Atmaca Murad
Department of Psychiatry, Fırat University, Faculty of Medicine, Elazığ, Turkey.
Alpha Psychiatry. 2022 Sep 1;23(5):212-216. doi: 10.5152/alphapsychiatry.2022.22840. eCollection 2022 Sep.
Metacognitive therapy is a relatively novel and growing psychotherapeutic approach. Within the last 20 years, several metacognitive-oriented therapy methods have been developed. They are metacognitive therapy which was developed by Wells, metacognitive training which was produced by Moritz et al. especially for patients with psychotic disorder, and metacognitive reflection and insight therapy for psychotic patients. Among them, the most structured one seems the metacognitive therapy. The main notion of metacognitive therapy is to alter the dysfunctional metacognitive interpretations and strategies underlying psychopathology. However, it should be emphasized that it has some fundamental differences from cognitive behavioral therapy because metacognitive therapy is a relatively new school of cognitive therapy, its effectiveness in the treatment of many psychiatric disorders continues to be evaluated intensively. Obsessive-compulsive disorder is one of these disorders. As obsessive-compulsive disorder is a lifelong disorder that causes significant loss of workforce and pharmacotherapy is sometimes insufficient, psychotherapeutic approaches are of great importance. In this context, exposure and response prevention still seems to be an important treatment option in terms of psychotherapeutic approaches. However, it is clear that a new approach is required in psychiatry practice in cases where exposure and response prevention and classical cognitive behavioral therapy are not sufficient and remain with residual symptoms. In this respect, metacognitive therapy can be an important alternative to fill this gap. However, more evidence needs to be created with studies with much larger samples.
元认知疗法是一种相对新颖且不断发展的心理治疗方法。在过去20年里,已经开发出了几种以元认知为导向的治疗方法。它们是由韦尔斯开发的元认知疗法、莫里茨等人专门为精神病患者设计的元认知训练,以及针对精神病患者的元认知反思与洞察疗法。其中,结构最为严谨的似乎是元认知疗法。元认知疗法的主要理念是改变心理病理学背后功能失调的元认知解释和策略。然而,应该强调的是,它与认知行为疗法有一些根本区别,因为元认知疗法是认知疗法中一个相对较新的流派,其在治疗许多精神疾病方面的有效性仍在持续深入评估中。强迫症就是这些疾病之一。由于强迫症是一种终身性疾病,会导致劳动力大量损失,且药物治疗有时并不充分,心理治疗方法就显得尤为重要。在这种背景下,就心理治疗方法而言,暴露与反应阻止疗法似乎仍然是一种重要的治疗选择。然而,很明显,在精神病学实践中,当暴露与反应阻止疗法和经典认知行为疗法都不够充分且仍有残留症状时,就需要一种新的方法。在这方面,元认知疗法可以成为填补这一空白的重要替代方法。然而,需要通过更大样本量的研究来提供更多证据。