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Major depressive disorder (MDD) is currently ranked the third leading cause of disability in the world. Treatment-resistant depression (TRD) causes the majority of MDD disability. Strikingly, 50% of individuals with MDD will fail to remit with 2 adequate trials of antidepressant medications, thus qualifying as treatment resistant. Current pharmacological and psychotherapeutic treatment strategies for TRD are limited in effectiveness, thus, new interventions are needed. Mindfulness-Based Cognitive Therapy (MBCT) is a new psychotherapeutic treatment with established efficacy in preventing relapse of depression for individuals in complete remission. MBCT is a group-based, 8-week intervention that uses mindfulness meditation as its core therapeutic technique. It teaches people to have a different relationship to depressive thoughts and feelings. Strategies are focused on decreasing rumination, enhancing self-compassion, increasing acceptance, and decreasing avoidance. This modified version of MCBT, which includes the use of metaphor and adaptations of the original intervention, will be discussed through the clinical case of a woman with long-standing TRD. A brief review of the current MBCT literature and future directions for the treatment of TRD are discussed.