OCD Family Podcast S3E111: More Choices, Better Outcomes: An Intro To Metacognitive Therapy (MCT) for OCD with Dr. Pia Callesen, Ph.D. & Bronwyn Shroyer, LCSW
Oct 19, 2024
Bronwyn Shroyer, LCSW, clinician and lived-experience OCD specialist, and Dr. Pia Callesen, Ph.D., research psychologist and leader in metacognitive therapy, explain MCT basics and why it differs from exposure. They discuss thought-handling strategies, metacognitive beliefs, detached mindfulness, practical experiments, and using MCT as a structured, transdiagnostic toolbox for OCD and related problems.
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Pia Chose MCT After A Denmark Trial Win
- Pia described choosing MCT after a Denmark trial found 74% recovery in depression versus ~50% for cognitive therapy.
- She trained with Adrian Wells and switched fully to MCT because it was more effective in her research.
Test Harm Thoughts By Holding Them Intentionally
- Do behavioral experiments that hold on to uncomfortable intrusions to test if thoughts cause actions or events.
- Example: intentionally repeat a violent thought and observe that no action follows to reduce fusion belief.
Exposure May Repair Metacognition As A Bonus
- Exposure therapies may restructure metacognitive beliefs as a secondary effect, which could explain part of CBT's effectiveness.
- MCT intentionally targets beliefs directly rather than relying on incidental change from exposure.
