Metacognitive Training for Depression (D-MCT) (English)
Metacognitive training for depression (D-MCT) is a new treatment concept for depression. It is conceptualized as a variant of cognitive behavioral therapy (CBT) that adopts a metacognitive perspective to focus on the modification of cognitive biases and dysfunctional beliefs. The training seeks to enable group members to recognize and correct their often automatic and unconscious thought patterns. To this end, D-MCT teaches participants about depressive thought patterns using creative and engaging strategies along with practical examples from daily life. It also targets dysfunctional assumptions about one’s thought processes as well as dysfunctional coping strategies (e.g., social withdrawal, thought suppression, rumination as problem-solving). While the training was inspired by Metacognitive Training (MCT) for Psychosis, it focuses on different (i.e., depression-specific) cognitive biases.
The feasibility and effectiveness of a beta version of the training were confirmed in an open-label pilot study (Jelinek, Otte, Arlt, & Hauschildt, 2013). The training proved to be effective in reducing depressive symptoms at a medium effect size (Cohen’s d between 0.56 and 0.73). Moreover, cognitive biases and rumination were significantly reduced and self-esteem was increased (effect sizes between d = 0.26 and 0.64). The experience from the pilot study helped to improve the training material. The updated version was compared to health-training in a randomized control trial (funded by the vffr).
All patients also received a standard psychosomatic outpatient treatment program at the RehaCentrum Hamburg. At the end of the treatment, as well as 6 months later at follow-up, symptom improvement was greater in the D-MCT than the health-training group (Jelinek et al., 2016), and change in depression was mediated by a decrease in dysfunctional metacognitive beliefs, particularly ‘need for control’ (Jelinek, Van Quaquebeke, Moritz, 2017). Moreover, analyses of subjective appraisal rating suggest that patient acceptance of D-MCT is high (Jelinek, Moritz, Hauschildt, 2017).
Contribution & e-training MCT
If you download the MCT material, please make a contribution ($35/35€ for individuals; $100/100€ for institutions). You may donate online via this link, for more information see here. Your contribution will be used to revise, develop and evaluate new (self-help) treatments. Of course, we will send you an official donation receipt. Please note that we have developed certified e-trainings for the MCT and D-MCT (www.uke.de/e-mct; www.uke.de/e-dmct).
D-MCT Modules (English)
The eight modules (60 minutes each) are available for download from the links below. Any comments or suggestions would be appreciated. Please email Lena Jelinek (email@example.com). The use of the Metacognitive Training Program for Depression (D-MCT) is permitted with the understanding that it is not to be used for commercial purposes. The statutory provisions of copyright law also apply (e.g., no modification of the materials, no use of slides for other purposes without the authors’ prior consent).
Please note that a brief D-MCT manual is available for download in English here. The full manual is available in German (publisher: Beltz) and Japanese (publisher: Kaneko Shobo).
- DMCT_Module_1_Thinking_and_Reasoning_1.pdf (693.1 KiB)
- DMCT_Module_2_Memory.pdf (1.1 MiB)
- DMCT_Module_3_Thinking_and_Reasoning_2.pdf (1.1 MiB)
- DMCT_Module_4_Selfworth.pdf (892.8 KiB)
- DMCT_Module_5_Thinking_and_Reasoning_3.pdf (1,023.2 KiB)
- DMCT_Module_6_Behaviors_and_Strategies.pdf (951.0 KiB)
- DMCT_Module_7_Thinking_and_Reasoning_4.pdf (899.3 KiB)
- DMCT_Module_8_Perception_of_Feelings.pdf (1.2 MiB)
Homework, Manual and Exercises
Dietrichkeit, M., Hagemann-Goebel, M., Nestoriuc, Y., Moritz, S., & Jelinek, L. (2021). Side effects of the Metacognitive Training for Depression compared to a cognitive remediation training in patients with depression. Scientific Reports.
Dietrichkeit, M., Moritz, S., & Jelinek, L. (2020). Die Behandlung psychischer Störungen mittels metakognitiver Interventionen am Beispiel des Metakognitiven Trainings für Depression (D-MKT). [The treatment of mental disorders using metacognitive interventions using the example of Metacognitive Training for Depression (D-MKT)]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 68, 160–170.
Jelinek, L., Faissner, M., Moritz, S., & Kriston, L. (2019). Long-term efficacy of Metacognitive Training for Depression (D-MCT): a randomized controlled trial. British Journal of Clinical Psychology, 58, 245–259.
Jelinek, L., Hauschildt, M., & Moritz, S. (2015). Metakognitives Training bei Depression. Weinheim: Beltz.
Jelinek, L., Hauschild, M., Wittekind, C. E., Schneider, B. C., Kriston, L., & Moritz, S. (2016). Efficacy of Metacognitive Training for Depression (D-MCT): a randomized controlled trial. Psychotherapy and Psychosomatics, 85, 231–234.
Jelinek, L., Moritz, S., & Hauschildt, M. (2017a). Patients’ perspective on treatment with Metacognitive Training for Depression (D-MCT): results on acceptability. Journal of Affective Disorders, 221, 17–24.
Jelinek, L., Otte, C., Arlt, S., & Hauschildt, M. (2013). Denkverzerrungen erkennen und korrigieren: Eine Machbarkeitsstudie zum Metakognitiven Training bei Depressionen (D-MKT). [Identifying and correcting cognitive biases: a pilot study on the Metacognitive Training for Depression (D-MCT)]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 61, 1–8.
Jelinek, L., Van Quaquebeke, N., & Moritz, S. (2017b). Cognitive and metacognitive mechanisms of change in Metacognitive Training for Depression. Scientific Reports, 7, 3449.
Help us to help others!
In view of the challenging financial situation of many psychiatric hospitals, it is our goal to provide metacognitive training for depression (D-MCT) free of charge. Your donation is essential to our work and will help to improve the lives of many individuals suffering from depression. We would be very grateful if you would support D-MCT by donating to our program.
All donations will be used to support the further development of the D-MCT (future tasks: translation of modules into other languages, creating new graphics, hiring students to conduct D-MCT groups in clinics). Upon request, we will send you a receipt for your donation (please send an email to Steffen Moritz (firstname.lastname@example.org) and include your mail address). Please inquire about different possibilities for sponsorships.