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07-07-2021 | ORIGINAL PAPER

Mindfulness-Based Compassionate Living (MBCL): a Qualitative Study into the Added Value of Compassion in Recurrent Depression

Auteurs: Rhoda Schuling, Marloes J. Huijbers, Hiske van Ravesteijn, Willem Kuyken, Anne E. M. Speckens

Gepubliceerd in: Mindfulness | Uitgave 9/2021

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Abstract

Objectives

Mindfulness-based cognitive therapy (MBCT) has been found effective in reducing depressive symptoms in adults suffering from recurrent depression. However, sustained recovery after MBCT is modest and may require additional, sequential treatment. Basing such additions on known working mechanisms of MBCT, like increases in (self-)compassion, is likely to reap further benefits. Mindfulness-based compassionate living (MBCL) is designed as a follow-up to MBCT and has been shown effective in reducing depressive symptoms. It has a similar format to MBCT: eight weekly group sessions and additional home practice. MBCL has a more explicit focus on cultivating (self-)compassion in response to difficult experiences. Little is known about the potential experiential added value of MBCL after MBCT. The current study aims to fill this gap.

Methods

A grounded theory approach was used to analyze in-depth interviews, which were held post-intervention with a purposive sample of patients who participated in a randomized controlled trial of MBCL for recurrent depression.

Results

Participants indicated that MBCL particularly had added value in terms of its immediate applicability in situations of deep suffering. Four themes emerged: (1) the container of kindness, (2) exposure to the difficult, (3) empowerment, and (4) common humanity.

