To achieve successful treatment results in the metacognitive therapy of OCD, an average of 12 sessions per week which lasts 45-60 minutes is needed.
Metacognitive therapy has two main metacognition changes. And this therapy is to answer and analyze questions like:
What is metacognitive therapy?
Metacognitive therapy is a form of counseling that works by understanding the way clients think. Attaching a negative belief to a situation can lead to increased anxiety and other physical symptoms, so it’s important for those who suffer from these issues to identify their thoughts as soon as possible.
- How the person relates to his thoughts
- How he/she experiences his/her thoughts
- Focus on what he/she believes about his/her thoughts.
Differences of Metacognitive Therapy in Cognitive Behavioral Therapy in OCD
- Metacognitive therapy describes obsessive-compulsive disorder with a specific metacognitive model. It can be applied to all subtypes of OCD.
- Metacognitive therapy focuses on metacognitive beliefs about obsessions and compulsions.
- It does not regulate other areas of belief, such as exaggerated responsibility, intolerance, or perfectionism.
- Metacognitive therapy does not benefit from familiarization strategies or does not require extended exercises in the session.
- The main purpose of metacognitive therapy in obsessive-compulsive disorder is to treat the obsessional stimulus and to develop a functional plan for directing behaviors.
Metacognitive Therapy for OCD
- Asking questions about feelings that accompany the trigger (emotion extraction).
- Evaluations of the patient about stubborn repeaters
- Questioning of metacognitive beliefs about stubborn repeaters.
In the case formulation, the therapist finally asks questions about the patient’s responses to stubborn repeaters, about the nature of their open or implicit neutralization, and their beliefs about their need to deal with these responses (rituals and beliefs about stop signals).
In the next step, the therapist explains to the patient that the problem is actually the obsessional thoughts/doubts/emotions rather than the responses to them. And the meanings for the patient, and some behavioral experiments are performed to demonstrate this. Then the treatment is rational.
Some obsessions cause embarrassment and are also perceived as threatening. To avoid this situation, the therapist normalizes the content of obsessions.
The first step in the regulation of metacognition in OCD is detached mindfulness education, which is provided by means of distance setting. Instead of struggling with the patient’s stubborn repetitive thoughts in the awareness provided by distance-setting, alternative and more functional ways are possible.
There are four components of awareness provided through spacing:
The first is awareness. Awareness is the state of being objectively aware of emotion and thought.
The second is the awareness provided by the distance setting. Practices show that obsessions are only a mental event and not an important part of the patient.
The third is the exercise and the response commission (ERC), which means that the patients perform their rituals, but instead the rituals are for maintaining the awareness of obsessional thoughts along with rituals, instead of reducing the danger or getting rid of the idea. This application makes it easy to distance the person.
The fourth is metacognitive exercise and ritual prevention. Unlike traditional cognitive behavioral therapy approaches, it is a shorter exercise than traditional exercise and reaction to reduce cognitive attention focus syndrome under the patients’ exaggerated threat perception and to question the beliefs of fusion. As a result of repetitive practices, the person learns the skill of awareness.
Source of the article: Metacognitive Therapy for Anxiety and Depression – Adrian Wells
Last Updated on December 11, 2022 by Lucas Berg