Metacognitive Therapy
Never heard of Metacognitive Therapy, or have you heard of it and you’re not quite sure what it is? Read on to find out more about what it is and who it is suited for.
What is Metacognitive Therapy?
Metacognitive Therapy (MCT) is considered a ‘third-wave’ cognitive behavioural therapy, where the target of therapy is metacognition (Hayes & Hoffman, 2017). Metacognition can be be simply described as ‘thinking about thinking’; the aspect of cognition that controls mental processes and thinking (MCT Institute, 2018).
The metacognitive model proposes that your way of dealing with difficult thoughts, emotions, or situations may depend on your metacognitive beliefs (i.e., your beliefs about thinking). Metacognitive beliefs may be about the need to engage in particular ways of thinking (e.g., “Worrying about future scenarios helps me stay prepared”), and other metacognitive beliefs may concern thinking about memories (e.g., “If I go over this memory in my mind I’ll understand what happened better”). Because you hold these beliefs about the way you need to think, you may then focus your attention on patterns of thinking such as worry (thinking about the future) or rumination (thinking about the past). Thinking may also be biased toward focusing on the self, as well as focusing on threatening information perceived either from others or the environment. In some psychological disorders, these patterns of thinking feel like they become difficult to control, where you may feel that you have lost control not only over your thoughts, but also on what you do (i.e., your behaviours). You may then engage in a range of dysfunctional coping strategies in an attempt to manage difficult thoughts, feelings, and situations, such as further worry, rumination, threat monitoring, avoidance, and reassurance-seeking (Wells, 2009). According to the metacognitive model, when you respond as such, this may cause extended psychological distress and may inadvertently exacerbate and prolong your difficulties (Normann & Morina, 2018). You may also develop metacognitive beliefs about the uncontrollability and dangerousness of thoughts and feelings (e.g., “I have no control over my worry”; “I am losing my mind”; Wells, 2009).
In Metacognitive Therapy, we focus initially on illuminating metacognitive beliefs and dysfunctional thinking and behavioural coping strategies. Once you are aware of your metacognitive beliefs and ways of thinking and behaving in response to your difficulties, we spend time teaching you new ways of focusing your attention, new ways of relating to negative thoughts and beliefs, and we work on modifying the metacognitive beliefs that give rise to unhelpful thinking patterns (MCT Institute, 2018).
MCT is a talk-based and structured therapy, with evidence suggesting effectiveness of weekly treatment over 5-12 sessions, depending on your individual needs (Wells, 2009).
Who is Metacognitive Therapy appropriate for?
MCT is appropriate for anyone able to engage in a talk-based therapy, who experiences difficulties with ‘overthinking’ - such as worry and rumination - where it feels like thinking gets out of control.
Research suggests that this is a viable therapy option for anxious and depressive symptoms generally (Normann & Morina, 2018). There is evidence to suggest that MCT is effective for the following specific disorders, both in the short- and long-term:
Generalised Anxiety Disorder (Nordahl et al., 2018; Solem et al., 2021)
Major Depressive Disorder (Callesen et al., 2020)
Obsessive Compulsive Disorder (Fisher & Wells, 2008; van der Heiden et al., 2016)
Post-traumatic Stress Disorder (Brown et al., 2021).
Interested in learning more?
If you’re interested in learning more about this style of therapy, you may like to visit the MCT Institute webpage.
I offer Metacognitive Therapy as a treatment option, based on your style, unique needs, and individual difficulties. If you’d like to ask me any questions about this style of therapy, or to book in for a session, please contact me.
