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

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.+