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Advances in Metacognitive Therapy

The metacognitive model of psychological disorders is described and data on outcome and processes related to Metacognitive Therapy (MCT) are summarized. Data from uncontrolled and controlled trials are encouraging, as MCT appears to generally be an acceptable and effective treatment, and highly effective for patients with Generalized Anxiety Disorder, in particular. MCT leads to change in metacognition, and metacognition also predicts outcome in other treatment modalities. The theoretical issue of mental modes and how these might relate to conceptualization of treatment effects is discussed, as are recent applications of MCT to new patient populations. Areas for future research are provided, with a focus on the implications of the metacognitive model for understanding the origins of biased mental control and the effect of attachment relationships.