Metacognitive Therapy for Major Depressive Disorder: Development and Clinical Potential

Adrian Wells and colleagues have developed a metacognitive model of psychological dysfunction which shows clinical promise for treating multiple Axis I disorders. This paper explores the fundamentals of this model and the self-perpetuating cycle of counterproductive coping behaviors underlying it. Several therapeutic techniques that have been designed to interrupt this cycle are described and contrasted with cognitive behavioral therapy (CBT). Papageorgiou and Wells’ specifications of the general model for rumination and depression are outlined, and empirical tests of a clinical metacognitive model of major depressive disorder (MDD) are described. The metacognitive therapy (MCT) treatment package for MDD is summarized. Finally, evidence from recent clinical tests that support the effectiveness of MCT for treating MDD is discussed. Wells’ model appears potent and efficient for reducing anxiety and depression, and his treatment package is a novel approach to combating MDD that should be investigated in further studies.