Cognitive-behavioural therapy (CBT) is often seen as the gold standard for treating depression.
However, a new study has found that ‘metacognitive therapy’ has a better outcome and is quicker.
Three-quarters of patients with depression recovered after being given metacognitive therapy in comparison to only half given CBT.
Metacognitive therapy involves targeting basic thinking processes.
It focuses on how people think, in contrast to CBT which concentrates on the content of thoughts.
A simple example of metacognition is realising one is prone to repetitive thinking of depressive thoughts — what psychologists call rumination.
Metacognitive therapy is about learning to deal with rumination more effectively.
One strategy is learning that thoughts are just thoughts and do not reflect reality.
Like any thoughts, they can be allowed to float away without causing distress.
Professor Adrian Wells, the study’s author, said:
“CBT has been the therapy of choice for many years in treating patients with major depression — with varying degrees of success.
We don’t know for sure why MCT might be more effective, but it is a method that has a solid scientific basis, grounded in the latest cognitive psychology.
We’re very excited about the results.
The focus of the two treatments is different: MCT aims to change basic mental regulation processes that have become biased, whilst CBT aims to modify thought content and is based much more on clinical observation.”
The study included 174 people with major depression, 85 of whom received metacognitive therapy and 89 received CBT.
Six months after the therapy, 74 percent of patients receiving metacognitive therapy had recovered, compared with just 52 percent of those receiving CBT.
Metacognitive therapy was also quicker, taking an average of 5.5 sessions compared to 6.7 for CBT.
Professor Wells, who co-developed the therapy, thinks it has a bright future:
“We think MCT may cost less than CBT but no formal analyses have been run on this to date.
However MCT appears to give results more quickly so fewer sessions may be required.
We do think MCT may be easier to use because it has a core set of principles that can be applied to many types of disorders and does not depend on reality-testing of different negative thoughts.
Instead it helps patients to reduce the process of repetitive negative thinking and worrying.”
The study was published in the journal Frontiers in Psychology (Wells, 2020).