction (MBSR)

MBSR was developed by Jon Kabat-Zinn, who is credited by the UMass Memorial Health Center for Mindfulness with creating the programme in 1979 at what was then UMass Memorial Medical Center in Massachusetts. That centre describes the original MBSR programme as now taught worldwide, with instructors guiding participants through eight weeks of shared practice. The 2023 randomised trial by Hoge and colleagues, which compared MBSR with the antidepressant escitalopram in adults with anxiety disorders, likewise used an eight-week course of weekly sessions.

The US National Center for Complementary and Integrative Health (NCCIH) describes MBSR as a programme that teaches mindful meditation but also includes discussion sessions and other strategies to help people apply what they have learned to stressful experiences. In other words, the sitting practice is one part of a course that also involves talking through experiences and learning to use the skills in daily life.

Mindfulness-based cognitive therapy (MBCT)

NCCIH says that MBCT integrates mindfulness practices with aspects of cognitive behavioural therapy. The programme was designed with depression in mind. The National Institute for Health and Care Excellence (NICE), in its depression guideline, describes the mindfulness group intervention it covers as one using a programme such as MBCT that is specifically designed for people with depression.

NICE sets out the typical structure in guideline NG222, Depression in adults: treatment and management, published in June 2022. The group mindfulness and meditation option is provided preferably by two practitioners, at least one of whom has therapy-specific training and competence. It usually consists of 8 regular sessions, with 8 to 15 participants in the group. NICE says the focus is on concentrating on the present, observing and sitting with thoughts, feelings and bodily sensations, and breathing exercises, with an emphasis on increasing awareness of thoughts and feelings rather than changing them. It adds that participants need to be willing to do homework, including using mindfulness recordings at home between sessions, and that it does not directly help with relationship, employment or other stressors that may contribute to depression.

What NICE recommends

NG222 mentions MBCT in two places. First, in the section on a new episode of less severe depression, it lists group mindfulness and meditation among the treatment options that can be used as first-line treatments, with the choice matched to the person's needs and preferences. The NHS mindfulness page echoes this by saying that mindfulness-based therapies are recommended by NICE as a way to treat less severe depression.

Second, the guideline's section on preventing relapse deals with people who have recovered from depression on antidepressants alone but are assessed as being at higher risk of relapse. For them NICE says to consider continuing their antidepressant medication, or a course of psychological therapy (group CBT or MBCT) for people who do not wish to continue on antidepressants, or both the medication and a course of group CBT or MBCT. For people starting group CBT or MBCT for relapse prevention, it recommends a course with an explicit focus on relapse prevention skills, usually 8 sessions over 2 to 3 months, with the option of additional sessions over the next 12 months.

These recommendations concern depression. They are decisions made between a person and their clinician, and nothing here is advice about whether any course suits a particular reader. This page does not cover guidance on anxiety. Evidence on mindfulness for anxiety is discussed in Does mindfulness work for anxiety?.

A taught programme is not the same as a quick exercise

The research on programmes and the research on brief practice are not interchangeable. A programme such as MBSR or MBCT combines weekly group sessions, trained facilitators, discussion, and regular homework across about two months. A few minutes with a timer or a recording is a much smaller thing. The Mindful minutes timer and the Body scan, step by step page are exercises for trying a practice, and nothing in the trials of full programmes shows that short solo sessions would give the same results. Readers new to the basic practice may prefer to start with How to meditate: mindfulness for beginners.

NCCIH advises asking about the training and experience of the instructor of any meditation or mindfulness practice you are considering, and it says not to use these practices to replace conventional care or to postpone seeing a health care provider. It also reports negative experiences in a minority of participants in studies; see Mindfulness: risks and limits. Anyone with depression, severe anxiety or other persistent difficulties should speak to a doctor or qualified mental health professional about the options, which may or may not include a mindfulness programme.

The short version

MBSR and MBCT are structured, taught, roughly eight-week courses. NICE guideline NG222 includes group mindfulness among options for less severe depression and names MBCT as one choice for relapse prevention. They are different from a quick online exercise and are best discussed with a health professional.