Doody's Review Service
Reviewer: Christopher J Graver, PhD, ABPP-CN(Madigan Healthcare System)
Description: Cognitive therapy has been expanding by leaps and bounds. This is a guide to metacognitive therapy (MCT) straight from the originator of this new variant.
Purpose: The purpose is to provide readers with an introduction to metacognitive therapy, illustrate parallels and areas of divergence with traditional cognitive therapy, and to prepare therapists to employ the skills necessary for this approach.
Audience: Unsurprisingly, this book will be relevant and of interest to psychologists, psychiatrists, and other mental health workers, as well as students of these disciplines. As the originator of this therapy, Dr. Wells is the logical author of this book.
Features: It begins with an introduction to MCT and a discussion of a key difference between MCT and CBT, that of metacognitions. While the distinction is clear, the reason why CBT theory is not sufficient does not emerge as a clear component of this chapter. The next chapter discusses assessment within the context of MCT and then moves on to the basics of working with patients. Sample questions and dialogues are provided, similar to the classic CBT texts. These are continued throughout the chapters on MCT in the treatment of generalized anxiety disorder, PTSD, and major depression. While the chapters delve deeply into the approach particularly for the first few sessions, appendixes at the end provide a long-term structure. Examples of assessment instruments are also included for both symptoms and relevant MCT techniques, such as case formulation interviews. However, more in-depth examples and sample dialogues throughout the process would be welcome, as would a companion workbook. The references are current and the index is adequate, but missing some key terms.
Assessment: For readers who have already bought into the necessity of metacognitive therapy, this book provides a reasonable introduction to the approach, as well as tools to help implement it. On the other hand, readers seeking scientific literature on the approach and its status as an empirically supported treatment should continue their search elsewhere.
From the Publisher
"Wells has written a very important book, rich in clinical understanding and practical guidance. Metacognitive therapy is based on a well-developed and thoroughly tested model that addresses core disordered processes, including attentional bias and rumination. The procedures he describes will be enormously useful to therapists of all persuasions, and can form the bedrock of low-intensity and high-intensity interventions for a wide range of disorders."Chris R. Brewin, PhD, Clinical, Educational, and Health Psychology, University College London, UK
"Metacognitive Therapy for Anxiety and Depression offers a strategy for addressing those well-learned and hard-to-fix thinking patterns that can be tough to change. As a clinician who has struggled with helping people work through dysfunctional thinking patterns, I can appreciate the usefulness of Wells's methods. Metacognitive therapy helps both the patient and the therapist take a step back from the sometimes repetitive work of cognitive therapy, and lends a new perspective with the potential for breaking through treatment roadblocks. Well done!"Monica Ramirez Basco, PhD, PhD, Scientific Review Officer, National Institutes of Health
"The metacognitive model is based on years of research on the nature of different levels and processes of thinking underlying psychological disorders. Clinicians who read this revolutionary book will be able to utilize techniques found nowhere else. Intriguing, creative, and effective clinical strategies are illustrated with clear case examples that demonstrate how to modify recurrent patterns of rumination, worry, and overreliance on problematic processes of thinking. Chapters on specific disorders provide tools and conceptualizations that take the cognitive model in new and exciting directions. I highly recommend this brilliant contribution."Robert L. Leahy, PhD, Department of Psychiatry, Weill Cornell Medical College, New York Presbyterian Hospital
"This book presents a new and innovative approach that focuses on how patients think, as much as what they believe. It is firmly grounded in basic science and packed full of powerful clinical strategies for helping people change the way they think. Wells shows how attention training and detached mindfulness techniques can be applied to a full array of anxiety and depressive disorders with impressive and lasting results. His approach will appeal to clinical practitioners, students, and mental health researchers alike, and should find widespread acceptance in the clinical community. It should prove to be a valuable tool for graduate training across professional disciplines."Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University
"Adrian Wells' publication of MCT is an excellent practical guide for practitioners and provides substantial scientific evidence. This book will be of great value to post-graduate students, researchers, academicians, clinicians, and practitioners."
"In sum, MCT is a new and novel treatment and an exciting addition to the third wave of behavior therapy....Serves as a repository/summary of [Wells'] work to date—a treatment manual that combines his theories, conceptualizations, assessment measures, and interventions into a cohesive approach....Therapists trained in more traditional CBT will undoubtedly be very interested in how some of the MCT techniques might work with their current patients who are seemingly 'stuck' using more traditional cognitive techniques."