This small study (39 patients) shows this type of therapy is effective for depression.
This randomized controlled trial examines the efficacy of metacognitive therapy (MCT) for depression.
Participants receiving MCT improved significantly more than the WL group.
Thirty-nine patients with depression were randomly assigned to immediate MCT (10 sessions) or a 10-week wait list period (WL). The WL-group received 10 sessions of MCT after the waiting period. Two participants dropped out from WL and none dropped out of immediate MCT treatment.
Large controlled effect sizes were observed for both depressive (d = 2.51) and anxious symptoms (d = 1.92).
Approximately 70–80% could be classified as recovered at post-treatment and 6 months follow-up following immediate MCT, whilst 5% of the WL patients recovered during the waiting period.
The results suggest that MCT is a promising treatment for depression. Future controlled studies should compare MCT with other active treatments.
Metacognitive therapy was associated with large improvements in depressive symptoms.
Comorbid disorders and symptoms were also improved.
Treatment gains were large and sustained for 6 months follow-up.
There were no significant differences in treatment effect for patients with moderate- or severe recurrent depression.
These results support MCT as a potentially effective treatment for depression that could lead to improved outcomes.
Below is a quick description of this kind of therapy:
The goals of MCT are to
- first discover what patients believe about their own thoughts and how their mind works (called metacognitive beliefs),
- then show the patient how these beliefs lead to unhelpful responses to thoughts that serve to unintentionally prolong or worsen symptoms, and
- finally to provide alternative ways of responding to thoughts in order to allow a reduction of symptoms.
the model was designed to be transdiagnostic (meaning it focuses on common psychological factors thought to maintain all psychological disorders).
The metacognitive model of mental disorder
symptoms are caused by a set of psychological processes called the cognitive attentional syndrome (CAS).
The CAS includes three main processes, each of which constitutes extended thinking in response to negative thoughts.
These three processes are:
- Threat monitoring
- Coping behaviours that backfire
All three are controlled by patients’ metacognitive beliefs, including the belief that such processes will help address their problems (although the processes all ultimately have the unintentional consequence of prolonging distress).
MCT is a time-limited therapy which usually takes place between 8–12 sessions.
The therapist uses discussions with the patient to discover their metacognitive beliefs, experiences and strategies.
The therapist then shares the model with the patient, pointing out how their particular symptoms are caused and maintained.
Therapy then proceeds with the introduction of techniques tailored to the patient’s difficulties aimed at changing how the patient relates to thoughts and that bring extended thinking under control.
Examples of metacognitive beliefs are; “Worry is uncontrollable”, “I have little confidence in my memory for words and names”, and “I am constantly aware of my thinking”
There are two versions of the metacognitions questionnaire.
- The Metacognitions questionnaire (MCQ) first developed by Sam Cartwright-Hatton and Adrian Wells (1997)
- The Metacognitions questionnaire 30 (MCQ-30; Wells & Cartwright-Hatton, 2004) is a 30-item version of the MCQ
These questionnaires have established reliability and validity, are widely used and have informed research on the importance of metacognitive beliefs and metacognitive knowledge in psychological disorders
Read more about metacognition and metacognitive therapy on www.mct-institute.com.
For more information about this study: Tackling depression by changing the way you think