Conclusion

This study shows that participants experienced an additional value of MBCL over and above MBCT. The results provide insight into the processes underlying the efficacy of MBCL in reducing depressive symptoms and may help address underlying mechanisms of vulnerability in this population as well as tap into mechanisms that enhance resilience.
Literatuur
go back to reference Baldessarini, R. J., Lau, W. K., Sim, J., Sum, M. Y., & Sim, K. (2015). Duration of initial antidepressant treatment and subsequent relapse of major depression. Journal of Clinical Psychopharmacology, 35(1), 75–76.CrossRef Baldessarini, R. J., Lau, W. K., Sim, J., Sum, M. Y., & Sim, K. (2015). Duration of initial antidepressant treatment and subsequent relapse of major depression. Journal of Clinical Psychopharmacology, 35(1), 75–76.CrossRef
go back to reference Bauer, M., Whybrow, P. C., Angst, J., Versiani, M., & Möller, H. J. (2002). World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for biological treatment of unipolar depressive disorders, Part 1: Acute and continuation treatment of major depressive disorder. World Journal of Biological Psychiatry, 3(1), 5–43. https://doi.org/10.3109/15622970209150599 Bauer, M., Whybrow, P. C., Angst, J., Versiani, M., & Möller, H. J. (2002). World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for biological treatment of unipolar depressive disorders, Part 1: Acute and continuation treatment of major depressive disorder. World Journal of Biological Psychiatry, 3(1), 5–43. https://​doi.​org/​10.​3109/​1562297020915059​9
go back to reference Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. Harper & Row. Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. Harper & Row.
go back to reference Beck, A. T., Shaw, R. A. J., Brian, F., & Emery, G. (1979). Cognitive therapy of depression. The Guilford Press. Beck, A. T., Shaw, R. A. J., Brian, F., & Emery, G. (1979). Cognitive therapy of depression. The Guilford Press.
go back to reference Boeije H. (2014). Analysis in qualitative research. Sage Publications. Boeije H. (2014). Analysis in qualitative research. Sage Publications.
go back to reference Boland, R. J., Keller, M. B., & Bol, R. J. (2002). The course of depression. Guilford Press. Boland, R. J., Keller, M. B., & Bol, R. J. (2002). The course of depression. Guilford Press.
go back to reference Crane, R. S., Eames, C., Kuyken, W., Hastings, R. P., Williams, J. M. G., Bartley, T., Evans, A., Silverton, S., Soulsby, J. G., & Surawy, C. (2013). Development and validation of the mindfulness-based interventions–teaching assessment criteria (MBI: TAC). Assessment, 20(6), 681–688.CrossRef Crane, R. S., Eames, C., Kuyken, W., Hastings, R. P., Williams, J. M. G., Bartley, T., Evans, A., Silverton, S., Soulsby, J. G., & Surawy, C. (2013). Development and validation of the mindfulness-based interventions–teaching assessment criteria (MBI: TAC). Assessment, 20(6), 681–688.CrossRef
go back to reference Cuijpers, P., Dekker, J., Hollon, S. D., & Andersson, G. (2009a). Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: A meta-analysis. Database of Abstracts of Reviews of Effects (DARE): quality-assessed reviews. Centre for Reviews and Dissemination. Cuijpers, P., Dekker, J., Hollon, S. D., & Andersson, G. (2009a). Adding psychotherapy to pharmacotherapy in the treatment of depressive disorders in adults: A meta-analysis. Database of Abstracts of Reviews of Effects (DARE): quality-assessed reviews. Centre for Reviews and Dissemination.
go back to reference Cuijpers, P., Van Straten, A., Warmerdam, E., & Andersson, G. (2009b). Psychological treatment versus combined treatment of depression: A meta-analysis. Depression and Anxiety, 26, 279–288.CrossRef Cuijpers, P., Van Straten, A., Warmerdam, E., & Andersson, G. (2009b). Psychological treatment versus combined treatment of depression: A meta-analysis. Depression and Anxiety, 26, 279–288.CrossRef
go back to reference Feldman, C., & Kuyken, W. (2011). Compassion in the landscape of suffering. Contemporary Buddhism, 12(01), 143–155.CrossRef Feldman, C., & Kuyken, W. (2011). Compassion in the landscape of suffering. Contemporary Buddhism, 12(01), 143–155.CrossRef
go back to reference Feldman, C., & Kuyken, W. (2019). Mindfulnes: Ancient wisdom meets modern psychology. Guilford Publications. Feldman, C., & Kuyken, W. (2019). Mindfulnes: Ancient wisdom meets modern psychology. Guilford Publications.
go back to reference Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473.CrossRef Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473.CrossRef
go back to reference Forte, A., Baldessarini, R. J., Tondo, L., Vázquez, G. H., Pompili, M., & Girardi, P. (2015). Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders. Journal of Affective Disorders, 178, 71–78.CrossRef Forte, A., Baldessarini, R. J., Tondo, L., Vázquez, G. H., Pompili, M., & Girardi, P. (2015). Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders. Journal of Affective Disorders, 178, 71–78.CrossRef
