Application of Metacognitive Therapy Techniques in Generalized Anxiety Disorder: A Technical Report

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders, characterized by excessive and uncontrollable worry that significantly impairs an individual's functioning.Although cognitive behavioral therapy is an evidence-based treatment for GAD, it is associated with high relapse rates and only moderate levels of improvement.Metacognitive therapy (MCT) has emerged as an effective psychotherapeutic approach for anxiety disorders, including GAD.According to MCT, the most fundamental factor in the maintenance of GAD is the presence of negative metacognitive beliefs about worry-such as the belief that worry is uncontrollable and dangerous.Conversely, the presence of positive metacognitive beliefs about worry leads individuals to respond to negative thoughts with intense worry, resulting in a prolonged cycle of thinking.Therefore, treatment should first focus on modifying negative metacognitive beliefs, followed by identifying the dysfunctional cognitive and behavioral strategies used by the individual.In the final stage, the focus should shift to addressing positive metacognitive beliefs.In this context, the primary aim of this paper is to present the theoretical foundations of MCT and its conceptualization of psychopathology in detail.Additionally, the paper aims to illustrate the stages and techniques of MCT through a sample GAD case interview based on Wells' (2013) metacognitive model for GAD.