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02-07-2019 | ORIGINAL PAPER | Uitgave 1/2021

Mindfulness 1/2021

The Role of Engagement in Mindfulness-Based Cognitive Therapy for the Prevention of Depressive Relapse/Recurrence in Perinatal Women

Mindfulness > Uitgave 1/2021
Amanda P. B. Evans, Sherryl H. Goodman, Sona Dimidjian, Robert Gallop
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One core assumption of mindfulness interventions is that engagement via session attendance and at-home mindfulness practices is essential to the programs efficacy. In two samples of pregnant women who underwent Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT-PD), we aimed to evaluate predictors of engagement as well as associations between engagement and clinical outcomes.


Pregnant adult women with depression histories received MBCT-PD in an open trial (N = 49) or a pilot randomized clinical trial (N = 43). Engagement was measured by quantity of at-home practice and class attendance. Clinical outcomes were self-reported depressive symptoms measured at post-intervention and at 6-months postpartum. Potential predictors of engagement included baseline demographic and clinical characteristics.


On average, women reported engaging in formal mindfulness practice 3.35 (SD = 1.86) times per week for 13.95 (SD = 7.25) minutes per session. Greater engagement was significantly associated with decreased depressive symptoms at post-intervention and 6 months postpartum, with medium to large effect sizes. The number of children was negatively associated with attendance and occasions of practice, with medium to large effect sizes, although not statistically significant. Prior depressive episodes, age, income, and education were not associated with engagement variables.


Engagement is associated with improvements in mothers mental health following MBCT-PD. Given the association between mothers depression and their parenting behavior, MBCT-PD may be a useful intervention for enhancing parenting skills.

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