Metacognitive Therapy Versus Exposure-Based Treatments of Posttraumatic Stress Disorder: A Preliminary Comparative Trial in an Ordinary Clinical Practice

Abstract

AbstractCognitive behavioral therapy, prolonged exposure, and eye movement desensitization and reprocessing are effective treatments for posttraumatic stress disorder (PTSD). They emphasize the processing of trauma-related memories and exposure as central components in treatment. In contrast, the metacognitive model emphasizes that PTSD is caused by a persistent negative thinking style, and the goal is to find alternative coping strategies and modify metacognitive beliefs without the use of exposure. In a quasi-experimental A-B design, patients diagnosed with PTSD received either MCT (n = 32) or TAU “treatment as usual” (n = 28) consisting of exposure-based treatments and were tested on different measures of symptoms. The results indicated that both treatments were effective and performed well on both trauma and anxiety symptoms. Recovery rates and clinical improvement were higher in the MCT condition at post-treatment. The study indicates that MCT could potentially be a viable alternative to trauma-focused treatment of PTSD.Clinical trial registration: The study is a clinical and quality audit of an ordinary routinely delivered clinical service in a specialized trauma clinic involving treatments for patients with PTSD. The trial was a preliminary stage in a larger trial of chronic PTSD.