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Dr. Robert Allan

Q: What is the difference between mindfulness-based stress reduction and cognitive behavioral therapy?

A: Mindfulness-based stress reduction is typically an eight-week program (we offer one in the department of psychiatry). People attend every week (currently, virtually) and practice being mindful – being in the moment. Something you can do to be mindful is to sit quietly, disregarding your thoughts and focusing on your bodily sensations. However, if you realize in the moment that, say, you haven’t paid the rent, recognize it, and take care of that after your mindfulness practice. The idea is to get “beneath” your thoughts to your essential biological nature.

CBT (cognitive behavioral therapy) is conducted in psychotherapy sessions. We tend to believe our thoughts and they can make us feel sad, depressed, and hopeless. In conversations with a therapist, you can discover thoughts or generalizations that make you feel badly, like “my life is miserable,” and “I’m never going to get better.” CBT helps people identify and challenge their negative thoughts with the question, “what is the evidence?” The goal is to recognize and challenge negative thinking outside of the therapy as well.

These two are not discrete phenomena. CBT and mindfulness-based stress reduction can reinforce one another. Doing meditation, yoga, tai-chi — these are mindfulness exercises. Counseling and cognitive behavioral therapy — with or without a workbook — sends people home to work on their thought processes like they’re studying for school.

These are very effective modalities, and in this study there was no difference in outcome between mindfulness or CBT. They both improved outcomes in chronic back pain patients when compared to usual medical care.

– Dr. Robert Allan, Psychology

This question was answered during the episode of Spine Time called “The Mind-Spine Connection: How our thoughts, feelings, beliefs, and attitudes can influence spinal health.” A video of that episode, held on November 4, 2020, is available on YouTube. To sign up for future episodes of Spine Time, where you can ask questions of our spine specialists, subscribe here.

See more “Ask a Spine Doctor” Q&As