The Scope of Metacognitive Therapy in the Treatment of Psychiatric Disorders

Abstract

Metacognitive therapy (MCT) is a novel and promising transdiagnostic psychotherapy intervention based on the Self-Regulatory Executive Function model of conceptualizing emotional disorders. It was developed by Adrian Wells in 2009. Its therapeutic response occurs by reducing dysfunctional metacognitive beliefs regarding worry and rumination, often seen in patients with psychiatric disorders. Since its inception, it has been increasingly applied to a wide spectrum of psychiatric illnesses, but mainly focusing on mood and anxiety disorders. To our knowledge, no study has detailed its existing therapeutic scope in psychiatry. In this comprehensive narrative review, we describe the various psychiatric illnesses in which MCT has been used, the advantages of MCT, and the limitations of the MCT research. In addition, we propose some solutions to systematically examine its place in psychiatry. We encountered its potential role in treating trauma and stress-related disorders, obsessive-compulsive spectrum disorders, personality disorders, psychotic disorders, substance use disorders, and sexual disorders.

Effectiveness of Metacognitive Therapy in Patients With Depression and Comorbid Anxiety Symptoms: A Case Series From India

“…This study’s findings provide evidence for the effectiveness of MCT among patients with depression and comorbid anxiety symptoms in the Indian context. This is complementary to our recent review highlighting the preliminary evidence for the effectiveness of MCT in various psychiatric disorders [ 32 ]. Substantial reductions were observed in depressive and anxiety symptoms in our patients at post-treatment and follow-up.…”

Effect of metacognitive therapy on depression in patients with chronic disease: a protocol for a systematic review and meta-analysis

“…In our systematic review, we hold a keen interest in delving into the efficacy of MCT for patients with chronic diseases for several reasons: (1) specific intervention strategies of MCT will regulate repetitive negative thinking cycles and other unproductive behaviours that maintain depression, helping patients realise that worry and contemplation have no advantages and can be alleviated; (2) in MCT, patients will practice new reaction methods to enhance their attention control ability to get rid of worries and contemplation28; (3) contrast to other therapies, MCT does not require in-depth analysis and challenging the patients’ concerns and (4) MCT has the advantages of short intervention period, convenient implementation methods, reliable implementation effects and low cost 16…”

“…Patients may express ‘My contemplation is uncontrollable’. While positive metacognitive beliefs manifest as useful beliefs about contemplation and worry, such as ‘My contemplation will help me find a solution’ 16. To alleviate depression symptoms, MCT helps patients in reducing CAS and developing healthy metacognitive beliefs.…”

Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety

“…This type of maladaptive rumination (also termed brooding rumination) predicts both depression and anxiety, and the duration and severity of SI (Nolen-Hoeksema et al, 2008; O’Connor, 2011; Sarkisian et al, 2019). A transdiagnostic treatment approach that has shown some promise in modifying common cognitive processes underlying SI, depression, and anxiety is metacognitive therapy (Sharma et al, 2022). This therapeutic approach aims to modify metacognitive beliefs that drive psychological processes such as rumination (Wells, 2009), suggesting that this treatment modality might have some utility for young people experiencing depression, anxiety and SI.…”

“…This therapeutic approach aims to modify metacognitive beliefs that drive psychological processes such as rumination (Wells, 2009), suggesting that this treatment modality might have some utility for young people experiencing depression, anxiety and SI. Much of the existing evidence regarding metacognitive therapy concerns the treatment of major depression and anxiety disorders in adults (Sharma et al, 2022). There is currently limited empirical evidence for the applicability and efficacy of this approach among young people (Normann and Morina, 2018; Thorslund et al, 2020) providing an opportunity for future research.…”