Treating posttraumatic stress disorder with metacognitive therapy: a preliminary controlled trial.
OBJECTIVE
Exposure, trauma-focused cognitive therapy and eye-movement desensitisation and re-processing (EMDR) are effective treatments for posttraumatic stress disorder (PTSD) producing equivalent outcomes. How might the field advance? One way is to base new treatments on PTSD maintenance mechanisms. A treatment that does this, metacognitive therapy (MCT), underwent preliminary controlled evaluation in this study.


METHODS
Twenty participants aged 18 to 65 years with chronic PTSD were randomly allocated to either a total of 8 sessions of MCT or a delayed treatment control. Measures of PTSD, emotional symptoms, and underlying metacognitive variables were obtained at pretreatment and posttreatment. Patients were followed-up at 3 and 6 months postintervention.


RESULTS
Statistically significant reductions in PTSD symptoms, depression, and anxiety at posttreatment were observed in the MCT group but not in the control group. Changes were maintained over follow-up. The average number of sessions delivered was 6.4. Eighty percent of patients (intention to treat) met clinical significance criteria for recovery based on the IES. Treatment was well tolerated with only one (10%) dropout. Changes in thought control strategy hypothesized to be involved in the maintenance of PTSD were found.


CONCLUSIONS
MCT appeared to be a brief treatment producing high recovery rates. The data add to existing uncontrolled evaluations and provide strong justification for future evaluation of this treatment against existing evidence-based interventions.
University of Manchester and NTNU, Trondheim, Norway. adrian.wells@manchester.ac.uk.
Adrian
A
Wells
Judith S
JS
Colbear
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010865:Pilot Projects; D011614:Psychotherapy, Brief / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000628:therapy*; D013732:Test Anxiety Scale; D016896:Treatment Outcome
cognitive behavioral therapy; metacognition; metacognitive therapy; ptsd; traumatic stress