Project Description

A significant number of patients with moderate-to-severe depression are non-responsive to pharmacological or standard psychotherapeutic treatments, presenting with treatment-resistant depression (TRD). Mindfulness-Based Cognitive Therapy (MBCT) is a NICE-recommended third-wave therapy that integrates mindfulness practices with standard cognitive therapy principles and is offered through expert teams routinely through National Health Service (NHS) Trusts in the Midlands, and in some NHS sites across the UK. Despite growing evidence of the MBCT value in moderate-to-severe depression treatment, limited research exists on MBCT’s effectiveness in TRD. Local findings from the Mood Disorders Nottingham University research team suggest that introducing mindfulness in TRD may be challenging due to the persistent nature of depression implicating maintenance/self-protective processes that potentially obstruct access to mechanisms that lead to increased mindfulness- hence hindering recovery.

The proposed PhD will co-develop and pilot an adapted MBCT intervention-delivered through the Nottingham Healthcare NHS Foundation Trust (NHFT)- in TRD. In phases 1 & 2, it will employ a mixed-method design to assess its acceptability and clinical impact through participants’ post-intervention and follow-up changes on depressive and other mental health and associated symptomatology; and qualitatively through emergent themes from semi-structured interviews on participants’ perceived changes in mental health symptomatology and functioning, experiences, and drivers and barriers to engagement. In Phase 3, key stakeholder focus-group discussions will consider the implications of the findings for TRD treatment, informing future innovative intervention development and delivery at NHFT, and across other NHS sites in the Midlands and beyond.