What is the specific therapeutic goal of MBCT concerning unpleasant thoughts?

Mindfulness-Based Cognitive Therapy (MBCT) states its aims as a graded series:

1. Becoming more aware of bodily sensations, feelings and thoughts from moment to moment.

2. Learning a different way of relating to what is found there, meeting unwanted material with mindful acceptance and acknowledgement instead of the habitual, automatic routines that keep difficulty going.

3. Being able to choose the most skilful response to any unpleasant thought, feeling or situation that is met. This is the terminal aim, and it is stated at the level of what the person then does.

That last step is what makes the goal specific to MBCT rather than to cognitive therapy in general. Cognitive therapy works on the content of a thought, identifying a distorted appraisal and restructuring it. MBCT deliberately leaves the content alone: a thought is treated as a passing mental event rather than as a fact, and the therapeutic pay-off of that shift is the freedom it creates to respond deliberately instead of reacting automatically.

The question asks for the goal concerning unpleasant thoughts in particular. In the programme's own statement of aims, mindful acceptance and acknowledgement are described for unwanted feelings and thoughts, whereas the aim named for unpleasant thoughts, feelings or situations is being able to choose the most skilful response to them. Among the choices offered, that aim is stated by achieving skilful behavioural choice.

Checking this against the other choices:

• Cultivating non-striving acceptance names an attitudinal stance, non-striving being one of the attitudinal foundations of mindfulness practice, and acceptance is genuinely cultivated in the programme. It describes how difficult material is met along the way rather than the goal MBCT states for unpleasant thoughts, which is expressed at the level of the response that is then chosen.

• Reducing all cognitive distortions is the content-change goal of Beck's cognitive therapy. MBCT retains cognitive-therapy psychoeducation but deliberately drops the restructuring step, and the word all overstates the aim even within cognitive therapy itself.

• Detaching the self from inner feelings describes reduced contact with experience. The programme asks for the reverse, namely full contact with the unpleasant thought or feeling with identification loosened rather than the experience pushed away, which is why decentring is explicitly distinguished from detachment and dissociation.

The specific therapeutic goal concerning unpleasant thoughts is therefore achieving skilful behavioural choice.