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Table 2 Mindfulness-Based Cognitive Therapy (MBCT) and the Health Enhancement Program (HEP) Content by Session

From: Mindfulness-based cognitive therapy (MBCT) versus the health-enhancement program (HEP) for adults with treatment-resistant depression: a randomized control trial study protocol

Session MBCT HEP
1 Automatic Pilot: focuses on becoming aware in the present moment. Problems in Improving Health: focuses on physical fitness, functional movement exercises, and music and imagery.
2 Dealing with Barriers: Participants discuss problems in focusing attention and are encouraged to adopt an attitude of “letting go” of self-criticism and judgment. Physical Activity to Enhance Well-being: Physical activities focus on posture and alignment as ways to optimize function. Supportive music imagery exercises are used to improve sense of well-being.
3 Mindfulness of the Breath: Participants complete a sitting meditation in which they shift from focusing on body sensations to focus on their breath in a sitting posture. Mindful movement techniques are begun. Understanding Dietary Guidelines: Participants engage in a lecture and discussion series about basic nutrition principals. Diet journaling is reviewed and demonstrated as a way to better understand healthy food choices.
4 Staying Present: Concepts of attachment/avoidance to pleasant/unpleasant sensations, moods, and thoughts are discussed. The “three-minute breathing space” is taught as a simple intervention for use throughout the day. Fine-tuning Dietary Choices: Participants learn the use of the USDA* My Pyramid Food Tracker Program and behavioral changes are discussed as a way to meet dietary goals.
5 Allowing/Letting Be: Focus is on allowing experiences “to be” without judging or trying to change them. Adapting to an Unpredictable Environment- Part I: Activities focus on functional movement and alignment. Supportive Music Imagery focuses on responding to the environment in creative ways.
6 Thoughts Are Not Facts: Focus is on viewing thoughts as mental events and not concrete facts. Adapting to an Unpredictable Environment – Part II: Activities such as walking, jogging and stretching are discussed as participants are encouraged to respond to the environment in creative ways to enhance well-being.
7 How Can I Best Take Care of Myself: Participants learn their unique warning signs of depression relapse or worsening. Responding to the Environment in Creative Ways: Participants learn the kinetic chain of functional movement and build group cohesion through group song writing exercises.
8 Using What Has Been Learned to Deal with Future Moods: Participants discuss how they will keep the momentum of their practice going. Therapists distribute information about settings where group mindfulness practice can be continued. Support for Continuing Practice: Participants review the course and plan for maintaining gains including all components of HEP. Participants review their goals with the dietician.+
  1. *USDA = United States Department of Agriculture.
  2. + The original HEP protocol was amended to include Nutrition in session 8.