go back to reference Garland, E. L., Farb, N., Goldin, P., & Fredrickson, B. (2015). Mindfulness broadens awareness and builds eudaimonic meaning: A process model of mindful positive emotion regulation. Psychological Inquiry, 26(4), 293–314.CrossRef Garland, E. L., Farb, N., Goldin, P., & Fredrickson, B. (2015). Mindfulness broadens awareness and builds eudaimonic meaning: A process model of mindful positive emotion regulation. Psychological Inquiry, 26(4), 293–314.CrossRef
go back to reference Germer, C. (2009). The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions. Guilford Press. Germer, C. (2009). The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions. Guilford Press.
go back to reference Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15(3), 199–208.CrossRef Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15(3), 199–208.CrossRef
go back to reference Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353–379.CrossRef Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353–379.CrossRef
go back to reference Hardeveld, F., Spijker, J., De Graaf, R., Nolen, W., & Beekman, A. (2010). Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatrica Scandinavica, 122(3), 184–191.CrossRef Hardeveld, F., Spijker, J., De Graaf, R., Nolen, W., & Beekman, A. (2010). Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatrica Scandinavica, 122(3), 184–191.CrossRef
go back to reference Judge, L., Cleghorn, A., McEwan, K., & Gilbert, P. (2012). An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy, 5(4), 420–429.CrossRef Judge, L., Cleghorn, A., McEwan, K., & Gilbert, P. (2012). An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy, 5(4), 420–429.CrossRef
go back to reference Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. Hyperion. Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. Hyperion.
go back to reference Kirby, J., Tellegen, C., & Steindl, S. (2015). Cultivating compassion: a systematic review and meta-analysis of compassion-based interventions. PROSPERO: International prospective register of systematic reviews Kirby, J., Tellegen, C., & Steindl, S. (2015). Cultivating compassion: a systematic review and meta-analysis of compassion-based interventions. PROSPERO: International prospective register of systematic reviews
go back to reference Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., Hayes, R., Huijbers, M., Ma, H., Schweizer, S., Segal, Z., Speckens, A., Teasdale, J. D., Van Heeringen, K., Williams, M., Byford, S., Byng, R., & Dalgliesh, T. (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.CrossRef Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., Hayes, R., Huijbers, M., Ma, H., Schweizer, S., Segal, Z., Speckens, A., Teasdale, J. D., Van Heeringen, K., Williams, M., Byford, S., Byng, R., & Dalgliesh, T. (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.CrossRef
go back to reference Mueller, T. I., Leon, A. C., Keller, M. B., Solomon, D. A., Endicott, J., Coryell, W., Warshaw, M., & Maser, J. D. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. American Journal of Psychiatry, 156(7), 1000–1006. Mueller, T. I., Leon, A. C., Keller, M. B., Solomon, D. A., Endicott, J., Coryell, W., Warshaw, M., & Maser, J. D. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. American Journal of Psychiatry, 156(7), 1000–1006.
go back to reference Rosen, G. M., & Davison, G. C. (2003). Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27(3), 300–312.CrossRef Rosen, G. M., & Davison, G. C. (2003). Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27(3), 300–312.CrossRef
go back to reference Schuling, R., Huijbers, M. J., Van Ravesteijn, H., Donders, A., Kuyken, W., & Speckens, A. (2016). A parallel-group, randomized controlled trial into the of mindfulness-based compassionate living (MBCL) compared to treatment-as-usual in recurrent depression: Trial design and protocol. Contemporary Clinical Trials, 50, 77–83.CrossRef Schuling, R., Huijbers, M. J., Van Ravesteijn, H., Donders, A., Kuyken, W., & Speckens, A. (2016). A parallel-group, randomized controlled trial into the of mindfulness-based compassionate living (MBCL) compared to treatment-as-usual in recurrent depression: Trial design and protocol. Contemporary Clinical Trials, 50, 77–83.CrossRef
go back to reference Schuling, R., Huijbers, M. J., Van Ravesteijn, H., Donders, A., Cillessen, L., Kuyken, W., & Speckens, A. (2020). Recovery from recurrent depression: Randomized controlled trial of the efficacy of mindfulness-based compassionate living compared with treatment-as-usual on depressive symptoms and its consolidation at longer term follow-up. Journal of Affective Disorders, 273, 265–273.CrossRef Schuling, R., Huijbers, M. J., Van Ravesteijn, H., Donders, A., Cillessen, L., Kuyken, W., & Speckens, A. (2020). Recovery from recurrent depression: Randomized controlled trial of the efficacy of mindfulness-based compassionate living compared with treatment-as-usual on depressive symptoms and its consolidation at longer term follow-up. Journal of Affective Disorders, 273, 265–273.CrossRef
