Metacognitive therapy

What is metacognitive therapy?

Metacognitive therapy (MCT) is a form of psychotherapy that focuses on changing thought patterns and beliefs that contribute to mental health problems. The creator of MCT is psychologist Adrian Wells. This therapy is based on the principle that it is not only our thoughts that affect our well-being but also our approach to those thoughts and how we deal with them. Metacognitive therapy can be helpful for various forms of mental health problems.

How does metacognitive therapy work?

Metacognitive therapy (MCT) focuses on changing the way people think about their own thoughts, also known as metacognitions. The principle is that many psychological problems depend not only on the content of our thoughts, but also on how we manage and relate to those thoughts. For example, a person may not only worry about an event (a thought), but also believe that they need to worry to prevent bad things from happening (a metacognition).

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In MCT, the therapist works to help the client identify and challenge these maladaptive metacognitive beliefs. An example of this is the idea that worrying is something necessary or useful. Unlike traditional cognitive behavioural therapy (CBT) which often focuses on changing the content of negative or dysfunctional thoughts, MCT concentrates more on the process of how we think.

This means teaching clients to develop more flexible control over their thinking. MCT teaches people to break out of thought traps such as catastrophizing and overgeneralizing. It also helps reduce engagement in harmful thought patterns such as excessive rumination and worrying.

MCT has been shown to be effective for a variety of psychological conditions. This includes anxiety disorders, depression, PTSD and OCD. MCT teaches clients to manage their metacognitive processes in a more adaptive way. The goal of MCT is to reduce the tendency to get stuck in negative thought patterns, thus reducing psychological distress.

What can metacognitive therapy help with?

Metacognitive therapy (MCT) is effective in treating several psychological problems. It is particularly useful for different types of anxiety problems, especially generalized anxiety disorder, by helping to manage worrying thoughts.

For people with depression, MCT reduces symptoms by breaking the cycle of negative thought patterns and rumination. It is also useful for treating obsessive-compulsive disorder by changing the approach to obsessive thoughts. Additionally, MCT can help manage intrusive memories in post-traumatic stress disorder.

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MCT can help with sleep problems, health anxiety, and social anxiety by changing the way you think about these problems. In addition, it can help people with chronic pain manage their thoughts and feelings about the pain for better pain control.

By focusing on “thinking about thinking”, MCT teaches clients to reduce maladaptive rumination and worrying, leading to a reduction in psychological symptoms.

Metacognitive therapy for GAD

Metacognitive therapy has been shown to be particularly effective for the treatment of generalized anxiety disorder (GAD). Treatment focuses on changing metacognitions that are thought to maintain and reinforce anxiety and worrying behaviours.

By changing the metacognitive processes that maintain GAD, MCT aims to reduce chronic worry and improve the client’s ability to manage anxiety. This approach has been shown to be particularly effective for GAD. This is because it directly addresses the underlying thought processes that contribute to the disorder.

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Techniques used in metacognitive therapy

MCT can be helpful for several different conditions. Here are some common MCT techniques:

1. Identifying metacognitions: The therapy begins by identifying the client’s maladaptive metacognitions that contribute to GAD. This may include beliefs that worrying is useful to prevent negative events or that one cannot control their anxious thinking.
2. Challenge metacognitions: The therapist encourages the client to question and challenge these beliefs. They also explore how these thoughts contribute to their anxiety.
3. Modifying thought patterns: MCT focuses on helping the client develop more adaptive ways of relating to their thoughts. This may include reducing time and engagement in anxious thoughts and ruminations.
4. Attention training: This is a central part of MCT. The client learns techniques to intentionally direct their attention away from anxious thoughts and instead focus on tasks or activities in the present moment.
5. Practical exercises and homework: The therapy often includes practical exercises during the sessions as well as homework where the client applies the learned strategies in real-life situations.

How long does a treatment with MCT take?

The length of a metacognitive therapy treatment varies depending on the needs of the individual, the severity of the condition and the progress of the therapy. MCT is generally a short-term treatment, usually involving 8 to 16 sessions. The length of treatment is individualized.

The therapist continuously evaluates the client’s progress and can adjust the treatment if necessary. If the client reaches their goals, treatment can be terminated earlier. Follow-up sessions may also be relevant to maintain progress and manage possible relapses. MCT treatment is flexible and adapted to the client’s needs.