Managing Worrying About Worrying with Metacognitive Restructuring Versus Metacognitive Defusion

Area of Science:

• Psychology
• Clinical Psychology
• Cognitive Behavioral Therapy

Background:

• Generalized anxiety disorder (GAD) is often characterized by meta-worrying.
• Metacognitive therapy (MCT) and acceptance and commitment therapy (ACT) are evidence-based treatments for GAD.
• The comparability of specific components within MCT and ACT for managing meta-worrying requires further investigation.

Purpose of the Study:

• To compare the efficacy of metacognitive restructuring (MCT) and acceptance and commitment therapy (ACT) defusion exercises in managing meta-worrying.
• To explore the cost-effectiveness of these interventions.
• To examine the moderating effects of generalized anxiety, dispositional worrying, and depression on treatment response.

Main Methods:

• A subclinical sample of college students received a brief intervention targeting a single meta-worry.
• Interventions included either metacognitive restructuring (MCT) or ACT defusion exercises.
• Believability, distress, willingness ratings, generalized anxiety, dispositional worrying, and depression were assessed.

Main Results:

• Both metacognitive restructuring and ACT defusion exercises were equally effective in reducing believability, distress, and willingness ratings for targeted and untargeted worries.
• Metacognitive restructuring sessions were significantly shorter than ACT defusion sessions, suggesting greater cost-effectiveness.
• Generalized anxiety, dispositional worrying, and depression did not moderate treatment outcomes.

Conclusions:

• Metacognitive restructuring and ACT defusion exercises show comparable efficacy in reducing meta-worrying.
• Metacognitive restructuring may offer a more cost-effective approach for managing meta-worrying in GAD.
• Findings support process-based cognitive behavioral therapy (PB-CBT) research and practice.