Metacognitive Therapy Could Benefit Wide Range of Mental Illnesses

Targeting dysfunctional beliefs patients hold about thoughts could help treat depression, anxiety, and OCD.

While cognitive therapies focus on dysfunctional thoughts, a newer approach takes things to the next level — literally. Findings of recent studies suggest that targeting “metacognitions” —thoughts about thoughts — could help relieve symptoms of a range of disorders, including depression,1,2 anxiety,1 obsessive-compulsive disorder (OCD)3 and schizophrenia spectrum disorders.4

Though often overlooked by therapists, the beliefs people hold regarding their thoughts can be as harmful as the dysfunctional thoughts themselves. Metacognitive therapy (MCT), developed by psychologist Adrian Wells, PhD, of the University of Manchester in England, is based on the theory that “disturbances in thinking and emotion emerge from metacognitions that are separate from other thoughts and beliefs emphasized in cognitive-behavioral therapy (CBT),” Robin Bailey, a senior lecturer and PhD candidate at the University of Central Lancashire, England, told Psychiatry Advisor.

For example, metacognitive beliefs about worry such as “Worrying keeps me safe” or “I will find answers if I analyze my problems,” may influence the ongoing thought processes that produce worrisome thoughts. Studies have shown that “metacognitive beliefs consistently contributed more to disorders like [OCD], depression, and general anxiety disorder than cognitive appraisal,” which focuses on how one views a given situation, says Bailey, who has studied the role of metacognitive beliefs in health anxiety5.

A meta-analysis published in the May 2014 issue of the journal Depression and Anxiety reviewed 16 studies, including nine controlled trials, examining the efficacy of MCT in the treatment of anxiety and depression.1 They found significant improvement among patients who received MCT as compared to those who received CBT or no treatment.