Workshop 8

Metacognitive Therapy: A practical guide to treating Anxiety, Traumatic Stress, and Depression

Adrian Wells, University of Manchester, UK

Metacognitive Therapy (MCT) is an evidence-based and formulation-driven treatment approach. Unlike cognitive therapy, which focuses mainly on the content of thoughts, MCT focuses on altering cognitive processes and the way individuals relate to their cognitions. It is based on the idea that all disorders are caused by a maladaptive style of thinking called the Cognitive Attentional Syndrome (CAS). The CAS consists of worry/rumination, attentional monitoring for threat, and unhelpful coping behaviours. The CAS is driven by erroneous metacognitions. Metacognitions are the internal factors that control, regulate, and interpret thinking itself. A large empirical database now supports the metacognitive theory, and evidence from recent clinical studies suggests that the treatment is both highly effective and brief in use. In this workshop the metacognitive theory and the nature of the CAS in three disorders (PTSD, GAD, Depression) will be presented. Case formulations and treatment of the CAS in each disorder will be described in detail and illustrated with written and videotaped case material. Three disorders can be covered in detail because in the MCT approach the similarities between disorders are emphasised giving rise to many generic treatment strategies.