Psychology

Metacognitive Therapy for Anxiety and Depression

Metacognitive Therapy for Anxiety and Depression

Adrian Wells

Language: English

Pages: 316

ISBN: 1609184963

Format: PDF / Kindle (mobi) / ePub


This groundbreaking book explains the "whats" and "how-tos" of metacognitive therapy (MCT), an innovative form of cognitive-behavioral therapy with a growing empirical evidence base. MCT developer Adrian Wells shows that much psychological distress results from how a person responds to negative thoughts and beliefs—for example, by ruminating or worrying—rather than the content of those thoughts. He presents practical techniques and specific protocols for addressing metacognitive processes to effectively treat generalized anxiety disorder, obsessive–compulsive disorder, posttraumatic stress disorder, and major depression. Special features include reproducible treatment plans and assessment and case formulation tools, plus a wealth of illustrative case material.

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Practice, 7, 407–413. Papageorgiou, C., & Wells, A. (2001a). Metacognitive beliefs about rumination in recurrent major depression. Cognitive and Behavioral Practice, 8, 160–164. Papageorgiou, C., & Wells, A. (2001b). Positive beliefs about depressive rumination: Development and preliminary validation of a self–report scale. Behavior Therapy, 32, 13–26. Papageorgiou, C., & Wells, A. (2001c). Metacognitive vulnerability to depression: A prospective study. Paper presented at the 35th annual

and extension of a priming methodology. Cognitive Therapy and Research, 14, 161–176. Segerstrom, S. C., Tsao, J. C. I., Alden, L. E., & Craske, M. G. (2000). Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood. Cognitive Therapy and Research, 24, 671–688. Shiffrin, R. M., & Schneider, W. (1977). Controlled and automatic human information processing: II. Perceptual learning, automatic attending, and a general theory. Psychological Review, 84, 127–190.

processes that constitute the CAS in their different guises. The third skill is using metacognitive-focused Socratic dialogue. The fourth skill is learning to implement metacognitive-based exposure. MCT is a skilled undertaking. Practice is the key to efficient and effective use of this approach. Supervision is a powerful ally in maintaining an appropriate focus on metacognitive factors in treatment and in developing greater levels of skill. IDENTIFYING AND SHIFTING LEVELS The natural

noticed a change in your emotions related to thoughts about the trauma? When was that? What was the internal event that triggered your initial emotion? Was it a thought, a memory, or a feeling?” An effective sequence for obtaining information for the case conceptualization is to ask about symptoms/affect first, and then to ask about the strategies used to manage or avoid symptoms. The therapist next asks about attentional monitoring for threat and about worry/rumination. Questions are then

thought prevents the individual from discovering that the negative image does not have the power to cause negative outcomes. This is because the person can attribute the nonoccurrence of the feared event to use of the covert coping response rather than to the fact that the belief about the importance of the intrusion is faulty. Another problem with the use of coping responses is that the person risks setting up a widening range of associations between the intrusion and situations. For example,

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