go back to reference Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2012). Mindfulness-based cognitive therapy for depression. Guilford Press. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2012). Mindfulness-based cognitive therapy for depression. Guilford Press.
go back to reference Sim, K., Lau, W. K., Sim, J., Sum, M. Y., & Baldessarini, R. J. (2016). Prevention of relapse and recurrence in adults with major depressive disorder Systematic review and meta-analyses of controlled trials. International Journal of Neuropsychopharmacology, 19(2), pyv076. https://doi.org/10.1093/ijnp/pyv076CrossRef Sim, K., Lau, W. K., Sim, J., Sum, M. Y., & Baldessarini, R. J. (2016). Prevention of relapse and recurrence in adults with major depressive disorder Systematic review and meta-analyses of controlled trials. International Journal of Neuropsychopharmacology, 19(2), pyv076. https://​doi.​org/​10.​1093/​ijnp/​pyv076CrossRef
go back to reference Strauss, C., Taylor, B. L., Gu, J., Kuyken, W., Baer, R., Jones, F., & Cavanagh, K. (2016). What is compassion and how can we measure it? A review of definitions and measures. Clinical Psychology Review, 47, 15–27.CrossRef Strauss, C., Taylor, B. L., Gu, J., Kuyken, W., Baer, R., Jones, F., & Cavanagh, K. (2016). What is compassion and how can we measure it? A review of definitions and measures. Clinical Psychology Review, 47, 15–27.CrossRef
go back to reference Undurraga, J., & Baldessarini, R. (2012). A 30-year meta-analytic review of antidepressant efficacy in acute major depression. Neuropsychopharmacology, 37, 851–864.CrossRef Undurraga, J., & Baldessarini, R. (2012). A 30-year meta-analytic review of antidepressant efficacy in acute major depression. Neuropsychopharmacology, 37, 851–864.CrossRef
go back to reference Van Aalderen, J., Donders, A. R. T., Giommi, F., Spinhoven, P., Barendregt, H. P., & Speckens, A. (2012). The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: A randomized controlled trial. Psychological Medicine, 42(05), 989–1001.CrossRef Van Aalderen, J., Donders, A. R. T., Giommi, F., Spinhoven, P., Barendregt, H. P., & Speckens, A. (2012). The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: A randomized controlled trial. Psychological Medicine, 42(05), 989–1001.CrossRef
go back to reference Van den Brink, E., & Koster, F. (2015). Mindfulness-based compassionate living: A new training programme to deepen mindfulness with heartfulness. Routledge.CrossRef Van den Brink, E., & Koster, F. (2015). Mindfulness-based compassionate living: A new training programme to deepen mindfulness with heartfulness. Routledge.CrossRef
go back to reference Van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., Fjorback, L. O., & Piet, J. (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.CrossRef Van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., Fjorback, L. O., & Piet, J. (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.CrossRef
go back to reference Vos, T., Abajobir, A.A., Abate, K.H., Abbafati, C., Abbas, K.M., Abd-Allah, F., Abdulkader, R.S., Abdulle, A.M., Abebo, T.A., Abera, S.F., Aboyans, V., Abu-Raddad, L.J., Ackerman, I.N., Adamu, A.A., Adetokunboh, O., Afarideh, M., Afshin, A., Agarwal, S.K., Aggarwal, R., ... & Murray, C.J.L. (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 390(10100), 1211-1259 Vos, T., Abajobir, A.A., Abate, K.H., Abbafati, C., Abbas, K.M., Abd-Allah, F., Abdulkader, R.S., Abdulle, A.M., Abebo, T.A., Abera, S.F., Aboyans, V., Abu-Raddad, L.J., Ackerman, I.N., Adamu, A.A., Adetokunboh, O., Afarideh, M., Afshin, A., Agarwal, S.K., Aggarwal, R., ... & Murray, C.J.L. (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 390(10100), 1211-1259
go back to reference Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C., Fratiglioni, L., Jennum, P., Lieb, R., Maercker, A., Van Os, J., Preisig, M., Salvador-Carulla, L., Simon, R., & Steinhausen, H. C. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21(9), 655–679.CrossRef Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C., Fratiglioni, L., Jennum, P., Lieb, R., Maercker, A., Van Os, J., Preisig, M., Salvador-Carulla, L., Simon, R., & Steinhausen, H. C. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21(9), 655–679.CrossRef
Metagegevens
Titel
Mindfulness-Based Compassionate Living (MBCL): a Qualitative Study into the Added Value of Compassion in Recurrent Depression
Auteurs
Rhoda Schuling
Marloes J. Huijbers
Hiske van Ravesteijn
Willem Kuyken
Anne E. M. Speckens
Publicatiedatum
07-07-2021
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 9/2021
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-021-01675-9