Depression is one of the leading mental health problems and can affect all aspects of life, which has wider implications for society. For many people depression can come and go, and last for years or even decades. Mindfulness-based cognitive therapy (MBCT) was developed for prevention of recurrent depression and is increasingly used to treat persistent depression. There is substantial evidence showing it is effective. However, its availability remains limited, a considerable proportion of graduates relapse, and participants may find it difficult to continue mindfulness practice beyond the standard 8-weeks. The research reported in this thesis aimed to address these challenges by testing an individual blended mindfulness-based intervention (MBI) that was designed to support patients with their mindfulness practice over a longer period of time.

It was conducted in two stages and this thesis reports results in four separate studies. Following initial pilot testing with University students, the first stage served to test feasibility and acceptability of the intervention in depressed patients over a period of 3-months (reported as study 1). Results were encouraging and suggested a number of small changes to the intervention. The second stage served to test the intervention in depressed patients over a period of 6-months. The thesis reports findings on clinical outcomes and psychological mechanism of this intervention (study 2), changes in hippocampal volume (study 3) and qualitative analyses of patient and therapist experiences (study 4).

Results from the second stage showed that the intervention was effective at developing mindfulness skills and reducing depression, but brain imaging assessments didn’t find significant changes in hippocampal volume.

This research suggests that the alternative format tested can have significant beneficial effects. Brain effects will need to be investigated more thoroughly.