Metacognitive therapy for obsessive-compulsive disorder: A case report
Abstract
Obsessive-compulsive disorder (OCD) is a common and disabling disorder. The most effective psychological treatment for OCD is currently exposure with response prevention (ERP). Although ERP is an effective therapy, recovery rates are relatively modest, so there is room for improvement. Metacognitive therapy (MCT) for OCD focuses primarily on modifying metacognitive beliefs about obsessions and compulsions, instead of their actual content. Based on a few small preliminary studies, there are some indications for the effectiveness of MCT for OCD. In the present article, the metacognitive model and treatment are discussed, as well as empirical support for its efficacy. Because detailed descriptions of the application of this treatment modality for patients with OCD are scarce, the authors report a case study to illustrate the content of this form of therapy.
References
American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Crossref, Google Scholar- (2006). Treatment of obsessive-compulsive disorder by U.S. psychiatrists. Journal of Clinical Psychiatry, 67, 946–951. Crossref Medline, Google Scholar
- (1996). Revision of the Padua Inventory of obsessive-compulsive disorder symptoms: Distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34, 163–173. Crossref Medline, Google Scholar
- (2009). Obsessive-compulsive disorder: A comparison between CBT and the metacognitive approach. International Journal of Cognitive Therapy, 2, 107–122. Link, Google Scholar
- (2005). How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behaviour Research and Therapy, 43, 1543–1558. Crossref Medline, Google Scholar
- (2008). Metacognitive therapy for obsessive-compulsive disorder: A case series. Journal of Behavior Therapy and Experimental Psychiatry, 39, 117–132. Crossref Medline, Google Scholar
- (1979). Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry. American Psychologist, 34, 906–911. Crossref, Google Scholar
- (1995). The Yale– Brown Obsessive-Compulsive Scale (Y-BOCS): Part I. Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011. Crossref, Google Scholar
- (2004). Does meta-cognition or responsibility predict obsessive-compulsive symptoms: A test of the metacognitive model. Clinical Psychology and Psychotherapy, 11, 137–144. Crossref, Google Scholar
- (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. Crossref Medline, Google Scholar
- (2012). Metacognitions and obsessive-compulsive symptoms: The contribution of thought-fusion beliefs and beliefs about rituals. International Journal of Cognitive Therapy, 3, 330–340. Link, Google Scholar
- (1966). Modifications of expectations in case of obsessional rituals. Behaviour Research and Therapy, 4, 273–280. Crossref Medline, Google Scholar
- (1951). Two-factor learning theory: Summary and content. Psychological Review, 58, 350–354. Crossref Medline, Google Scholar
- (2008). Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessive-compulsive symptoms. Journal of Anxiety Disorders, 22, 475–484. Crossref Medline, Google Scholar
- (2009). An empirical test of the metacognitive model of obsessive-compulsive symptoms: Fusion beliefs, beliefs about rituals and stop signals. Journal of Anxiety Disorders, 23, 436–442. Crossref Medline, Google Scholar
- (2010). Efficacy of cognitive-behavioral therapy for anxiety disorders: A review of meta-analytic findings. Psychiatric Clinics of North America, 33, 557–577. Crossref Medline, Google Scholar
- (2015). Cognitive-behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review, 40, 156–169. Crossref Medline, Google Scholar
- (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149–154. Crossref Medline, Google Scholar
- (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16, 233–248. Crossref Medline, Google Scholar
- (2008). An open trial of group metacognitive therapy for obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 39, 451–458. Crossref Medline, Google Scholar
- (2008). Psychological treatment of obsessive-compulsive disorder: A meta-analysis. Clinical Psychology Review, 28, 1310–1325. Crossref Medline, Google Scholar
- (2016). A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults. Health Technology Assessment, 20, 1–392. Crossref Medline, Google Scholar
- (2016). Metacognitive therapy for obsessive-compulsive disorder: A pilot study. Journal of Obsessive-Compulsive and Related Disorders, 9, 24–29. Crossref, Google Scholar
- (1995). The sensitivity to change of measures for obsessive-compulsive disorder, Journal of Anxiety Disorders, 9, 241–248. Crossref, Google Scholar
- (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley. Google Scholar
- (2000). Emotional disorders and metacognition: Innovative cognitive therapy. Chichester, UK: Wiley. Google Scholar
- (2009). Metacognitive therapy for anxiety and depression. New York, NY: Guilford. Google Scholar
- (2001). The Thought Fusion Instrument. Manchester, UK: University of Manchester. Google Scholar
- (1998). Relationships between worry, obsessive-compulsive symptoms and metacognitive beliefs. Behaviour Research and Therapy, 36, 899–913. Crossref Medline, Google Scholar

