474 - Metacognitive Therapy

Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC

Executive Director, AllCEUs Counselor Education

Host: Counselor Toolbox Podcast

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Objectives

• Learn about metacognitive therapy

• Explore the multiple aspects of metacognition

• Practice applying MCT to depression, pain, learned helplessness and other stressful situations

Introduction

• Distress is a signal that the person is trying to respond to threats to their wellbeing

• Distress is normally reduced by effective coping strategies

• Disorders result when

• The person’s coping skills backfire

• Believe they have no control over their thoughts

• Believe it is in their best interest to keep ruminating. Rumination often focuses on questions that have no easily identifiable answers.

• What if?

• Why do I feel this way?

• Why me?

• What does this symptom mean?

Introduction

• Metacognitive essentially means “thinking about thinking” and refers to the knowledge and regulation of one’s own cognitive processes

• MCT agrees that prior experiences create schema which influence interpretation of events, however, MCT focuses not on the content of the thoughts but the what the person pays attention to.

• Metacognitive experiences are the reactions people have as a result of their cognitive appraisals

• MCT focuses on disorder specific cognitive biases such as mood congruent memory

• In one study, NFC, acted as the only mediator between treatment and depression recovery

Metacognitive Components

• Metacognitive knowledge refers to declarative knowledge of cognitive processes and includes

• Personal knowledge (e.g., Ways of thinking (rumination, analysis), and personal abilities and limitations) (Mindfulness)

• Negative metacognitive beliefs (distress intolerant thoughts) focus on

• The uncontrollability of thoughts and belief that thoughts need to be controlled

• Rumination

• Threat monitoring

• Unhelpful reactions that backfire (away behaviors)

• Positive metacognitions are beliefs about the need to have the particular beliefs to stay safe or prepared

• Task knowledge (e.g., How to do something (cook, meditate, learn, control thoughts)) (Skills Training)

• Strategic knowledge (e.g., Advantages/disadvantages and applicability of each strategy) (Problem Solving)

Metacognitive Components

• Metacognitive experience is the personal experience and perception of difficulty that accompanies cognitive activity.

• How confident do I feel that I can do it and it will be successful? (Fact-based reasoning vs. Emotional reasoning)

• Metacognitive monitoring and control refers to self-supervision and regulation of the cognitive processes including their ability to plan, monitor, evaluate and regulate their cognitive activities by adjusting task goals, regulating attentional awareness (shot), and selecting cognitive strategies.

• What is the best course of action

• How effective is this course of action

• What needs to be done differently or continued?

Example Application

• (Rumination) If I think about it enough I will find answers.

• How long have you been at it? How much longer will it take?

• What if there is no answer?

• (Need to control thoughts) If I do not control my thoughts I will do something bad.

• How do you know which ones to control?

• What types of bad things have happened by not controlling your thoughts?

Example Intervention

• A à B  C

• A=Critical and unconstructive feedback

• B=They hate me. They don’t consider other perspectives. They are entitled. They aren’t accepting responsibility for their part.

• C=Anx