Metacognitive Training for Obsessive-Compulsive Disorder: A randomized controlled trial

Objective: Less than half of help-seeking individuals with obsessive-compulsive disorder (OCD) receive evidence-based treatment recommended by guidelines. Metacognitive Group Training for OCD (MCT-OCD) aims to fill the treatment gap, until evidence-based treatment is available as it is easy to administer even by less trained personnel and highly standardized, which facilitates preparation and thus, dissemination. Method: An assessor-blind randomized controlled trial comparing the MCT-OCD (n = 39) to a care as usual control condition (n = 40) was conducted. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) represented the primary outcome. Secondary outcomes targeted treatment processes. Patients were reassessed eight weeks (post) after baseline and three months (follow-up) after post. Results: In the MCT-OCD group, OC symptoms declined more than in the control group from baseline to post with a moderate effect (η_p² = 0.078) in the complete cases sample. Decrease in compulsions and dysfunctional metacognitions was larger in the MCT-OCD than the control group from baseline to post and from baseline to follow-up (compulsions only). Acceptability of the MCT-OCD was good. Conclusions: The results demonstrate that the MCT-OCD is a promising add-on treatment for reducing OC symptoms and dysfunctional metacognitions. Its easy dissemination enables a large number of patients with OCD to be treated.