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. 2017;8(4):960-972.
doi: 10.1007/s12671-016-0672-z. Epub 2017 Jan 12.

Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome

Marloes J Huijbers  1 , Rebecca S Crane  2 , Willem Kuyken  3 , Lot Heijke  4 , Ingrid van den Hout  5 , A Rogier T Donders  6 , Anne E M Speckens  1
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Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome

Marloes J Huijbers et al. Mindfulness (N Y). 2017.

Abstract

As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.

Keywords: Intervention integrity; Mindfulness-based cognitive therapy; Recurrent depression; Teacher competence; Therapist competence.

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Conflict of interest statement

Ethical Standards

The study was approved by the Medical Ethics Committee Arnhem-Nijmegen (nr. 2008/242) for all participating sites and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants gave their informed consent prior to participation in the study. Patients and teachers provided additional informed consent to recording of the sessions on videotape.

Conflict of Interest

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Changes in depressive symptoms, rumination, cognitive reactivity, mindfulness skills, and self-compassion from pre to post treatment, grouped by the mean teacher competence score from lowest to highest. The solid line represents the mean
See this image and copyright information in PMC

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