Mindfulness-based Cognitive Therapy (MBCT) is an eight-week NHS-recommended intervention and shows efficacy in reducing relapse into depression. In Paper One, a systematic review and meta-synthesis of 19 qualitative studies of MBCT for depression was conducted, using a meta-ethnographic approach. Three overarching themes were developed: Becoming skilled and taking action, Acceptance, and Ambivalence and variability. The findings provide an understanding of the experiences of MBCT for people with depression whereby MBCT can be beneficial whilst simultaneously bring challenges. In Paper Two, in order to more comprehensively explore experiences of MBCT for depression, a secondary database of 35 interviews post-MBCT and during a 12-month follow-up was analysed. Using reflexive thematic analysis, two overarching themes were developed: Reconnection and Process. Participants described changing relationships with their experience, self, and others, alongside recognition of gradual changes. The findings have clinical implications in terms of encouraging recognition of an ongoing, gradual move towards reconnection with experiences which may have been lost during depression. In Paper Three, clinicians' views around access to, delivery of, and adaptations to MBCT were explored as provision of MBCT across the UK remains limited and may not always be delivered in line with the evidence-base. A two-stage Delphi approach was used to develop 59 statements which were rated by 25 clinicians in three online rating rounds. Most statements reached consensus; 15 statements did not. The findings highlight the importance of a delicate balance between adherence to the evidence-base and a client-centred, transparent approach in access to, delivery of, and adaptations in MBCT. Paper Four includes a critical discussion of each paper, reflections around the thesis changes, cultural considerations, and overall clinical and research implications.
|Date of Award||31 Dec 2021|
- The University of Manchester
|Supervisor||Peter Taylor (Supervisor)|