Metacognitions in generalized anxiety disorder: theoretical and practical perspectives

Expert Rev Neurother. 2013 Feb;13(2):135-41. doi: 10.1586/ern.12.161.


Cognitive behavioral therapy has been found to be efficacious in the treatment of generalized anxiety disorder (GAD). However, reviews of the clinical significance has indicated that approximately 50% of patients with GAD return to a 'well' status following treatment. So how might the field advance? One way is to base new treatments on GAD maintenance mechanisms. A treatment that does this is metacognitive therapy (MCT), which targets the beliefs about worrying, instead of worrying itself. So far, MCT has been evaluated in two open trials, and two randomized controlled trials, all of which achieved quite favorable results. That is, MCT achieved statistically significant decreases in GAD symptoms, with large effect sizes and high recovery rates, and was found to be superior to two forms of cognitive behavioral therapy. In this article, an overview of MCT and results of the studies on the effectiveness of MCT for GAD is given.

Publication types

  • Review

MeSH terms

  • Anxiety Disorders / rehabilitation*
  • Cognitive Behavioral Therapy / methods*
  • Humans