Metacognitive Training for Obsessive-Compulsive Disorder (MCT-OCD)

Metacognitive training for obsessive-compulsive disorder (MCT-OCD) is a group training for people with obsessive-compulsive disorder (OCD). MCT-OCD includes some elements from cognitive behavioral therapy but mainly focuses on OCD-relevant cognitive biases and metacognitions. These cognitive biases and metacognitions include paying increased attention to threatening stimuli and exaggerating one's own responsibility for negative events, which are common in many patients with OCD. Interventions developed by our working group, such as association splitting (see here), are also part of MCT-OCD. The training aims at modifying these cognitive biases and metacognitions. We developed MCT-OCD, which is also known as myMCT, as a slide-based group intervention. It is based on the self-help manual Metacognitive Training for OCD (Moritz & Hauschildt, 2016, see here). Taking individual experiences into account, patients identify their cognitive biases and metacognitions in a playful way using humorous exercises, and functional coping strategies are provided. MCT-OCD also addresses dysfunctional beliefs (e.g., "I always have to do everything perfectly") and coping strategies (e.g., thought suppression). Eight cognitive biases/metacognitions are addressed in total: perfectionism, intolerance of uncertainty, fusion beliefs, control of thoughts, overestimation of threat, inflated responsibility, biased cognitive networks, and biased attention. Given that OCD and depression often co-occur, depressive thinking patterns are also addressed.

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The first pilot study of MCT-OCD showed a high acceptance of the intervention by participants (Jelinek et al., 2018). In the study, almost 90% of the participants stated that they would recommend MCT-OCD to others and rated it as helpful. Furthermore, OCD symptomatology in the pilot study (as measured by the Y-BOCS) reduced from baseline to post assessment with a large effect size (d = 1.48; Miegel et al., 2020c). However, because patients received MCT-OCD as an add-on treatment during their inpatient stay, the specific effects of MCT-OCD are difficult to interpret. Still, symptom reduction was positively correlated with MCT-OCD appraisal. In addition, session-specific effects in two studies of MCT-OCD showed differential effects of individual modules on the particular cognitive biases (Miegel et al., 2019, 2020a). The results and experiences from the first study were used to revise the MCT-OCD and adapt it to better meet the needs of participants. The revised version was then tested in a randomized controlled trial (for the study protocol, see Miegel et al., 2020b). Again, there was high acceptance of the intervention; almost all patients (96.7%) evaluated the training as “useful and comprehensible" (Miegel et al., 2021). The analyses of the efficacy of the randomized controlled trial (Miegel et al., 2021) demonstrated a significantly greater decrease in OCD symptomatology with a medium effect size in the MCT-OCD group compared to the control group from baseline to post assessment (η_p² = .078).

You can download the modules and homework sheets directly from this page (see below). To receive the manual, please register here.

MCT-OCD Modules

The material is available for download from the links below. Any comments or suggestions would be appreciated. Please email f.miegel@uke.de. Use of the MCT-OCD 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).

Modules

Homework

Translator and co-author: Dr. Terence Ching (thwching@gmail.com)

Please also note that we have developed e-learning programmes for the MCT and D-MCT: www.uke.de/e-mct | www.uke.de/e-dmct

Core members

Dr. Franziska Miegel
Prof. Dr. Lena Jelinek
Prof. Dr. Steffen Moritz
Dipl.-Psych. Birgit Hottenrott
Dr. Marit Hauschildt

Publications

Jelinek, L., Zielke, L., Hottenrott, B., Miegel, F., Cludius, B., Sure, A., & Demiralay, C. (2018). Patients’ perspectives on treatment with Metacognitive Training for OCD: feasibility and acceptability. Zeitschrift für Neuropsychologie, 29(1), 20–28.

Miegel, F., Cludius, B., Hottenrott, B., Demiralay, C., & Jelinek, L. (2020). Session-specific effects of the metacognitive group training for obsessive–compulsive disorder: significant results for thought control. Scientific Reports, 10, 17816. Link to article (full text)

Miegel, F., Cludius, B., Hottenrott, B., Demiralay, C., Sure, A., & Jelinek, L. (2020). Session-specific effects of the Metacognitive Training for Obsessive-Compulsive Disorder (MCT-OCD). Psychotherapy Research, 30, 474–486. Link to article (abstract)

Miegel, F., Demiralay, C., Moritz, S., Wirtz, J., Hottenrott, B., & Jelinek, L. (2020). Metacognitive Training for Obsessive-Compulsive Disorder: a study protocol for a randomized controlled trial. BMC Psychiatry, 20, 350. Link to article (full text)

Miegel, F., Demiralay, C., Sure, A., Moritz, S., Hottenrott, B., Cludius, B., & Jelinek, L. (2020). The Metacognitive Training for Obsessive-Compulsive Disorder: a pilot study. Current Psychology. Link to article (full text)

Miegel, F., Moritz, S., Hottenrott, B., Demiralay, C., & Jelinek, L. (2021). Metacognitive Training for Obsessive-Compulsive Disorder: a randomized controlled trial. Journal of Obsessive-Compulsive and Related Disorders, 30, 100647. Link to article (abstract)

Moritz, S. & Hauschildt, M. (2016). Erfolgreich gegen Zwangsstörungen. Metakognitives Training – Denkfallen erkennen und entschärfen (3. Auflage). Heidelberg: Springer.

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