Mindfulness better than CBT for treating depression, study finds

Practising mindfulness is much better than taking part in talking therapies at helping people recover from depression, a British study has found.

People who used a mindfulness self-help book for eight weeks and had six sessions with a counsellor experienced a 17.5% greater improvement in recovery from depressive symptoms than those who underwent cognitive behavioural therapy (CBT) while being supported by a mental health practitioner.

The study’s authors say their findings have shown supported mindfulness-based cognitive therapy (MBCT) is “clinically superior” to CBT, which is the treatment the NHS usually offers people with mild or moderate depression. Half a million people a year are referred to NHS talking therapy services in England, in which CBT is the commonest form of treatment.

MBCT is “significantly” more effective than CBT, and cheaper for the NHS to offer, they concluded. Their results have been published in JAMA Psychiatry, an American medical journal.

The NHS says mindfulness involves people paying attention to “what is going on inside and outside ourselves, moment by moment” and “the sights, sounds, smells and tastes of the present moment” as well as being aware of their thoughts and feelings as they happen.

About one in 10 people experience some form of depression during their life.

Researchers led by Prof Clara Strauss, the deputy director of research at the Sussex Partnership NHS mental health trust, undertook a randomised control trial involving 410 people who had been referred to NHS talking therapy services in England. They investigated whether practitioner-supported MBCT self-help was better or worse than practitioner-supported CBT at relieving symptoms of mild to moderate depression, such as low mood.

More people would be able to banish their depression if the NHS began offering the mindfulness-based treatment as an alternative to CBT, Strauss and her fellow researchers believe.

“If study findings are translated into routine practice, this would see many more people recovering from depression while costing the health service less money,” they say in the paper.

Strauss added that guided MBCT self-help could “give people experiencing mild to moderate depression another choice for how to support their recovery and if our findings were replicated at scale could lead to more people from mild to moderate depression than do currently”.

People using mindfulness in the LIGHTMind 2 trial spent eight weeks following the advice in The Mindful Way Workbook, which helps them build up their mindfulness skills by guiding them on what they should do every day in order to be aware of their thoughts, feelings and physical sensations in a non-judgmental way. Doing that helps people address some of the behaviours that can maintain feelings of depression and steer away from negative thoughts.

They also had six one-to-one half-hour “support sessions” on the telephone with a therapist discussing their progress, experience of practising mindfulness and asking questions.

The other participants used CBT, though they were also supported by a counsellor. Trial participants were analysed 16 weeks after their treatment ended.

“In our study 63% of people receiving CBT self-help recovered from depression, compared with 74% of people receiving MBCT self-help. That means that 17.5% more people recovered from depression in the MBCT self-help arm of the study than in the CBT self-help arm,” said Strauss.

Mindfulness-based treatment is also a cheaper way of tackling depression because people using it needed on average £526 less of subsequent treatment for the illness and visited NHS services such as GP surgeries less often than those who had used CBT, the study also found.

Andy Bell, the interim chief executive of the Centre for Mental Health thinktank, said: “This is a welcome study that helps to deepen our understanding about the most effective ways to treat depression. The more we know about the range of options people find helpful, the more people can get effective therapy that’s attuned to their needs.

“Depression is a very common condition, and most people with it never get any treatment. The NHS in England has invested in expanding the provision of talking therapies for people with anxiety or depression over the last 15 years: predominantly in the form of CBT.

“It’s vital that these services also offer people the full range of effective therapies without long waits. There’s never going to be a one-size-fits-all solution for everyone with depression, so offering people a choice of effective options will enable more people to recover.”