MCT vs CBT

Throughout this blog, I’ll be looking at ways to address worry and feel more able to interrupt it. We will also be looking at other types of unhelpful thinking like negative, ruminative and self-critical thinking, but let’s begin with worry.

Let’s think about what worry is….

…because you can’t change something if you don’t know what it looks like. I think this is partly because there are different definitions of worry. I did some googling and this is what I found.

Co-pilot says worry is “the state of being anxious and troubled over actual or potential problems.”

Cambridge dictionary: “a problem that makes you feel unhappy or frightened.”

However, both of these muddle worry up with feelings or problems rather than defining worry itself. A better definition comes from the Oxford Dictionary;

“to keep thinking about unpleasant things that might happen or about problems that you have.”

This definition makes most sense to me because it defines worry as a behaviour, something that we do when we feel overwhelmed or out of control. 

A behaviour of thought. And that’s good news…because we can change a behaviour.

I discovered this during a lecture when I was training to be a Cognitive Behaviour Therapist, and it blew my mind. I always thought worrying was part of my personality or inherited from my mum (an Olympic level worrier!).  To find out this was something that I did when I was uncomfortable was a massive turning point for me. It meant I could change

But how? The traditional way of working with worry uses CBT (Cognitive Behavioural Therapy) techniques.  

Cognitive Behavioural Therapy (CBT).

Many of the books, videos and resources you will find are based on CBT techniques.  CBT explores the relationship between our thoughts, feeling and behaviours. Our experiences and the beliefs we form as a result can influence how we respond to things and the choices we make.  CBT will often focus on what the thought is and challenge its content. For example – “how likely is it that what you are worrying about will actually happen?”  so that individuals can see there is no need to worry.

CBT is an evidence-based treatment which means that it has been tested and found to be effective in treating specific issues. There are lots of ways of working with worry in CBT which we will explore as we go. 

I am a qualified Cognitive Behavioural therapist, fully accredited by the British Association of Behavioural & Cognitive Psychotherapies (BABCP).  This is the regulatory body for CBT Therapists.

If you are thinking of starting CBT, I would recommend accessing the BABCP website for guidance and using their register to check the therapist is known to them as you then know they are subject to BABCP regulations for practice.

Metacognitive Therapy (MCT).

Metacognitive Therapy (MCT) developed by Prof. Adrian Wells (2005), differs from CBT in a key aspect; rather than focusing on the content of thoughts and evidencing them, MCT takes a metacognitive view – exploring the thoughts about the thoughts.  It suggests it is rigid and recurrent thinking styles which maintain certain disorders and reducing these, through challenging beliefs around them and interrupting unhelpful thinking, can help people move into recovery.  MCT says this involves focusing attention on potential danger leading to unhelpful strategies such as worry (future focused negative thinking), rumination (prolonged, repetitive, negative thinking), threat monitoring, avoidance and reassurance seeking.  

We will look at each of these in more detail in later blog posts, and I’d love to hear your experiences in the comments!

MCT explores worry and anxiety in a different way to CBT. For example, a client is worrying about the common core belief “I am not good enough”.  As a CBT therapist I would ask, “what is the evidence that you are not good enough?”  This might work well in some circumstances, but in reality there are times when we are not good enough, or even when we are the evidence of this might not shake the belief.  So, this will only take us so far.

However, as an MCT therapist I would ask, “what is the effect of analysing whether you are good enough?”  Often, people will realise that their overthinking is making their anxiety and mood worse. This enables them to explore whether worrying and ruminating is actually keeping them stuck in their beliefs rather than moving them forward.  MCT also offers sustainable techniques to reduce their overthinking and problematic behaviours like procrastination and avoidance.

I am a qualified Metacognitive Therapist. If you are thinking of starting MCT, I would recommend accessing the Metacognitive Therapy Institute website for guidance and using their register to check the therapist is known to them as you then know they are fully qualified to practice.